Hugo Maximilian von Starkloff was the father of Maximilian Carl Starkloff. Both were physicians.

Muench family tied to father-and-son physician heroes
By Karl Muench, M.D.

As a third-year medical student at Washington University School of Medicine in 1958, I spent many days and nights learning clinical medicine on medical and obstetrical wards at St. Louis City Hospital No. 1, called Max C. Starkloff Memorial.

At that time, I did not know who Max C. Starkloff, M.D., was, nor why the hospital was named in his honor. Nor did I know of his connection to the Muench family. Later I learned that he was the hero of the 1918-1919 influenza epidemic as health commissioner for St. Louis.

Dr. Maximilian Carl Starkloff (1858-1942), whom I shall here call Dr. Max Carl, was a son of Dr. Hugo Maximilian von Starkloff  (1834-1914), whom I shall here call Dr. Hugo Max. Dr. Hugo Max was born in Germany and educated in Tuebingen, Heidelberg, and Prague, receiving his medical doctorate in 1852. He immigrated to the United States, and served in the Civil War as a surgeon and as medical director of the 1st Division of the 7th Army Corps.

In 1889 President Benjamin Harrison appointed him as American consul in Bremen. There in 1893 as a diplomat, he had the unusual distinction to function as a physician in preventing the spread of a cholera epidemic that had started in the neighboring city of Hamburg. The action of Dr. Hugo Max to stem the cholera epidemic in Germany presaged that of his son in the St. Louis influenza epidemic 25 years later.

Although Dr. Hugo Max received full recognition for aborting the epidemic, he was supported by the legendary Dr. Robert Koch, whom the German government had recruited to help. Dr. Koch, the founder of modern bacteriology, had discovered the causative agents of anthrax, cholera and tuberculosis. His anthrax work was the first to prove the germ theory of disease. Before his studies, tuberculosis was thought to be an inherited disease, and for his illumination of tuberculosis, Dr. Koch was to receive the Nobel Prize in Physiology or Medicine in 1905.

The bulk of Dr. Hugo Max’s career was as a distinguished St. Louis surgeon and professor of surgery.  In evidence of his versatility in public service, for more than 15 years he was director of public schools in St. Louis.

Dr. Max Carl

Dr. Max Carl pursued his medical education in St. Louis and received his medical degree there in 1881. In 1895 he became health commissioner, and in that role achieved his first hero status for his selfless actions with a broken arm, aiding patients at the City Hospital (later to be named for him) in the aftermath of the 1896 tornado that devastated St. Louis, taking 140 lives, injuring 1,000, and destroying 8,000 buildings. But his greatest professional achievement came 23 years later in the influenza epidemic.

Tim O-Neill of the St. Louis Post-Dispatch gave this description (the date is unknown):

ST. LOUIS – In October 1918 the meat grinder known as World War I was lurching to its exhausted conclusion in

the Argonne forest. Another even bigger killer was just getting started. The 1918-19 influenza pandemic, known to history as the Spanish flu, was racing across the world. Estimates of the flu’s worldwide toll range from 25 million to 50 million deaths, including 675,000 in the U.S. The numbers overwhelmed the butchery of four years of ghastly trench war, which managed to kill about 8.6 million, including 116,000 American doughboys.

In St. Louis a strong-willed doctor moved quickly, drastically, and successfully to limit the horror. He was Dr. Max C. Starkloff, then in the 15th of his 30 years as city health commissioner. He prevailed on Mayor Henry Kiel to let him order the closing of almost all public places, including churches, schools, dance halls, fraternal lodges, theaters – even open-air funerals. His proclamation said that “Spanish flu is now present and probably will become epidemic in St. Louis.”

The Liberty Loan Organization canceled its rallies. Washington University football players wore masks in practice.

St. Louis police officers were told to forgo arrests on petty cases, the better to reduce court docket calls. Starkloff issued his order on Oct. 7, 1918, only three days after the first reported case of influenza in the city. But there already had been two flu deaths among the soldiers just south of the city at Jefferson Barracks, where the hospital population was 800 and growing quickly.

Starkloff’s strategy was “social distancing,” the simple practice of keeping people away from one another. During the brief but deadly sweep of the flu that fall, the death rate in St. Louis was 2.8 per 1,000 residents, lowest among the nation’s major cities. The rate was 8.0 in Pittsburgh, 7.6 in San Francisco and 7.1 in Kansas City.

Businessmen whose sales plunged beseeched City Hall to loosen the rules. Catholic Archbishop (later Cardinal) John J. Glennon urged Starkloff to reopen the churches. But the son of a German-born doctor held firm and had the trust of Mayor Kiel, who told Starkloff, “I don’t want anyone to die. Therefore, I shall support you.”

On Nov. 11, Armistice Day, Starkloff let downtown stores sell American flags, but only outside on the sidewalks. He allowed the schools to reopen a few days later and lifted the last of his ban on Nov. 18. Near month’s end, Starkloff closed the schools again for a short time. Deaths continued, even spiking in December. But the number of new cases fell. The virus worked quickly through its victims, then faded. It had infected 31,500 people in St. Louis and killed 1,703.

Starkloff retired in 1933 and died at home in Carondelet in 1942 at age 82. Shortly after his death, a grateful city renamed its City Hospital just south of downtown in memory of him.

Editor’s Note: The St. Louis City Hospital complex was abandoned in 1989. After the site was cleaned up, the City of St. Louis sold the complex to a private developer. For more information, see the following PDF form located on the Missouri Department of Natural Resources website: http://www.dnr.mo.gov/env/hwp/bvcp/docs/St%20Louis%20City%20Hospital.pdf

Hugo Max's daughter writes best-selling cookbook

Sister of "Joy of Cooking" Author Irma Rombauer Becker married to Muench

A daughter of Dr. Hugo Max, Irma Louise Starkloff Rombauer (1877-1962), became famous as the author of the nation’s best-selling and most enduring cookbook, The Joy of Cooking.  This writing is heavily indebted to the marvelous biography of Irma and her daughter, Stand Facing the Stove, by Anne Mendelson. Irma’s sister, Elsa Starkloff (1876-1918), was the wife of Julius Thamer Muench (1875-1950), a distinguished St. Louis attorney and grandson of Friedrich Muench (1799-1881).

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