1793 Two Hundred Years Ago

In early August cases of “malignant fever” broke out among Philadelphlans along the city’s waterfront. Like the last epidemic, thirty years before, it would turn out to be yellow fever. By August 19 Dr. Benjamin Rush knew that an epidemic was under way and felt certain (wrongly) that its cause lay in rotting coffee left on the Bell’s Arch Street wharf in July by a Santo Domingan sloop, the Amelia . The spoiled coffee’s effluvium had permeated the air around the docks, Rush theorized, conducting the hated fever into the lungs of waterfront residents. When he consulted with two of his colleagues about the symptoms they were seeing, the meeting was reported in the local newspapers as confirmation of a city health crisis. “I have not seen a fever of so much malignity, so general,” he wrote to Dr. James Hutchinson on August 24, “since the year 1762.” Dr. Rush stood apart from many of his peers in his belief that rotten coffee was the agent and in his prescription: he was a purge and bloodletting man.

On August 22 the mayor of the capital city, Matthew Clarkson, drew his own conclusions and directed removal of all sitting garbage in hopes it would slow the disease’s spread. Some people preferred to believe that Santo Domingans had slipped into town on the Delaware River, bringing the contagion with them. Most of the city, though, had settled on a theory that didn’t blame damaged coffee or shadowy refugees or the city’s cleanliness. A packed French merchant ship, Sans Culottes , had reached Water Street in July, and reports of its squalid cargo became dirtier by the day.

The fever usually killed quickly, taking the victim from headache to nausea, stupor, black vomiting, incontinence, fever, yellow eyes and skin, and, finally, death within a few days. Philadelphia went from being the crowded nation’s capital to a near ghost town in a matter of months as thousands fled the city. The fever killed 160 in the first three weeks of August; nearly 600 more were dead by mid-September; 1,000 died in September’s last two weeks. In October, when most people hoped that cool weather and rains would slow the epidemic, two thousand more died instead.

In all of this the real heroes were the city’s French-trained doctors and black volunteers who did most of the carting of the dead. The disease took some time to reach Philadelphia’s black neighborhoods, and in the first weeks of the crisis African-Americans were thought to be immune to the killer. At a time when much of his government was fleeing for the countryside, Mayor Clarkson announced he would see the crisis through to the end and asked for volunteers. At first only two men offered their services: the black ministers Richard Allen and Absalom Jones, later founders of the first black Methodist and black Episcopalian churches in America, respectively, and co-founders of the Free African Society. The society would eventually go bankrupt from its relief effort during the plague, gathering the dead, housing the sick, and serving as nurses when hospitals refused to receive victims, who supposedly put other patients at risk.

The quarantine barracks, Bush Hill, were underwritten by the Philadelphia entrepreneur Stephen Girard and supervised by the French doctor Jean DevÀze, who saved many through his use of cool baths and liquids. Dr. David Nassy was successful in 98 of 117 fever cases he saw from the end of August through mid-October. The French doctors in town didn’t know any better than the Americans what spread the disease, but French medical experience in the tropics helped them relieve the symptoms once the fever had taken hold. This contrasted violently with the bloodlettings many Yankee doctors desperately prescribed throughout the epidemic. Alexander Hamilton was saved, as was his wife, by a childhood friend from the West Indies, Dr. Edward Stevens.

Nervous citizens lit bonfires to “purify the air,” carried pieces of tar, or fired off guns, until it was outlawed. The plague and its accompanying scare shut down every paper in the city except Andrew Brown’s Federal Gazette , which gave itself over to advice and medical debate over treatment of the disease.

On October 28 there were only two deaths reported at the Bush Hill quarantine site; that morning’s frost also encouraged many to return from Philadelphia’s outskirts. Although it was widely believed the fever epidemic would die with a change of season, no one connected this with the real culprits, that year’s damp spring and large crop of (virus-carrying) mosquitoes.

On Sunday, November 10, President Washington arrived from Mount Vernon to decide for himself whether the capital was safe for the Congress to reconvene in December. He rode alone through the streets and found the city fit, if hardly recovered. In three months the yellow fever had killed perhaps as many as five thousand people—roughly a tenth of Philadelphia’s population at the time. Over the coming years the disease would visit most other large port cities, working its way South until the end of the century.