SPANISH FLU 1918 IN THE FIRST WORLD WAR

 The following account of "Spanish Flu" in Llanelly is taken from the local newspapers of the period. The relative lack of press coverage of the influenza epidemic of 1918 was probably due to wartime press censorship, and perhaps to an over-riding concern for husbands, sons and brothers fighting far from home. Spanish flu was not of course from Spain, but was so called because the news of the epidemic was first published in Spain, a non-belligerent in the World War not subject to the same press censorship.

The First Outbreaks

The first oLlanelly Hospital Marble Hall Rd. built 1885. Photograph 1910utbreak in Britain was in May, 1918. By July the disease was "raging all over the country".[1] In August Medical Officer of Health Dr. E. Evans said that "a very serious epidemic of influenza had occurred .... and no less than five fatal cases had been registered from this cause". He confirmed that this was the 'Spanish flu'. [2]

The most important features of the illness according to Dr. Owen Williams Medical Officer of Health "..were the suddenness of its onset with high temperature and considerable prostration, pains in the head and limbs, and frequently there was gastric disturbance." In July Dr. Williams said that Burry Port was affected and numerous cases had been reported in the urban district; and in Llanelly "several members of staff at the Town Hall were laid up with the flu".[3] In August cases were reported in Llanelly; in October the epidemic was increasing in severity; [4] and the disease was "rampant in Carmarthen". [5]

By the beginning of November influenza was "raging in Carmarthenshire" as a whole and in addition to adults some thousands of children were affected.[6]

"Don't be Frightened"

At the beginning of November, the "Llanelly Star" was telling its readers: "Do not be frightened. There is nothing to be frightened about if you take the following precautions". The precautions were simple: "if you get a cold or sore throat, go to bed and stay there for four or five days. Influenza only becomes dangerous when you do not go to bed. Dissolve a teaspoonful of common salt in a tumbler of warm water and gargle ... two or three times a day. Don't go into crowds more than you can help. Wear warm clothes. Eat well, but do not drink spirits. Go to bed early and have as long nights in bed as you can. Remember that you catch disease most easily when you are cold, wet, hungry and tired." [7]

To supplement the beneficial effects of bed-rest, wholesome food and salt water gargle, patients could treat themselves with a variety of more or less effective patent medicines, pills, pastilles and syrups.

"Dr. Cassells Tablets are the perfect modern home remedy for Nervous Breakdown, Nerve and Spinal Paralysis, Malnutrition, Wasting, Anaemia, Sleeplessness, Indigestion, Kidney Trouble, Premature decay" and, of course. influenza. [8]
If the patient had availed him or herself of "First Aid" in the home, then flu would have "been conspicuous by its absence". This "scientific disinfectant soap ... is made in a unique way, and its value in combating microbe-borne disease can hardly be over-estimated." It came in triple tablets at a price of sevenpence halfpenny.[9]
"A sure and certain cure" was Tom Prickett's Celebrated Bronchial Cough Cure which also dealt with "All Chest Troubles" and influenza naturally. [10] If the patient was in a hurry then Veno's Lightning Cough Cure would "check influenza at the outset". "Prices 1s 3d. and 3s., the 3s. size being the more economical". The patient was advised to "insist on having Veno's, and refuse all substitutes". [11]

Telephones were a relatively recent introduction and most people would encounter them only in offices or places of work, but the "Sansjerm" Telephone Shield was ready and waiting to assist the concerned employer. It promised to minimise the risk of contagion, was "germ, dust and moisture proof, sanitary and pleasantly deodorant." The price was 1s. for each, and 1s. for a box of one dozen refills.[12]

The Woman's Part

Women were warned that "according to a high authority the influenza epidemic is much more prevalent in the female than in the male sex" - so said an advertisement by Style and Mantle at 16, Castle St., Swansea. "One of the best preventatives is to be provided with a reliable outer garment of wet resisting material such as a Raincoat or a Mackintosh" of which the shop had "a large selection.... in fashionable shades and shapes, prices ranging from 32s. 11d. to 5 guineas.[13]

It was a hard time for many women who had husbands and sons away serving in the armed forces with no extra money for a new coat or time to take a crowded omnibus to go into Swansea.

An irate Margaret Osborne wrote under the heading The Woman's Part, "It is rather hard luck that an influenza epidemic should have broken out just now and that we should have a torrent of good advice from doctors on how to avoid influenza at the very time when there is very little opportunity of taking that advice. To keep warm, to eat good food, and to avoid over crowding would be easy enough for a good many of us in peace-time but with rationed food, with rationed fuel and with trains and omnibuses full to bursting we might as well ask for the moon. Moreover, the woman's part - that is often to stay at home till someone brings in the influenza and then remain and nurse it. Evidently the very best medical advice is not for us - we must take the second best. 'If you can't be aisy, be as aisy as you can.' "[14]

