key: cord-0013099-c8a8ocge authors: Vázquez-Espinosa, Emma; Laganà, Claudio; Vazquez, Fernando title: The Spanish flu and the fiction literature date: 2020-07-07 journal: Rev Esp Quimioter DOI: 10.37201/req/049.2020 sha: e3d312b019ea1df8b95c0da9289ef748e5e97bf2 doc_id: 13099 cord_uid: c8a8ocge This review focuses on the fictional literature in which the Spanish flu is represented either as an anecdotal or as a historical aspect and the effect on the author or fictional character. We examine this sociocultural period in the press and mainly in Anglo-Saxon literary works and from other countries, including Spanish and Latin American literature that is not very represented in some international reviews on the subject. Also, we include books about the previous and subsequent influenza pandemics to the Spanish flu. Flu has caused global pandemics over the centuries. In the 18th century, the influenza pandemic between 1708-1709 was not fairly assessed [1] . During epidemics and pandemics in 1847-1848 and 1889-1893, it was recognized that the respiratory complications of flu could greatly elevate the death rate [2] . Another pandemic has been in 2005, the avian flu, with the emerging cultural patterns and interpretative repertoires and metaphors [3] . The Spanish flu, in 1918, killed 50-100 million people in the World and, in Spain, caused as many deaths as in the Spanish Civil War. About the Spanish flu, there are different studies, this is not an exhaustive list, in the world [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] and in Spain [14] [15] [16] [17] with its spatial-temporal patterns [18] . This pandemic has been reviewed from different points of view: sociological or historical and the origin of the flu [19] [20] [21] . This review focuses on the fictional literature in which influenza is represented either as an anecdotal or as a historical aspect and the effect on the author or fictional character. In neither case it is an exhaustive review, but it focuses mainly on Anglo-Saxon literary work and from other countries, including Spanish and Latin American literature that is not very represented in some international reviews on the subject. All literature books are cited in the Tables with authors and their books in English and Spanish and we include books about the previous and subsequent influenza pandemics to the Spanish flu. The Spanish flu and the fiction literature 1 Servicio de Neumología, Hospital Universitario La Princesa, Madrid, España 2 Servicio de Radiodiagnóstico, Hospital Universitario La Princesa, Madrid, España 3 Servicio de Microbiología. Hospital Universitario Central de Asturias, Oviedo, España. 4 Departamento de Biología Funcional, Área de Microbiología, Facultad de Medicina. Universidad de Oviedo, Oviedo, España. 5 Instituto Oftalmológico Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, España. 6 Grupo de Microbiología Translacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. fonso XIII had to interrupt this work and his conversations with Germany to stop sinking Spanish ships in the Atlantic. The "ABC" newspaper reported on September 30, 1918 that «H. M. the King is sick with the flu. The attack is mild, and although his majesty has a fever, so far the ailment is of no importance". On October 4, however, the official party pointed out a fact that indicates that the King did not suffer from the flu: a series of "scarlet fever eruptions of normal evolution" on his body. Skin rashes that do not fit with the usual symptoms of the Spanish flu, in the same way that the fact that ten days later the press continued to report mild fever and more skin problems does not coincide with the picture of this disease for Cervera C [24] . The first signs of scarlet fever can be flu-like symptoms, including a high temperature of 38 ºC or above, a sore throat and swollen neck glands. It could be probable that these two theories may be both true, the flu can later in the course of the disease be complicated by scarlet fever in a percentage of patients. Scarlet fever circulating with chickenpox or influenza can be particularly dangerous. Another explanation is, although infrequently, the flu can take with an exanthematous skin rash. The treatment and vaccines of the Spanish flu pandemic. The treatment was based in several substances and bacterial vaccines in relationship with the