by Jim Murphy
The situation is the kind that produces nightmares in thoughtful people. Yet the history of yellow fever offers hope. We know, for instance, that Benjamin Rush was alert enough to recognize the disease before it had spread much beyond Water Street and sounded an alert. Modern doctors should be able to spot yellow fever and issue warnings even sooner.
We know, too, that the antimosquito breeding campaigns in Cuba and Panama were very effective in halting the infections and that massive insecticide campaigns can control the populations of Aedes aegypti. Prompt warning and fast (if unpleasant) action have kept yellow fever and related diseases in check over recent decades as well, and the same will be true in the future. Meanwhile, dedicated scientists develop theories and test them, hoping to discover a safe and effective cure.
Yet, if the history of yellow fever tells us anything, it is that this is a struggle with no real end. Yellow fever as we know it now might be conquered, but another version of the disease will eventually emerge to challenge us again. And when it does, we will have to overcome our fears and be prepared to confront it.
Sources
While researching An American Plague, I consulted a great many books, newspapers, magazines, personal journals, and letters. Below is a select list of sources, arranged by broad subject categories. While most of the titles are self-explanatory, I’ve provided some personal comments on a few. I hope this will make it easier for curious readers to learn more about various topics covered in these pages.
FIRSTHAND ACCOUNTS: NONMEDICAL
Biddle, Henry D., ed. Extracts from the Journal of Elizabeth Drinker, from 1759 to 1807, A.D. Philadelphia: J. B. Lippincott Company, 1889.
Elizabeth Drinker was an avid journal keeper, taking note of what was happening around her in lively and dramatic writing. My favorite entry isn’t even from the period of the fever, but from March 1799. That was when the Drinkers were having their privy cleaned, or as Elizabeth put it, “removing the offerings from ye temple of Clacine.” The workmen, it seems, ate their meals while in the pit!
Cappon, Lester J., ed. The Adams-Jefferson Letters. Chapel Hill, N.C.: University of North Carolina Press, 1959.
Adams’s genuine fear of Genêt’s activities and the Philadelphia street riots arc made very clear in Volume 2, pp. 346–47.
Carey, Mathew. A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia: With a Statement of the Proceedings That Took Place on the Subject, in Different Parts of the United States, To Which Are Added, Accounts of the Plague in London and Marseilles; and List of the Dead, from August 1, to the Middle of December, 1793, 1st and 3rd editions. Philadelphia: Mathew Carey, 1793.
Aside from unfairly condemning the black nurses, this short history with a very long title is probably the best overall firsthand account of the fever. Leafing through the necrology, seeing page after page of the names of the dead, gives a true sense of the immensity of this disaster.
——. The Address of M. Carey to the Public. Philadelphia: Mathew Carey, 1794.
Cresson, Joshua. Meditations Written during the Prevalence of the Yellow Fever in the City of Philadelphia in the Year 1793. London: W. Phillips, 1803.
Cresson is good at documenting how outlying communities often turned away—sometimes using violence—those fleeing Philadelphia.
Helmuth, J. Henry C. A Short Account of the Yellow Fever in Philadelphia: For the Reflecting Christian. Translated from the German by Charles Erdmann. Philadelphia: Jones, Hoff & Derrick, 1794.
His aim was to convince readers that the fever was a warning from God for the sins of the entire community. One way he attempted to do this was by writing detailed “you are there” scenes of the devastation.
Heston, Isaac. “Letter from a Yellow Fever Victim, Philadelphia, 1793,” ed. Edwin B. Bonner. Pennsylvania Magazine of History and Biography, 86 (1962): 205–7.
Heston’s letter touches on numerous aspects of the epidemic—the fact that many newspapers had ceased to publish, that doctors were arguing, and that the streets were empty and desolate. At one point he wrote: “But through all the dainger, thanks be to god, we have yet been preserved, but how long It may continue so, it is impossible to say, for this hour we may be well, and ne[x]t find our selves past recovery.” Ten days after writing this, Isaac Heston died of yellow fever.
