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A Complete Halt to the Liquor Traffic: Drink and Disease in the 1918 Epidemic

In Philadelphia, authorities faced a familiar challenge: to protect public health while maintaining individuals' rights to act, speak, and assemble freely.

When the annual Pennsylvania convention of the Woman’s Christian Temperance Union (WCTU) began on October 4, 1918, delegates “rejoiced” that the state Board of Health had closed all saloons, and most other sites of public assembly, as a preventive measure against the influenza epidemic. The most influential organization advocating for prohibition, the WCTU pressed for ratification of the 18th Amendment banning the sale of alcohol as influenza raged in 1918. But their celebration was short-lived, because the delegates soon learned that the closing order applied to them as well. The convention ended and delegates left for home. A variety of headlines conveyed the irony of the situation: “Rejoiced Too Soon,” “Even the State W.C.T.U. Is Hit,” and “Convention that Didn’t Convene.”

The decision to ban public gatherings marked a significant intervention by state health officials during a deadly epidemic. The situation’s irony is evident in these headlines. The Board of Health prohibited drinking as a social activity for public health reasons, whereas temperance advocates wanted a ban on drinking as a personal behavior and commercial activity. The temperance advocates obtained a desired outcome, but not for the reasons they wanted.

The connections between drink and disease during the 1918 influenza outbreak provides evidence of the historical tension between drinking as a social activity and as a heath issue. Experts still debate alcohol’s medical value, although the terms are significantly less polemical today than in early-twentieth-century America. Public health officials struggle to convince the public about the value of stringent measures, including closing bars, to control disease outbreaks. Moral judgments infuse discussions of the therapeutic value of controlled substances. The 1918 situation thus anticipated current debates over health policy and business practices. As local and state governments closed bars and restaurants in spring 2020 to support social distancing, health experts denied the medical value of alcohol in killing the virus and warned that alcohol abuse could spike as a result of social alienation.

The saloon debate during the influenza epidemic marked the convergence of three intersecting trajectories in fall 1918: the campaign for prohibition, which would culminate in the 18th Amendment; mobilization for World War I, which paired demands for sacrifice with patriotic appeals for consumption; and the rise of professional medical experts, whose confidence in diagnostic skills accompanied a more activist role for public health experts. These trajectories can be highlighted in the example of Philadelphia. The city hard hit by the epidemic and Pennsylvania was evenly divided between “dry” and “wet” sides of the temperance debate.

Although city leaders initially responded slowly to the outbreak, the Department of Health took drastic measures on October 3 by banning nearly all forms of public assembly: “All theatres, schools, churches, motion picture houses, dance halls, and other places of public gathering in Philadelphia ...