Appalachia Appalachian Medicine Heritage Proctor / Hazel Creek

1918 Flu In Southern Appalachia

The Blind Pig family has been lucky this winter-none of us have been sick much-I feel like I should say knock on wood-and actually knock-that’s what Granny would do. My niece and I shared a lovely stomach bug on Thanksgiving night-I may never want to eat Turkey again-but other than that we’ve mostly been well.

Some of you may remember-in the winter of 2009 I had the worst case of flu I’ve ever had-well I’ve only had the real flu twice-so maybe I should say-I was sicker than I’ve ever been in my life. I couldn’t even let my Blind Pig readers know-I finally had The Deer Hunter let everyone know-I hadn’t died although I felt like I might. If you missed the posts you can read about it here:


I remember learning about the 1918 Flu Epidemic in school-seems like it was in Elementary School. I’m sure I thought it was interesting and sad-but 2 things made the stark reality of the Epidemic come alive for me. One was my bout of the flu in 09-I truly did think I was near death’s door more than once-and the other was when I first visited one of the old cemeteries that are scattered through out the Smoky Mountain National Park.

Proctor was the first cemetery I visited along with the kids from TLC! I was so busy snapping photos I didn’t take time to really read the info on the stones-until one of the students pointed out several from the same family who died within days of each other. Right away I thought of the flu of 1918.

While it was obvious some of the stones in the Proctor Cemetary were from the era of the Great Flu-we soon noticed other mass casualties from the same family occurred in different time frames. Although it had been months since I had the flu-as I looked and thought about the heartache those families endured by loosing more than one beloved to the 1918 Flu or to some other spreading illness-it made me so thankful to live in the days of modern medicine with fever reducers in my medicine cabinet.

In 1918 The NC Board of Health offered the following advice about the Flu Epidemic:

“Influenza and What You Should Know About It,” Bulletin of the North Carolina Board of Health, 33:5 (1918), pp. 38–39.

How and Where Influenza is Spread

  1. By careless spitting, coughing, sneezing, and using the same drinking vessel or towel others have used. The disease germs are carried in the spittle and in the little drops of secretion from the nose and throat.
  2. In crowds and public gatherings, churches, schools, picture shows, business houses, fairs, circuses, trains, or in any other places where people congregate. Soda fountains are especially dangerous if they do not supply individual sanitary cups and sterilized spoons.

How to Keep Away From Taking Influenza

  1. Keep away from crowds, especially indoor gatherings.
  2. Avoid people who cough, sneeze and spit without holding a handkerchief over the nose and mouth.
  3. Do not use common drinking cups or towels, and keep away from the soda fountain that does not supply individual cups and sterilized spoons.
  4. Keep the bowels open. Snuff Vaseline up the nose three times a day. Gargle mouth and throat and rinse out nose with warm salt water, using a level teaspoonful of salt to a glass of warm water. Sleep and eat regularly. These are very important.
  5. Keep in the open air and sunshine as much as practicable and have good ventilation in the home and office. Sleep with your windows open.
  6. Wash your hands before eating and never put your unwashed hands in your mouth.
  7. Do not give the disease to others—when you sneeze or cough always bow the head and cover both the nose and mouth with handkerchief.

Symptoms of Influenza and What to Do if You Take It

  1. In most cases a person taken with influenza feels sick rather suddenly. He feels weak, has pains in the eyes, ears, head or back, and may be sore all over. Many patients feel dizzy, some vomit. Most of the patients complain of feeling chilly, and with this comes a fever in which the temperature rises to 100 degrees to 104 degrees. In most cases the pulse remains relatively slow.In appearance one is struck by the fact that the patient looks sick. His eyes and the inner side of his eyelids may be slightly bloodshot or congested. There may be running from the nose, and there may be some cough. These signs of a cold may not be marked; nevertheless the patient looks and feels very sick.
  2. If you have any of the above symptoms, go to bed at once and send for a doctor and follow his directions explicitly.
  3. If you cannot obtain a doctor at once, stay in bed with plenty of cover to keep you warm, open all the windows and keep them open, take medicine to open the bowels freely, and take nourishing food, as milk, eggs, and broth, every four hours.
  4. Allow no one else to sleep in the same room. Protect others by sneezing and coughing into cloths which can be boiled or burned.
  5. Stay in bed until a doctor tells you it is safe to get up; or, until you have been without a fever for at least four days.

