Hirsch places the first authoritative influenza epidemic in the year 1173; Zeviani in 1293; Gluge in 1323; Schweich, Biermer and Ripperger in 1387; while Saillant, Thompson, Zuelzer and Leichtenstern accept nothing prior to the first pandemic of 1510 as being unquestionably influenza. It should be remarked here that opinion is not unanimous in every case as to the identity of all epidemics following 1510.
Hirsch concluded that there have been about eighty epidemics since that of 1173. Parkes states that in the fourteenth century there were six epidemics, in the fifteenth seven, in the sixteenth eleven, in the seventeenth sixteen, in the eighteenth eighteen, while in the first half of the nineteenth ten epidemics are on record.
Table I shows in brief review the occurrence of the more important epidemics since the year 1173. Like all similar summaries given in tabular form it possesses the disadvantage of telling only parts of the entire story, and those in only a very general way, but it will suffice as a resumé and for the emphasis of certain phenomena to which attention will be later directed.
Concerning the epidemic of 1889, it is usually stated that it had its origin in Bokhara in May of that year. As will be seen from the table influenza was present also in Greenland and the Hudson Bay territory in the spring of 1889. The possibility of simultaneous origin in at least two localities in that year will be discussed later. The epidemic remained in Bokhara until August of the same year, after which time it slowly traveled to Siberia where at Tomsk traces of the disease were observed with certainty in October. At that time it was also observed in the Caucasus and in European Russia. It appeared in Petrograd in October, 1889, and remained epidemic until December of that year. The spread of this epidemic throughout the world is indicated in the following table adopted from Leichtenstern:
Spread of Influenza in 1889–90.
| Month. | 1889–90. |
|---|---|
| First (October) | St. Petersburg, Moscow, Courland, Livonia, Finland. |
| Second | Berlin, Paris, Vienna, Sweden, Denmark. |
| Third | London, Holland, Belgium, Balkan States, North America. |
| Fourth | Capetown, Egypt, Honolulu, Mexico, Japan, Hong Kong. |
| Fifth | San Francisco, Buenos Ayres, India, Sierra Leone, Scilly Islands. |
| Sixth | Chili, Kamerun, Zanzibar, Basutoland, Tasmania. |
| Seventh | British Bechuanaland, Barbados. |
| Eighth | Gold Cost, Natal. |
| Ninth | Trinidad. |
| Tenth | Iceland, Madagascar, China, Senegal. |
| Eleventh | Kashmir, Katunga. |
Between the years 1889 and 1893 according to Leichtenstern there was no period altogether free from influenza. Here and there individual cases or small epidemics sharply localized were observed. In 1893 another epidemic appeared in many places and became quite widespread. There was not, according to this author, the definite geographic progression that had been observed in 1889. This was but a recrudescence, a lighting up from endemic foci remaining after the first wide spread. In the first half of 1893 there was a light spring epidemic, and in November of the same year a larger epidemic swept over the whole of Europe. The height of the latter was reached chiefly in December.
The influenza incidence subsequent to 1893 will be discussed later.
| TABLE I. | |||||
|---|---|---|---|---|---|
| Influenza epidemics previous to 1889. | |||||
| Date. | General features. | Site of origin. | Direction of spread. | Localities affected. | Rapidity of spread. |
| 1173 | Rather meagre description. | Unknown. | Described in Italy, Germany, England. | Not known. | |
| 1239 1311 | Described by Zeviani. Records not definite. Not generally accepted. | Described in France. | Invaded all of France. | ||
| 1323 | Mentioned by Hirsch, Gluge and Zeviani. Most believes it was a typhoid epidemic. | ||||
| 1327 | Mentioned by Zeviani, Hirsch and Gluge. Rather doubtful. | Described in Italy. | |||
| 1358 | Described by Zeviani. Not generally accepted. | Savoy, Germany, France, Catalonia. | |||
| 1387 | (Zeviani, Schweich, Gluge, Hirsch and Ripperger.) Characteristic description. | Italy. | Italy, France, Strasbourg, Southern Germany. | ||
| 1403 | A very short epidemic. (Gluge, Ripperger, Pasquier.) | France. | Described in France. In 1404 it invaded Flanders and Germany (Hirsch). | ||
| 1411 | Described only in Paris. Extent unknown. | Described only in Paris. | Described by Pasquier as in Paris. | ||
| 1414 | Characteristic description. | In Italy and France in February and March. In the Danube district between January and April. | |||
| 1427 | Very characteristic description. | Described in France. | |||
| 1438 | Cited only by Zeviani. | Described in Italy. | |||
| 1482 | Very limited description by Mezeray. | ||||
| 1510 | Widespread over all of Europe. | Malta (?) (Webster and Hancock report that it began in Africa). | Generally, from South to North. | Malta, Sicily, Spain and Portugal, Italy, France, Hungary, Germany, Holland, England, Norway. | |
| 1557 | All of Europe. | Conflicting information (Asia?). | General direction from South to North in Europe. | Asia, Constantinople, Sicily, Italy, Spain, Dalmatia, Switzerland, France, Netherlands, England. | 4 months from Italy to Netherlands. Sicily in June. Nimes in July. Italy in August. Madrid in August. Dalmatia in September. Netherlands in October. |
