Appalachian Medicine

Thinking of the 1918 Flu Pandemic

old medicine bottles on shelf

Brasstown felt the effects of COVID-19 in a huge way last week. Thankfully, no one has the virus, but due to an abundance of caution the Folk School decided to suspend classes, dances, concerts, and events until April 18. You can read more about their decision here.

All the discussion about the spread of the virus set my mind to thinking about the great flu of 1918.

I remember learning about the 1918 pandemic in school. I believe it was in a middle school history class. When I was well into adulthood two things made the stark reality of the event come alive for me.

One was my own bout of the flu in 2009. I truly thought I was near death’s door more than once during my illness. As I laid on the couch and suffered I wondered how in the world people survived before having access to fever and cough medicine.

The other event was visiting the Proctor Cemetery for the first time and noticing the headstones of family members who died within days of each other from the flu.

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

“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.


Some of the advice given by the NC Board of Health is similar to the advice they are giving today about social distancing.

Unless folks lived in cities or towns I doubt they would have even heard about the bulletin much less read it. While in today’s world we can follow the hourly progress of COVID-19 as it reeks havoc in most areas of the world.

Drop back by tomorrow to hear from a survivor of the 1918 Flu Pandemic who lived just over the mountain from me.


hand holding apple

Come cook with me!

Location: John C. Campbell Folk School – Brasstown, NC
Date: Sunday, August 23 – Saturday, August 29, 2020
Instructors: Carolyn Anderson, Tipper Pressley

Experience the traditional Appalachian method of cooking, putting up, and preserving the bounty from nature’s garden. Receive hands-on training to make and process a variety of jellies, jams, and pickles for winter eating. You’ll also learn the importance of dessert in Appalachian culture and discover how to easily make the fanciest of traditional cakes. Completing this week of cultural foods, a day of bread making will produce biscuits and cornbread. All levels welcome.

Along with all that goodness Carolyn and I have planned a couple of field trips to allow students to see how local folks produce food for their families. The Folk School offers scholarships you can go here to find out more about them. For the rest of the class details go here.

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  • Reply
    March 18, 2020 at 7:57 pm

    Gotta get your immune system built up 3 things elderberry elderberry elderberry, and if you do get it read this showing good results, can’t hurt,

  • Reply
    March 18, 2020 at 11:22 am

    Tipper, every time someone says “it’s just like a bad case of the flu” I think “there’s a person who never had a bad case of the flu.” Like you, I once was so ill with flu that I truly understood how people die from it. Good gracious.
    (Also, of course, CORVID-19 is NOT “just a bad case of the flu.”)

    • Reply
      March 18, 2020 at 4:40 pm

      Just realized I typed corvid instead of covid…I’m more used to writing about crows, I guess!

  • Reply
    Robyn Seamon
    March 18, 2020 at 8:40 am

    Thanks so much for sharing Tipper! I never heard any personal stories from the 1918 flu epidemic. It sounds eerily similar to what is going on now. For the most part, I think we have thought we would never experience anything like the plagues and flu that we studied about in History classes. Now it is very close at hand. I pray when it is all over, that it won’t be as devastating!
    Please everyone be extra careful with all the safety measures we have been told about over and over the last few weeks. This is what we have control over!

  • Reply
    Kat Swanson
    March 17, 2020 at 10:53 pm

    My head is full of the sad stories of loss and tales of survival told to me by my elders in wise co. Va. about the spanish flu….it will take lots of APPALACHIAN TENACITY FOR US TO GET THROUGH THIS FLU… fight like they did.

  • Reply
    March 17, 2020 at 8:27 pm

    My Daddy was born in the Ouachita Mountains of Arkansas in 1918. My grandfather caught the flu and recovered, but three of his brothers (my great-uncles) from teenage to mid 20’s did not. It was a devastating time for the family, especially for the two young widows with little children.
    The bulletin from the NC Dept of Health posted here is eerily familiar as we are waking up to the current Breaking News. Take care, everyone!

