Max C. Starkloff
Max C. Starkloff | |
|---|---|
 Dr. Max C. Starkloff, c. 1900 | |
| Health Commissioner, St. Louis, MO | |
| In office 1895–1903 | |
| Preceded by | George Homan |
| Succeeded by | John H. Simon |
| Health Commissioner, St. Louis, MO | |
| In office 1911–1933 | |
| Personal details | |
| Born | Maximilian Carl von Starkloff December 30, 1858 Quincy, Illinois |
| Died | January 15, 1942 (aged 83) St. Louis, Missouri |
| Cause of death | pyelonephritis |
| Resting place | Bellefontaine Cemetery |
| Citizenship | United States |
| Political party | Republican |
| Spouse(s) | Mollie E. (Flynn) Starkloff, (1879-before 1900) Genevieve (Baldwin) Starkloff (c. 1903-his death)[1] |
| Children | Adele Marie (Starkloff) O'Madigan, Max Starkloff, Carl E. Starkloff, and Gene Baldwin Starkloff |
| Parents |
|
| Relatives | Irma S. Rombauer, half-sister, Max Starkloff, grandson |
| Residence | Carondelet, St. Louis |
| Education | Pennsylvania Military Academy |
| Alma mater | St. Louis Medical College |
| Profession | physician, surgeon |
Max Carl Starkloff (December 30, 1858 – January 15, 1942) was an American physician and the Health Commissioner for St. Louis, Missouri from 1895 to 1903 and from 1911 to 1933. He is noted for closing all public venues and prohibiting public gatherings of more than 20 people in October 1918 during the 1918 influenza pandemic. His actions are credited as being an early instance in modern medicine of social distancing.[2][3]
Family and early life
Maximilian Carl von Starkloff was born on December 30, 1858 in Quincy, Illinois, the third son of Hugo Maximilian von Starkloff and Hermine Auguste (Reinhard) Starkloff.[1] Starkloff later dropped the "von" to appear less aristocratic.[4]
His father, Dr. Hugo von Starkloff, was a German immigrant who served the United States Army as a surgeon before and during the American Civil War. He also was a U.S. Consul to Bremen, Germany.[1] Upon his arrival to take up his post, von Starkloff "landed in the middle of the cholera panic and sprang into action, setting up sanitary measures that kept the epidemic from reaching steamers bound for the United States."[4] This "presaged that of his son in the St. Louis influenza epidemic 25 years later."[5]
His half-sister was Irma S. Rombauer, author of the Joy of Cooking.[4] Max Starkloff, his grandson, was a disability rights activist.[4]
Starkloff attended public schools then attended the Pennsylvania Military Academy (now Widener University) in Chester, Pennsylvania. He received his medical degree from the St. Louis Medical College (now the Washington University School of Medicine).[1]
First tenure and the 1896 St. Louis tornado
St. Louis Mayor Cyrus Walbridge appointed Starkloff to his first term as the Health Commissioner of St. Louis in 1895.[6] He published a pamphlet on how to avoid communicable disease that year.[7]
The next year, the U.S.'s third most deadly tornado of record struck St. Louis, leaving up to a 3-mile-wide (4.8 km) swath of destruction in the urban core, and killing a couple of hundred and injuring a thousand more,[8] in addition to destroying 8,000 buildings.[5] The city's main hospital, City Hospital, was wrecked. Starkloff started to make his way to the hospital from his office at City Hall, when a falling pole knocked him over and broke his right arm. He improvised a sling and then traveled by ambulance to what was left of the hospital. There Starkloff took charge of recovery efforts despite his injury. It was not until after several hours of work that his broken arm was set.[5][9]
He successfully returned 17 prisoners to the city jail from the hospital's prison ward without incident, and setup a temporary hospital at a vacant convent until several years later when the construction of the replacement City Hospital was sufficiently complete.[5][9]
Starkloff's first tenure as Health Commissioner ended in 1903.[1][6]
Second tenure and the 1918 influenza pandemic
Reappointment and run for Mayor
St. Louis Mayor Frederick Kreismann[10] reappointed Starkloff as Health Commissioner in 1911.[1]
In 1913, Starkloff ran against fellow Republican Henry Kiel for Mayor and lost. Nevertheless, they remained on good terms.[11]
