First came the Great War. Then came something far deadlier: the 1918 flu.
The influenza pandemic that broke out 100 years ago was far more virulent than this year's nasty flu season. Dubbed the Spanish flu, it is estimated to have killed 50 to 100 million worldwide. More than 675,000 Americans perished from the disease - a number that dwarfs the 117,000 U.S. service members who died in World War I.
But fighting the war took precedence over fighting the flu, which claimed most of its victims during a devastating 10-week period between September and December.
One of the first warning signs came in August 1918 when 60 sailors in Boston went to the hospital saying they felt as though they "had been beaten all over with a club."
But a more frightening report arrived the next month from Camp Devens, 30 miles west of Boston, where 45,000 men were packed into an encampment built for 35,000 troops.
"I saw hundreds of young stalwart men in uniform coming into the wards of the hospital. Every bed was full, yet others crowded in," reported Victor Vaughan, dean of the University of Michigan School of Medicine and director of the surgeon general's Office of Communicable Disease. "The faces wore a bluish cast; a cough brought up the bloodstained sputum."
Although Vaughan and William Henry Welch, a famed pathologist from Johns Hopkins, recommended that no one be transferred from the base, the war effort was considered too critical to stifle troop movement.
Thus, when Army medical officers warned that shipping thousands of soldiers on troop transports would "result in thousands of cases of the disease, with many deaths," they were ignored. Rather than send only those who already had survived a bout of flu, troop ships were packed with those coming down with the disease or bound to experience it on board. Thousands fell sick crossing the Atlantic, and thousands died as a result.
By mid-October, the situation had become so dire that President Woodrow Wilson called his Army chief of staff to the White House, suggesting that perhaps the troop ships should be halted until the flu abated. He was reassured by Gen. Peyton March that every medical precaution was being taken.
"The shipment of troops should not be stopped for any cause," March told the president.
Although the Army later advised against transfer of flu sufferers from base to base within the United States, the order did not come in time for 3,108 soldiers who were packed aboard a train from a base northwest of Chicago for another camp in Georgia. By the time the train reached Augusta more than 50 hours later, 2,000 of the soldiers needed hospitalization, and more than 10 percent of them died.
Despite putting the new arrivals under quarantine, the camp hospital reported, "the disease ultimately spread through the entire camp, and before the epidemic was finished approximately 8,000 soldiers were afflicted. Between five and six hundred died from the disease or its complications."
Through a curious twist of fate, it came to be called Spanish influenza. Although it first surfaced in the United States, China and France, all three of those countries were at war with Germany by 1918, and the war effort brought sharp restrictions on what reporters could publish. When the king of neutral Spain - Alfonso XIII - his prime minister and several cabinet members came down with the disease, the news was broadcast worldwide, and the illness was forever misnamed.
In the United States, no one seemed to take the stiff-upper-lip approach more seriously than U.S. Surgeon General Rupert Blue. Even as the disease was sweeping through military bases, killing soldiers and sailors by the thousands, Blue warned against rushing to see doctors with "mild cases of influenza."
"The present generation," Blue said Oct. 13, "has been spoiled by having had expert medical and nursing care readily available."
The ultimate test of which war mattered most came in late September, when an enormous mass march was scheduled to sell millions of dollars in war bonds in Philadelphia. Although several doctors warned against the "Liberty Loan March," Philadelphia's five daily newspapers refused to publish any of their warnings, and the health commissioner allowed the parade to go on.
It drew several hundred thousand people - said then to be the greatest parade in the city's history - on Sept. 28.
Six days later, the city had 636 new cases of the flu, and there were 139 deaths. Phone service was curtailed because 800 operators were sick. During one week in October, 4,597 Philadelphians died. In four weeks, 47,094 people came down with influenza, and 12,191 died.
Cold-storage plants were used to stack up hundreds of bodies, a trolley-car company donated packing cases as coffins, cemeteries raised their fees and told mourners to dig graves for their dead, and wagon loads of bodies were buried in open trenches in a potter's field.
As the city recoiled, the Philadelphia Inquirer persisted: "What are the authorities trying to do? Scare everyone to death? What is to be gained by shutting up well-ventilated churches and theaters and letting people press into trolley cars?"
The newspaper kept stride with the federal mandate for positive news, suggesting people "do not even discuss influenza. . . . Worry is useless. Talk of cheerful things instead of disease." With that, the Inquirer banished news of the pandemic to its back pages.
By mid-November, the war was over, but the flu marched on. The influenza that so affected the war also played a critical role in establishing peace.
A year earlier, Wilson had outlined in his famous 14-point speech a blueprint to keep the world safe from future wars. He called for an end to secret treaties and proposed a plan that would consider the rights of native people who lived in colonial territories, require reduction in world armaments and guarantee freedom of the seas. He also proposed the League of Nations, an international organization empowered to ensure "political independence and territorial integrity [of] great and small states alike."
Wilson arrived in Paris for the peace talks prepared to battle with Georges Clemenceau, the 77-year-old "Tiger" of France, who wanted Germany to pay heavily for waging war.
The talks dragged on and turned so bitter that Wilson threatened to head home without an agreement. And then he came down with the flu.
"The president was suddenly taken violently sick with the influenza at a time when the whole of civilization seemed to be in the balance," his doctor, Cary Grayson, wrote to a friend back home on April 14, 1919. "From your side of the water you can not realize on what thin ice European civilization has been skating. . . . Some day perhaps I may be able to tell the world what a close call we had."
Instead, Grayson told the public that Wilson had caught a cold.
Wilson would recover sufficiently to resume the talks. But he was an enfeebled shadow of his former self, quickly caving in to Clemenceau's demands.
"It is of course impossible to say what Wilson would have done had he not become sick," historian John Barry wrote in his best-selling book "The Great Influenza." "Influenza did weaken him physically, and - precisely at the most critical point of the negotiations - influenza did at the least drain from him the stamina and the ability to concentrate. That much is certain. And it is almost certain that influenza affected his mind in other, deeper ways."
Clemenceau's greatest triumph - and Wilson's greatest humiliation in his moment of weakness - was acquiescence to what became known as the "War Guilt Clause." Germans viewed that clause as putting full responsibility for the war on Germany, and it demanded payment of a sum far greater than anything the country could afford.
Wilson's Fourteen Points had been widely distributed in Germany, and Germans saw their abandonment as a betrayal. For 14 years, the Weimar Republic ruled Germany amid hyperinflation, political extremism and contentious relationships with the victorious Allies.
In 1933, Weimar collapsed, and the stage was set for the rise of Adolf Hitler and his Nazi party.
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Part of a continuing series about facets of the past that remain relevant.