belief in the bacterial theory of disease: "Bacterial vaccines, some were derived exclusively from the Pfeiffer's bacillus, the presumed cause of influenza, were widely used, while others contained one or more other organisms found in the lungs of victims" [25] . The treatment included "symptomatic therapy with salicylates and quinine and codeine, for pneumoniae intramuscular or intravenous silver or platinum colloid, digitalis, alcamphor oil, or adrenaline, and bleeding" [26] . In the Espasa encyclopedia (popular Spanish Encyclopedia), it was cited that "the serums and vaccines inspired by bacterial associations are now abandoned"; and that "strychnine, oxygen inhalations, arsenicals, salicylates and bleeding are prescribed" [27] . Other treatments were vapors from aromatic plants, purgatives, sweats, medicinal plants, and hydrotherapy, strong showers with alternating hot and cold water, iodine, leeches, cardenal brand water filter to trap all microbes. Marañón advocated to use a light antiseptic nasal douches twice a day [19] . Loeb L [28] found "striking similarities between orthodox and commercial suggestions for treating influenza" in The Lancet and the British Medical Journal between 1889 and 1919. The first reference in the Spanish press to an epidemic The name of influenza. The name of influenza is believed to have been used in the city of Florence in the 14th century (by Villani in 1358), considering that the disease was due to the «influenza di freddo» (to the cold) or «di stelle» (to the stars, by the astrological theories in those times) [22] [23] . In 1742, Sauvage use the name «grippe». The terms «gripper» (French), «to grip» (English) or «greifen» (German) mean in Spanish «agarrar, atrapar». Perhaps the abrupt way of presenting this disease on many occasions has justified the name «grippe», that in Spanish it was written «grippe» until at least 1925, and then with a single p. At the beginning of the Tolstoi´s book, "War and Peace" (1869), a novel that is the chronicles of the French invasion of Russia and the impact of the Napoleonic era on Tsarist society, Tolstoi writes that: "On a July day in 1805… Anna Pávlovna had been coughing for a few days; it was a "grippe", as she said ("grippe" was a new word then, that very few used"). Another word in Spanish was "trancazo" ("strike with a bar"), "tranca" means "iron or wood bar" and from this word derives "trancazo" that is a colloquial name for flu. Other nicknames were Spanish flu or Spanish Lady, also French flu. It appears that French journalists had, initially, called it the "American flu"; but the fact that the American soldiers were his allies in the warlike conflict advised not to assign such a link to them; and as there were also cases of influenza in Spain, it was decided to generalize the use of this expression, which was later assumed by Germans and others [22] . Another most popular name in Madrid, was the "Soldado de Nápoles" ("Naples soldier"), a popular song in the zarzuela (popular musical genre or "género chico" in Spain) called La canción del olvido (The forgotten song) due both, were "highly contagious". Today, there are many authors who avoid such a name (the Spanish flu) and they aptly refer to it as the "1918-1819 influenza pandemic". The origin of the Spanish flu pandemic. There are several theories about the origin: a) the origin could be in China and after in Philippines and the USA and the army in Europe. b) English soldiers in France in 1916, the disease soon spread to other neighboring countries (England, Italy, Spain) and to more distant ones (the USA) as a consequence of the displacement of the troops [22] . c) the regular arrival of Chinese workers to Africa and Europe, throughout those years, could have been the origin of an earlier introduction (coinciding with the war). And this is a very plausible interpretation due to the circumstance that the Spanish Royal Family and the Spanish ministers suffered the flu, in the month of May 1918, and could contribute to this unjustified name [21] . The flu in the Spanish King is debated, the majority of scholars think that it was a flu. For Cervera C [24] was scarlet fever: between September and October 1918, Al-War could represent the newness material to build your novels, whereas the pandemic represented historical continuity of the past plagues and this matter was