What To Do After Recovering From an Attack of Influenza

  1. Influenza is a treacherous disease. If one is fortunate enough to escape pneumonia during or immediately following the attack, the lungs and respiratory system are frequently so inflamed that tuberculosis develops. The heart is overworked and needs rest. Therefore, do not return to work or leave home until you have regained your strength, whether it is a week or a month.
  2. If complete recovery does not take place within two weeks, have your family physician carefully and thoroughly examine every vital organ and function of the body. Follow instructions the doctor may give you after such an examination.

Taken from NC Digital Collection.


Much of the advice given by the NC Board of Health in 1918 would still be good advice today-I’m not so sure about the sniffing of Vaseline though. It is true sickness can hit you quickly. When the girls were little and a stomach virus infiltrated our home-it would show it’s ugly head in both girls within a matter of hours.

Unless folks lived in cities or towns I doubt they would have even heard about the NC Board of Health’s advice-much less read it. Families who lived in rural areas of Western NC and beyond-probably relied on oldtimey Medicinal Remedies and a good deal of faith to get through the sicknesses that sometimes blindsided their homes.

Before the Flu Epidemic of 1918 was over-it killed millions of people across the world. On the video above-he infers the flu making itself known in the mountains of TN was proof the outside world had reached one of the most isolated regions in the US. Kinda makes me think about smallpox and other sicknesses that were hand delivered to the Native Americans.

Click here to see some photos from the Epidemic of 1918-none from Appalachia-but still fascinating.



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  • Reply
    January 10, 2011 at 7:20 pm

    That flu epidemic in 1918 is mind boggling. Especially knowing there wasn’t much in the way of treating those ill with it. I’ve only had the flu once in my life and hope I never have it again.

  • Reply
    January 10, 2011 at 10:55 am

    The flu hit us. Baby granddaughter (20 months old) got it christmas eve day. That poor baby was so sick, she didn’t even care to open packages. She never got her cute Christmas dress on.
    Then the blacksmith got it Christmas night. He was one sick guy. I got it a few days later. One good thing, it helped to keep the calorie gained down for the holidays.

  • Reply
    January 9, 2011 at 10:21 pm

    I had the flu exactly once. I would not wish it on anybody. May we all be careful this year!

  • Reply
    B. Ruth
    January 9, 2011 at 5:06 pm

    My Father in 1918 would’ve been seven and my Mother three…They probably grew up with the dread of the flu..
    This post reminded me of my parent’s insistence on warm to hot water gargling when we first showed signs of sore throat, sniffles or flu symptoms. I hated it, but, Mother made us do it, to the point of actually standing there until we finished the glass of salt water…“Do not swallow it either“, she would say.
    There are five simple little marble stones where my Grandparents are buried in NC…I have wondered about them all my life. All the children in little row. I was told they died of pneumonia probably following the flu.
    I think the Vaseline that was mentioned to rub up the nose was not Vaseline but Vicks VapoRub! My parents used it by the big jars full. If we had a stuffy nose it was rubbed on our chest then a cloth was moistened with water as hot as we could stand it and placed on our chest….The nose was rubbed with Vicks too….This would help open us up and seemed to help the congestion…Also a Vaporizer was filled with a lump of Vicks, it would melt and the steam would fill the room. Today when I smell it, it reminds me of home and a sense of caring…
    Does that make sense?
    Vicks has camphor, eucalyptus, petrolatum, etc. (plus the color of Vaseline)…It was first discovered in NC….and the University of Chapel Hill has all the documents and history of it there…
    I have made a list of the meds in our cabinet that we used on a regular basis growing up…and yes the dreaded Castor Oil is on the list. LOL
    Sometime we could post these old meds and see what folks families used growing up in Appalachia…We were still using occasional herbs, too like sassafras and comfrey etc…in the forties…Now herbs are back in vogue! LOL

  • Reply
    January 9, 2011 at 1:31 pm

    Tipper, Thanks for the reminder on the flu epidemic of 1918, It took my Great Grandmother, and left 9 small children behind. This was such a tragic event in history. Thanks for sharing….You are AWESOME!!!
    Are You ready for the SNOW??????? These storms remind me of when I was a small child!!!!!!

