Medical history moment

By Jacob Steere-Williams

A century ago, in the middle of September 1918, in Charleston’s Health Office, Dr. J. Mercier Green sat soberly staring at newly arrived reports from the Naval Training Station, The Citadel and Porter Military Academy. Influenza had arrived in Charleston and before it would leave over 6,000 Charlestonians were struck with the disease.

“Cases broke out shortly after cadets arrived,” reported Dr. Robert Wilson from Porter Military Academy, which was soon echoed by Dr. Cathcart at The Citadel, who wrote, “Cases broke out 3-5 days after arrival of Boys.” In the midst of World War One, just after news reached America about success at the Battle of Saint-Mihiel, Charleston’s future looked grim. Green took action.

Like many other public health officials around the country, Green put in place a ban on public gatherings — much to the disapproval of Charleston’s clergymen. For more than a month schools, universities, churches, theatres and other institutions of social gathering were closed in the hopes of starving out the spread of the most dangerous outbreak of infectious disease in modern history, the so-called “Spanish-flu” of 1918-1919. The pandemic killed somewhere between 50 to 100 million individuals around the world. Green’s anti-flu tactics were not unique and he was part of a movement that scholars call the “new public health.” Armed with new advances in laboratory-based bacteriology and an unbridled hope in the conquering of infectious disease, public health officials around the country employed the three pillars of the new system; identification, isolation and disinfection.

One of Dr. Green’s public health responses during the epidemic, however, was remarkably forward-thinking. Unlike today’s rigorous system of infectious disease reporting, in the late 19th century public health officials kept records of mortality (deaths) but not necessarily morbidity (sickness) figures. In the midst of the crisis, Green intuitively knew that if the health office was going to be of any help to Charlestonians, he needed to find out who in Charleston was sick with the flu, not just who had died.

What Green did, in October 1918, is one of the most noteworthy systems of disease surveillance in modern American history. He called upon the city’s physicians to send daily updates on who was sick, listing names and addresses. The reports came flooding into Green’s office, on everything from prescription cards to personalized notebooks; he received so many from late fall 1918 to early 1919 that they were pasted together in a book, detailing who in Charleston — rich and poor, white and black — was sick with the flu.

Today the archival record of Green’s epidemiological sleuthing can be seen at the Waring Historical Library. Labeled “MSS 292: Report of Cases of Influenza” it preserves as a powerful record of one of the deadliest epidemic in Charleston’s history and the mindset of one of Charleston’s most innovative medical leaders.


The Waring Library Society is a “friends of the library” organization that supports the mission of the Waring Historical Library. Named for Joseph I. Waring, Jr., its first director, the Waring Historical Library preserves rare books, manuscripts and museum artifacts documenting the history of the health sciences in South Carolina and the Southeast. To learn more about the Waring’s programs and events or to become a member of the society, please visit






Mercury newspapers can be found at the following locations:


Buxton Books

Caviar & Bananas

The Meeting Street Inn (Rack)

Clair's Service Station, Folly Rd. (Rack)

Harris Teeter, Houston-Northcutt Blvd. (Rack)

Mt. Pleasant Library, Mathis Ferry Rd. (Rack)

Pitt St. Pharmacy

The Square Onion, I'On (Rack)