not modern for their literature [32] . In the essay "On Being Ill" (1926), Virginia Woolf lamented that flu hadn't become a central theme in literature [33] . Susan Sontag pointed out, "novelists tend to focus on illnesses that can be "used" as metaphors, plague with its medieval aura, cancer with its mysterious provenance, tuberculosis with its rosy-cheeked energy and Dickensian associations. These illnesses, unlike influenzae, carry built-in mythologies primed for literary appropriation" [33] . For Hovanec [34a] . "The flu acts as metaphor for the dehumanizing and denaturalizing aspects of modern life, which take on many forms". Belling [31] divides fiction representing the pandemic in two groups: the authors with "experienced" disease, or autobiographical works, and those with "registered rather than experienced" motifs. The first group: authors who were alive at the time ("experienced") (table 1) The best known is Katherine Anne Porter's novella Pale Horse, Pale Rider. a) At the beginning, was considered not a serious infection. On 24 June 1918, the war poet Wilfred Owen composed an ironic letter to his mother and considered the flu something of a joke: "STAND BACK FROM THE PAGE! and disinfect yourself" [35] . b) T. S. Eliot makes a possible reference to the Spanish flu in his poem Sweeney among the Nightingale: "The person in the Spanish cape". Elliot and Vivien (his wife) caught the disease in November 1918 and he was working in his masterpiece poem "The waste land". "-He represented Beatrice's immortality, also outbreak in the Spring of 1918 can be found in the Madrid newspapers "ABC" and "El Sol" (The Sun), the latter one published its first headline about the subject on 22 May 1918 [18] : "What is the cause? An epidemic in Madrid. In June 2 of 1918, "The Times" in Madrid, talked about an epidemic with the name the Spanish flu and this name began to circulate and in August the 'Journal of the American Medical Association' dedicated its number to the "Spanish flu" [18] . An important book about the Spanish flu and the press is that of Davis RA [19] . In the Spanish press, it was the subject of attention with different comic strips that are not included in this work but that can be found in the digital newspaper archives [29a] . These comic strips remember the previous coloured engraved satires, in the Wellcome collection, such as "An Address of thanks from the Faculty to the Right Hon.ble Mr. Influenzy for his kind visit to this country" (by Temple West) (https://wellcomecollection.org/ works/kn2xshu9) [29b] . The God punishes is a typical approach to the plagues and pandemics. This is just one example: In León, Spain, during the Spanish flu in his prayer "Pro tempore pestilentiae" ("For the times of pestilence"), the bishop: "exhorts their parishioners to repent of their guilt because sins are the cause of scourging with that God punishes us". Among the reasons cited by the bishop to explain the incidence of influenza are the desecration of holidays, blasphemy, obscene and immoral amusements and debauchery [29a] . And in Zamora (city in Castilla), with one of the highest mortality, there were a lots of Mass and the consequent spreading of the flu. Instead the literature of the plague (Bocaccio´s Decamerone, Camus´s The plague), or tuberculosis (such as Thomas Mann´s The Magic Mountain), the 1918-1919 pandemic have hardly been the subject of novel or realistic descriptions by writers. Could it be the coincidence in the time of the First World War with the most fatal stages of the pandemic that contributed to the desire not to insist more on the evocation of so many sufferings, and thus favor a deliberate forgetfulness? Stalin said: "a single death is a tragedy; a million deaths is a statistic", the little literature in the 1918 pandemic, perhaps was due to the "flu overwhelmed language in ways that World War I did not" [31] . The Spanish flu is called a "forgotten pandemic" [31] , that's the difference for example, between literature of the Spanish flu and the literature of the World War I and the poets of the war. Or for F. Scott Fitzgerald, Gertrude Stein, Ernest Hemingway and John Dos Passos, the flu did not represent a topic in their novels, the Great g) Thomas Wolfe, Look homeward, Angel; A story of the buried. This is his first novel, a semi autographic story, covers the span of time from