The Last Plague: Spanish Influenza and the Politics of Public Health in Canada by Mark Osborne Humphries (review)

If, like me, you tried to write an undergraduate essay in the early 2000s on “Spanish Flu” in Canada, you probably found few sources, wrote your 10 or 20 pages, and moved on with your life thinking you knew what there was to be known. Mark Osborne Humphries’ The Last Plague: Spanish Influenza and the Politics of Public Health in Canada now joins Esyllt Jones’s Influenza 1918: Disease, Death, and Struggle in Winnipeg (UTP 2007) in showing us how little we actually understood. Humphries’ important and insightful book significantly alters the place of Spanish Flu in the landscape of Canadian social and medical history. Some 50,000 Canadians died in this epidemic, and in The Last Plague Humphries demonstrates that their deaths ultimately brought Canada into a new, modern era of public health work and knowledge.

Even if they have never spared a thought for cholera, smallpox, or any other historical epidemic, most students and scholars of modern history are at least familiar with the existence of the global 1918–19 influenza pandemic, hot on the heels of the First World War. Humphries gives the wartime context of the epidemic its due, but his crucial contribution to the historiography is to reframe the story completely, moving it from the footnotes of wartime social and military history to a central position in the long history of Canadian public health. In Humphries’ assessment, the Spanish Flu epidemic served as a vital turning point in the evolution of Canadians’ collective understanding of the proper role of government in fostering a healthy population, as well as the country’s understanding of disease more broadly (from something outsiders brought in, to something Canadians themselves spread). In public health, as in so many other respects, the wartime crisis prompted dramatic re-imaginings of how state and citizens should interact. The book therefore has important things to say to those interested not only in health history, but also in wartime society and state formation.

Above all, this is a book about context, and this long view proves not only innovative but also highly instructive. After the introduction, the book begins nearly a century before the Spanish Flu epidemic, outlining in chapters two to four how Canada dealt with various 19^th century epidemics, how public health and sanitation reform movements influenced Canada before 1914, and how the country dealt with an influenza epidemic in 1889–91. Chapters five through seven examine the 1918–19 influenza pandemic, assessing the impact of the disease’s first (milder) and second (deadlier) waves, as well as municipal, provincial, and federal government responses. Chapter eight covers the related-but-separate issue of the epidemic’s wartime context. The remaining two chapters and conclusion demonstrate the role of the epidemic in fundamentally changing the course of Canadian public health policy from 1919 onward. Sixty-nine pages of endnotes, a wide-ranging 39-page bibliography, and a 17-page index round out this useful resource for both scholars and students.

The bibliography stands as a testament to Humphries’ exhaustive primary and secondary source research, which encompasses bureaucratic, military, women’s, labour, and Western social history, as well as the history of medicine and health which is its primary focus. Overall, Humphries’ sources serve him well: his detailed tracking of the multiple vectors of influenza in chapters five and six, for example, convincingly overturn the previously-held assumption that the epidemic came to Canada from Europe with returning soldiers. Similarly, in chapter seven he makes excellent use of primary sources and existing provincial and local studies of the epidemic, to tell the on-the-ground story of how Canadians dealt with the deadly flu. The discussion of medical and popular remedies in circulation (pp. 121–22), and the descriptions of poverty and sickness in flu-stricken working-class districts (pp. 124–26) are particularly evocative and moving. However, Humphries’ love affair with his sources occasionally gets...