On 28 December 1889, and at the height of global anxiety about a spreading epidemic, the American journal Medical News published a lengthy article by Dr Roberts Bartholow about ‘The Causes and Treatment of Influenza’.Footnote ¹ Noting that the ‘reappearance of influenza in one of its cyclical manifestations, or epidemics, is an interesting event’, Bartholow offered a sweeping statement about the impact of the disease:

To treat influenza, Bartholow recommended cures such as sulphurous acid, iodoform, tannin, resorcin, chinoidin, calomel, antipyrin, acetanilide, phenacetin, and more.

This article resembled many contemporary reports about an epidemic already referred to in late 1889 as ‘Russian influenza’ that combined specific descriptions of symptoms with prognostication about the course of disease. Bartholow’s recommended treatments were clearly intended for doctors and druggists rather than the general public, yet his sage advice to maintain vital tone and condition obviously appealed to more general readers. Appearing at the early stages of an epidemic, the tone of Bartholow’s article was serious yet reassuring in its claims that the disease was cyclical and familiar, its causes soon to be discovered, and its cure within reach.

Although close reading of an illustrative text, such as Bartholow’s editorial, allows historians to understand how a medical expert explained a disease outbreak, new tools from the digital humanities permit interpretations on a larger scale, across a broader range of textual evidence, and with the potential to uncover additional angles that promote revealing analysis.Footnote ² This article explores a digital humanities approach to medical history that takes advantage of the great expansion of texts accessible through digitised collections to facilitate synthetic analysis across layers of experience, from the global to the national and regional, down to the local and even the personal. Digital humanities methods, in other words, allow historians to explore more sources with new tools while also enhancing traditional techniques of close reading and layered analysis.

In terms of a digital humanities approach to medical history, the real significance of Bartholow’s article was the manner in which it was replicated, cited and even challenged at a national level. A database search for ‘Bartholow’, or the frequent misspelling, ‘Bartholomew’, located more than fifty newspapers over the next ten days that explicitly referenced this expert discussion of influenza.Footnote ³ Nearly three-quarters of these articles appeared on 28 December 1889, the publication date of the Medical News article. These articles consisted almost entirely of text taken from a wire service summary of the journal article, either in a long version of several paragraphs or a short version of a few sentences. The widely held view of the Russian flu as a disease outbreak to be observed, anticipated but not feared, was expressed in, for example, the headline ‘Look Out for ‘La Grippe’, used by a Georgia newspaper, the Macon Telegraph, to introduce the main points of Bartholow’s article.Footnote ⁴ In other words, searching through digitised collections reveals the ways iterations of a single text appeared across the United States and gave readers in disparate locations simultaneous access to expert commentary on a disease.

Keyword searching reveals that a few newspapers framed Bartholow’s authoritative commentary relative to observations from local physicians, who shared the general assessment of the limited danger of this disease.Footnote ⁵ Yet a strikingly different, even unique, interpretation of Bartholow’s article appeared in a Missouri newspaper, the Sedalia Weekly Bazoo, in a 7 January 1890 editorial, which began with a sweeping denunciation of journalistic practice:

After referring to European hospitals full of patients, businesses and schools closed, and public services curtailed, accompanied by sudden and unexplained increases in mortality, the editorial seemingly mocked alarmist reports of illness in closer proximity: ‘In the Eastern States, everybody who has a cold in his head reports himself as a victim of La Grippe, and goes about warning his neighbours to be warned by his melancholy example.’ The Sedalia Weekly Bazoo then offered its own corrective to stories that ‘read like wild fiction, based on a slight substratum of fact’: ‘There is nothing new in influenza; it is an old acquaintance; we know all about it. It is rarely fatal; it does not usually prevent its victims from attending to business. It sometimes assumes an epidemic type and cases become frequent, but it never lays whole communities low. It has never in its past visitations created a general panic; there is no reason why it should do so now.’ Finally, the editorial ended with a sharp retort to the expert advice offered in the Medical News ten days earlier: ‘[The influenza] is probably not nearly so much to be feared as the remedies which Dr Bartholomew [sic] of Philadelphia recommends as safeguards: the inhalation of sulphuric-acid gas, five grains of chinoidin three times a day and two grains of calomel at night. A patient who survived these medicines need fear no epidemic in this world.’Footnote ⁶

The circulation of expert knowledge about influenza involved both repetition and contestation. The Sedalia Weekly Bazoo used wire service reports to provide information about the spread of disease in Europe and the United States, yet this editorial challenged both the nature of most newspaper reporting and the specific recommendations of a medical expert. A digital humanities approach that uses broad analytical tools to identify a single text for close analysis offers medical historians a tool to explore tensions between claims of medical expertise and interpretations of human experience.

The Russian influenza, like other nineteenth-century disease outbreaks, is especially suited to a combination of searching across large amounts of texts and close reading of specific texts because of the potential to trace the diffusion of knowledge across communication networks while also carefully evaluating the substance of this information. Medical experts like Bartholow can be tracked by both their names and their ideas, yet this approach requires a combination of tools and techniques. Interpreting specific texts requires the skills of close reading, yet it was the digital humanities tools of word searching and synthetic analysis that identified the texts deserving close interpretation within the broader context. Diseases like influenza epidemics lend themselves to multiple forms of analysis, because the disease can be examined across levels (global, regional, local and personal) as well as across a variety of discursive forms (expert analysis, factual reporting, subjective responses and editorial commentary).