When the so-called 'Spanish flu', the most lethal pandemic in human history, visited Ireland in 1918, it seemed that manifold remedies were readily and cheaply available.
Formamint promoted itself as a preventative and a curative through a deceptively designed public notice, advising "every influenza patient should suck four or five of the tablets a day". "Suck a Formamint every day and you will be safe from Spanish influenza and other epidemics," it boasted. It came with recommendations from three titled ladies, including Lady Joicey-Cecil (who really did exist).
In a city replete with carbonated water companies, another advertisement promised: "Avoid influenza by drinking Grattan's Sparkling Quinine, a delicious beverage and anti-malarial specific for the prevailing epidemic."
The influenza epidemic hit Ireland in three waves, firstly in June and July 1918, then again in October and November as the Great War was coming to a close, and finally returning in February 1919.
Accurate estimates of its global impact are conjectural, but it is claimed that around 500 million people (around a quarter of the world's population) were infected, perhaps 10% of whom died, that is almost 3% of humanity.
It crept upon the world while the Great War was still raging and while the Defence of the Realm Act (DORA) still severely restricted reporting. Consequently, fully accurate coverage tended to be suppressed, except in neutral Spain, where it was reported in more detail, especially when King Alfonso XIII fell gravely ill, thus becoming known as Spanish flu.
The authentic origin of the influenza virus (the H1N1 strain) has been much debated, but the true source has never been convincingly identified. Ironically, in light of the epicentre of the current coronavirus (Covid-19), the least affected large nation in 1918 was China.
In Ireland, it constituted the worst epidemic since the Great Famine, but, for all its global impact, was nowhere near as deadly; about 300,000 of the Irish population were afflicted, of whom 23,000 perished. One (perhaps too precise) figure asserts that 7,582 Ulster men, women and children passed away.
It was first noticed in Belfast towards the middle of June 1918. One of its earliest Ulster victims was 21-year-old Catherine Isabella Fenton, born into farming stock in Dunloy, where she died in early July, only one month after starting her career as a probationer nurse.
By July 10, the Belfast Board of Poor Law Guardians was caring for over 200 patients and Londonderry had already buried 15 victims, including four from one family and two prospective brides. One of the latter had ordered an 18-carat gold ring to "last her all her life"; she was buried before it arrived.
The danger seemed to evaporate for two or three months, but the most lethal outbreak occurred in October and November 1918. Averaging over 60 funerals a day at Glasnevin, Dublin referred to it as 'The Super Influenza'. Its recent death rate of 18.6 per thousand had risen to 60.2 and was now running higher than the birth rate.
One Press entry claimed that hundreds of the Dublin Metropolitan Police Force had been felled by it and several had died. The streets of the capital had been treated with "a solution of Jeyes' fluid and carbolic acid".
In Ireland during the general election of December 1914, during which many unionists asserted that there was a far greater threat from Irish nationalism than from influenza, it was claimed that "the influenza epidemic prevented many people from exercising their franchise". Some never made it to mid-December: it was reported that, in Co Westmeath, Mary Dardis (102), James Foley (102) and Mary Duffy (100) had all succumbed.
All towns and cities were beginning to acknowledge the necessity of preventative measures although, as with the current coronavirus outbreak, there was disagreement about what should be enacted or imposed, and at what stage.
The second wave of influenza deluged its victims, with 500 to 600 people affected in Lurgan alone. In Newry, it was reported that the Petty Sessions had been seriously interrupted by the indisposition of solicitors and witnesses, and at the town's Edward Street railway station 22 members of staff had been laid low. In Lurgan, a widow Dawson and her nine children from Edgarstown were all confined to the Union Infirmary with influenza.
By mid-November Larne had suffered over 1,000 instances and, inventing adjectives, the Larne Times bemoaned that "there are comparatively few houses in which residents have gone scatheless". In Randalstown, Dr McKee was unable to perform his duties at the dispensary and it was stated that the Guardians were so desperate that they "were prepared to give away money for a doctor".
