When the annual Pennsylvania convention of the Woman’s Christian Temperance Union (WCTU) began on October 4, 1918, delegates “rejoiced” that the state Board of Health had closed all saloons, and most other sites of public assembly, as a preventive measure against the influenza epidemic. The most influential organization advocating for prohibition, the WCTU pressed for ratification of the 18th Amendment banning the sale of alcohol as influenza raged in 1918. But their celebration was short-lived, because the delegates soon learned that the closing order applied to them as well. The convention ended and delegates left for home. A variety of headlines conveyed the irony of the situation: “Rejoiced Too Soon,” “Even the State W.C.T.U. Is Hit,” and “Convention that Didn’t Convene.”
The decision to ban public gatherings marked a significant intervention by state health officials during a deadly epidemic. The situation’s irony is evident in these headlines. The Board of Health prohibited drinking as a social activity for public health reasons, whereas temperance advocates wanted a ban on drinking as a personal behavior and commercial activity. The temperance advocates obtained a desired outcome, but not for the reasons they wanted.
The connections between drink and disease during the 1918 influenza outbreak provides evidence of the historical tension between drinking as a social activity and as a heath issue. Experts still debate alcohol’s medical value, although the terms are significantly less polemical today than in early-twentieth-century America. Public health officials struggle to convince the public about the value of stringent measures, including closing bars, to control disease outbreaks. Moral judgments infuse discussions of the therapeutic value of controlled substances. The 1918 situation thus anticipated current debates over health policy and business practices. As local and state governments closed bars and restaurants in spring 2020 to support social distancing, health experts denied the medical value of alcohol in killing the virus and warned that alcohol abuse could spike as a result of social alienation.
The saloon debate during the influenza epidemic marked the convergence of three intersecting trajectories in fall 1918: the campaign for prohibition, which would culminate in the 18th Amendment; mobilization for World War I, which paired demands for sacrifice with patriotic appeals for consumption; and the rise of professional medical experts, whose confidence in diagnostic skills accompanied a more activist role for public health experts. These trajectories can be highlighted in the example of Philadelphia. The city hard hit by the epidemic and Pennsylvania was evenly divided between “dry” and “wet” sides of the temperance debate.
Although city leaders initially responded slowly to the outbreak, the Department of Health took drastic measures on October 3 by banning nearly all forms of public assembly: “All theatres, schools, churches, motion picture houses, dance halls, and other places of public gathering in Philadelphia must close immediately in the hope of checking the spread of Spanish influenza.” On October 4, Philadelphia Health Director Wilmer Krusen issued an order that brought “a complete halt” to “every branch of the liquor traffic” by closing breweries, distilleries, bars in hotels and restaurants, and “clubs of any character.” The same day, acting State Health Commissioner Franklin Royer issued a similar order for the entire state of Pennsylvania that closed “all public meeting spaces and saloons,” including the WCTU convention.
The Evening Public Ledger offered a colorful description of how the ban went into effect: “All saloons closed at 7 o’clock last night after last-minute scenes that rivaled those in cities where prohibition laws were about to go into effect.” Other newspapers described “the eleventh-hour rush to ‘stock up’ or ‘tank up’ made by crowds immediately before the dry rule became effective,” with some seeking “to imbibe enough to last them a lifetime.”
The closing order prompted criticism from both liquor sellers and health officials. One week into the ban, on October 12, Philadelphia Coroner William Knight sharply criticized the measure as “absurd.” A “fool order” that “cost many lives,” Knight thought it should be easy to get liquor as a health remedy.
Other health experts defended the ban. Dr. A. A. Cairns, medical inspector of the Bureau of Health, stated, “Whiskey is an old-time remedy that has gone out of practice.” The Harrisburg Telegraph cited “some doctors” in Philadelphia who argued that “indiscriminate use of whisky” was actually “undermining the constitutions of many persons” and “making them more susceptible to succumbing to the disease.” The Telegraph begged: “Keep the saloons shut tight.”
Debates continued as the number of cases and deaths spiked, then gradually diminished. On October 28, the ban and most other closing orders were lifted. But the Philadelphia Board of Health continued to warn against intemperance.
This debate about the medicinal value of alcohol occurred mostly among physicians, saloonkeepers, liquor dealers, and health officials. One notable exception was in a letter signed “W.C.T.U. Worker,” published in late October under the headline “The Dangers That Lurk in Alcohol.” The letter combined personal observations with the dire statement that if “a man’s life is hanging by a thread,” due to sickness, “he would far better be given his chance to pull through without whisky than be made a sorry victim of the whisky habit.” The letter’s implication that the “hell on earth” resulting when “a drunkard neglects his wife and children” was worse than any possible “use of whisky as a remedy” was a remarkable statement of how temperance advocates emphasized alcohol’s dangers even during a deadly epidemic.
An even more striking example of gendered language occurred at the very end of the epidemic in a desperate appeal by Health Commissioner Royer to maintain the closing order. As municipal authorities increasingly opened saloons even though death rates remained high, Royer called on “Citizens of Pennsylvania” to support nurses and public health workers putting their lives at risk in the face of “reckless wholesale and retail liquor dealers and some small business interests are putting dollars above human life.” More specifically, Royer made this dramatic appeal: “Women of Pennsylvania, demand of your husbands that they forthwith shut the mouths of those who clamor for premature removal of these essential restrictions. Think of your sisters at the bedside of the sick and what insult and danger would await them if restrictions over the sale of alcoholic beverages should be removed in sections where influenza now rages.” Royer invoked common temperance themes: women’s duty to preserve moral behavior in the face of temptations, the charge that commercial liquor interests placed profits over morality, and the promise of prohibition as a step towards law and order. Yet, this statement stands in stark contrast to most discourse about alcohol and influenza, which made almost no reference to gendered tropes of morality, sacrifice, and social good.
The debate about alcohol and influenza, with a few exceptions, was primarily about the almost exclusively male space at the intersection of commerce, sanitation, and medicine. Despite women’s significant contribution to caring for patients, they were largely excluded from the debate on saloons as public spaces and whiskey as a treatment. Exactly one month after WCTU delegates praised the closing of saloons, even as they regretted the end of their own assembly, the Pennsylvania liquor ban ended, bringing to a close this intense period of debate about the relationship between drink and disease.
Researching and writing this essay in spring 2020, in a context dominated by COVID-19, suggests both striking similarities and significant differences. Most obviously, social distancing measures implemented across the United States in 2020 also required the closure of many bars, restaurants, and other places of public assembly. In most cases, these orders have not prompted debate about the morality of alcohol consumption. One exception, perhaps, has been the question of why liquor stores in many states were declared “essential” and remained open, yet churches, synagogues, and mosques were closed. The duration of public health measures is also different. Whereas closing orders in Pennsylvania in 1918 lasted just over three weeks, a timeline common during the influenza epidemic, closing orders in 2020 have lasted nearly two months, and are likely to continue in some form into the summer and perhaps later.
But the most important similarity is the challenge of balancing protective public health measures while maintaining the rights of individuals to act, speak, think, and assemble freely. Royer pled with “Women of Pennsylvania” to support extending closing orders despite the opposition of businesses who were “putting dollars over human life,” which certainly anticipated elements of the current debate about “reopening” the country. In 1918, as in 2020, adhering to the recommendations of public health officials requires adaptation, adjustment, and sacrifice that become increasingly difficult to sustain over the long term.