As Jackson Countians grapple with daily news of COVID-19 disruption, we use words like “unprecedented” and “never before.” The conditions we currently face have no equal in living memory. Strange times indeed, but this is not the nation’s first pandemic. Just like today, Americans roughly 100 years ago were wearing masks and working from home.

In an article which originally appeared in the Missouri Historical Review in 1968, and published by the State Historical Society of Missouri, writer Kevin McShane described how Kansas City coped with the great infleunza of 1918. Businesses were closed, crowds were limited and there was the inevitable backlash. McShane’s essay is more relevant today than when it first appeared — and is reprinted below. Lessons learned 100 years ago can help guide our way today.

Brad Pace, Editor

The 1918 Kansas City Influenza Epidemic

By Kevin C. McShane

 “I believe the epidemic had its start in Kansas City by girls kissing soldiers in the army schools and from the cantonments who had become carriers of the disease. They carried to their homes, kissed others and in their turn these others have aided in communicating the disease. There is a great deal of kissing…and if a ban should be placed on it there would be less influenza.” This statement by Dr. A. J. Gannon, head of the contagious disease division, reflected his opinion on the origin of the influenza epidemic of 1918.

First reports of the disease in Kansas City came from the army-sponsored Sweeney Motoring School for mechanics. Within 24 hours 170 cases developed, followed by 500 in the next 48 hours, and 800 in the next week. Soon, 2300 of the 3000 students contracted the disease. Between September 29 and October 4, 15 of the motor mechanics died. In an attempt to check the spread of influenza, Major F. H. McGregor, commandant of all the army mechanic schools, ordered a quarentine — a meaure that proved to be the most successful in combatting the disease. Army officials described the quarantine as a “reverse quarantine” because it was designed to protect the army men from civilians instead of the opposite.

Few pestilences have spread so quickly and left such a pattern of desperate attempts to thwart it. The dread “flu” of 1918 killed more than 500,000 Americans and 20,000,000 suffered a temporary attack. No effective cure for the viral influenza was developed during the world-wide pandemic. New York City and other eastern ports received the initial impact that began in the battlefields in Europe. Medical research tried but failed to combat the influenza until 1931 when Dr. R. E. Shope, author of Swine Influenza, isolated the virus.

The speed and ferocity of the epidemic overwhelmed the authorities in the early stage. Within a few days three girls who had visited the Motoring School began sneezing and coughing. Civilian officials, led by Dr. Gannon and Dr. E. H. Bullock, health director and head of the General Hospital, believed in a quarantine, but opposition to this health measure came from business and political interests.

Although few people gave the cooperation that Dr. Gannon needed, no detail escaped him. His office made suggestions, offered advice and finally dictated many directives. Rules about public gatherings were published October 17, 1918, in the Kansas City Star:

All theaters and motion picture shows, all schools and all churches must close. Public gatherings of twenty of more persons [interpreted by the health board to include dances, parties, weddings and funerals] are forbidden. Stores employing twenty-five or more persons may not open until 9 o’clock and must close at 4 o’clock. Crowding in any store is forbidden. Not more than twenty persons standing may be carried on street cars. Music and amusement in hotels, restaurants and cabarets is forbidden.

Any public gathering place either complied with these directives or Dr. Gannon’s office placarded it with yellow signs marked “Unfit for human habitation.”

Health inspectors served notices on two principal offenders, restaurants and streetcars. Many cafes and restaurants served meat scraps in soup stock pots. These were used a second or third time when the customers did not eat the meat. Dr. Gannon denounced it as a “dangerous practice.” The streetcar situation also bothered the health department. Inspectors insured the cleaning of streetcars. By the second week of the epidemic it became necessary to fumigate thirty-two cars before they could return to duty. On October 8, Earnest B. Atchley, publicity man for the Kansas City Railways Company, said, “This company employs a force of 100 men, whose duty it is to clean, sweep and disinfect the cars every day, and since the influenza has come to Kansas City, the cars are cleaned, instead of every day, twice a day.” On the same day in the Kansas City Times an article reported that conductors rejected inspectors from many streetcars and would not recognize the inspectors’ authority. Mayor James Cowgill’s proclamation on October 8, gave inspectors the necessary power to regulate the streetcars according to Section 9, Article 14 of the City Charter which gave the hospital and health board “The power to take all steps necessary to avoid, suppress or mitigate such a disease.”