  • Reply
    March 17, 2020 at 7:21 pm

    Tipper, I caught the flu in 2018 and it was awful. I was out of work for a month. I also had a UTI on top of the flu. Thanks Tipper for all the good tips. Lets pray the Good Lord will watch over us all.

  • Reply
    Ken Roper
    March 17, 2020 at 6:07 pm

    When my girls heard about the Coronavirus, they both agreed that they wished they were more like daddy. One of them said “you’re not afraid of anything”. They’ll get that way too as they get older. But I am afraid of the hard winds, just when they are here I try not to show it.

    My youngest girl and her husband came up Saturday and got me a bunch of things I needed. Both of them had been talkin’ on the phone. Jennifer convinced Laura to let her come and help daddy during this epidemic. Anyway, Jennifer is closer by over a hundred miles. Lauralea lives at Chapel Hill with her two girls and Steve. Jennifer is near Warm Springs, Ga., at Pine Mountain, and all her girls are grown. One of the twins, Keva is expectin’ in a few weeks. She calls the twins, Keva and Kaysha.

    As one of Trump’s doctors says, “Now it’s time for the Millaneouls to take Care of the Greatest Generation.” …Ken

  • Reply
    Bill Burnett
    March 17, 2020 at 5:36 pm

    My paternal Grandfather’s brother was in the Army and came home on leave, the whole family gathered to visit, immediately upon return to base he was hospitalized with the Spanish Flu, within a shot period the rest of the family became ill my Great Grandmother was pregnant and had a son who was one, My Great Grandmother gave birth to another son on December 18, 1918 who died the day he was born, his mother died December 19, 1918 and her one year old son died December 22, 1918. Luckily her Husband and eight other children survived. A cousin of mine whose Grandmother (my Greataunt) worked for the CDC published an article about the Spanish Flu Pandemic which is available online.

  • Reply
    Miss Cindy
    March 17, 2020 at 5:07 pm

    We need to all be very aware how dangerous this virus is and stay careful and healthy!

  • Reply
    Brenda Schlosser
    March 17, 2020 at 3:50 pm

    My maternal grandparents were a very young married couple with a baby boy during this time. All three had the flu. My Granny told me she and my Grandpa were so sick they couldn’t take care of the baby the way he needed. They did the best they could, but the baby didn’t survive. She never quite got over his death because she felt she was to blame. She and my Grandpa were near death themselves. They couldn’t attend his funeral. When they recovered, my Grandpa carved a stone for the baby’s grave. It was later replaced with a headstone. Stay well, Tipper.

  • Reply
    Paula Rhodarmer
    March 17, 2020 at 1:35 pm

    My grandmother and grandfather were survivors of the flu of 1918. They had homesteaded in Jackson, Wyoming but had moved into town for the winter. I remember her face and the sadness in her voice as she told me about that time. She said she had two small children and she worried most about them. She told my daddy and his sister as much about the sickness as she thought they could understand. She told them if she or their daddy got sick that she would leave a large pan of cornbread for them to eat on and that they must not leave the house for any reason. Her husband got sick first, and was only slightly conscious very soon after. She prepared the large cake of cornbread and brought water in for the kids to drink. Then she came down with it shortly after. For days both she and her husband hardly knew they were alive. Neighbors brought food to the door, or left in on the doorstep. Somehow, by God’s grace, my grandparents both pulled through. My grandmother told me that as she recovered in bed, she watched the wagons with bodies on them pass her house as they went down the road to a common burial plot. My daddy was too young to remember any of this, but my grandmother never let him, or me, forget the hardship everyone faced that autumn in 1918.

  • Reply
    Hank Skewis
    March 17, 2020 at 1:34 pm

    Evveryone please use caution and common sense and stay healthy!

