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  • Fever of War: The Influenza Epidemic in the U.S. Army during World War I
  • Christopher M. Langford
Carol R. Byerly. Fever of War: The Influenza Epidemic in the U.S. Army during World War I. New York, New York University Press, 2005. xv, 251 pp., illus. $21 (paper), $65 (cloth).

Carol Byerly's account of the impact of influenza on the U.S. Army during the influenza pandemic of 1918–19, toward the end of and just after World War I, has three main elements. First, she focuses on the mentality of the U.S. Army's medical establishment at the time and argues that even though army doctors were well aware of the terrible mortality that disease had inflicted on armies in the past, their experience, and successful exploitation of the dramatic medical advances of the prewar years meant that when America entered the war in 1917 army doctors had unprecedented confidence in their ability to keep soldiers healthy. Second, she documents the way in which, as she puts it, "the influenza epidemic exploded these expectations and delivered an experience in failure to army physicians who could do nothing to prevent the flu or to treat the deadly pneumonia that often ensued" (p. 182). Third, she notes the way that "in the wake of this fall from confidence, medical officers began to discount the significance of the epidemic as a medical event" (p. 182). [End Page 92]

The first and second parts of her account are extremely interesting and largely successful. She paints a persuasive picture of the growing confidence of U.S. Army doctors in the years leading up to the war, recounting, for example, the story of William Gorgas, the army doctor who ran the campaigns which succeeded in eliminating yellow fever from Havana, Cuba (1900–1902), and the Panama Canal Zone (1904–1906). Gorgas went on to be U.S. Army Surgeon General from 1914 to 1918. She also documents in detail the sense of powerlessness and failure among army doctors in 1918, confronted as they were by an unusually lethal form of influenza, a disease that in any case, even in a mild form, was effectively untreatable by them (though good nursing care probably did make a difference). Doctors knew that overcrowding probably made things worse, but military exigency apparently required this. One might wish to add only that Byerly's account of the mindset and reactions of American army doctors would also hold for many other doctors at that time, in the United States and elsewhere, civilian as well as military.

In relation to the third part of her account, Byerly is less successful. There is no doubt that the United States and other societies tended to forget the 1918–19 pandemic after an amazingly short time. Alfred Crosby entitled the 1989 edition of his book on the outbreak, America's Forgotten Pandemic: The Influenza of 1918 (Cambridge: Cambridge University Press, 1989), to draw attention to this fact. The United States, according to Crosby, ignored influenza to an amazing extent even in 1918. Crosby's possible reasons for America's amnesia included: that lethal epidemics might not have been regarded at the time as especially unusual; that deaths in action might have overshadowed influenza deaths; and that people generally perhaps tend to overreact to uncommon but deadly diseases like rabies, but treat too lightly a high-morbidity, low-case-fatality disease like influenza. Byerly argues essentially that physicians in the U.S. Army, having failed to defeat influenza in 1918–19, needed to—and managed to—bury the story, albeit with the complicity of the American public. This latter point muddies the water. Might it not be that Americans forgot influenza, not so much because of any cover-up by army doctors (which remains unproven anyway), but simply because, as Byerly also tells us, "Many people who had been traumatized by the war and the epidemic may have sought to forget those painful experiences" (p. 183)?

An extremely interesting part of Byerly's account relates to African Americans. We learn that they comprised 10 percent of the population but provided 13 percent of American draftees, and that at least 80 percent...

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