A majority of the upper house of the City Council agreed that all places of public gatherings be kept closed. But one alderman declared the resolution “Hun propaganda,” intended to frighten Kansas Citians. Theater operators toiled under the first ban of eight days which began on October 7. When a second ban began on October 17, they became incensed. Mayor Cowgill and William P. Motley, president of the hospital and health board, listened to their complaints at a mass meeting, actually forbidden by law since 150 attended. Motley told the film distributors, operators and owners that he had signed the ban because he felt that his office required it. He quickly added that theater owners had a legitimate complaint. Heated discussions followed this statement, with the result that motion picture men volunteered to check the public places allowed to stay open.

Signs of a rift between Motley and Dr. Gannon developed in early October when Motley, with the efforts of business interests behind him, urged a lifting of the first ban. After an analysis of the ten-day period showed that the highest death rate occured on the exact day the ban was lifted, Motley claimed that he was not informed of the number of cases in the city. He then staged open warfare against advisors of the health board and Dr. Gannon in particular. Motley and Cowgill were attacked for neglecting to do more constructive work. An editorial in the Kansas City Journal criticized, “Those selfish interests that have been besieging the municipal authorities in order that they may continue to make money, will now find that their selfishness will cost them far more dearly than if they had actively and willingly co-operated in protecting the public health.”

As Kansas City attempted to “shadow box” the disease, profiteering appeared. One physician informed a girl she had influenza and he requested that an ambulance take her to a hospital. He collected nine dollars, a notable sum in 1918, and she went to a hospital where doctors diagnosed her to be suffering from “revelry” the night before. Druggists profiteered by exacting tribute for simple nose and throat washes. Dr. Gannon condemned their actions when he stated, “I could make a tub full of antiseptic wash for the price some druggists are charging for a few ounces of salty water.” North-Mehornay Furniture Company advertised, “The best preventive for Influenza is to keep your rooms warm and dry. Buy one of our excellent heaters and be safe and comfortable.” Saloon owners joined in the profiteering by placing large signs behind the bars recommending the use of quinine and whiskey as a precautionary measure.

Other business men disregarded the seriousness of the epidemic. Hotels neglected to report cases, feeling that their establishments might suffer. Many landlords failed to maintain a temperature of 70 degrees in their flats and rooming houses. One city alderman commented, “Hundreds of citizens have complained of a lack of heat, and the hospital and health board had declared that the landlords are prolonging the epidemic of inlufneza and pneumonia by not furnishing enough heat.” An inspector for the contagious disease division found one man with discontinued gas service who “probably lived through the night through the kindness of neighbors who heated bricks to keep the sick man warm.” Debate over the question, business first or health first, continued throughout the epidemic.

Some landlords feared condemnation of their apartments and other buildings. Fire wardens examined and condemned 42 structures. One warden explained, “In the building at 1009 St. Louis Avenue we found tenants dumping slops and sewage out of the window into the alley. One of the women tenants told us that eight families lived in this building and there was no plumbing in the place.”

This spotlighted a major health problem in Kansas City. In 1912, 15,000 privies existed within the city. One housing report stated: “In the Penn Valley district, inhabited by working men and their families — substantial, everyday, you-and-I-kind of people — there are 1179 dwellings. The toilet facilities are comprehended in the following: Modern, 200; dry sewer connected, 439; vaults, 530.”

