Tuberculosis, Philately and the history of the ‘Christmas seal’

Paris: Comité National de Défense contre la Tuberculose; Quimper: Comité d’Hygiène Sociale du Finistère, [between 1930 and 1939?]. Image Credit: Wellcome Collection, CC BY.

Christmas has long been recognised as a time of charity and fundraising. Perhaps familiar to some is the ‘Christmas seal’ – a label placed on post over the Christmas period – to raise awareness and funds for charitable organisations.

Christmas seals fall into a category known as ‘cinderella stamps’: items that resemble stamps but cannot be used in payment for postage

While the Christmas seal concept has been adopted to raise funds for many different types of charitable organisations, they have most closely been allied to raising awareness of tuberculosis. According to a New York Times article, the concept originated in Denmark in 1904, when a Danish postal worker called Einar Holbøll came up with the idea to sell the penny seals to raise money for children with tuberculosis.

Other countries quickly followed suit with fundraising seals being produced to support tuberculosis causes in Sweden, Iceland and Argentina.

At the time, tuberculosis was still one of the major causes of death globally. And despite the discovery of the M. tuberculosis bacillus by Robert Koch in 1882, no effective treatment had been found. Organised national efforts to combat the disease were looking for means to raise awareness and financial support for the disease. These campaigns can be seen as some of the very first public health initiatives, in which the financial contributions of ordinary people were used to fund treatment of a disease.

Picture credit: W. Dibb Private Collection.

The first American Christmas seals were produced in 1907 by a Red Cross volunteer called Emily Bissell, who adopted the idea to help raise money for a tuberculosis sanatorium in Delaware that was under the threat of closure if a sum of $300 was not raised.

Although she could not get permission to have the U.S. national postal service to print and distribute the seals, as they had in Denmark, she was allowed to privately sell the seals in the post office lobbies. The seals were such a success they raised over ten times the amount needed and became an annual tradition that raised major funds for The National Tuberculosis Association (now known as the ‘American Lung Association’). The American Lung Association continues to sell their Christmas Seals™. Selling tuberculosis Christmas seals has also funded major disease prevention programmes in countries, such as Canada, through chest X-ray screening or tuberculin tests.

The Cross of Lorraine

National Tuberculosis Association, 1940. Image Credit: Wellcome Collection, CC BY.

Many examples of the Christmas seals created to raise funds for tuberculosis charities contain the symbol of the double-barred cross. Symbolically known as the ‘Cross of Lorraine’, it was adopted as the symbol of the fight against tuberculosis at the International Conference on tuberculosis held in Berlin, 1902.

A French doctor – Gilbert Sersiron – proposed the emblem which had been the banner of Godfrey of Bouillon, one of the leaders of the first Crusades who successfully laid siege to Jerusalem and became it first ruler. In adopting this Crusader symbol, the cross became a symbol of the new, organised anti-tuberculosis ‘crusade’.

 

Flora Malein

 

 

 

 

 

You can read more about postal items and infectious disease in a previous post, here

Sources used:

The New York Times: https://www.nytimes.com/1989/12/24/style/pastimes-stamps.html

The American Lung Association: https://www.lung.org/get-involved/ways-to-give/christmas-seals/history.html

The Canadian Lung Association: https://web.archive.org/web/20111115234620/http://lung.ca/involved-impliquez/christmas-noel/history-histoire/index_e.php

TB Alert: https://web.archive.org/web/20090302074617/http://www.tbalert.org/about/cross.php

John, Simon (2017). Godfrey of Bouillon: Duke of Lower Lotharingia, Ruler of Latin Jerusalem, c.1060-1100. Taylor & Francis. ISBN 978-1-317-126300.

https://wellcomecollection.org/works/msbjucxs

https://wellcomecollection.org/works/hdh9a7xw

The “Spanish” Influenza Pandemic of 1918-19

In this centenary year there have been several new books, articles and television programmes about the pandemic which killed between 50 and 100 million people worldwide.  Much of this writing, however, has been very America-centric, and has ignored the influenza that had been spreading in Europe from the autumn of 1916.  Although this version of influenza had a low penetrance, it had a high mortality due to the fact that 25% suffered what we now know to be a cytokine storm, so 20% died a very unpleasant death.  At the time it was not known what was happening – was it an infection, or some new poison gas produced by the other side?  Amongst the British it almost exclusively affected soldiers, but when they discovered that German and Austrian soldiers and civilians were badly affected, the conspiratory theory was discarded.  In UK there was a small outbreak in Aldershot, but it did not spread.  The bacteriologists could find no common organism and labelled it “purulent bronchitis”.  It was not until the 1918 pandemic, when it was noted that survivors of purulent bronchitis were immune to the influenza, that they realised they were looking at the same disease.  Sadly, no tissues or samples remain of this early manifestation.

By definition “Spanish” Flu started in the USA in March 1918.  This behaved in quite the opposite way to the purulent bronchitis.  The mortality of the first wave (March-early September) was no higher than normal influenza epidemics, but it was extremely infectious.  In the worst week, in July 1918, 46,275 British soldiers in France reported sick – they nearly overwhelmed the medical system.  It was during this time that the infection got its misnomer.  The warring nations did not wish to give any information to the enemy that might suggest that they had an increased rate of sickness, but Spain, which was neutral, had no such compunction.  This meant that our press was able to report an epidemic in Spain, and the name stuck.  The incorrect fact that it had started in Spain was believed to such a degree that when exploring the National Archives in Malta I came across the draft of a telegram from the Governor to the British Ambassador in Madrid demanding medical information.  This was sent in cypher.

National Archives of Malta, CSG 01 – 1033/1918

In September 1918 it appears that the two expressions of the influenza met and mutated in Étaples near Boulogne and created the  deadly 2nd wave which caused a huge death rate as it still had the high penetrance of the American 1st wave, but about 10% suffered the haemorrhagic cytokine storms.  The figures are frightening.  17 million died in India alone, Samoa lost 20% of its population.  In London 13,000 died of influenza (in 1912 the influenza deaths has been 535).

It must have been a horrendous time to be a doctor, struggling to understand why so many previously healthy young people were dying, and struggling to find places to nurse them.  Many factory buildings had to be converted into makeshift hospitals.  Let us all pray that we are able to contain the next severe pandemic.

Jane Orr