Excuse me for being sniffy about ‘man flu’

Is any disease more widely derided than ‘man flu’? To those born with two X chromosomes, man flu is a figment of our imaginations, an excuse for XYs to wallow between the covers while soliciting endless cups of tea. Man flu, it is often claimed, is nothing more than a fancy word for a cold, or as the medical correspondent of The Times once put it, ‘a more respectable excuse for a few days off work.’ In other words, man flu is for wimps and not something a ‘real’ man ought to go on about.

Mr Punch in front of a fire eating gruel: ‘It’s no joke being funny with the influenza.’  Punch, circa 1891.

Mr Punch in front of a fire eating gruel: ‘It’s no joke being funny with the influenza.’
Punch, 1891.

Speaking as an XY and, I hope, a real man, such moralising has always struck me as unfair. For one thing, scientists have recently found that men have many more temperature receptors in the brain, meaning that we really may feel the fever that accompanies a cold more acutely than women. For another, it was not that long ago that male convalescents could expect care and sympathy rather than disparagement when, through no fault of their own, they found themselves laid up in bed with a pulsating head and a runny nose.  Paradoxically, this was particularly true of the late Victorian period when notions of what constituted ‘manly’ behaviour were more proscriptive than they are today.

For instance, during the waves of infection that followed the ‘Russian’ influenza epidemic of the early 1890s, it was presumed that far from being malingerers or somehow lacking in ‘pluck’, men who took to their beds with flu really were ill and should be encouraged to stay there. This was partly a reflection of the growing medical awareness in the 1890s that far from being a ‘trivial’ infection on a par with a common cold – which is how doctors had thought of flu at the beginning of the epidemic – flu was a very serious illness that carried a high risk of respiratory disease and relapse. Another factor was the growing recognition that flu was also a nervous ailment that could spark all sorts of peculiar psychogenic symptoms ranging from fatigue to depression and psychosis. But perhaps the biggest reason was the recognition that some male patients were particularly susceptible to repeat attacks. As The Times’s medical correspondent observed in 1895:

Whether it is that the sufferer from it was originally more susceptible than his fellows who escaped; or whether the disease, having once got a foothold, has thereby created a susceptibility which did not previously exist, the result is the same. The man who has had influenza once may expect to have it a second time and a third time and as often as it makes it appearance.

This sympathy for male convalescents had been heightened by the death of leading public figures, such as Queen Victoria’s grandson, the Duke of Clarence. Fondly known as ‘Prince Eddy’, Clarence had originally caught a ‘chill’ while attending the funeral of his cousin, Prince Victor of Hohenlohe, shortly after the Christmas of 1891. However, rather than taking the medical advice to rest, on his return to Sandringham in the new year Clarence had foolishly joined a hunting party on the royal estate, only to retire to bed early complaining of a headache and high temperature. Within days his chill had turned into flu accompanied by pneumonia. When a telegram announcing his death was posted on the gates of Marlborough House, the women’s rights campaigner, Josephine Butler, who a few year’s earlier had lost her own husband to flu, predicted the announcement was ‘an event that will call out all the nation’s sympathies’. She was right: Clarence’s state funeral prompted displays of mourning such as had not been seen since the death of his grandfather, Prince Albert, 30 years previously.

However, perhaps the event that did most to alter perceptions of male flu convalescents was the illness of the Prime Minister Lord Rosebery in the winter of 1895. Like Clarence, Rosebery had tried to carry on with his official duties when he would have been better off convalescing, only to collapse while attending a Liberal party banquet. The press was told he had suffered ‘a sharp attack of influenza’ and on his doctors’ orders he was removed to his country house at Epsom. But rather than making a rapid recovery, Rosebery began to complain of fatigue and insomnia. Unable to sleep and with his writing hand mysteriously paralysed so that he could not compose letters to Queen Victoria, he spent six weeks laid up in bed, leaving his Cabinet colleagues to get on with the job of running the country. If ever there was a case of man flu this was it. Indeed, Rosebery’s doctor, Sir William Broadbent, searched in vain for a convincing diagnosis, finally settling on ‘long-continued derangement of the digestive organs’. Meanwhile. Rosebery’s friends speculated his illness had been brought on by depression following the death of his wife, Hannah de Rothschild, five years earlier, coupled with the stress of trying to unite his warring Cabinet colleagues.

Today, one can only imagine the sort of jokes should Messrs Cameron and Clegg find themselves laid up in similar circumstances. But to judge by the newspaper reports of the day, there was nothing but sympathy for Rosebery. As the correspondent of the St James’s Gazette put it, ‘We are very sorry, indeed, politics apart … that [Rosebery] is still to be regarded as an invalid, suffering badly from that nervous prostration which is one of the most distressing of our modern maladies’, while the Daily News argued that  ‘the very same sort of thing would have happened if he had been a butcher, or a baker, or a candlestick maker. Any member of those respectable occupations might have been caught by influenza.’

This shift in attitudes to male flu convalescents in the 1890s can be seen most clearly in cartoons in the Victorian comic weeklies. Thus whereas at the beginning of the Russian epidemic, magazines like Punch portrayed flu convalescents as hypochondriacs, as the respiratory and nervous dangers of flu became better known there was a volte face. A good example came in 1898 when Moonshine published a cartoon making fun of a stoical businessman named ‘Mr Brown’. In the first three panels Brown is shown dismissing flu as a joke. Influenza, he insists, is simply ‘an old-fashioned cold’. ‘Why, if anyone sneezes or has a little pain in their big toe, they think they have influenza.’ After contracting the disease himself, however, Brown changes his tune and in the last panel is shown quaking at the thought that having had flu once he is ‘bound’ to get it again. The cartoon is pointedly captioned: ‘The man who did not believe in influenza’.

By the middle 1890s, Harley Street doctors specialising in the treatment of neurasthenia were constructing the ‘nervous sequels’ of influenza in similar terms, further destigmatising the diagnosis. As the eminent Victorian throat surgeon, Sir Morell Mackenzie, observed, while at the beginning of the epidemic doctors had regarded flu as merely ‘a convenient means of escape from troublesome engagements’, by 1891 this was no longer the case. Influenza was a ‘powerful nervous poison’ with a capacity ‘to run up and down the nervous keyboard… stirring up disorder and pain in different parts of the body with what almost seems malicious caprice’. The ‘really dangerous time’, he warned, came when the patient thought he was over the worse, hence the importance of dissuading the ‘busy man’ from resuming his avocation before he had fully recovered.

With another flu season upon us that is advice that XXs – and my wife in particular – would do well to take on board. Don’t get me wrong: I can take a joke as well as the next man. But there are occasions when a sniffle really ought not to be sniffed at.

This post is adapted from my new book, which is published on 1st November.

This post is adapted from my new book, which is published on 1st November.


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