The Yellow Fever Epidemic of 1793 is believed to have killed several thousand people in Philadelphia, Pennsylvania, United States. The yellow fever epidemic struck the city when it was the capital of the United States and a major seaport.
The summer of 1793 had been a profitable one for the coastal city of Philadelphia, experiencing a rising demand for tobacco and sugarcane. The on-going Haitian Revolution forced many French refugees to flee, and many of them landed in Philadelphia. However, the citizens of the city didn't know that some of the refugees were suffering from "Yellow Jack,"[2] a raging fever that turned its victim's skin and eyes yellow. In what turned out to be one of the most devastating epidemics in U.S. history, the yellow fever epidemic of 1793 killed ten percent of Philadelphia's population in the first month alone[3].
A source of contention in the Philadelphia College of Physicians was Dr. Benjamin Rush's claim to having found a cure. Doctors of the time believed in vis medicatrix naturae, "the healing power of nature."[4] This was the belief that the body would in its own course rid itself of any illness or poisons and that it was the doctor's job simply to help this natural process along. Rush saw that nothing was coming from this practice and decided more drastic measures needed to be taken. He tried many treatments (with no results) that included: administering shaved tree bark with wine, brandy, and aromatics such as ginger or cinnamon; sweating the fever out by coating a patient's body with a thick salve of herbs and chemicals; and wrapping the whole body in a blanket soaked in warm vinegar.[5] Finally, after hours of reading for an answer, Dr. Rush came upon John Mitchell's letter concerning a yellow fever outbreak fifty years prior in Virginia. Mitchell noted that the stomach and intestines filled with blood and that these organs had to be emptied at all costs. He urged doctors to be blunt and to forget any "ill-timed scrupulousness about the weakness of the body."[6]
Last used during the American Revolutionary War, "Ten-and-Ten" was an intense purge of the body produced through administering ten grains of calomel (mercury) and ten grains of jalap (the poisonous root of a Mexican plant related to the morning glory that was dried and powdered before ingesting).[6] Both substances, being highly toxic, would create the desired elimination that Dr. Rush was looking for. To accelerate the process, he increased the dosage to ten-and-fifteen and administered it three times a day, in effect poisoning his patients to rid the body of waste. Rush also believed in bloodletting, as did many doctors of the time. He removed copious amounts of blood from a patient with the thought that it would cleanse the body. Many at the time believed the body held about twenty-five pounds of blood.[7] In reality, the body holds less than half of this amount, and many of Rush's patients passed out because they were bled so radically. However drastic Rush's methods were, he saw signs of improvement, claiming that eight out of ten patients had gotten better with a single treatment, and that the next day nine out of ten were over the fever.[7]
Nevertheless, success came with criticism. Most doctors believed he was poisoning his patients instead of curing them. Dr. Jean Devèze publicly criticized Rush saying: "He, I say, is a scourge more fatal to the human kind than the plague itself would be."[7] Other doctors suggested treatments of their own, but no one claimed to have the cure as fervently as Rush did. He continued to face criticism until he himself fell ill with the fever. He had a servant administer the cure to him and fully recovered within five days. It wasn't until that point that many people sought him out for his cure; afterwards, over one hundred and fifty people came to him for help.[7] Still, most of Philadelphia's physicians condemned his technique and christened him as the "Prince of Bleeders."[8]
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Re-elevating the morale of the city
Although the College of Physicians came to no agreement about the illness, they did provide a list of precautions and measurements to be delivered to the citizens of Philadelphia. The list included things such as: cleaning the streets, hospitalization for victims, avoiding fatigue, limiting the intake of beer and wine, placing patients in airy rooms, removing spoiled clothes and linens often, putting strong smelling substances such as vinegar on handkerchiefs to place over the mouth, using gunpowder to purify the air, and to stay away from people with the disease.[9][10] The list, however, did not offer a cure.
In response to the list, the citizens of Philadelphia created a feeling panic. One citizen, Mathew Carey noted, "Acquaintances and friends avoided each other in the streets, and only signified their regard by a cold nod."[10] Immediately people began evacuating the city to country homes and relatives far away, leaving behind the poor who could not afford such luxuries. Mayor Clarkson became increasing concerned over this because the poor were swiftly becoming poorer. As the middle and upper class people began closing their shops, many poor people lost their jobs, and could therefore not pay for food, medicine, a physician, or a nurse. A militia company from nearby Fort Mifflin began hauling a cannon around the streets, firing off gunpowder to calm the citizens that were left in the city. This was just one unsuccessful precaution taken to re-elevate the mood of the city.