Eugene's birth in 1900 to his definitive departure from home at the age of 19. The setting is a fictionalization of his home town of Asheville, North Carolina, called Altamont, Catawba in the novel. Brother´s writer died with influenza. h) John O´Hara, in a short story The doctor´s son. His father worked during the flu outbreak in the Pennsylvania mining and O´Hara accompanied his father on house calls. Here, O´Hara, as the narrator, adopts a point of view of observer not such as a personal or familiar victim also dramatizes another major public health risk: the gathering of crowds [34] . i) While Pale Horse, Pale Rider represents the best literature of the flu and perhaps the paradigm of the Spanish flu, there was a lack the interest on it, maybe the reason is the traumatic experience just of a person [36] and without importance in comparison to the World War I. Katherine Anne Porter, the author, suffered influenza at twenty eight years old in 1918, and her father had planned in advance her funeral. Twenty years later, she published Pale Horse, Pale Rider, a novella in which her autobiographical protagonist, Miranda, almost dies of the flu. The story closely follows an account of Porter's own illness and recovery during the pandemic, when she was working as a reporter in Denver. j) William Keepers Maxwell wrote They came like swallows. A novel about a Midwestern family that falls ill love-affairs of numerous dead men who surely had never thought of him... if it wasn't appendicitis, influenza maybe". e) Michael Arlen, in The green hat, the protagonist was inspired in the heiress Nancy Cunard, who caught the flu in 1919 with pneumonia and depression. f) Virginia Woolf wrote an essay on flu, On being ill, and she describes the mental effects of disease. Her mother had died of influenza in 1895. In her diary writes: "Influenza, which rages all over the place, has come next door." "Rain for the first time for weeks today and a funeral next door; dead of influenza". She had several bouts of influenza: in 1918 was kept in bed 8 days, in 1920, 1922, 1923 and 1925. In her book, Mrs. Dalloway, there are two flu quotations: "For having lived in Westminster-how many years now? Over twenty, -one feels even in the midst of the traffic, or waking at night, Clarissa was positive, a particular hush, or solemnity; an indescribable pause; a suspense (but that might be her heart, affected, they said, by influenza) before Big Ben strikes". "Thus, when she said in her offhand way "How's Clarissa?" husbands had difficulty in persuading their wives and indeed, however devoted, were secretly doubtful themselves, of her interest in women who often got in their husbands' way, prevented them from accepting posts abroad, and had to be taken to the seaside in the middle of the session to recover from influenza". a chaotic city and many did not want to listen to the rational explanations for the reason for that epidemic, so on October 1 was celebrated the first black wedding (shvartze khasene in Yiddish). Sforim recounts the first black wedding in his book: It was a Jewish ritual to protect themselves from deadly epidemics, consisting of looking for a boyfriend and girlfriend among the most disadvantaged in the city (crippled or destitute) and marrying them in a cemetery [20] . d) Géza Csáth, Hungary writer, in the short story The redhaired girl: "I had taken to my bed. I had contracted influenza. In the evening, fever developed. At such times it is as though the air has become as dense as oil, and everything seems to be swimming in a soft warm fluid…. I saw my father hurrying to with the ongoing Russian civil war, it had a major problem of food shortages and the existence of gangster gangs. Due to its strategic position and suffering from different infections throughout history with quarantines since the time of Catherine the Great, Iliá Mechnikov chose Odessa in 1886 as the first center of disease control (Bacteriological Institute) of Russia with vaccinations against the rage. His assistant Yakóv Bardakh continued his work investigating anthrax, typhoid, cholera, malaria and tuberculosis. Bardakh's Jewish origin led to his dismissal and one of his students, Stefansky, was put in his place, but his fame was so great that he was the most famous doctor in southern Russia. The arrival of the Spanish flu (ispanka) and other infections