Whereas: Stories from the People’s House

Sick Days

Martin Foster of Illinois/tiles/non-collection/1/12-14-Foster-PA2015_03_0057a.xml Collection of the U.S. House of Representatives Representative Martin D. Foster championed a proposal to bolster the Public Health Service in response to the influenza crisis.
Shortly after noon on Friday, October 11, 1918, Martin D. Foster of Illinois anxiously asked for permission to speak on the floor. The six-term Congressman, who’d been a small-town doctor in down-state Illinois, was still digesting the latest grim reports about the rapid spread of a lethal Spanish influenza outbreak. What Foster had read alarmed him.

Days earlier, the House had agreed to an extended period of recesses interrupted by brief pro forma sessions, and it was not set to consider any new legislation until it reconvened the following week to take up appropriations bills. But Foster had an urgent proposal to make. “I would not ask this except on account of the disease which is now raging throughout the country, which is carrying off a good many hundreds of our people each day,” Foster said.

Foster hoped that the House would consider emergency legislation to alleviate an acute wartime shortage of doctors. After the U.S. entered the First World War in 1917, tens of thousands of doctors had been called into the services, leaving many towns and rural counties without a nearby medical professional. As the flu wave ricocheted across the country Foster feared that no one would be around to care for the ill.

What Foster had in mind was a bill to bolster the Public Health Service (PHS). The PHS had roots in the Marine Hospital Service (MHS) which attended to the health of sailors at the nation’s ports during the late 18th century. By 1870, the MHS boasted a corps of certified physicians, with pay and rank equivalent to commissioned officers in the Army and Navy, who could be mobilized to duty stations around the country. In 1912, the MHS was renamed the Public Health Service to reflect its status as America’s premier medical division.

Using his status as a member of the Rules Committee, Foster proposed that the House pass a bill, Senate Joint Resolution 63, allowing the PHS to mobilize civilian doctors from across the country into an emergency reserve from which they could be dispatched to influenza hotspots. But there was an immediate obstacle. Foster spoke to a largely empty chamber. Sickness had sidelined so many Representatives that the House lacked a quorum, the minimum number of Members necessary to conduct business. Without a quorum it would, in theory, be impossible to hold a vote on Foster’s proposal.

St Louis Red Cross/tiles/non-collection/1/12-14-St_Louis_Red_Cross-loc.xml Image courtesy of the Library of Congress In October 1918, the Red Cross arrived in almost military form to aid in St. Louis, one of the epicenters of the influenza outbreak.

The Spanish Flu Comes to Washington

Beginning in the late spring of 1918, the Spanish influenza epidemic ravaged the U.S. for over a year. It hit in three waves, the last of which finally subsided in North America during the summer of 1919. More than 50 million people died worldwide, and an estimated 650,000 perished in the United States alone (eclipsing America’s combined combat deaths in the First and Second World Wars, the Korean War, and the Vietnam War).

The first flu wave appeared in the U.S. in March 1918 at Camp Funston in Fort Riley, Kansas, where soldiers trained before being sent to Europe during World War I. The flu sickened hundreds at Camp Funston, and for the next six months what seemed at first like a run-of-the-mill outbreak spread sporadically and unevenly throughout the U.S. Eventually, it traveled overseas as troops deployed to the front.

In September, at another military camp outside Boston, a mutated strain of the flu virus began a second, far deadlier, influenza wave. This outbreak ravaged large cities along the eastern seaboard before heading west. In October alone, more than 195,000 Americans perished.

In the District of Columbia the epidemic carried on unabated for weeks, quickened by the influx of government workers who had streamed into the capital to help mobilize for war. Housing was limited, and the overcrowding amplified the virus’s impact. Tens of thousands of cases were reported and a far larger number undoubtedly went undocumented.

DC Red Cross/tiles/non-collection/1/12-14-DC_Red_Cross-loc.xml Image courtesy of the Library of Congress Doctors, nurses, and volunteers at the Red Cross station in the District of Columbia worked overtime during the autumn of 1918.
More than 1,000 people died of the flu in the DC region alone; newspapers reported an equivalent number who succumbed to what was described as pneumonia, but likely was the flu or secondary respiratory crises brought on by the flu. Each day, the Washington Post published grim lists of the dead, along with their addresses and ages, on its front page. In Washington and elsewhere victims in their 20s or 30s far outnumbered the ranks of infants or elderly whom flu outbreaks typically claimed. As one survivor, William Sardo, recalled years later, the flu “wiped out entire families from the time that the day began in the morning to bedtime at night . . . it happened all the way across neighborhoods, it was a terrifying experience.”

