Category: Spanish Flu

After that deadly killer, the Spanish flu, slipped silently into Delaware in 1918, a devastating autumn outbreak crushed the state’s health care system.  By the middle of September, the pathogen started making considerable inroads in New Castle County, and in the waning days of the month, nearly a thousand Wilmington residents fell ill.  This unchecked spread created a tremendous strain, crushing all parts of the early 20^th-century health care system.  However, in particular, the surge of the stricken needing around-the-clock inpatient care completely overwhelmed medical centers as beds filled up and officials scrambled to increase capacity. 

In this two-part series, we examine the impact of the pandemic of 1918 on Delaware hospitals.  It begins by exploring the inpatient system in 1917, the year before the virus staggered the state.  The second part considers the direct consequences of the 1918 autumn surge and actions officials took to increase capacity. 

When that unforgettable year, 1918, arrived, Delaware hospitals already suffered from a shortage of nurses and doctors as many caregivers were off serving the military.  Moreover, hospital beds were in short supply, a condition that existed long before World War I.  The city had three public hospitals and one proprietary (physician-owned) facility.  In New Castle County, the Trustees of the Poor managed the County Hospital, a place previously known as the County Almshouse.  Below the canal, two public centers existed to provide around-the-clock bedside nursing care, the “Milford Emergency Hospital,” and Dr. Bebee’s Hospital in Lewes.  There were also a few federal and state institutions.

Delaware Hospitals in 1917

Presented in chronological order, this is a list of inpatient medical centers in 1917 with notes about the institutions. 

• United States Marine Hospital, Lewes – Located on the government reservation at Breakwater, the “Delaware Breakwater Quarantine Hospital” opened on October 20, 1884, under Acting Surgeon William P. Orr.  It included a surgeon’s quarters, six patient beds, a kitchen, and a small shed.  The Marine Hospital Service inspected arriving ships, checking for infectious diseases.  By 1912, the American Medical Directory reported that the “United States Marine Hospital” had 32 beds.   But sometime during 1917, the United States Navy took over the station as a base, as the processing of immigrants stopping there during World War I.¹

• New Castle County Hospital, Farnhurst – Originally known as the New Castle County Almshouse, the poorhouse opened at Farnhust in 1884.  According to the Morning News, the legislature changed the name to the New Castle County Hospital in 1899, which pleased most of the Trustees as the institution had always been conducted more as a hospital than an almshouse.  ³.  Late in the 1890s,  the Trustees of the Poor added a “pest house,” a separate building to treat contagious patients.   The public hospital had 250 beds in 1917.⁴

• Homeopathic Hospital, Wilmington – The first public hospital in the city started admitting patients on February 10, 1888, at Shallcross Avenue and Van Buren in the former Heald’s Hygeian Home.  Originally envisioned to be a general hospital for all doctors, allopathic physicians objected to homeopathic doctors having admitting privileges, so funders established it as a homeopathic medical center.  By 1917, it had 75 beds.  When its door swung open to receive patients, it was the only hospital in Wilmington.  In 1940, it was renamed Memorial Hospital.⁵,⁶

• Delaware State Hospital for the Insane, Farnhurst – A center for the treatment of mental illnesses, the hospital was established in 1889.  It had a capacity for 450 patients in 1917.

• Delaware Hospital, Wilmington – With the homeopathic hospital flourishing and drawing many patients, allopathic practitioners decided they, too, needed a hospital.  They purchased a lot at 14^th and Washington streets and built a new 100-bed brick structure, which was named the Delaware Hospital.  The first patient, James Sutherland, arrived on February 22, 1890.⁷

• Dr. J. J Jones Private Hospital, Wilmington.  Established in 1896 by Dr. John J. Jones at 1012 Delaware Avenue, Wilmington.  By 1917 the private hospital had 30 beds.