| 1562 1563 | Uncertain information. | Only small epidemics at most. | |||
| 1580 | True pandemic covering the Orient, Africa and Europe. | Orient (Hirsch) Africa and Malta (Pechlin). | From Asia to Constantinople and in Europe from South to North. | Orient, North Africa, Constantinople, Malta, Venice, Sicily, Italy, Spain, Hungary and Germany to the Baltic, Bohemia, France, Belgium, England, Denmark, Sweden. | France in May. Germany and Hungary in August. England and Rhine Valley in September. Saxony in October. |
| 1587 | Apparently quite localized. | Described in Italy and Germany. | |||
| 1591 | High mortality. Indefinite information. | ||||
| 1593 | Spread over a wide area in Europe. | Said to have commenced in Belgium, “following a violent earthquake,” and gradually extended over all the cities of Europe. | Uncertain. | ||
| 1626 | Local. | Described in Italy. | |||
| 1627 | In America. | Spread from North America to West Indies and Chili. | |||
| 1647 | In America (Webster). | ||||
| 1658 | Local. | England (?). | Described in England and in Treptow near Stettin. | ||
| 1675 | Over Western Europe. | Germany (?). | Germany, Hungary, England, France. | Germany in September, England and France in October and November. | |
| 1688 | Apparently localized in Great Britain and Ireland. | England(?). | Described only in England and Ireland. | ||
| 1693 | England and the adjacent continent. | Dublin(?). | Dublin, Oxford, London, Holland, Flanders. | One month from Dublin to London. | |
| 1709 1712 | A period of extensive endemics. | In 1712, onset in Germany. | 1712, spread from Germany to Holland and Italy. | Italy, France, Belgium, Germany, Denmark. | Six months from Germany to Italy. |
| 1729 | First epidemic said to have originated in Russia and first described as entering Europe from the Northeast rather than the Southeast. First spread. Pandemic period. | Usually designated as Russia (Moscow). F. Hoffman claimed to have seen the epidemic in Halle in February, 1729. | Russia through Sweden, Poland, Germany, etc. to Italy and perhaps North America. | Moscow, Sweden, Poland, Silesia, Austria, Hungary, England, Switzerland, France, Italy, Iceland. | Moscow in April, 1729. Sweden in September, England in November. Paris in December. Rome in February, 1730. |
| 1732 | Second spread. Pandemic period. | Over Europe and America. According to Pelargus it again followed the route from Russia through the North of Europe and then South. | Germany in November. France in January, 1733. Spain and Italy in February. | ||
| 1737 | Not generally recognized. | England, North America, Barbados, France. | |||
| 1742 1743 | Slow spread from Germany. Recurrences in Germany up until 1745. | Began either on the shores of the Baltic Sea or in single cities in Germany. | Occurred in Germany in Jan. and Feb., 1742, and then disappeared to reappear in Switzerland in the spring. | Germany, Switzerland, Italy, France, Holland, Belgium, England. | Germany in January, 1742. England in April, 1743. |
| 1757 1758 1761 1762 1767 | A period of related epidemics with complicated geographic pictures and without clear cut direction of spread. | Began either first in North America and spread thence to Europe or else began spontaneously in both hemispheres. | France, Scotland, America, Finkler states that in 1762 influenza first started in Germany and spread thence in a very irregular way over Western Europe. Gluge and Hirsch state that in 1767 the disease appeared simultaneously in Europe and North America. | Barbados, Germany, Austria, Hungary, Denmark, England, Ireland, Alsace. | Villalba states that the epidemic in 1767 had traveled over the whole of Europe in a period of two months. |
| 1775 1776 | Slow spread through Western Europe. | First appearances in Autumn of 1775 in village of Clausthal in the Harz mountains. | First spread to Vienna, and after a quiescence broke out in France and England and possibly spread to America and China. | Germany, Italy, Austria, England, Ireland, France. | Invaded Vienna in June. Made appearance in Italy in September. In England and France in October, November and December. |
| 1780 1781 | Western Europe and possibly Brazil and China. | January, 1780 in France. | Spread to Alsace, Germany and Italy, and in March reported in Rio de Janiero. Appeared in Sept. 1780 on Southern coast of China. | Three months from France to Brazil. | |
| 1781 1782 | One of the most widespread pandemics. Abundant literature. | China and perhaps India in Autumn of 1781 (Hirsch). English writers connect onset with occurrence of influenza in the British Army in India, Nov., 1781. Wittwer and others begin its history in Petrograd in January, 1782. | Through Siberia and Russia to Petrograd, Finland, Riga, Germany, etc. | China, India, America, Russia, Riga, Germany, England, Scotland, Netherlands, Ireland, France, Italy, Spain. | Moscow, January, 1782. Riga, February. Germany, March. England, April. Scotland, May. Ireland, France and Italy, June. Spain, August. |