Influenza arrives in St. Louis
Aware of the incidence of the flu in New York in early 1918[12] and particularly in Boston that summer,[3] Starkloff began preparations for St. Louis. He requested that all doctors report each case of influenza to his office.[13] Starkloff then published an article on mitigating pneumonia, advising people to avoid the sick, crowds, alcohol, and fatigue, and to seek fresh air.[14] Although he believed the sick should self-quarantine, he did not yet think that action beyond that was necessary.[3]
In the first few days of October 1918, outbreaks of the pandemic flu began in Missouri. On October 4th, Springfield, Missouri had 130 cases.[15] The first case on the Jefferson Barracks Military Post, about 10 miles south of St. Louis, was reported on October 1st, and within a week there were 800 cases.[16]
Starkloff asked the Board of Aldermen for special powers, but Mayor Keil thought that no action should be taken at that time.[15] However, by October 7th, 115 influenza cases were reported in St. Louis,[15] and given the nearly a thousand cases at Jefferson Barracks, Starkloff thought that drastic action was necessary and prevailed upon Mayor Keil and the Board of Aldermen to agree to extraordinary measures. On October 8th they gave Starkloff the power to issue public health edicts. They also issued an order for October 8th to close down theaters and other public places, and prohibiting public gatherings of more than 20. The order also required schools to close on October 9th.[3][15] Although the St. Louis Health Department thought the pandemic under control, the effect of the flu pandemic soon peaked. Authorities recorded 559 flu cases and 32 deaths on October 18, 1918. By November 1st, the incidence had declined and Mayor Keil asked that restrictions on public gatherings be lifted, but Dr. Starkloff refused this for the first ten days on November.[15]
Armistice Day and the resurgence of the flu
Armistice Day occurred on November 11, 1918. Due to the public holiday, stores were closed, but public celebration occurred outdoors as the people St. Louis celebrated the end of World War I.[3] With the waning of the flu pandemic in St. Louis, Starkloff relented to the gradual reopening of public places.[15]
This proved to be premature, as there was a resurgence of the flu among the young. Schools had reopened on November 14th, but by November 28th Starkloff had them closed again and had banned those under 16 "from stores, including department stores, ten-cent stores, and theaters." Influenza cases peaked on December 3 at 1,467, and influenza deaths peaked on December 10th at 58.[15] By year's end, new cases had fallen to 50 a day. Starkloff ended restrictions on December 28th, and schools reopened on January 2, 1919.[3]
Effectiveness of measures
Starkloff's efforts to contain the incidence of flu had two major outcomes.
First, St. Louis had one of the lowest death rates from flu in the country.[3] Compared to Philadelphia which permitted a Philadelphia Liberty Loans Parade of 200,000 during the start of the flu pandemic there, St. Louis had half the per capita death rate.[17][18]
Second, Starkloff's intervention served to "flatten the curve." In comparison to Boston's incidence of the flu, which peaked with a death rate of about 160 per 100,000 about two weeks after the first cases, St. Louis had a peak less than 60 per 100,000 about six weeks after the first cases were reported.[16]
Later life and legacy
Starkloff's second tenure as Health Commissioner ended in 1933.[1]
After a decade-long chronic illness, Starkloff died at home of a subsequent bout of pyelonephritis on January 15, 1942.[19] That same year, St. Louis renamed City Hospital to the Max C. Starkloff Memorial Hospital.[5][20]
As modern day pandemics occur, Starkloff's social distancing precautions continue to be cited in both medical[15][16] and popular[17][18] literature.
References
- ^ a b c d e f g Marquis, Albert Nelson (1912). The book of St. Louisans; a biographical dictionary of leading living men of the city of St. Louis and vicinity. St. Louis, MO, US: St. Louis Republic. p. 569. OCLC 342643.