Jones, Absalom, and Richard Allen. A Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, in the Year 1793: and a Refutation of Some Censures, Thrown upon Them in Some Late Publications. Philadelphia: Printed for the Authors, by William W. Woodward, 1794.
There are at least two facsimile versions of this remarkable work available: Philadelphia: Franklin Court Print Shop & Bindery, 1979, and Philadelphia: Independence National Historical Park, 1993.
Miller, Lillian B., ed. The Selected Papers of Charles Willson Peale and His Family, Vol. 2, Parts 1 and 2. New Haven. Conn.: Yale University Press, 1988.
Minutes of the Proceedings of the Committee . . . to Attend to and Alleviate the Sufferings of the Afflicted with the Malignant Fever, Prevalent, in the City and Its Vicinity, With an Appendix. Philadelphia: Printed by R. Aitken, 1794.
Iron merchant Caleb Lownes kept the minutes of the committee, recording in his neat handwriting the day-to-day problems he and its other members had to deal with. He missed only two meetings during the epidemic.
Stearns, Samuel. An Account of the Terrible Effects of the Pestilential Infection in the City of Philadelphia. Providence, R.I.: William Child, 1793.
Winchester, Elhanan. Wisdom Taught by Man’s Mortality; Or the Shortness and Uncertainty of Life: Adapted to the Awful Visitation of the City of Philadelphia, by the Yellow Fever, in the Year 1793. Philadelphia: R. Folwell, 1795.
FIRSTHAND ACCOUNTS: MEDICAL
Biddle, Alexander. Old Family Letters Relating to the Yellow Fever. Privately printed, 1892.
A collection of all the letters Benjamin Rush wrote to his wife, Julia, from the end of August to mid-November 1793. A copy of this volume, with notes by Lyman H. Butterfield, can be found at the Free Library in Philadelphia.
Butterfield, L. H., ed. Letters of Benjamin Rush. Princeton, N.J.: Princeton University Press, 1951.
Rush was headstrong and stubborn, but he reveals many other sides of his personality in these letters to family and friends.
Cathrall, Isaac. A Medical Sketch of the Synochus Maligna, or Malignant Contagious Fever, as It Lately Appeared in the City of Philadelphia. Philadelphia: T. Dobson, 1794.
A detailed examination of the disease’s symptoms and possible causes, along with Cathrall’s treatment, which included throwing cold water over the patient’s head every morning and evening; he also warns readers never to tell patients they have yellow fever, because “I have known a patient [to] faint in this disease from an unguarded expression, and afterwards die apparently from a slight attack.”
Currie, William. A Description of the Malignant, Infectious Fever Prevailing at Present in Philadelphia. Philadelphia: Thomas Dobson, 1793.
Provides a very clear and detailed description of the symptoms of the disease, plus his reasons for believing it was an imported illness.
Devèze, Jean. An Enquiry into, and Observations upon the Causes and Effects of the Epidemic Disease, which Raged in Philadelphia From the Month of August till Towards the Middle of December, 1793. Philadelphia: Pierre Parent, 1794.
Contains a description of his gentle medical treatment of fever victims. Devèze was one of the few doctors who worried that rainwater might carry injurious vapors into well water.
Nassy, David. Observations on the Cause, Nature, and Treatment of the Epidemic Disorder, Prevalent in Philadelphia. Translated from the French. Philadelphia: Parker and Co., for Mathew Carey, 1793.
Argues that Philadelphia is normally a very healthy city, so the fever must have been imported.
Rush, Benjamin. Medical Inquiries and Observations, 2nd edition. Philadelphia: J. Conrad and Co., 1805.
Contai
ns the entire text of his Account of the Bilious Remitting Yellow Fever, as It Appeared in the City of Philadelphia, in the Year 1793. Despite the passage of twelve years, Rush has the same firm belief in his cure as he did in 1793.