If all else failed, a "Housewife" writing to the Editor of the Llanelly Star a week earlier said that she had found Apple Tea very useful in cases of influenza and thought the recipe should be more widely known. "Remove the stalks of 1lb of apples, but not the peel. Mash the apples, cut them up with a fruit knife, place them in a basin with a quart of cold water. Cover the basin and allow the apples to simmer gently in a moderate oven until the liquid is reduced to one pint. Strain this, and serve hot. Apple tea can be made in a saucepan, but it should be an aluminium or a fire-proof china pan as either iron or enamel would spoil the flavour." There is no record of its efficacy or lack thereof.[15]

Daily Life Disrupted by the Epidemic

The number of schools which had to be closed was increasing daily. Schools in the Llanelly rural area were ordered to be closed at the end of October. [16] The Borough Education Committee reported that in the same month there was an outbreak in the New Dock district which affected school attendance and that it was spreading in the direction of the town. Over two hundred children were absent from school in the area and several members of the teaching staff were "laid up". [17]

At the end of October the "scourge" of influenza was increasing in severity in Llanelly and district and scores of new cases were being reported daily.[18] The Public Lending Library was "closed until further notice".[19] Several of the works were suffering from absenteeism owing to illness and in the first week of November, postal deliveries had been delayed "for hours every day this week" because of staff depleted by illness. There was "unavoidable delay in the distribution of ration books" and householders were asked "not to trouble the Post Office or the Food Control Office .... but to go on with their registered suppliers until they receive their books". [20]

In October visiting rules at Llanelly Hospital had been suspended and the Children's Ward had been strictly isolated.[21] By the end of October the Corporation of Llanelly was inviting applications to be received by Monday, 4th November from "qualified nurses for temporary positions as nurses in connection with the influenza epidemic".[22]

In July the Llanelly Star had said that the "Spanish 'flu' appears to be rampant, but if laughter is cheap medicine then those who go to see Charlie Chaplin in the latest new million dollar contract production, 'A Dog's Life' get a real good dose." [23] Despite being "saturated with disinfectant" [24} by November the cinemas were under threat of closure.

On 9th November the Llanelly Star [25] reported an emergency meeting of the Licensing Committee of Carmarthenshire County Council which discussed the position of theatres and cinemas. The Medical Officer of Health had suggested the exclusion of children under 14, and that these places of entertainment should be adequately ventilated in intervals between the performances. The chairman said that as there were continuous performances in the town, the point arose as to what time the interval for ventilation should come in. "Every two or three hours" was suggested as being "not too much to ask". Mr. T.P. Jones said that if there was a danger of infection these places should be shut. He himself had been obliged to leave Vint's * "like a drunken man... on account of the foul atmosphere, although they have a fan there".

Mr. Parry said he did not wish to go to extremes but he had seen women with children going to these places. Mr. Jones said "it was a serious thing to have these houses open at all, but he was not suggesting closing them. Mr. Parry said that "at any rate it was a scandalous shame that women should take in young babies". The committee were told that a notice had been published in the local papers that day that cinemas would be closed from 5 - 6pm and that children under 14 would not be admitted.

Mr. Isaac and Mr. C.S. Jones representing the places of amusement said the notice should cover the requirements of the committee, and said that the Hippodrome was well ventilated with fans, etc. Asked if half an hour for ventilation was adequate, Mr. Isaac replied "it would be impossible to have an hour's interval in a theatre," that there was "only one place with a continuous performance and that was ventilated every day for an hour." The recommendations of the Medical Officer of Health were agreed to.

Two months later at a meeting reported on l1th January 1919 a "recent regulation passed by the Corporation, ordering an interval of not less than 30 minutes between any two entertainments at local theatres and cinemas was discussed . The local secretary of the Cinematograph Association had written asking that the interval should be reduced to 10 minutes as the longer period seriously inconvenienced the proprietors in arranging their entertainments. The application was refused.

Victims of the Epidemic

In August five fatal cases were recorded.[26] In September a young member of the clerical staff at the Llanelly Copperworks, Merddin Owen, joined the Royal Navy and was posted to Crystal Palace in south London. While there he contracted influenza and died.[27]

Operating theatre Llanelly Hospital 1910In November Edward Cadifor Davies who had been discharged from the South Wales Borderers had "an attack of influenza" and died five days later. In the same Obituary column the death of Miss Martha Stevenson of Cwmbach was announced. She had been "well-known in the town and district, and had been at Stradey Castle and Stebonheath Hospital for some time. She had come "home to nurse her mother and other members of the family who were ill with influenza and caught the infection herself with fatal results." [28]

Also in November the wife of Arthur Williams of New Dock "died after childbirth, the infant also dying; her husband died the following day from "an attack of influenza.". Two of the children of Mr. Austin, a baker, also of New Dock died from influenza. [29]

At the end of November, Griff Bowen of Mount Pleasant having contracted influenza on Sunday, died on Thursday morning, a rugby enthusiast who had played half-back for Llanelly.[30] On 29th November "little" Will Beeston, only son of Mr. and Mrs. Arthur Beeston of Glevering Street" whose "physical powers could not withstand the influenza" died.[31]