- ^ "How Public Health Policies Saved Citizens in St. Louis During the 1918 Flu Pandemic". bioMérieux Connection. 2018-10-25. Retrieved 2020-03-15.
- ^ a b c d e f g "St. Louis, Missouri and the 1918-1919 Influenza Epidemic". The American Influenza Epidemic of 1918: A Digital Encyclopedia. 2019-02-13. Retrieved 2020-03-15.
- ^ a b c d Cooperman, Jeannette (2015-08-20). "The Starkloff Family: Independent From the Start". St. Louis Magazine. Retrieved 2020-03-14.
- ^ a b c d e "Muench Medical & Cookbook Heroes". Muench Family Association. Retrieved 2020-03-14.
- ^ a b City of Saint Louis (1908), The Mayor's message with accompanying documents, St. Louis, MO, US: A. Unger & Co., Printers, p. 199, OCLC 41184094
- ^ Starkloff, Max C. (1895). "A circular on the means of preventing, avoiding and suppressing communicable disease". City of St. Louis Health Department. OCLC 1090292517. Retrieved 2020-03-15 – via HathiTrust.
- ^ "This Month in Climate History: May 27, 1896, St. Louis Tornado". National Centers for Environmental Information (NCEI). Retrieved 2020-03-15.
- ^ a b "Dr. Starkloff, 82, dies". St. Louis Post-Dispatch. St. Louis, MO, US. 1942-01-16. p. 7A. ISSN 2574-9498. OCLC 728712735. Retrieved 2020-03-15.
- ^ "St. Louis Mayors: Frederick H. Kreismann". exhibits.slpl.lib.mo.us. 2001. Archived from the original on 2004-09-25.
- ^ Jones, Mike (2020-01-19). "The St Louis Mayor From Lafayette Square - Henry W. Kiel". Lafayette Square. Retrieved 2020-03-15.
- ^ Billings, Molly (1997). "The 1918 Influenza Pandemic". Virology at Stanford University. Archived from the original on 2009-05-04.
{{cite web}}: Unknown parameter|name-list-format=ignored (|name-list-style=suggested) (help) - ^ "Doctors Here Must Report Influenza" (PDF). St. Louis Globe Democrat. 1918-09-20. p. 2. OCLC 832804369. Retrieved 2020-03-16.
- ^ Dr. Max C. Starkloff (1918-09-21). "Pneumonia Causes 10 Per Cent of Winter Deaths; How To Avoid It". St. Louis Post-Dispatch. p. 11. ISSN 2574-9498. OCLC 832807956. Retrieved 2020-03-15.
- ^ a b c d e f g h Belshe, Robert B. (Mar–Apr 2012). "A Century of Influenza Prevention in St. Louis". Missouri Medicine. 109 (2): 119–123. ISSN 0026-6620. OCLC 79502782. PMID 22675791. Retrieved 2020-03-15.
- ^ a b c McKinsey, David S.; McKinsey, Joel P.; Enriquez, Maithe (Jul–Aug 2018). "The 1918 Influenza in Missouri: Centennial Remembrance of the Crisis". Missouri Medicine. 115 (4): 319–324. ISSN 0026–6620. OCLC 7850378090. PMID 30228752. Retrieved 2020-03-14.
{{cite journal}}: Check|issn=value (help) - ^ a b Mounk, Yascha (2020-03-10). "Cancel Everything". The Atlantic. Retrieved 2020-03-15.
- ^ a b Roos, Dave (2020-03-11). "How U.S. Cities Tried to Halt the Spread of the 1918 Spanish Flu". HISTORY. Retrieved 2020-03-15.
- ^ "Standard Certificate of Death" (PDF). Missouri State Board of Health. 1942-02-24. Retrieved 2020-03-15.
- ^ "City Hospital. [Max C. Starkloff Memorial.] 1515 Lafayette Avenue". The Missouri Historical Society. Image by Joseph Hampel, 1946. Retrieved 2020-03-14.
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