such as cholera and typhus made Odesa Felice (1912 Felice ( -1917 . He contracted the flu in Prague on October 14, 1918 and while in his sickbed he witnessed the fall of the Austro-Hungarian Empire from his window. "Getting the fever as a subject of the Habsburg monarchy and recovering from it as a citizen of a Czech democracy was certainly overwhelming, but also a little comical" wrote his biographer. In: Letters to Felice (18) (19) XII, 12) [20] . i) Saneatsu Mushanokōji, member of the Japanese avant-garde Shirakaba, in Love and death, described the death by flu of a young´s girlfriend. j) Suryakant Tripathi (Nirala) (first modern Hindi poet of India). In 1918 many members of Nirala´s family died of flu and there was not enough wood to cremate them. "My family disappeared in the blink of an eye" [20] . The authors talk about the facts: "I caught the flu" in their diaries and letters, while mainly about the consequences of the flu in the novels and poems. The most important Spanish writers in this period and the Spanish flu are Josep Plá, Rosa Chacel and Miguel Delibes The first group: authors who were alive at the time ("experienced") a) Ramón de Valle-Inclán, an Spanish playwright, poet and novelist, Letters: "Letter to Don Julio Romero de Torres (a famous Spanish painter): ... I beg your pardon that I did not write to you before thanking you. The cause has been not having Josefina, in all this time, with a health day. All this as a result of a "flu" that left her very delicate" [39] . b) Josep Plá, The Gray Notebook. Josep Plá´s dietary wrote between March 1918 and November 1919. Plá caught the flu that year. Spanish flu caused the faculties to close and Plá returns to his town, Palafrugell, to the family home: "Since there is so much flu they have had to close the College… The flu continues to relentlessly kill people. In these last days I have had to attend various burials". There are extensive references in the text. c) Juan Pérez Zúñiga, The fashionable illness (Poem). He was a writer, journalist and humorist. He wrote this po- Table 5 Spanish Epistolary (years 1957, 1961, 1964, 1965, 1966 (years 1957, 1961, 1964, 1965, 1966 and 1968) j) Rosa Chacel, her novel Acropolis is a look at women and their stage of growth in a generation that lived the Spanish flu. It covers the period of the Spanish flu until the proclamation of the Second Republic ("Segunda República") in 1931: "It was not enough with the date, from 15 24, 1918) , he echoes the song of the "zarzuela" of Barbieri "Gloria and Wig" (Gloria y Peluca): "Do not cover your face/ pretty girl,/ that whoever hides the good/ God takes it away" and he changed it: "If you cover your face,/ pretty girl/ you will get rid of flu/ and scarlet fever". He was following Professor Marchoux´s advice, in the Pasteur Institute, advocated wearing mask for the flu [19] . d) Ramón Gómez de la Serna, a Spanish writer, dramatist and avant-garde agitator especially known for "Greguerías" (a short form of poetry that roughly corresponds to the one-liner in comedy): "The flu is the fog of death, that little smoke that she also throws on the harsh days of winter" "Some guys on the fringes of life, who seem to go down unspecified sidewalks, are household disinfectants. They pass with their big appliances on their backs talking about indifferent things to avoid the contagion of the epidemics that have just died out. They know that their path had to be secret so as not to startle the life of the street, which is neglected of all the problems and on which they are cast as shadows. They leave a wake of fallen microbes, but they are looked upon with benevolence, since they are heroic soldiers who enter the house where there has been a flu, and close the doors of the fateful rooms, and are inexorable executioners of evil in the hermetic rooms". In The bullfighter Caracho (1926): "The sensible man maintained that if those misfortunes were exorbitant it is because he had been focused with a telescope in agony and that of a tuberculosis patient or that of a carpentry officer who dies of the flu calling his mother cannot be focused in this way"). In Social gatherings in the café (Pombo): "Salvador sometimes has long absences. Pombo misses the little Satan who sniffs everything and is distracted from ideas by sniffing things, sensual and dissolute. It is that Salvador always