• Emergency Hospital, Milford, DE.  Established in 1908, on the fourth floor of the Central Hotel, the medical facility, the first public facility in southern Delaware, received emergency cases that were not contagious.  it had grown to 16 beds by 1916.⁹

• Physicians and Surgeons Hospital, Wilmington – As the number of doctors increased in the city in the waning decades of the 19^th century, many were not affiliated with either of Wilmington’s public hospitals.  These unaffiliate doctors decided in 1909 to set up an open hospital, which they called physicians and surgeons.  They bought a large home at eight and Adams streets, which they equipped and opened on December 20, 1909.  The institution also established a training school for nurses, the first class graduating in 1915.  By 1917, the facility accommodated 25 patients, and in 1921 Physician’s and Surgeon’s established the first contagion unit in Wilmington, putting an end to the longtime problem of what to do with patients suffering from infectious disease.  Up to that time, contagious patients were either sent to the Farnhurst Pest Hour or quarantined in their own homes.  In 1928, the governing association changed the name to Wilmington General Hospital, as this represented the institutional mission, “an open hospital for all people,” which also welcomed all reputable physicians and surgeons.  On April 25, 1929, operations moved to a greatly expanded modern hospital at Broom and Chestnut streets.¹⁰

• Beebe Hospital — The first hospital downstate, the proprietary institution opened in 1916.¹¹

Once the surge slammed the state at the end of September 1918, the existing medical centers overflowed with patients, beds spilling into hallways and other spaces where ever they could be jammed.  This forced physicians to save beds for the most gravely ill while others suffered at home. 

Next (coming soon) — In part two, we examine how Delaware hospitals established facilities and took other measures to expand capacity.

For more on Delaware Hospitals and the Spanish influenza see the Delmarva Spanish Flu Archive

Endnotes

1. American Medical Directory. United States: American Medical Association, 1912.  http://bit.ly/35f8Imn[↩]
2. Taylor, Frank Hamilton. The Hand Book of the Lower Delaware River: Ports, Tides, Pilots, Quarantine Stations, Light-house Service, Life-saving and Maritime Reporting Stations. United States: G.S. Harris & Sons, printers, 1895, Google Books[↩]
3. Trustees of the Poor, Morning News, April 27, 1899[↩]
4. Farnhurst, Delaware, a web page, https://www.farnhurst.com/new-castle-county-almshousehospital-1884–1933.html[↩]
5. Homeopathic Care Before it was Trendy,” Delaware Today, July 14, 2014, http://bit.ly/2MHqbxr[↩]
6. Homeopathic Hospital Association of Delaware, Thirty-FirstAnnual Report for the year ending November 15, 1918, in the collection of the Wilmington Public Library[↩]
7. Delaware Hospital, Twenty-Eighth and Twenty-Ninth Annual Report, 1917 and 1918, in the collection of the Wilmington Public Library[↩]
8. Delaware Hospital Annual Report, 1917-1918, in the collection of the Wilmington Public Library[↩]
9. American Medical Directory, 5^th edition, 1916, 327, Hathi trust https://bit.ly/3pME0cg[↩]
10. Morning News, “P & S Hospital to be Wilmington General Hospital,” June 11, 1928. p 14[↩]
11. Helping Hand – Hospitals Had Many Changes, January 5, 1993, News Journal[↩]

Since I started researching the pandemic of 1918 two years ago, I have spent many hours online mining data and at archives analyzing death certificates, undertaker registers, physician statements, and health department reports.  Once I have sifted through death records for an area, I frequently pause to visit the cemeteries to remember those who perished in that perilous time when there was no vaccine or treatment to protect people from the virus.

On a sunny Saturday afternoon in late autumn, while strolling through the Riverview Cemetery in Wilmington searching for victims, I paused at the headstone for Nurse Ethel Tammany.  The twenty-three-year-old healthcare professional graduated from the Delaware Hospital School of Nursing in 1917 at the head of the class, a distinction she justly deserved, her colleagues at the hospital noted. “She had a bright, sunny disposition and seemed to bring sunshine into each room of suffering she entered.  She was deeply devoted to her work, and the many doctors and nurses with whom she had been associated will miss her helping hand,” a published tribute added. 

With a diploma in hand, the caregiver soon took a job at the Harlan Plant of Bethlehem Steel in Wilmington as an industrial nurse.  The global pandemic clobbered Delaware the next year, and several emergency hospitals opened across the City to expand Delaware’s capacity for in-patient treatment.  Miss Tammany started working at the New Century Club Emergency Hospital, helping alleviate pain and suffering.  After becoming infected by the virus, she developed pneumonia and died on Oct. 9, 1918.   Dr. John Palmer wrote that the “La Grippe” was the primary cause of death on the state certificate. 