McClure Flats, an area between 19th and 20th streets with Central Alley in the middle, also caused the health department concern. Condemnation efforts met with resistence. It was reported in the Kansas City Journal:

About two hundred persons, white, Mexican and colored live and die, — 'mostly die’ doctors say…the place was raided by the health squad and twenty-three cases of influenza found. Garbage cans had been provided but the residents of McClure Flats do not believe in garbage cans…Children played in the garbage in the rear of a flat where an influenza patient was dying. On this garbge pile was poured the slops from the sick room.

On November 27, the health board pronounced McClure Flats unfit for habitation. Henry Benjamin, health board member, asked if the flats could not be cleaned up. Dr. Bullock answered this by saying, “The brick walls are crumbling, underneath the floors which are built directly upon the ground — there are no cellars — large numbers of rats have nests. As you know, rats are one of the greatest carriers of disease. A number of large holes in the floors of the rooms afford rodents entry into the living quarters of hundreds of persons.” Benjamin’s question illustrated the apathy of the health board.

Conditions such as these warranted more direct action. But politics interfered. An editorial declared, “Practically every member of the health and sanitary departments hold their jobs by the grace of the bosses, and the same is true of members of the police department who are charged with enforcement of the multitude of health ordinances…Sanitary and police officers long ago learned that it is of little avail to cite offenders into court or order them to clean up. In either instance there is a scurrying for, ‘Tom’, for ‘Mike’, or for ‘Johnny’ or some other ward boss with sufficient power to ward off punishment.”

Kansas City suffered from a fifty-fifty arrangement for jobs in the health department between Joe Shannon’s “rabbits” and Tom Pendergast’s “goats.”

Politics dominated the history of the General Hospital and the hospital and health board. In 1909 doctors faced charges of inhuman treatment for throwing pneumonia patients into tubs of ice water and making convalescent patients work on a patient’s ulcerated leg as a punishment, and patients were fighting in terror against having operations the doctors were trying to press upon them. Finally, an investigating committee for the city found the charges “purely a political move to embarrass the Democratic administration.”

The same situation prevailed in 1918. Nothing missed Motley’s surveillance. Early in October, Motley insisted that the city hospitals stop purchasing cauliflower and shelled pecans. He said, “These are war times. I want patients and employees to get plenty to eat but we’re not going to put out non-essentials.” His attack upon petty problems never ceased while larger problems faced the health board.

Dr. Gannon tried to ignore the political squabble. With the powers of a “health czar” he cajoled, threatened and harassed the citizenry. His efforts included fumigating schools, barber colleges and factories; ordering stores to provide disinfectant finger bowls for cahsiers; complaining about undertakers who allowed inexperienced employees who normally served as chauffers to practice on influenza victims; and, requesting insurance agents and house-to-house peddlers to stay away from quarantined homes. Health inspectors needed motor cars to help in the cleanliness campaign. Instead of the health board obtaining the use of the city’s vehicles for the doctors and inspectors, the health department relied on the courtesy of the public welfare board who loaned the cars.

The shortage of motor cars troubled the health department almost as much as the shortage of nurses and doctors. Many Kansas City doctors and nurses had enlisted in the armed services. The demands of the war coupled with the influenza epidemic impeded nurses’ training in all the hospitals.

St. Joseph’s Hospital, erected in 1917, had barely established any routines before the epidemic struck the city. “The new structure where every room had sunlight a part of the day…saw ambulances wheeled to the back doors day and night, chaplains and nuns were on constant vigil as time was so short for some of the victims that no hospital stay could help them and the same ambulance delivered the silent ones elsewhere.” One young nurse recalled the treatment of “silent ones.” She cleaned patients with bichloride baths to kill the germs before the undertakers arrived.