  • Reply
    kathryn magendie
    January 9, 2011 at 11:00 am

    I can’t remember the last time I had the flu – years and years (and I’m going to knock on wood now!) okay, just knocked.
    I linked you to my blog the other day, because there is always something interesting here…thankyou! And glad you are okay now!

  • Reply
    January 9, 2011 at 10:47 am

    What a terrible time that was.
    And the memories poured out in the comments are sad but still interesting.

  • Reply
    laoi gaul-williams
    January 9, 2011 at 8:58 am

    i have had flu three times in my life and the year before last swine flu (although to be honest to me it just felt like flu).
    in my family tree research i discovered that my great great uncle Betteridge died in a German POW camp of flu shortly before the end of the great war~i have a copy of the telegram sent to his mother. this has prompted me to look more closely to see if there were any unusual losses at the time.

  • Reply
    lynn legge
    January 9, 2011 at 5:11 am

    wow tipper, i can just imagine the wide spread of influenza in those days. we are truly lucky to have the modern medicines and knowledge of diseases nowdays…
    i hope that you and yours stay healthy and the ole bad bugs stay away ..
    always so interesting to read about the families and relations and how small this whole world really is.. as you have said.
    big ladybug hugs and stay warm
    lynn 🙂

  • Reply
    Dee from Tennessee
    January 9, 2011 at 2:47 am

    My grandfather was 20 yrs old in 1918 and all of his family got the flu except for him. He took care of all of them and thanks be unto God they all survived and he didn’t catch it.
    I’ve had the “real” flu once …1969 I think. It was the week prior to finals, and I kept saying, “I can’t be sick, I can’t be sick.” One of my friends from Roan Mountain looked at me and said , “You look green , Dee.” I called home and my daddy and uncle came and got me. It was rough. I’ve heard a LOT of people say, “Oh, I had the flu, but I kept going.” And, I’m thinking — really? lol
    Okay, thanks for Homeland Series link…I had not even though about them having a fb page. WBIR is our first station of choice– we get Knoxville stations and Tri-Cities stations (Johnson City and Bristol) but it’s WBIR all the way for us! Love, love,love and miss, miss, miss Bill Landry and the series.

  • Reply
    Greta Koehl
    January 8, 2011 at 9:52 pm

    One of the most chilling experiences I’ve had in genealogy happened during a long weekend after the Texas death certificates came out on Family Search. For some reason I had a stretch of certificates that went in chronological order in the same area of Texas. The early ones cited pneumonia and something else, but when I looked at the dates, I had an eerie feeling that it must have been the influenza epidemic. And finally after a couple of months the cause of death on certificate after certificate was influenza.

  • Reply
    David Templeton
    January 8, 2011 at 8:25 pm

    I think about the kids that went to orphanages when their parents died. I think of the families that took in their kin, children, old folks after the flu destroyed the family fold.
    Aunt Bernice is still living. I don’t know how old she is but both of her parents died in the epidemic and left her and four brothers and sisters orphaned except that relatives took them in and raised them.
    I don’t remember if I knew that you had the flu, the year you were gone so long. I know we knew something awful was wrong and we knew your were terrible sick. Many of us prayed for you. I did.

  • Reply
    Don Casada
    January 8, 2011 at 8:21 pm

    I wanted to say that all of Miss Cindy’s advice is good, but the first one is outstanding: avoid crowds. That is an excellent admonition completely independent of flu considerations. And for this mountain boy who cherishes time in high lonesome territories, avoiding crowds also helps with two of her other pieces of advice – improves my attitude and definitely keeps at least the mental part of me from overheating 😉
    By the way, this may be completely unrelated, but Captain Billy Moore (the Captain William P Moore of your WC Penland correspondence) died in 1918.