Ethel Tammany was laid to rest at the Riverview Cemetery in Wilmington.  Her mother, father, three sisters, and two brothers survived her.    She had lived at 2114 W. 17^th Street, Wilmington.

About a quarter of the United States population caught the virus, 675,000 died, and life expectancy dropped by 12-years. With no vaccine to protect against the pathogen, people were urged to isolate, quarantine, practice good personal hygiene, and limit social interaction. That was all they had.

I will share more of these remembrances as I complete my fieldwork and visit cemeteries to remember the front line heroes fighting the global pandemic of 1918.

For more on Nurses & Others on the Front Line of the Pandemic of 1918 see

Wilmington Nurses Paid a Heavy Price Fighting the Pandemic of 1918

Delmarva Spanish Flu Archive

For additional photos see the Facebook album

When COVID-19 disrupted everyday life in March, the research I had been working on for over a year, the pandemic of 1918, took on greater urgency.  But, the storehouses of primary documents I needed to provide deeper insight for the investigation closed.  Of course, I mined the great abundance of digital content accessible from the Delaware Digital Newspaper Project and Delaware Public Archives partnerships with content providers. These important on-demand sources yielded enormous data as I closely read 102-year-old newspapers, seeking to understand how Delaware responded to the growing outbreak. 

Although these primary sources provided a day-by-day understanding of the fateful year, I needed to carefully analyze more robust original traces of the past to fully assess the deeper, complex dimensions of the pandemic in Delaware.  Government officials, prison wardens, police officers, judges, public health officers, nurses, coroners, doctors, undertakers, and cemetery caretakers penned reports in 1918 to document their work as they struggled to cope with the Spanish Influenza.  This 102-year-old data is found in death registers, police blotters, prison registers, court calendars, coroner’s inquests, and the minutes and correspondence of health boards and local and state government.

These mainly undigitized materials are carefully curated in special collections departments of public and university libraries and in the vast holdings at the Delaware Public Archives, whose collections, spanning centuries, open windows to the past.    Here is where the Wilmington Public Library, the Delaware Public Archives, and Special Collections at the University of Delaware came in.  These organizations, each in its particular way, adapted to our upended world in 2020, continuing to serve researchers and patrons. 

At the Wilmington Library, the librarians found other ways to support the community after the institute shut its doors to walk-in patrons.  One was to provide remote reference desk assistance so this opened up the strong resources of the Delaware Room.  I have used that outstanding resource many times.  For this investigation, I needed 1918 annual reports from the Homeopathic, Delaware, and Memorial hospitals, the New Castle County Workhouse, and the Bureau of Police.  Within 24-hours, the Wilmington Reference Librarians scanned the relevant sources for me.

Furthermore, the reference department provided valuable additional information in the vertical files (newspaper clipping) in the Delaware Room.  This gem for researchers, a unique pre-computer age catalog of 3 X 5 cards and vertical files with local materials from 1922 to 1977,  should not be overlooked.  For the better part of the 20th century, the city’s librarians cut out and indexed articles about local subjects and people from several periodicals.  Included were newspapers, such as the Delaware Republican, Morning News, Evening Journal, Journal Every Evening, and Sunday Morning Star. 

Although the staff doesn’t add to these files now as databases have replaced this old method for accessing information, they continue to maintain the catalog and the vertical files.  And even though many Delaware newspapers have now been digitized, this repository of excellent material still yields helpful information not located digitally. 

Another collection was at the Delaware Public Archives.  Working carefully within guidelines laid out by public health officials, the state agency reopened to research by appointment.  That provided an opportunity to spend days in the reading room, studying the prison registry from the New Castle County Workhouse, court dockets, the Wilmington Bureau of Police Blotter, the city ambulance log, and minutes from state and local boards of health.

At the University of Delaware, an email to Special Collections at the Morris Library produced annual reports that weren’t available at other repositories. 

As Delawareans struggled when COVID-19 struck the nation, these Delaware libraries and the Archives found ways to adapt and serve during a global pandemic as they re-engineered ways to make resources available to patrons.  Thank you, Wilmington Public Library, Delaware Public Archives, and Special Collections at the Morris Library at the University of Delaware for maintaining access to your collections during this unprecedented year. This assistance was essential as I researched a new lecture on the Spanish Influenza in Delaware in 1918 for the Delaware Humanities.

For more Information

New Delaware Humanities Lecture Examines Pandemic of 1918