The early twentieth century was a major turning point for medicine. New treatments and new vaccines were becoming available. New understandings of how disease spread and how the human body worked were being uncovered. And it was starting to become easier to spread this information to the general public how they could better take care of themselves and prevent illness. This time period also saw two of the greatest public health crises of the century: the millions of wounded of World War I and the Spanish Flu Epidemic. Dr. Rupert Blue, the Surgeon General at the time, would lead the effort to preserve the health of the public with these great tests.
Blue was born in North Carolina in 1868 and was raised in South Carolina. His father, an attorney, encouraged him to pursue a legal career. Blue said he never liked the law and wanted a career in medicine instead. When his father died, he felt he could go his own direction. In 1889, he enrolled at the University of Virginia as pre-med major. He ultimately earned his medical degree from the University of Maryland in 1892.
He joined the Marine Hospital Service in 1893, which later became the Public Health Service. His early dealt specifically with sanitation issues. He worked to clear out rat infestations in major cities to stem the spread of disease. As a result, Blue created the Public Health Commission of California in 1903, serving as its first president. In 1905, he spent several months in New Orleans organizing mosquito eradication efforts.
President William H. Taft named him as the nation’s fourth Surgeon General in January 1912. Blue changed the focus of the Public Health Service toward research, disease eradication, and educating the public about new medicines and how to better preserve their own health. In 1916, fellow physicians named his president of the American Medical Association, a position he served in for the next year.
Before World War I, most of the deaths of soldiers were caused by disease. When the nation entered the war in 1917, Blue directed efforts to ensure that military camps were free of pests, clearing out swamps, and ensuring that enough vaccines were produced to protect the troops from diseases such as diphtheria, tetanus, or smallpox. Congress directed the Public Health Service to provide services for disabled veterans as well, the beginnings of the federal veterans administration hospitals.
At the same time as the military and the Public Health Service planned for the health care needs of returning veterans, the outbreak of the deadly Spanish Flu Epidemic seized the attention of the nation and the world in 1918.
Blue recommended a good diet and covering the mouth and nose when sneezing or coughing but also emphasized what has become known as “social distancing” in 2020: avoiding crowds and wearing masks. His advice was published in newspapers across the country. The Red Cross made 260,000 surgical masks and many cities closed bars, restaurants, and schools, including across Texas. Some cities banned access to public transportation for those who refused to wear a mask.
There were some who tried to take advantage of the chaos and fear and started trying to sell fake cures and lie about made-up treatments that did nothing. Blue responded, “The Health Service urges the public to remember that there is as yet no specific cure for influenza and that many of the alleged cures and remedies now being recommended by neighbors, nostrum vendors and others do more harm than good.” In fact, a flu vaccine would not be developed until the 1930s.
Still, there were some Americans who ignored Blue and insisted the threat from the pandemic was exaggerated and even protested wearing masks. Nevertheless, more than 500,000 Americans died from the flu. Thousands of Texans died.
As the flu epidemic began to fade by late 1919, Blue urged the federal government to prepare for future epidemics. He proposed strengthening the National Health Service and endorsed the idea of a national health insurance system to ensure everyone could afford access to health care.
Blue stepped down from his position as Surgeon General in March 1920. He remained active in public medicine, serving three years in Europe to help coordinate health care for a Europe still recovering from the devastation of World War I and worked with international organizations on the issue of public health.
He retired in 1932 and returned to South Carolina, settling in Charleston. He died at age 79 in 1948.