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	Life in 1918
	Snapshot of the World in 1918
	The Nation's Health
	Seeking Medical Care
	The Public Health Service

Chinese text is on the left hand side of the image. A hand holds a needle which is being inserted in another hand.

Acupuncture was based on the premise that a disruption in energy flows caused illness. [Credit: National Library of Medicine]

A physician stands with his back to the viewer. The physician stands next to a bed with a patient. Another physician is seated on the opposite side of the bed.

By 1900, an increasing number of physicians were receiving clinical training. This training provided doctors with new insights into disease causation and the nature of specific types of diseases. [Credit: National Library of Medicine]

A color drawing of a physician surrounded by other types of doctors (e.g. a horse doctor, lady doctor, tooth doctor, quack doctor). A poem below the image is titled “Oh You Doctor.” The opening lines read “You call yourself doctor. Well any old fool can get a diploma who’s gone to some school.”

Poor training and loose regulations meant that some doctors were little more than quacks. [Credit: National Library of Medicine]

Seeking Medical Care

Feeling Sick in 1918?

If you became sick in nineteenth-century America, you might consult a doctor, a druggist, a midwife, a folk healer, a nurse or even your neighbor. Most of these practitioners would visit you in your home.

By 1918, these attitudes toward health care were beginning to change. Some physicians had begun to set up offices where patients could receive medical care and hospitals, which emphasized sterilization and isolation, were also becoming popular.

However, these changes were not yet universal and many Americans still lived their entire lives without visiting a doctor.

How Did Ordinary People View Disease?

Folk Medicine:

In 1918, folk healers could be found all over America. Some of these healers believed that diseases had a physical cause such as cold weather but others believed it had a supernatural cause such as a curse.

Treatments advocated by these healers ran the gamut. Herbal remedies were especially popular. Other popular remedies included cupping, which entailed attaching a heated cup to the surface of the skin, and acupuncture. Many people also wore magical objects which they believed protected the wearer from illness.

During the influenza pandemic of 1918 when scientific medicine failed to provide Americans with a cure or preventative, many people turned to folk remedies and treatments.

Scientific Medicine

In the 1880s, building on developments which had been in the making since the 1830s, a growing number of scientists and physicians came to believe that disease was spread by minute pathogenic organisms or germs.
Often called the bacteriological revolution, this new theory radically transformed the practice of medicine. But while this was a major step forward in understanding disease, doctors and scientists continued to have only a rudimentary understanding of the differences between different types of microbes. Many practicing physicians did not understand the differences between bacteria and viruses and this sharply limited their ability to understand disease causation and disease prevention.

Drugs and Druggists:

Although the early twentieth century witnessed growing attempts to regulate the practice of medicine, many druggists assumed duties we associate today with physicians. Some druggists, for example, diagnosed and prescribed treatments which they then sold to the patient. Some of these treatments included opiates; few actually cured diseases.

Desperate times called for desperate remedies and during the influenza pandemic, many patients turned to these and other drugs in the hopes that they would provide a cure.

Nurses:

Between 1890 and 1920, nursing schools multiplied and trained nurses began to replace practical nurses. Isolation practices, sterility, and strict routines, practices associated with professionally trained nurses, increasingly became standard during this period.

In 1918, nurses served as the physician’s hand, assisting doctors as they made the rounds. During the pandemic, many nurses acted independently of doctors, treating and prescribing for patients.

Physicians:

Throughout the eighteenth and much of the nineteenth centuries, pretty much anyone had the right to call oneself a physician. By the late nineteenth century, growing calls for reform had begun to transform the profession.

In 1900, every state in the Union had some type of medical registration law with about half of all states requiring physicians to possess a medical diploma and pass an exam before they received a license to practice. However, grandfather clauses which exempted many older physicians meant that many physicians who practiced in1918 had been poorly trained.

While access to the profession was tightening, women and minorities, including African-Americans, entered the profession in growing numbers during the early twentieth century.

What Did Doctors Really Know?

Growing understanding of bacteriology enabled early twentieth-century physicians to diagnose diseases more effectively than their predecessors but diagnosis continued to be difficult. Influenza was especially tricky to diagnose and many physicians may have incorrectly diagnosed their patients, especially in the early stages of the pandemic.

Bacteriology did not revolutionize the treatment of disease. In the pre-antibiotic era of 1918, physicians continued to rely heavily on traditional therapeutics. During the pandemic, many physicians used traditional treatments such as sweating which had their roots in humoral medicine.

Reflecting the uneven structure of medical education, the level and quality of care which physicians provided varied wildly.

A black and white drawing. A man wrapped in a blanket in a chair is clutching his throat on the left side of the image. A table with medicines is next to him. A huddle of doctors consult one another in the upper right hand corner of the image.

Although doctors often made house calls, they were not always able to provide their patients with a correct diagnosis or a cure. [Credit: National Library of Medicine]

A black and white ad for Ka-Tar-No. The drug promises to cure catarrh and all catarrhal disease.

Drug advertisers routinely promised quick and painless cures. [Credit: National Library of Medicine]

A black and white photograph of a nurse in an early twentieth century uniform.

Nursing attracted ambitious and educated women from both the middle and working class. [Credit: Office of the Public Health Service Historian]

Cover page from Harper’s Weekly. A woman stands in front of a fireplace holding a child in her arms. A young girl clings to her skirt. A doctor stands with his back to the viewer. He is bent over listening to the heartbeat of the child in the woman’s arms.

While the stethoscope was in common use at this time, many doctors still relied on traditional methods to diagnose their patients. [Credit: National Library of Medicine]