…The 1918–1919 influenza pandemic taught public health experts a complex and contradictory set of lessons. On the positive side, the pandemic seems to have diminished the appeal of atmospheric theories of infection. Although some commentators continued to mention weather conditions as a variable in the disease's spread, the Spanish influenza confirmed the importance of droplet and contact infection. As William Osler was credited with observing, the flu never traveled faster than modern transportation, confirming that it was human bodies and not some ethereal atmospheric force that spread it.45 Natural experiments, such as the flu's introduction into San Quentin prison, enabled a clearer understanding of the contingent nature of infection; at the prison, the peaks of the illness followed nights that the inmates had gathered to watch a movie (and likely without benefit of handkerchiefs).19
…During the pandemic, another, more common alternative, namely the cloth handkerchief, came to fill a similar function. Although the gauze mask received the greater degree of publicity, the handkerchief got an equally big boost from public health authorities. Starting in September 1918, public health officials urged the public to use their hankies as cloth shields when coughing or sneezing. This message appeared in the first influenza precautions issued by Surgeon General Rupert Blue and was repeated by local health departments throughout the remainder of the epidemic.45The City of Chicago even passed a law making people who coughed or sneezed without using a handkerchief liable to arrest.46 Likely one big reason for the emphasis on handkerchief use was its ease of practice. Compared with gauze masks, which were expensive to buy and uncomfortable to wear, the cheap, easily washed handkerchief was a good substitute. But for very poor Americans, even a handkerchief, much less a frequently washed one, represented a luxury.
…With even greater zeal, interwar advertisers carried on the work of promoting personal hygiene by invoking the fear of influenza. Timed to run during cold and flu season, advertising promotions of mouthwash, cough drops, and tonics reminded their readers that “a cold may be something far more dangerous.”58 For example, the 1929 ads for Listerine® alerted readers to the dangers of “street car colds,” using illustrations of men sneezing while using public transportation.59 When in the late 1920s, consumers began to use paper tissues—originally marketed to remove cold cream—as disposable handkerchiefs, advertisers quickly began to promote this usage of the product. Ads for disposable tissues in the 1940s and 1950s featured mothers training their sons to manage their “man sized sneezes.”60