Another unsettling fact was the low number of government officials that kept showing up for work. Only ten out of eighteen senators and thirty-six out of seventy two representatives showed up at the state legislature to deal with the crisis. These numbers dropped even lower after the doorkeeper Joseph Fry died of the fever one night.[11] On September 10 George Washington left saying he wanted to keep his wife safe, and would be gone briefly for fifteen days, but his return kept being put off.[12] Other jobs in the city were going undone as well: such as burying the dead bodies, and cleaning the streets and the docks; measures that were supposed to help stifle the fever. Farmers refused to bring food into the city for fear of contracting the disease. This made the cost of available food in the city to go up two or three times as much as when the fever was not occurring.
One more increasing concern of Mayor Clarkson's was the almshouses being at maximum capacity. Not only were the homeless on the streets scaring people, and an additional opportunity to transmit the fever, but they were also receiving no care. A prestigious Pennsylvania hospital turned away fever victims because they feared the disease would spread rampantly through the wards due to the close conditions of the patients and workers.[13] One solution was to turn Ricketts' Circus building into a place for the excess homeless. Seven yellow fever victims were placed in the abandoned Circus and left to die there.[14] The ones that were still alive were only moved, due to the neighbors complaining about the smells and sounds, to Bush Hill, an illegally seized building. However, Bush Hill was no better for the victims, as it was described as "limited, crude, and insufficient."[15]
Bush Hill
For the majority of the epidemic, Bush hill remained overcrowded and understaffed. "The sick, the dying, and the dead were indiscriminately mingled together," eyewitness Mathew Carey reported. "The ordure and other evacuations of the sick, were allowed to remain in the most offensive state imaginable… It was, in fact, a great human slaughter-house." It was not until Mayor Clarkson, in despair, organized a committee that the institution changed. Two members, Peter Helm, a barrel maker, and Stephen Girard, a very wealthy merchant and shipowner, decided to volunteer to personally manage the interim hospital.[16]
In days, the hospital was running more smoothly, and the patients' morale increased. The first thing Helm and Girard did was to split up the work. Helm took the chores that were concerned with the outside of the building. He established an area where coffins were to be constructed, provided decent housing for staff member of the mansion, had the barn converted into rooming space for those recovering from illness so that they would not be affected from the newly ill, found sufficient areas for storage supplies, and had the property's water pump repaired so that fresh water would be available to patients for the first time.[17] He also took on the daunting task of creating a system for receiving new patients and effectively carting away the dead. Stephen Girard had the assignment of making sure everything was running efficiently inside the building. His first action was to clean every room of every floor from top to bottom. He then categorized the one hundred and forty current patients and placed them in separate rooms; the dying in one room, the "very low"[16] in an additional room, and so on. He assigned each room and hallway a nurse, hired a French doctor named Jean Devèze, and placed a doorkeeper at the entrance to keep track of entrances as well as to prevent delirious patients from going out. In addition to managing those responsibilities, Girard found the time to personally help the patients, as one bystander describes: "I even saw one of the diseased...[discharge] the contents of his stomach upon [him]. What did Girard do? ...He wiped the patient's cloaths, comforted [him]...arranged the bed, [and] inspired with courage, by renewing in him the hope that he should recover. ---From him he went to another, that vomited offensive matter that would have disheartened any other than this wonderful man."[18]
Israel Israel
Another prominent figure from Mayor Mathew Clarkson's organization was forty seven year old Israel Israel.[19] A reserved merchant and tavern keeper, Israel became a saint of the epidemic. He was put in charge of many jobs, the first was to find housing, care, and support for the escalating number of orphans in the city. Not only did he rent a home, hire a matron, and have provisions carted to the door of the new home, but he provided all of these amenities to over one hundred and ninety two orphans. Israel Israel also went where no sane man would go, to the potter's field, from which noxious odors were wafting, and many believed the source of the epidemic; where he inspected burial procedures there. He was also the one who arranged for the harvesting of grain at Bush Hill, and headed the Committee of Distribution who handed out food, firewood, and clothes, to the city's rising number of disadvantaged families.[16] And it was also Israel who went to the Almshouse to persuade the keeper to open its doors to the poor once again.