Pitiful cases occurred as the invading influenza swept through the area. Inspectors discovered one woman who had been dead for twelve hours and had died without medical assistance. Two small children, hungry and grief-stricken, both too young to understand, had vainly tried to waken their mother. The hardships of a family in Kansas City, Kansas, were reported in the Kansas City Kansan, on December 3, “Leo L. Jones of 837 Sandusky died at St. Margaret’s Hospital. The same day all three of the children and a brother of Mr. Jones who was visiting him from Memphis, Tenn. were taken to the hospital with the dread disease. This morning, one of the girls, Essie Thelma, aged 5, died. A little boy, Jenidous, is very low and at noon his recovery was said by hospital officials to be doubtful, although the best is hoped for.”

The populace was partially responsible for the spread of influenza. People ignored the signs of coughing or dizziness that preceded the illness. The suddenness of the disease surprised healthy young men in particular. One employee at the Armour Packing plant said, “I picked up one box off a truck and I thought someone had stabbed me in the back.” As one reporter commented, “Men in prime physical condition and those of strongest physique have been the easiest victims while the more frail have almost invariably recovered.” Influenza respected no class, no geographic area and no age group. Many victims relied on remedies. Whiskey and rock candy remained remedies for some, although many doubted their help. Skunk oil hung around the neck of Orville Dalton, a Kansas Citian. This, he thought, helped him to ward off the disease. One woman “with the fear of death and ‘flu’ in her heart, and with a trusting disposition had been taking the advice of her neighbors and eating a cake of yeast each day.” It was reported on December 5, 1918, “Now she is sick in bed with severe pains in her stomach. She is belching gas and is afraid she is bloating. Scoffing friends intimate that the yeast has begun to work and she is ‘rising.’ She fears that she will have to have an operation but continues to eat the yeast.”

Earnest Crain, a non-smoker, heeded the suggestion of a neighbor and smoked cigarettes to stave off the disease.

Dr. Gannon offered one remedy by telling people they should eat onions and garlic. One woman sliced onions and put them on window sills, behind pictures and on the mantle of her home. A nurse in charge of the contagious disease ward at General Hospital said she had used soda through smallpox, fever and other epidemics and had never had an ill day. Eye, ear, nose and throat specialists proposed gauze masks to prevent influenza.

So with “Ku Klux seriousness,” Kansas Citians donned white masks. Barbers, hotel and restaurant waiters, factory employees, elevator operators, cashiers, bankers, streetcar conductors and conductorettes placed their confidence in masks, since “The wearing of masks as a preventive against influenza is said to be the only truly trustworthy safeguard against contraction of the disease.” However, wearing a mask provided a cover for certain activities, “Everybody should wear an influenza mask” said a soft-voiced gentleman to J. F. Elsworth, a grocer at 6427 East Thirteenth Street. “A freezing temperature also prevents influenza” the man declared, “and a grocery man should take all precautions against it. Try the ice box and see if it won’t cure your cold.” Mr. Elsworth did not take kindly to the suggestion but when a revolver was produced he did not hesitate. When he was released he found twenty-five dollars had been taken from the cash register.

On November 11, 1918, a frightened populace emerged from a hermit-like existence. Nearly 100,000 Kansas Citians joined in Armistice celebrations. As Mayor Cowgill said later, “Every man, woman, and child able to be out of bed was on the streets.” On November 17, one report stated that influenza as an epidemic no longer existed in Kansas City as was evident from the sparse and sporadic cases reported. While optimism persisted, however, Kansas Citians died.

The health board became concerned over the second phase of the epidemic and sought a scapegoat. They dismissed Dr. Gannon in a secret meeting. Motley objected to the doctor “doing too many things on his own initiative.” The volatile meeting rang with insults. “‘You’re a —- ——-’ shouted W. P. Motley. ‘No man can call me a — ——- and get away with it,’ answered Dr. Gannon. ‘Give me that badge, you’re fired.’ ‘I’ll keep my badge, you can’t fire me,’ came the reply.