  • Reply
    Ethelene Dyer Jones--one of the few left who knew Byron Herbert Reece in person!
    March 17, 2020 at 12:52 pm

    Tipper and all my friends on “Blind Pig and the Acorn”: Let us maintain all the precautions urged for this CoronaV-19 Pandemic. We live in a dangerous time. Let us love each other, pray for each other, and use good health measures and good old-fashioned mountain common sense to help us live through this pandemic. God bless.

  • Reply
    March 17, 2020 at 11:40 am

    Appalachia is known for deep devotion to family and roots. Growing up I heard enough about relatives who had long ago passed to feel I knew them. Such is the case with my maternal great grandmother, Mariah Lester. She had a houseful of young children, and after doing genealogical research I found one was just an infant. Even the remote mountains of Wyoming County, West Virginia did not protect this young Mother from the great flu pandemic of 1918. She had previously lost one child, Polly Ann, who had turned a tubful of boiling wash water over on herself while helping with the family laundry. Polly was only 10, and she had been buried in 1910 with only a simple fieldstone to mark her grave. When choosing a site for the burial of Mariah, her husband William Floyd “Little Floyd” placed her right beside Polly. Census showed he took the two smallest girls to live with his own parents to help. They were elderly and had already raised a huge family, so neither of the little girls made it to adulthood. The rest were boys and scattered about with other family they all seemed to fare very well. One would later be awarded the Navy Cross in WW11. I was fortunate to have met some of them, and they had a tremendous jolliness and sense of humor. My Uncle later paid for individual stones with names to mark the little row of children, and I was able to go visit the cemetery with him last year. It was said one cemetery had three in one day who succumbed to the flu, and the hill was later called Graveyard Hill.

  • Reply
    March 17, 2020 at 11:29 am

    Mama said her mama took care of the sick during the 1918 flu, but did not get it herself.

  • Reply
    March 17, 2020 at 10:42 am

    Tipper I am with you remembering how bad the flu can be…as I had a very bad case back in the 70’s…I’ve had the flu other times some rough episodes some not, sure know it can get deadly. I remember the Hong Kong Flu in 1968, they wouldn’t let anyone visit patients in the hospital unless they had a a certain name tag. All restaurants closed here except for carry out or drive through…we had Sunday’s church service on-line, and the grocery stores …whew! The youngers are helping the olders stay in by getting groceries or meds for them especially those with medical issues already. Things can sure change suddenly .

  • Reply
    Ed Karshner
    March 17, 2020 at 9:39 am

    1918 looms large in Chillicothe Ohio where I was born. Camp Sherman was on the outskirts of town and the Spanish Flu devastated Ross County. There are so many ghost stories about the epidemic. The most well known is about the Majestic Theater becoming a makeshift morgue and the adjacent alley becoming known as “Blood Alley.”

    I had just started a novel about Chillicothe in the 1920s and the aftermath of the outbreak. Right now, I’m occupied enough with pandemics and may look to something else!

    Stay safe and healthy everyone.

  • Reply
    March 17, 2020 at 9:25 am

    The advice given by the NC Board of Health hasn’t changed much in the past 102 years. Praying that people will follow the advice until the current virus pandemic is under control.

  • Reply
    Doug Bishop
    March 17, 2020 at 8:35 am

    Yes, there are a lot of small graveyards where the headstones are dated from 1917 to 1919. nearly all victims od Influenza.

  • Reply
    Ron Stephens
    March 17, 2020 at 8:27 am

    My wife’s great-grandfather’s first wife and their 12 year old son died within three days of each other of – we suspect – the ‘Spanish flu. They were buried together and both names were etched on one stone. (Genealogists shorthand this as OSSW meaning “on same stone with”.) Over the years since, that has caused a lot of confusion with people thinking it was husband and wife.

    This is a thought-provoking time for sure, a time to “look at our hole card” and think about who and what we rely on.

  • Reply
    Don Byers
    March 17, 2020 at 7:09 am

    I believe more troops died from flu and pneumonia in WWI than died from war…..I may be wrong but I think that is correct.

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