  • Reply
    January 8, 2011 at 5:49 pm

    I have always been intrigued with the 1918 flu and have read a lot about it. The stories are heart-rending. The saddest thing is that it was the healthy, young people who died. There’s a long-winded medical explantion for it, but the stronger the victim’s immune system, the harder the lungs fought, filling with fluid and drowning its victim. Our local cemeteries are filled with whole families felled by it too. Oddly enough, no one in my family died from it and all my grandparents were toddlers then.
    Years ago when I first started doing family research, I found tables listing the dates of major epidemics in America. Terrible, we were so vulnerable to so many things. Medical science sure has come a long way, but with all the new mutated and drug resistant bugs out there, something like it could happen again. Some epidemiologists say it’s only a matter of time. I sure hope they’re wrong, we don’t have the community spirit to help each other pull through like they did back then.
    Your pictures are gorgeous, what a beautiful place to rest for eternity!

  • Reply
    Miss Cindy
    January 8, 2011 at 5:47 pm

    Tipper, my grand father had four sisters who all died at close to the same time. They were near 20 years old, give or take. Cause of death was reported to be consumption. I don’t know exactly when, but they all lived here in Western North Carolina. I believe consumption would have been either the flu or TB.
    My ideas of flu prevention are pretty simple:
    1. avoid crowds
    2. don’t get over heated, it lowers your resistance
    3. nasal saline
    4. a good attitude ( no excess negative emotion)
    5. a healthy immune system
    I’ve had flu once in my life and I don’t care for a repeat!!
    My mother had spinal meningitis as a child. I think it was a miracle she survived.
    Good and timely post. Thanks

  • Reply
    barbara gantt
    January 8, 2011 at 5:04 pm

    My Daddy was born in Nov.1918 in Waynesville. His familyall came down with the flu shortly after his birth. My Granny would tell the story of how they survived. There were 3 older girls in the family. So 6 of them living in a tiny house. They were so sick that no one could cook or get the water. Friends would come each day and bring food and water to leave on the porch. Whoever was strong enough would get up and bring the food in and help to feed the others. They wold put their dirty laundry in the yard.
    Someone would come and boil the clothes in a pot in the yard or burn them. They all survived and lived to tell the story. Of course, my Dad remembered none of it. He grew and was the only one that didnt get the flu. My Granny thought that it was because of the breast milk that he was getting. They are all gone now but when I hear people talk of the flu, I remember this story. Barbara

  • Reply
    Mike McLain
    January 8, 2011 at 4:33 pm

    In my genealogy research, I also have found evidence of what looks like a pretty sizable epidemic of either typhoid or scarlet fever in the late 1890’s in western NC (I lost my notes I made on that and don’t remember which it was). I know that my great-grandfather, Burgess Patton died in 1890 of the disease in what is now Clay County. I also found evidence that his mother had come over from Macon County to visit a sister of Burgess and contracted the same disease and died. His wife was Luola Penland Patton and after Burgess died, she contract the disease but survived, only to be hit by Spinal Meningitis. She never recovered emotionally from that and her mother had to come and raise her 4 children.
    There are others that I have read about in my family, all in the Clay County and Macon County area, that were either very sick or died from that disease (not the meningitis). I have heard about the 1918 influenza epidemic, but have found no family members who were affected by it.
    It certainly is true, though, that almost any illness that hit a family in those days could lead to fatal consequences.

  • Reply
    January 8, 2011 at 4:32 pm

    i have had it twice in my life, both time felt i might die. i can understand how so many died in the epidemic because they did not have the med we have or the understanding of it that we have. people still die from it, the very young and very old like me. we get our flu shots every year.
    airplanes and ships are notorious for spreading the germs and don’t forget the handles to the grocery carts. thanks for the reminder

  • Reply
    January 8, 2011 at 4:07 pm

    I first realised how vast the epidemic was when visiting Hard Shell cemetary in Tellico Plains,Tn. where my people are from. In that tiny mountian town in just that one little cemetary, 1918 was the death year from newborns thru adults in maybe 1/3 of the graves. I couldn’t understand why so many people had died in that year until my husband reminded me of the epidemic of that year. I’ve always wondered how the virus found it’s way in such out of the way/out of town places like Tellico & other off the beaten paths of the time.