In early October, as the city shuttered most public gathering places, Congress began to feel the effects of the flu as well. On October 6, it was reported that Democratic Leader Claude Kitchin of North Carolina was stricken with the “grip,” and had been confined to his bed for several days. Then Speaker Champ Clark fell ill. Over the course of the next week, both men started to recover even as many of their colleagues fell sick and were bed-ridden.

On Monday, October 7, the House convened at noon and, after the announcement of the death of Representative J. Fred Talbott of Maryland (who had lost a long battle with kidney disease), moved to adjourn for the day out of respect. But before the gavel fell, Illinois Congressman Henry T. Rainey made an extraordinary request. “Mr. Speaker, it is a matter of common knowledge that an epidemic of alarming proportions is prevailing throughout the country. Out of an abundant precaution the Senate has ordered the galleries closed, which action, I understand, meets with the approval of the medical authorities, and so I ask unanimous consent that the Speaker be instructed to close the galleries of the House until further action shall be taken by the House.” The House consented to Rainey’s request.

While the flu outbreak did not close the House entirely, it slowed its activities to a crawl. For much of the first half of October the chamber stood in recess punctuated by brief pro forma sessions which few Members attended. Sickness, as well as the need to care for ailing family members, substantially thinned the ranks of the House.

Within days the decision was made to close the Capitol “to all visitors as an extra precaution.” In just the preceding 24 hours, 74 Washingtonians had died and health officials treated more than 1,600 new flu cases.

A Gentlemen's Agreement

When Representative Foster made his urgent request to raise a PHS doctor reserve corps, so few Members were present that Joseph Walsh of Massachusetts objected that the House lacked a quorum. Hold the bill until Monday the 14th, Walsh suggested. More Members would be in town and the Senate would be back in session. Foster agreed.

But when House leaders tried to resume the normal legislative calendar on October 14, an ensuing quorum call revealed that only 178 Members were present, far less than the required number to conduct business. Despite an attempt to consider the bill anyway, Speaker Champ Clark, who had recuperated from his own illness, ruled against it and the House quickly adjourned.

Ladislas Lazaro of Louisiana/tiles/non-collection/1/12-14-Lazaro-PA2016_04_0018a.xml Collection of the U.S. House of Representatives Ladislas Lazaro of Louisiana, called “Doc” by his colleagues, relied on his medical expertise to urge calm while supporting passage of the Public Health Service reserve corps bill.

The following morning, after Speaker Clark gaveled the House into session, Congressman Ladislas Lazaro, a doctor from southwestern Louisiana gained recognition to speak. Lazaro, whom colleagues affectionately called “Doc,” urged his fellow Members and the residents of the District of Columbia to “keep cool, avoid hysteria, and cooperate with the authorities in their fight against this disease.”

As Lazaro concluded his remarks and the House again took up the PHS proposal, less than 50 Members were in attendance. But, in a remarkable step, those present had agreed to a “modus vivendi”—as Speaker Clark explained from the rostrum—to consider the PHS bill under a unanimous consent agreement that would only work if no one ask for a quorum call. Leaders of both parties had struck this hasty gentleman’s agreement either before the House had come into session that day or as Members milled about the floor listening to Lazaro.

Although two Members initially balked at the plan and demanded a quorum call, other Members convinced them to withdraw their points of order. After roughly an hour of debate, with Foster outlining the dire impact of the flu in various sections of the country, the House approved the rule governing consideration of the PHS bill (S.J. Res. 63) on a division vote, 29 to 19. The House then resolved itself into the Committee of the Whole where Members spent several more hours debating amendments.

For much of the discussion, Lazaro and Foster assuaged concerns that the government might remove doctors from communities where they could do the most good. “I do not believe there are physicians anywhere who would leave their homes when they are badly needed to accept a commission in the Public Health Service,” Foster said. A good doctor, Foster continued, “would consider his first duty to his community; but if he could be spared with safety, he would go to some other community where they could not get medical help.”

Minutes later, the amended version of the PHS bill passed without objection. Immediately afterward, a point of order was made that a quorum was not present, and the House adjourned.