A Closing Order was imposed in Belfast on shops and places of entertainment for 5.30pm, with extensions at the weekend, from October 23 until the end of March 1919. This, however, was the result of the unavailability of coal. The health situation in Belfast will have been exacerbated by the fact that at the start of November the City Council Improvement Committee was in dispute with street sweepers and the cleansing department which prompted Councillor Jamison to declare that: "Belfast was now the dirtiest, filthiest and most insanitary city in Europe."
On November 2, the Water & Public Health Committee in City Hall recommended that "all schools, Sunday Schools and Technical Schools be closed and disinfected; that employers of labour should be advised to see that their premises are well-ventilated and that the services of the sanitary sub-officer be available for the disinfection of houses if called upon." The distribution of library books had been discontinued and one councillor urged the full closure of the Central Library. Another argued that the building was airy enough to allow visitors and felt that cinemas presented a greater threat to public health.
Presumably keen not to lose customers, all cinemas seem to have been disinfected after every performance, as the manager of the Picture Palace in Larne pointed out, "with the strongest disinfection and the windows (are) never closed". Despite this, cinemas, particularly popular with the working classes, may have been one of the principal slipstreams of the influenza virus. They were prime examples of crowded venues, which harboured dirt and accommodated poor personal hygiene.
Four years earlier, in May 1914, Lilian Spender, wife of the man who established the Ulster Volunteer Force, had been obliged to attend the Shankill Road Picture House to view a film of Carson's recent visit. She recorded in her diary that: "The atmosphere in the house was the very worst I ever encountered anywhere, for the audience was drawn exclusively from the slums and the smell was appalling. Tobacco smoke has the most delicate perfume to it and I would have welcomed it as a disinfectant, but they were too poor to smoke."
Soon after, in preparation for possible wartime conditions, she had visited an Orange Hall intended for use as dressing station. She described it as "the most unspeakably dirty place I was ever in".
The shortages and rationing during the Great War, compounded by the general poverty and malnourishment of the working class, also increased the susceptibility of the population to the lethal virus which was to plague them at the end of the conflict.
The general assault and stress of wartime service can only have served to reduce personal fitness and caused the death of many, like Driver Charles Mattison of 33 Combermere Street in Belfast, who had served in France since 1914, but died there a week after the Armistice from the epidemic, and never made it home.
Rifleman James Parker of Jennymount Street did make it to home soil, but was equally unfortunate. He had served throughout the conflict, being twice wounded. He was taken ill with influenza and pneumonia as he arrived at the Great Northern Railway station, and lay buried at Carnmoney within a week of his demobilisation.
At the end of November, the medical officer of Ballyclare encapsulated the aspirations of his profession by recommending that everyone avoid crowds, public meetings and entertainment, that personal and family visits be restricted, that children should be excused school and that burials should be prompt and wakes banned.
His public notice encouraged "every house, and all offices, workshops, churches, public halls, factories and school be REGULARLY DISINFECTED" and pointed out "arrangements have been made for the supply of Bacterol and the loan of sprayers for that purpose (free of charge)".
The fundamental problem was that all recommendations remained purely advisory and voluntary. Periodically, schools did close. Some might ultimately have wished it had been more often, as even those institutions better provided to deal with such matters could suffer: by October 31, only 17 boarders and two members of staff at Methodist College remained unaffected, and a handful of both groups were to die.
Cinemas and theatres remained open, attendance encouraged by front-page advertising in the local Press. Large crowds continued to attend sporting events, particularly football matches.
On Christmas Day 1918, 12,000 supporters gave the lie to the name of Cliftonville's ground, Solitude, when they crowded the terraces to witness a 1-1 draw in the annual Steel & Sons' Cup final.
Churches also commanded large congregations. In spite of the fact that its regular minister had succumbed to influenza, Larne Methodist Church was not deterred at its annual Harvest Festival on October 27: it held three services that day with "the evening service in particular taxing the seating accommodation of the church to its utmost".
The Belfast Telegraph reported that the annual thanksgiving had resulted in "overflowing congregations" around the province to the extent that they "have proved a veritable gold mine to nearly all the churches".
