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Over the past decade the Spanish influenza pandemic of 1918–19 has commanded an increasing amount of attention from professionals and laypersons alike. In 1997 pathologist Jeffery Taubenberger and his team published the first partial genetic sequencing of the virus's RNA, bringing science one step closer to unlocking the mysteries of a disease that in 1918 dealt the first major blow to what Eugenia Tognotti has called the “scientific triumphalism” of the germ theory of disease. The year 1918 was an era marked by the recent and astounding discoveries of the causative agents of diseases like cholera (1884), anthrax (1877), and tuberculosis (1882), and it was widely believed that laboratory trials would finally result in the isolation of the pathogenic agent of influenza. Moreover, a likely candidate already existed. On the heels of the nineteenth century's last large-scale flu epidemic in 1892, Richard Pfeiffer proposed that influenza was caused by Haemophilus influenzae, the bacillus later named after him. But his hypothesis was not universally accepted, and during the 1918–19 pandemic, the definitive case for Pfeiffer's bacillus failed to materialize, as laboratory studies produced no conclusive evidence that it was the microorganism responsible for causing the flu. Not until 1933 were Patrick Laidlaw and his team able successfully to isolate a flu virus from humans.
Despite the importance of Laidlaw's discovery, it was merely the first step in addressing the many peculiarities of the Spanish flu. Although the pathogen responsible for causing influenza had been identified, numerous questions about the 1918 virus remained unanswered: why did it yield a W-shaped mortality curve, why was it extremely virulent, what was its etiology? By revealing the genetic code of the virus, Taubenberger and his colleagues’ research held out the legitimate hope that these questions finally could be answered. The urgency to obtain answers and, more concretely, remedies (most notably in the form of a vaccine) escalated when it was discovered that the Spanish flu originated from an avian source and that it was basically the genetic “mother of all [influenza] pandemics.”
As noted in the introduction to this volume, the 1918–19 influenza pandemic started when Spain was very backward in public health matters and when the political crisis and adverse socioeconomic conditions made it difficult to answer the call for modernization from different medical sectors and health authorities. The Military Medical Service, having undergone a radical transformation during the reign of Isabel II (1833–68), was fighting to achieve scientific supremacy vis-à-vis an impoverished Civilian Public Health Service. But the Spanish army needed to reorganize and improve some of its infrastructure for this to occur. For instance, the hygienic conditions of the barracks and the food the soldiers were receiving were rather poor. As we shall see, these conditions would become prominent during the pandemic and, for some people, responsible for its existence and gravity.
As Charles Rosenberg has noted, an epidemic offers a cross-section of society, helping to highlight the existing and latent problems a given community has at the time of the outbreak. Moreover, an epidemic as a social phenomenon takes the form of a theatrical drama. In a limited time and space, different social groups are forced to modify their usual dynamic and to perform various activities to address the critical situation. This results in the mobilization of their members to perform propitiatory rituals, incorporating and reaffirming their fundamental social and cultural values.
Taking Rosenberg's approach as a starting point and using as my main sources military scientific journals and newspapers, as well as the general and popular press, this chapter explores the reactions of Spain's Military Medical Service to the 1918–19 influenza pandemic. In what follows I focus on the social impact of debates as well as on tensions and conflicts between different sectors of society. For this reason I assess whether the Military Medical Service defended scientific opinions that were more modern than those of the Sanidad Civil (Civilian Health Service) and whether there were any conflicts of interest between the measures they both took in response to the epidemic, especially as related to soldiers.
The Spanish Influenza Pandemic of 1918-1919 sheds new light on what the World Health Organization described as "the single most devastating infectious disease outbreak ever recorded" by situating the Iberian Peninsula as the key point of connection, both epidemiologically and discursively, between Europe and the Americas. The essays in this volume elucidate specific aspects of the pandemic that have received minimal attention until now, including social control, gender, class, religion, national identity, and military medicine's reactions to the pandemic and its relationship with civilian medicine, all in the context of World War I. As the authors point out, however, the experiences of 1918-19 remain persistently relevant to contemporary life, particularly in view of events such as the 2009 H1N1 swine flu pandemic. Contributors: Mercedes Pascual Artiaga, Catherine Belling, Josep Bernabeu-Mestre, Ryan A, Davis, Esteban Domingo, Magda Fahrni, Hernán Feldman, Pilar León-Sanz, Maria Luísa Lima, Maria deFátima Nunes, María-Isabel Porras-Gallo, Anny Jackeline Torres Silveira, José Manuel Sobral, Paulo Silveira e Sousa, Christiane Maria Cruz de Souza. María-Isabel Porras-Gallo is Professor of History of Science in the Medical Faculty of Ciudad Real at the University of Castile-La Mancha (Spain). She is the author of Un reto para la sociedad madrileña: la epidemia de gripe de 1918-1919 and co-editor of El drama de la polio. Un problema social y familiar en la España franquista. Ryan A. Davis is Assistant Professor in the Department of Languages, Literatures, and Cultures at Illinois State University. He is the author of The Spanish Flu: Narrative and Cultural Identity in Spain, 1918.