The Epidemic Abates

At the end of December, the Medical Officer was reporting that the disease was abating in the town. Despite his optimism there were still deaths to come.[32]

In February, 1919 a new influenza wave was "becoming serious and numerous deaths are reported from pneumonia."[33] (18) At a meeting of the Board of Guardians** in March it was recorded that "owing to the epidemic of influenza temporary assistance had to be engaged ..... there were twelve cases of influenza and five deaths, and the medical officer had ordered the workhouse*** to be isolated."[34] Even after the peak had passed, influenza was still having an effect: Enoch Davies of Burry Port had been "seriously attacked by the 'flu" early in 1919, had improved for a time "only to be again attacked" taking many months to recover. He died in June from meningitis.[35]

In 1918 as in 2020 statistics were gathered and comparisons were made with the previous epidemic.

At the Carmarthen Public Health committee meeting in mid-January, 1919, Dr. E. Cambria Thomas, acting County Medical Officer, said the total number of deaths from influenza in the county during November and December. 1918 was 349 - 174 males and 175 females - made up of 111 in urban districts and 233 in rural districts. He said that despite the rural population being only about 30 per cent higher than in the urban districts, the number of deaths appeared to be over 100 per cent higher.

Dr. Thomas went on to say that during the influenza epidemic of 1870 the mortality had been highest amongst people over 65, whereas in the 1918 epidemic the death rate was lower for that age group than for any other except for those between one and two years old, so that infants under one year and the aged has suffered less from the disease. The group with the highest death rate were those between 25 and 45 and next to them those between 15 and 25. The disease appeared to be more fatal in rural than in urban areas, and he thought this could be attributable to the "greater exposure to inclement weather by those pursuing agricultural work than was the case of those living in urban areas." He suggested that, "sanitary conditions in rural areas were also more defective than in towns."[36]

In October 1919 Dr. D. Arthur Hughes said that "471 deaths had been caused by the pandemic in the county during the year as compared with 34 in 1917, or as compared with an average of 23 for the previous eleven years. The death rate was 15.9 per 1000. This, allowing for the influenza fluctuation worked out to only 11.4 as compared with an average of 15.2 for the previous eleven years."[37]

End of the Epidemic

Llanelly Hospital ward c.1920For most people things did seem to be getting back to normal. Peacetime had come to Llanelly at last and the Borough Council decided that "Peace Teas" could be enjoyed by children in their various schools since there was no building in the town large enough for them all to sit down together to celebrate.[38]

Soldiers were welcomed home from active service but there was a sting in the tail of the peace: medical officers reported "infectious cases that were practically unknown in South Wales prior to the war."[39] Dysentery, malaria and trench fever were among those mentioned by the newspaper: those not mentioned were the consequence of "the return of many infected soldiers who had not resisted the temptations of foreign lands". ****

______________________________________________________________________________
* A cinema in Market Street: Leon Vint's Electric Palace opened in 1911 and was destroyed by fire in 1973.

** The Llanelly Board of Guardians, formed under the Poor Law Amendment Act 1834, were elected by local landowners and ratepayers and were responsible for administration of the Poor Law and management of the Union Workhouse.

*** The 'workhouse' became Bryntirion Hospital in 1948.

**** M.V. Adler, article in "The Lancet", BMJ 19th July,1980 Figures at treatment centres England and Wales
1918: 27,000 syphilis 17,000 gonorrhoea
1919: 42,000 syphilis 38,000 "
"A decade later the incidence of syphilis had fallen to below 1918 levels, but gonorrhoea continued to climb"

Notes and Citations

[1] Llanelly Star 6 July 1918
[2] Llanelly Star 10 August,1918
[3] Llanelly Star 6 July 1918
[4] Llanelly Star 26 October 1918
[5] Carmarthen Journal 25 October 1918
[6] Carmarthen Journal 1st November 1918
[7] Llanelly Star 2 November 1918
[8] Carmarthen Journal 1 August 1919
[9] Llanelly Star 16 November 1918
[10] Carmarthen Journal 31 October 1919
[11] Carmarthen Journal 22 November 1919
[12] Llanelly Star 5 April 1919
[13] Llanelly Star 28 March 1919
[14] Llanelly Star 16 November 1918
[15] Llanelly Star 9 September 1918
[16] Carmarthen Journal 1 November 1918
[17] Llanelly Star 19 October 1918
[18] Llanelly Star 26 October 1918
[19] Llanelly County Guardian 7 November 1918
[20] Llanelly Star 2 November 1918
[21] Llanelly Star 26 October 1918
[22] Llanelly Star 2 November 1918

Llanelly Hospital photos courtesy Llanelli Library:
The building ILL304 P91700c
The operating theatre ILL4531 P9170012
The ward ILL4921(viii) Llanelli Hospital c1920

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