Many at such services may have felt, like one correspondent to the local Press that: "God's displeasure has been felt by the scourge of influenza throughout the world". He was supported by a correspondent to the Belfast News Letter on November 20: "The havoc being wrought by the terrible disease now raging throughout the length and breadth of our land is truly appalling ... Might I suggest to all our churches that ... prayer be offered up to Almighty God to remove from our midst this awful affliction. We have had abundant evidence lately of what wonders can be wrought by prayer."
A week previously the population had been too ecstatic to worry about the suffering, simply relieved that the Great War was over.
In the midst of the menacing recurrence of the influenza attack, the streets of virtually every town and village in Ulster were packed, celebrating the signing of the Armistice.
There was "a tremendous crush" in Belfast as for several hours the city became "impassable for several hours". If influenza were a threat in such conditions, the reality was that, to a great extent, the war had inured the populace to the spectre of death.
The scourge was, of course, no respecter of class. Whilst the labouring classes were most vulnerable, it infiltrated all levels of society. One socially discriminating woman bemoaned that "it had been proved beyond all doubt that they were nursing an enormous number of the most respectable citizens", another commentator claiming that "the epidemic seems to be making headway still among the people of the middle class".
It was noted that two very fit, active and sporting dentists, William Henry Andrews and Alexander Henry Craig, the latter boasting "an unparalleled record as a sportsman", both succumbed, although it should be pointed out that, in the prevailing circumstances, peering into patients' mouths may not have been the most advisable practice. The Dowager Marchioness of Dufferin & Ava, a resilient lady who outlived her four sons, took a hit for the aristocracy, and survived.
The Larne Times printed "six safety suggestions" for avoiding infection which reflect the fact that contemporary knowledge offered little security. These included washing "the inside of your nose with soap and water at night and morning" and not "covering your neck with a muffler".
In contrast to the current fear induced by Covid-19, the advice concluded: "Do not be afraid of influenza; you are much stronger than any microbe so long as you do not drug yourself, overeat or overclothe."
The reality was that very few medical methods seemed to offer any protection beyond castor oil, quinine and Jeyes' fluid. As noted above, the streets of Dublin were awash with the disinfectant. At the end of October 1918, when Dr Hugh W Bailie, Medical Health Superintendent of Belfast City Council, pointed out that there were about 10,000 cases of influenza in the city, he suggested that all factories and workshops were disinfected twice a day with a small solution of Jeyes' fluid in three gallons of water.
Its shareholders must have prospered, but there were also numerous proprietorial brands which claimed to offer guaranteed remedies, even for hair loss which was blamed on the malignant effect of "the widespread influenza infection". Many companies, such as the ubiquitous Phosferine, took specious advantage of the pestilence by adding influenza to the list of ailments and diseases for which they allegedly acted as a panacea, none of which would pass muster today with the Advertising Standards Authority.
As beef substitutes, Oxo and Bovril were particularly popular, with the latter having to apologise for a shortage of bottles. The local manufacturer boasted: "To prevent influenza and colds in the head take occasionally a pinch of Gallaher's High Toast Snuff". Another brand claimed that "Influenza attacks can now be effectively repulsed after swallowing two Gensaprin tablets disintegrated in water", while being equally effective for toothache, headache, sciatica, neuralgia, rheumatism and a multitude of other ailments. Even Lifebuoy soap claimed to challenge "the scourge of influenza".
Even if such claims were true, they could not conceal the tragic reality which some families endured. On November 28, 1918, two sons and one daughter of William Campbell of Drumbeg died within 24 hours. A large crowd followed the three hearses for two miles, "the undertakers confessing that they had never in their experience seen anything like it".
Hamilton Cochrane of Ballygeegan near Killinchy died aged 16 in April 1919. His father John, then aged 70, had sired 14 children by two wives. Hamilton was the seventh member of the family to die.
Not too far distant at Cluntagh, garden labourer John Ringland and his wife, Sarah, produced a family of 12 children. Four of them had died before the 1911 Census; between December 21 and 29, 1918, despite the efforts of Dr Robert Sproule, influenza spirited away David (16), Maggie (6), John (19), James (3) and Janie (17). They lie side by side in Raffrey burial ground.
Keith Haines has written a number of books on Ulster history, including Belfast and the Great War (Amberley Military History)