Spanish Flu - was it Spanish and was it flu? Part 2 - Sanitation/Electricity/Pharma


Between 1900-1920, there were enormous efforts underway in the industrialized world to build a better society. The author will use New York as an example to discuss three major changes to society which occurred in NY during that time and their impact on mortality from infectious diseases.

1. Clean Water and Sanitation

In the late 19th century through the early 20th century, New York built an extraordinary system to bring clean water to the city from the Catskills, a system still in use today. New York City also built over 6000 miles of sewer to take away and treat waste, which protects the drinking water. The World Health Organization acknowledges the importance of clean water and sanitation in combating infectious diseases. (2)

2. Electricity

In the late 19th century through the early 20th century, New York built a power grid and wired the city so power was available in every home. Electricity allows for refrigeration. Refrigeration is an unsung hero as a public health benefit. When food is refrigerated from farm to table, the public is protected from potential infectious diseases. Cheap renewable energy is important for many reasons, including combating infectious diseases.

3. Pharmaceutical

In the late 19th century through the early 20th century, New York became the home of the Rockefeller Institute for Medical Research (now Rockefeller University). The Institute is where the modern pharmaceutical industry was born. The Institute pioneered many of the approaches the pharmaceutical industry uses today, including the preparation of vaccine serums, for better or worse. The vaccine used in the Fort Riley experiment on soldiers was made in horses.

US Mortality Rates data from the turn of the 20th century to 1965 clearly indicates that clean water, flushing toilets, effective sewer systems and refrigerated foods all combined to effectively reduce mortality from infectious diseases BEFORE vaccines for those diseases became available.

Have doctors and the pharmaceutical manufacturers taken credit for reducing mortality from infectious disease which rightfully belongs to sandhogs, plumbers, electricians and engineers?

If hubris at the Rockefeller Institute in 1918 led to a pandemic disease which killed millions of people, what lessons can we learn and apply to 2018?


While watching an episode of American Experience on PBS a few months ago, I was surprised to hear that the first cases of “Spanish Flu” occurred at Fort Riley, Kansas in 1918. I thought, how is it possible this historically important event could be so badly misnamed 100 years ago and never corrected?

Why “Spanish”?

Spain was one of a few countries not involved in World War I. Most of the countries involved in the war censored their press.

Free from censorship concerns, the earliest press reports of people dying from disease in large numbers came from Spain. The warring countries did not want to additionally frighten the troops, so they were content to scapegoat Spain. Soldiers on all sides would be asked to cross no man’s land into machine gun fire, which was frightening enough without knowing that the trenches were a disease breeding ground.

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