Influenza Hits the House

The following day, October 16, the flu claimed its first Member of the House: Jacob M. Meeker, who represented a district in St. Louis, Missouri. He likely caught the virus while touring the Jefferson Barracks, south of St. Louis along the Mississippi River. Like many military training facilities, Jefferson Barracks was an influenza incubator. By the time Meeker toured the sprawling military camp, more than 1,000 servicemen were sickened.

Over the next several months, the flu outbreak claimed at least two other Members of the House. Edward Robbins, 58, contracted the disease during a visit to Somerset, Pennsylvania, for a speaking engagement and after several days of illness died in a hotel there in late January 1919. A month later, another Missourian, William P. Borland of Kansas City, 51, died of what the newspapers described as pneumonia, but which very likely was influenza. The five-term Congressman contracted the illness while touring the western front in France.

Seattle Flu/tiles/non-collection/1/12-14-Seattle_Flu-loc.xml Image courtesy of the Library of Congress During the Spanish Influenza pandemic, the city of Seattle, Washington, would not permit anyone to ride on the street cars without wearing a mask. Masks were provided by the Seattle chapter of the Red Cross.

A First Step for Public Health

On October 18, a conference committee of three Representatives and three Senators reported that it had reached an agreement on the Public Health Service bill. Within days, both chambers agreed to the report and the final bill was approved on October 27. By the time the bill became law, the pandemic had already begun to peak in New England and had spread to virtually every state in the Union. “It makes no difference where and when an epidemic starts,” Doc Lazaro said the day the bill was debated in the House, “we are always a little slow in adopting the measures that we should adopt in order to stamp it out.”

Gradually, by late October 1918, life in the capital began to return to normal. By then, the House had begun considering major appropriations legislation—including an important supplemental military funding bill to support American forces in Europe. On November 4, after an unusually long span being closed, the House galleries were reopened to the public.

The following day, in the mid-term elections, voters turned nearly two dozen Democratic Representatives out of office; among them was Representative Foster. Republicans picked up 25 House seats to reclaim the majority. Foster, who left the House at the conclusion of the 65th Congress in March 1919, was appointed to a government commission to settle wartime mineral claims in the western states. Within months, Foster returned home to Olney, Illinois, “seriously ill from overwork.” By the fall, the Spanish influenza had run its course in the U.S. claiming its last victims in the summer of 1919. But the 58-year-old former Congressman, exhausted from an extended illness brought on by Bright’s disease, a kidney ailment, died on October 20, 1919.

The breadth and severity of the influenza pandemic underscored major shortcomings in America’s public health system which, in the decades leading up to the First World War, had just begun to take shape as a modern medical provider with a national reach. The bill to create a reserve corps of doctors to assist the PHS was a step toward meeting those needs. But it would take a Second World War to convince federal authorities to consolidate the government’s disparate public health agencies under a single agency. In 1946, a rapid-response team of medical professionals was institutionalized with the creation of the Communicable Disease Center, the forerunner of the modern Centers for Disease Control and Prevention.

Sources: John M. Barry, The Great Influenza: The Epic Story of the Deadliest Plague in History (New York: Viking, 2004); Laura Spinney, Pale Rider: The Spanish Flu of 1918 and How It Changed the World (New York: Public Affairs, 2017); Jeffrey K. Taubenberger and David M. Morens, “1918 Influenza: the Mother of All Pandemics,” Emerging Infectious Diseases 12 (No. 1, January 2006): 15–22; “1919 Pandemic Influenza Historic Timeline,” Center for Disease Control and Prevention, https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/pandemic-timeline-1918.htm (accessed 10 October 2018); Congressional Record, House, 65th Cong., 2nd sess. (7, 15 October and 4 November 1918); Reserve of the Public Health Service, U.S. House of Representatives, Report No. 833 65th Cong., 2nd sess. (18 October 1918); 40 Stat. 1017; Baltimore Sun (6 October 1918); Indianapolis Star (17 October 1918); New York Herald-Tribune (17 October 1918); New York Times (6 and 17 October 1918; 26 January 1919; 22 February 1919); St. Louis Post-Dispatch (16 October 1918); Washington Post (4, 12, 14, and 18 October 1918; 5 November 1918; 26 January 1919; 22 February 1919; 21 October 1919).

Categories: Legislation