| 1788 1789 | Throughout all of Europe. One year later in America. | Russia, in March, 1788. “Apparently independent origin in America in Sept., 1789.” | West and South. Spread in America in 1789 throughout United States from New York North and South and finally touching the West Indies, South America and Nova Scotia. Recurrences in single cities of U. S. in 1790. | Russia, Germany, Hungary, Denmark, England, Scotland, France, Italy, Switzerland. | Seven months required to cover this territory. |
| 1799 1800 | Local epidemic confined to Northeastern Europe. | Origin in Russia. | Spread West and South. | Russia, Galicia, Poland, Germany, Denmark. | |
| 1802 1803 | Local endemic outbreaks covering considerable territory which follow the last period by a quiescence of five months. There appears to have been an unassociated epidemic early in 1800 in China and one in Brazil. | First reported in France. | No clear cut direction. Recurrences until 1805–08. General dissemination throughout North America in 1807. | France, Germany, Italy, England, Switzerland, Central Europe. | |
| 1811 1815 1816 1824 1826 | Several epidemics in North America and to some extent in South America. | 1807, onset in Massachusetts in February. 1815, onset in Boston in September. 1824, onset in Boston in October. | Usually from New England West and South. | North and South America. | 1815, one month from Boston to New York, and five months to South Carolina and Brazil. 1824, three months from Boston to Georgia. |
| 1827 | Widespread epidemics throughout Eastern Russia and Siberia. | ||||
| 1830 1833 | Extensive influenza period made up of two or three pandemic periods. | China in January, 1830. | To Manila in September, 1830. Later to South Sea Islands and India. Appearance in Russia in October, 1830, with subsequent spread West and South and on to North America (Feb., 1832). | Entire earth. | Ten months from China to Russia. Four months from Russia to Germany. Two additional months through France, England, Scotland, Sweden, Belgium, Switzerland. Six months from Germany to Italy. |
| 1833 | Second pandemic in above period. | Probably Asia. | After an interval of one year Europe was again visited with an extensive plague which attacked the same countries in about the same order. | Europe. (America appears to have escaped this second epidemic.) | Petrograd in January. Berlin and Constantinople in March. Denmark and Sweden, France and Great Britain in April, Italy in May. |
| 1836 1837 | Third spread in above period. | Origin rather obscure, possibly in Russia. | West and South as previously. | Europe, Faroe Islands, Mexico,(?) India, Java. | Almost simultaneous invasion at Petrograd, Sweden, Denmark, Germany and England; Egypt, Syria, France, Ireland, Holland, and Switzerland one month later. Italy, Spain and Portugal yet another month later. |
| 1838 1847 | Every year in this period with the exception of 1840 showed, according to Hirsch, some local epidemic. | 1838, February; Island of Bourbon and Iceland. 1838, November; Australia and New Zealand. 1839, Abyssinia. 1841, Germany, Hungary, Ireland. 1842, Belgium, England, France, Egypt, Chili. 1843, Germany, England, Iceland, France, Siberia, the United States. 1844, Germany, England, Switzerland, Cayenne. 1845, Germany and Switzerland. 1846–1847, France, Russia, Constantinople, Brazil, England, Denmark, Belgium, Switzerland. | |||
| 1847 1848 | Epidemic period throughout Europe without clear cut direction of spread. | Origin uncertain. | Spread not definite, North America in 1848. | All of the countries of Western Europe, West Indies, New Zealand, Newfoundland, Sandwich Islands, Egypt, Algiers, West Coast of Africa. | |
| 1850 1889 | Epidemics covering larger or smaller territory every year, but none to compare in intensity with those of 1831, 1833, 1836 and 1847. | 1857, began in August in Panama and spread to West Indies and up and down the Pacific Coast. Prevailed in Europe in December. | 1850–51, particularly throughout the whole Western coast of South America with later spread to California & Europe. 1852, Australia, Tasmania, South America. 1853, Faroe Islands. 1854, Bavaria. 1855, Europe, spreading rapidly West and South from Petrograd. Later in same year, Brazil. 1857–58, widespread epidemic in both hemispheres. 1860–70, very irregular appearances in Australia, Tasmania, Philadelphia, the Bermudas, Holland, California, France, Switzerland, Africa, Germany, Belgium, Russia, Denmark, Sweden and Turkey. 1874–75, Extensive spread in America, Germany and France, with recurrence one year later in eleven areas of the United States. 1879, America. 1885–88, Re-appeared each year in Petrograd. 1889, (Spring) Greenland and Hudson Bay territory. (May) Bokhara in Turkestan from where the great pandemic of 1889–90 is usually said to have taken its origin. | 1855, only one month between Petrograd and Italy. | |
Table I shows that prior to 1510 the information was so limited as to be not entirely conclusive. We must rely upon the fragmentary descriptions of writers located usually in or near the intellectual centers who described the disease as they saw it in their city or country. We have no way of ascertaining what other countries were invaded, and we possess no method by which we may enumerate the “silent areas,” countries which in the absence of a chronicler have not been able to transmit their story.