Henry Benjamin, health board member, resigned from the health board after Dr. Gannon’s dismissal. Dr. Bullock resigned his job as superintendant of the General Hospital but decided to remain as health director. Miss Geraldine Borland, superintendant of nurses at General Hospital resigned in late January. Her resignation, never explained in newspapers, remained a mystery. An editorial explained the resignations of Gannon, Bollock and Benjamin in this manner:

The unfortunate feature of bossim in the conduct of municipal affairs is that it invariably leads to driving out the good men rather than the political henchmen who are often the victims of factional wrangles. Personal wrangles between the president and almost anybody who differs with him have characterized the situation even during the epidemic which has cost so many lives in the community.

Regardless of the political difficulties, infleunza cases multiplied. With Dr. Gannon dismissed, Dr. Bullock tried to carry on a campaign against the pestilence. Finally, Dr. Bullock, a flu victim himself, admitted the futility of resistance. He summoned help from the United States Public Health Service in a telegram in which he said, “Assistance is needed at once from your department to help control influenza epidemic in Kansas City, Mo. May we hope for your immediate help?” Two United States Public Health officers arrived. These men enacted no special legislation. Rather, the tornado-like pattern of the disease continued and the epidemic touched down in areas west of Kansas City.

In contrast, St. Louis exerted every effort to stop the epidemic. St. Louis enforced a harsh quarantine that aroused the business population. Health Commisioner Charles Starkloff of St. Louis met with Mayor Henry W. Kiel; Dr. B. C. Wilkes; Assistant Health Commissioner Henry Jordan; Dr. A. S. Barnes of the Chamber of Commerce; Dr. Canby Robinson, dean of the Washington University Medical School; Dr. Ellsworth Smith, president of the St. Louis Medical Society; Major L. C. H. Bahrenberg, Missouri representative of the United States Public Service; and John Schmoll, director of public welfare, to discuss the epidemic. The business interests asked the obvious question, “But why should St. Louis be made the example of a nation?” Dr. Starkloff retorted, “Because St. Louis has to date the best influenza record of the nation and we mean to keep it the best.” This city, larger than Kansas City, fought the epidemic without political involvement.

Instead of a spirit of cooperation in Kansas City, apathy greeted the health department’s efforts to correct unsanitary conditions. The new year, 1919, saw the end of the epidemic. Kansas City emerged with an alarming death rate. The 1918 death rate from all forms of inlfuenza and pneumonia soared to 718.1 per 100,000 population as compared to a death rate of 205.0 in 1917 and 301.1 in 1919. During the last four months of 1918, 1,865 Kansas Citians died from influenza and pneumonia.

Kansas City’s high death rate was caused by the refusal of merchants, restaurant owners and motion picture operators to comply with orders, by the use of home remedies, and finally and fatally, by the political feud between Motley and Dr. Gannon. Dr. Gannon refused to accept the political situation and apathy. He attempted to assert the power of a medical dictator, necessary in an epidemic. But hampered by the fifty-fifty poltical arrangement and the feud with Motley he was unsuccessful as Kansas Citians tolerated the worst epidemic in the history of the city.

SOURCES: Kansas City Times; Kansas City Star; Viral and Rickettsial Infections of Man; Kansas City Journal; Kansas City Post; Report on Housing Conditions in Kansas City, Misssouri; Tom’s Town; Jackson County Medical Journal XXVI; Jackson County Medical Society Commemorative Issue, L; Kansas City Kansan; St. Louis Globe-Democrat; United States Mortality Statistics 1920. Interviews: Mrs. Ester Dunn; Mr. William Taylor; Mr. James Silverman; Mrs Edris Crain.

For full sourcing and to read the original footnotes please click here.

Kevin C. McShane*

Kevin C. McShane teaches American History at Center South Junior High School, Kansas City, Missouri, and is a candidate for the Master’s degree in history at the University of Missouri, Kansas City.

*from McShane’s bio in the 1969 Missouri Historical Review article

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