Tom Ewing, Virginia Tech

Medical Misinformation during a Pandemic: Text as Data during the Russian Influenza (1889-1890)
Text as Data Workshop: October 2022: https://tada2022.org/

Introduction: Pandemics require large-scale processing of information at an urgent pace by government organizations, health officials, and individual citizens to predict the scope of outbreaks, gauge severity of outcomes, and recommend preventive measures. In late 1889, an influenza epidemic reached the United States, producing widespread cases as well as extensive reporting in newspapers and discussions among physicians. Quinine, a natural cinchona alkaloid, became immensely popular as a treatment for fever, cramps, and headaches. Even as quinine was recommended by health officials, prescribed by physicians, sold by druggists, and demanded by patients, reports circulated questioning the drug’s efficacy and warning of harmful effects. An interdisciplinary text as data approach combines large scale analysis of millions of words in newspapers and medical journals with close reading methods central to a humanities approach to the history of medicine.

Term Frequency: A keyword search for “quinine” during five years, 1888-1892, produces nearly 20,000 pages in Chronicling America, a historical newspaper database from the Library of Congress. Analysis by month clearly indicates the notable increase in January 1890. Term frequency is most useful as a method for identifying measurable changes in reporting, which in turn suggest shifts in public discourse and community behavior.

Contextual Analysis: Extracting the text surrounding a keyword is a method to understand potential meanings of important terms. The Voyant tool extracted 15 words on either side of the “quinine” from the Journal of the American Medical Association in 1888-1889 (quinine appeared 348 times, of 3.5 million total words). A sample of results indicates how expert medical discourse emphasized dosages, symptoms, and related treatments. The phrase, “I have not much faith” in the final result suggests disagreement about quinine’s efficacy.

Close Reading: Humanities scholars applying the method of close reading begin with careful review of relevant texts to identify notable meanings, important connections, and relevant patterns. This evidence is integrated into an interpretation supported with textual examples and informed analysis. Notes from newspaper articles indicate that behaviors and attitudes changed as a result of the pandemic, as people sought quinine from druggists, yet also encountered concerns about efficacy and ill effects. A close reading also considers other kinds of textual evidence, including headlines, advertisements, and poetry, which further illustrate how quinine became part of the historical experience of this epidemic.

Conclusion: In 1892, the journal Science declared that quinine “is too dangerous a remedy to be prescribed recklessly by medical men, and that its popular use by people ignorant of its action should be condemned and, if possible, prevented.” Understanding medical misinformation during a historical pandemic provides important lessons for improving public health guidance in response to future disease outbreaks. False reports in summer 2020 about hydroxychloroquine as a treatment for COVID-19 demonstrated the dangers of unsubstantiated claims about preventions and cures. The study of historical pandemics provides insights into the circulation of information and misinformation which may in turn inform responses to future disease outbreaks.

Sources:
Medical Journals: Journal of the American Medical Association, Boston Medical & Surgical Journal, Medical Record, Medical News
Historical newspaper databases such as Chronicling America allow for keyword searches over a period of time, within geographic locations, and by titles.

Illustration: Chronicling America, Pittsburg Dispatch, 1/4/1890, highlighted keywords: quinine, influenza, grippe

References and Additional Resources:

Newspaper articles about quinine are available from these issues (links to Chronicling America):
Boston Globe, December 28, 1889, p. 8
Democratic Northwest, January 2, 1890 (Napoleon, Ohio) link
Pittsburg Dispatch, January 4, 1890 link
Daily Morning Astorian, January 4, 1890 link
St Paul Daily Globe, January 4, 1890 link
Daily Deadwood Pioneer-Times, January 7, 1890, p. 2
Portland Daily Press (Maine), January 7, 1890, p. 4 link
Buffalo Evening News, January 8, 1890, p. 9
Delta Independent [Colorado], January 14, 1890, p. 2 link
“Typhoid and La Grippe,” Cincinnati Inquirer, January 15, 1890, p. 8
Richmond Dispatch, January 15, 1890, p. 4 link
The Daily News (Lebanon, PA), January 20, 1890, p. 1
Chicago Tribune, February 1, 1890, p. 10

Medical and Scientific Journals

W. Thornton Parker, "Danger from the Popular Misuse of Quinine," Science, Vol. 20, No. 502, September 16, 1892, p. 155 link

Russian Influenza studies

E. Thomas Ewing, “La Grippe or Russian Influenza: Mortality Statistics during the 1890 Epidemic in Indiana.” Influenza and Other Respiratory Viruses. Vol. 13, No. 13, May 2019. https://doi.org/10.1111/irv.12632.

E. Thomas Ewing, “’The Two Diseases Are So Utterly Dissimilar’: Using Digital Humanities Tools to Advance Scholarship in the Global History of Medicine.” Current Research in Digital History, Vol. 1 (2018). George Mason University Center for History and New Media: http://crdh.rrchnm.org/.

E. Thomas Ewing, “’Will It Come Here?’ Using Digital Humanities Tools to Explore Medical Understanding during the Russian Flu Epidemic, 1889-90,” Medical History, Vol. 61, No, 3 (July 2017), pp. 474-477.

E. Thomas Ewing, “The Last Pandemic. Using History to Guide Us in the Difficult Present,” Humanities. The Magazine of the National Endowment for the Humanities, Vol. 41, No. 3, Summer 2020, pp. 16-19, 44-45: https://www.neh.gov/article/last-pandemic.

Additional resources

Chronicling America: keyword "quinine,:" 1888-1892: 19,817 pages: results

For a related debate about alcohol during the 1918 influenza pandemic, see: E. Thomas Ewing, "A Complete Halt to the Liquor Traffic: Drink and Disease in the 1918 Epidemic," Nursing Clio, May 19, 2020.

Grant funding for this project from the National Endowment for the Humanities (HG-229283-15): products