Germantown
President Washington attempted to return to Philadelphia in early November, but was directed to Germantown, a suburb some 10 miles outside the city. He first lodged at the Dove House, on the campus of Germantown Academy, and then rented the Germantown White House on Germantown Avenue. Members of his cabinet joined him in the surburb, waiting out the epidemic until they could safely return to Philadelphia. Polly Lear, the young wife of his secretary Tobias Lear, was an early victim.
African Americans and the fever
The Yellow Fever Epidemic of 1793 was not only fought by the rich white men. The greatest effort in fighting the fever came from the under-privileged black communities, most prominently, the women. The Free African Society (founded 1787)[20] was the first organization in the United States founded by blacks for blacks, with the intention of helping the penniless members and to provide care to widows and fatherless children. Although they were ill treated and discriminated against in the past, the members of the Free African Society, led by Richard Allen and Absalom Jones,[21] were able to overlook the differences and help everyone in need. In fact, the Free African Society was the only group to step forward, offer its services, and consistently be there throughout the plague. Whenever anyone sent a request for assistance, a member from the society was sent, free of charge, to help as much as possible. They would care for the person, clean the sickroom, wash clothes and linens, buy supplies and nourishment, and care for the family members. Yet supply exceeded demand, and many of the wealthy families would outbid the poor for the saintly services. It got so out of hand that many of the nurses’ fees would reach four or five dollars a day, when the average yearly income was around two hundred dollars.[22]
End to the Fever
As November edged closer, and a frost became more evident, the cases of yellow fever diminished until there were none left (until the next summer). People began returning to their homes, but what they found was a completely changed city. The streets were astonishingly clean; the trash and garbage had been swept away along with the removal of cats, dogs, birds, and pigs. The beggars and homeless children were also nowhere in sight. They found the survivors "exhausted and haggard looking", smelling strongly of vinegar and camphor. The skin of many still had a yellow tinge to it, and those who had taken Rush’s mercury purge had "unsightly black"[23] teeth and were constantly spitting to rid their mouths of the foul taste.
Legacy
Everyone and anyone that was affected by the fever learned something throughout its process and in the time after, to revel in it. For instance, consider Dolley Payne Todd whose husband and newborn baby died of the fever. She took herself and her two year old son to a farm, and even became infected themselves. Then after the fever abated they returned to the city and ran a boarding house. However Dolley did not spend her life living in the past, and eleven months after her husband John Todd's death she remarried a Virginia congressman and future U.S. president James Madison.[24]
The government also found itself changed, both on the state and national level. Because many thought it was unconstitutional to meet outside of Philadelphia (this based on the fear of a future autocratic president, like the kings in Europe), congress didn't meet in the time of the plague when its nation needed it the most. To avoid any future problems, congress granted the president the power to move a meeting in a time of grave danger and threat.
Philadelphians' hopes of permanently retaining the national capital were dashed. There were smaller yellow fever outbreaks through the 1790s, and during the summer of 1798 John Adams's administration evacuated to Trenton, New Jersey. As scheduled, the federal government moved to the District of Columbia in November 1800. By then, Philadelphia had also lost the state capital. In 1799, Pennsylvania's legislature moved from Philadelphia to Lancaster, before permanently settling in Harrisburg in 1812.
Transformation also came to the city, where people agreed that foul smells were the cause of disease. Public health codes were strengthened and enforced, and in 1799 the United States' first water system, designed by Benjamin Latrobe, was constructed in Philadelphia,[25] revolutionizing the nation forever. Curiously, the water system did indirectly affect the risk of yellow fever, by reducing the barrels and cisterns of standing water in which mosquitoes breed. It caused Elizabeth Drinker, one of America's most prominent and faithful diarists, to take a bath after waiting twenty eight years.
In a later epidemic in 1802, yellow fever shaped the fate of the United States. Napoleon I of France sent thirty three thousand soldiers to America with the purpose of reinforcing French claims to New Orleans. Twenty nine thousand of these soldiers died of the yellow fever,[26] forcing Napoleon to sell the claims to Thomas Jefferson for unreasonably low prices, saying that they were too difficult to maintain. These claims became the Louisiana Purchase, more than doubling the nation's land at the time.