has the flu, his grip is temporary, so Bartolozzi and Flu are also savior". "Crespo: "If I had not said that the great Savior is Lucifer, I would say that this man is Mephistopheles, although of course Salvador is that in a very serious way with a black coat". He also alludes to his chronic flu in one of his characteristic humorous notes (in The Pombo´s holy crypt). e) Carlos Arniches, a Spanish playwright. His prolific work, drawing on the traditions of the "género chico", the zarzuela and the grotesque, came to dominate the Spanish comic theatre in the early twentieth century. In this theater comedy, The caciques, released in Madrid on February 13, 1920 abundance of the elderly with the flu; but "ou" will see later the best I have found. And the boys are picking them up for me, my wife. I have told him to pay them six pesetas for half a dozen ... I was already nine when I came; but the nine of both sexes, as "ou" wanted". f) Ramón Pérez de Ayala, in his Epistolary between Pérez de Ayala and Jesús Pabón: "I did not answer immediately because a whole month I suffered from the flu, which had me perfectly asthenic. The South American flus are very impertinent. I have not recovered yet, but I am improving". Table 6 The Finally, in table 6 we correlate the Spanish flu topics and the authors. In conclusion, we show the different literary works about the Spanish flu and an extensive list of them. All these works show the wrong idea of Virginia Woolf complained about the lack of novels devoted to influenza and we have contextualized the works with the historical situation of the Spanish flu. None to declare La epidemia europea de gripe de 1708-1709. Difusión témporo Epidemic Influenza: A Study in Comparative Statistics Avian flu: the creation of expectations in the interplay between science and the media The Influenza Pandemic of 1918-1919 in the British Caribbean A historical note on influenza in Ethiopia The age pattern of mortality in the 1918-19 influenza pandemic: an attempted explanation based on data for England and Wales The Effects of the 1918-1919 Influenza Pandemic on Infant and Child Health in Derbyshire Influenza: the Mother of All Pandemics A Most Protean Disease': Aligning Medical Knowledge of Modern Influenza Waiting for the Flu: Cognitive Inertia and the Spanish Influenza Pandemic of 1918-19 The ghost of pandemics past: revisiting two centuries of influenza in Sweden Stacking the Coffins: Influenza, War and Revolution in Ireland We all expected to die: Spanish influenza in Labrador La gripe española. La pandemia de 1918-1919 Una ciudad en crisis: La epidemia de gripe de 1918-19 en Madrid (Thesis) La pandemia de gripe española en el País Vasco (1918-1919). Ed. Fundación Museo Vasco Hª Medicina y de la Ciencia La gripe española Spatial-temporal excess mortality patterns of the 1918-1919 influenza pandemic in Spain The Spanish flu: Narrative and cultural identity in Spain The Spanish Flu of 1918 and How it Changed the World. Pale Rider. PUBLICAFFAIRS La gripe de 1918. Centenario de una crisis sanitaria devastadora La grippe et ses virus. Presses Universitatires de France. París Datos sobre las pandemias de gripe de 1889-90 y 1918-19 en Madrid y Salamanca, y estudios sobre la sialidasa de los virus de la gripe A y B y la esterasa del virus C. Discurso de recepción. Real Academia de Farmacia Madrid La mentira sobre que el Rey Alfonso XIII contrajo la Gripe española en 1918 The Fog of Research: Influenza Vaccine Trials during the 1918-19 Pandemic Sueros y vacunas en la lucha contra la pandemia de gripe de 1918-1919 en España Beating the Flu: Orthodox and Commercial Responses to Influenza in Britain Hemeroteca Digital. Biblioteca Nacional Hispánica. Available in A satire on the influenza of 1803 El asesino que diezmó León. Diario de León 18/12/2017 Overwhelming the Medium: Fiction and the Trauma of Pandemic Influenza in 1918 Waste in a Great Enterprise": Influenza, Modernism, and One of Ours Anxiety in the Time of Influenza: a Flu Literary Review The 1918 influenza pandemic in literature and memory. (Thesis) Regulating the 1918-19 Pandemic: Flu, Stoicism and the Northcliffe America's Forgotten Pandemic Somehow a word must be found: William Carlos Williams, the Legacies of Duchamp, and the Troping of the Found Psychology of the Pandemic pp The authors declare that they have no conflicts of interest