  • Reply
    Sheryl Paul
    January 8, 2011 at 3:27 pm

    It is a horrible disease and still kills. I remember seeing the tombstones where my parents are buried of families that were wiped out during the epidemic. We also had the hurricane of 1928 that wiped out whole families. It affected both sides of my family, there is a book that came out many years ago called “Black Cloud” which relates the stories of two of my family members during this event.

  • Reply
    Vicki Lane
    January 8, 2011 at 2:52 pm

    Wonderful post, Tipper! I’ll remember it the next time I wander through an old graveyard. And I’ll bet the flu could make its way into a future story of mine…
    By the way, I always knock wood when making statements about the future.

  • Reply
    susan kinkki
    January 8, 2011 at 2:37 pm

    hey girl! what’s up with you and the fam? we are hangin in there. mark is still unemployed and getting a little bummed about it. second winter with him home with me…yikes.
    i have fallen in love with making socks and now aprons. i am working on my third and fourth pair of socks. plus three aprons not to mention all the quilting i need to do. infact, i am going down to the basement in a bit to load up the gammill and start quilting a quilt for our bed. i saw where mark tried to pull the quilts up and he ripped the binding completely off. this is a quilt that is over thirty years old and has been used alot. i still cannot bear the thought of throwing away. i want to cut away the bad parts and use as a batting for another quilt. the quilt i will be working on is a pretty double irish chain made from yellow rose fabric, using same for backing. i will do custom quilting on it. it should turn out real nice and NO i DO NOT have a stitch regulator, i am the stitch regulator. my machine was one of the first premiers they made so it originally came with the smalle bobbin. mark got me the larger bobin, new stand, and laser light. shuld of had them retro fit the stitsh regulator then, now it is +5,000 and that is way out of my range. well, take care and keep healthy. i get my flu shot every year and since i moved to the UP havent been sick one day. the tropics are not good for my lungs. will be scary about going to visit my grand daughter this summer. take care. susan

  • Reply
    kenneth o. hoffman
    January 8, 2011 at 2:28 pm

    Tipper: that ole proctor cemetery had plenty of my folks in it,i don’t know how many were the result of the 1918 flu,the sadist loss was Pansy belle Hoffman, my dads youngest sister,she was about 9 or 10 years, she had an inner ear infection ,she lingered for some time waiting for a doctor. my dad always said it was the worst event in his life. how great it is we have the medicine today , although the mountains had remedies that we could use now. k.o.h

  • Reply
    Jim Casada
    January 8, 2011 at 2:18 pm

    Tipper–The great flu epidemic which ravaged the mountains in 1918 was a mere precursor of what was to come, world-wide, in 1919. That international epidemic took more lives than the intense combat of World War I, although it is likely that poulations weakened by scant foodstuffs and four years of war contributed to the death toll.
    One also has to wonder if the 1918 strain of flu simply expanded and continued into the next year. As someone who revels in trekking trails to tombstones, I recall once seeing a group of seven graves in the corner of a cemetery. The mother, father, and their five children had all died within a week. Almost certainly it was flu.
    Of course in that time period there were other deadly communicable diseases–TB and scarlet being particularly deadly. An aunt and uncle I never knew died of the former while an aunt died of the latter and Daddy always says that one reason my Grandpa Joe was so “quair” was a bout of scarlet fever he suffered when he was a young man. Of course to me his eccentricities were a pure delight–he was just a boy trapped in an old man’s body.
    Jim Casada

  • Reply
    Matthew Burns
    January 8, 2011 at 1:06 pm

    My Grandmaw Mary’s brother, Okey Kile, died in the 1918 flu epidemic. He was the apple of his daddy’s eye and after Okay died, my great-great granddaddy Alfred was never the same. Granny said that back in those days, the flu epidemics came through every few years but I’ve heard her say that the 1918 one was the worst that she’d ever seen. In 1931, my granddaddy Alfred caught another strain of the flu and subsequently caught pneumonia. The pneumonia, coupled with the fact that he still had to work out in the weather if his family was to eat,killed him in Feb. of that year. Even as a little child, Granny was a stickler about if any of us got the flu that she’d personally nurse us back to health. Even in her advanced age, even the mention of somebody having the flu would remind her of her brother Okey who died in the flu epidemic of 1918.

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