Death total
Since most record keepers of the time, ministers, sextons, and city officials, either fled the city, or became ill that late summer in 1793, no real total of how many deaths occurred is available. However estimates have been produced and put the number between four and five thousand people.[27] Yet even though the total doesn't begin to rival that of the original population of the city, the time span of two months that these deaths were incurred and the fear and panic they created remains unmistakably significant.
References
- ^ Arnebeck, Bob (January 30, 2008). "A Short History of Yellow Fever in the US". Benjamin Rush, Yellow Fever and the Birth of Modern Medicine. http://www.geocities.com/bobarnebeck/history.html. Retrieved 04-12-2008.
- ^ Yount, Lisa (2000). Epidemics. San Diego: Lucent Books. pp. 17. ISBN 1560064412.
- ^ Jacobs Altman, Linda (1998). Plague and Pestilence: A History of Infectious Disease. United States: Enslow Publishing Inc.. pp. 51. ISBN 0894909576.
- ^ Murphy, An American Plague, pp. 59.
- ^ Murphy, An American Plague, pp. 60.
- ^ a b Murphy, An American Plague, pp. 61.
- ^ a b c d Murphy, An American Plague, pp. 62.
- ^ Murphy, An American Plague, pp. 65.
- ^ Murphy, An American Plague, pp. 26.
- ^ a b Murphy, An American Plague, pp. 27.
- ^ Murphy, An American Plague, pp. 36.
- ^ Murphy, An American Plague, pp. 44.
- ^ Murphy, An American Plague, pp. 38.
- ^ Murphy, An American Plague, pp. 39.
- ^ Murphy, An American Plague, pp. 40.
- ^ a b c Murphy, An American Plague, pp. 71.
- ^ Murphy, An American Plague, pp. 72.
- ^ Murphy, An American Plague, pp. 74.
- ^ Murphy, An American Plague, pp. 69.
- ^ Murphy, An American Plague, pp. 47.
- ^ Allen, Richard; Absalom Jones (1794). A Narrative of the Proceedings of the Black people, During the Late Awful Calamity in Philadelphia in the Year 1793. Philadelphia: Franklin's Head.
- ^ Murphy, An American Plague, pp. 51.
- ^ Murphy, An American Plague, pp. 97.
- ^ Murphy, An American Plague, pp. 104 - 105.
- ^ Murphy, An American Plague, pp. 107.
- ^ Yount, Epidemics, pp. 18.
- ^ Murphy, An American Plague, pp. 101.
Bibliography
- Allen, Richard; Absalom Jones (1794). A Narrative of the Proceedings of the Black people, During the Late Awful Calamity in Philadelphia in the Year 1793. Philadelphia: Franklin's Head.
- Arnebeck, Bob (January 30, 2008). "A Short History of Yellow Fever in the US". Benjamin Rush, Yellow Fever and the Birth of Modern Medicine. http://bobarnebeck.com/history.html. Retrieved 04-12-2008.
- Barnard, Bryn (2005). Outbreak! Plagues That Changed History. New York: Crown Publishers. ISBN 0375829865.
- Garret, Laurie (1994). The Coming Plague: Newly Emerging Diseases in a World Out of Balance. New York: Farrar, Straus and Giroux. ISBN 0140250913.
- Jacobs Altman, Linda (1998). Plague and Pestilence: A History of Infectious Disease. United States: Enslow Publishing Inc.. ISBN 0894909576.
- Murphy, Jim (2003). An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793. New york: Clarion Books. ISBN 0395776082.
- Powell, John Harvey (1993). Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793. Philadelphia: University of Pennsylvania Press. ISBN 0812214234.
- Yount, Lisa (2000). Epidemics. San Diego: Lucent Books. ISBN 1560064412.
- "The Yellow Fever epidemic". Africans in America. PBS Online. 1998. http://www.pbs.org/wgbh/aia/part3/3p1590.html. Retrieved 04-12-2008.
See also
- Fever 1793, a historical novel about the epidemics
- Philadelphia Lazaretto, built in 1799 in response to the 1793 epidemic
External links
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