ALL ABOUT YELLOW FEVER
Bean, William B. Walter Reed: A Biography. Charlottesville, Va.: University Press of Virginia, 1982.
Blake, John. “Yellow Fever in Eighteenth-Century America.” New York: Bulletin of the New York Academy of Medicine, 44 (1968): 673–86.
“The Burning of the Quarantine Hospital on Staten Island.” Harper’s Weekly, September 11, 1858.
Coleman, William. Yellow Fever in the North: The Methods of Early Epidemiology. Madison, Wis.: University of Wisconsin Press, 1987.
Opens with a clinical discussion of yellow fever and how the disease travels from the forest to cities, followed by histories of three European outbreaks.
Duffy, John. The Sword of Pestilence: The New Orleans Yellow Fever Epidemic of 1853. Baton Rouge. La.: Louisiana State University Press, 1966.
Ellis, John H. Yellow Fever and Public Health in the New South. Lexington, Ky.: The University Press of Kentucky, 1992.
How concern and fear in the nineteenth century led to the establishment of health codes, hospitals, and other government measures to protect citizens from this disease.
Estes, J. Worth, and Billy G. Smith, eds. A Melancholy Scene of Devastation: The Public Response to the 1793 Philadelphia Yellow Fever Epidemic. Philadelphia: Science History Publications/USA, 1997.
Ten scholars discuss a wide variety of issues relating to the epidemic—from the impact of the newspapers to Rush’s cure to the unfair treatment of the black nurses that resulted in Jones and Allen’s Narrative. Includes a full-color painting of a nineteenth-century patient with yellow fever, black vomit and all.
Horsman, Reginald. Josiah Nott of Mobile: Southerner, Physician, and Racial Theorist. Baton Rouge, La.: Louisiana State University Press, 1987.
Humphreys, Margaret. Yellow Fever and the South. New Brunswick, N.J.: Rutgers University Press, 1992.
No disease alarmed Southerners in the nineteenth century more than yellow fever, and this book tells why. Also includes many of the erroneous theories developed to explain the cause of the disease, as well as discussions of the work done by Josiah Nott and Carlos Finlay.
Kelly, Howard A. Walter Reed and Yellow Fever. New York: McClure, Phillips & Co., 1906.
Kiple, Kenneth F., ed. The Cambridge World History of Human Disease. New York: Cambridge University Press, 1993.
Contains a very concise section on yellow fever through the ages.
Marotel, Gabriel. The Relation of Mosquitoes, Flies, Ticks, Fleas, and Other Arthropods to Pathology. Washington, D.C.: Government Printing Office, 1910.
Mitchell, John. “Account of the Yellow Fever which Prevailed in Virginia in the Years 1737, 1741, and 1742, in a Letter to the Late Cadwallader Colden, Esq, of New-York.” New York: American Medical & Philosophical Register 4, 1814.
Benjamin Franklin gave Rush a copy of this 1744 letter, from which Rush conceived his controversial cure.
Patterson, K. David. “Yellow Fever Epidemics and Mortality in the United States, 1693–1905.” Social Science and Medicine, 34 (1992): 855–65.
Powell, J. H. Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793. Philadelphia: The University of Pennsylvania Press, 1949.
A scholarly page-turner—active, dramatic, and suspenseful. Incidentally, Powell makes very clear in his notes that no one went around Philadelphia crying “Bring Out Your Dead,” even though some residents and a few irresponsible historians insist that they did.
Winslow, Charles-Edward Amory. The Conquest of Epidemic Disease: A Chapter in the History of Ideas. Madison, Wis.: The University of Wisconsin Press, 1980.
Covers a wide range of diseases but takes a very detailed look at the mystery surrounding yellow fever and the many attempts to explain its origins. Also has sections on Pasteur and germ theory and on the discovery that insects can transmit disease to humans.
YELLOW FEVER: FICTION
Anderson, Laurie Halse. Fever, 1793. New York: Simon & Schuster, 2000.
A very good book for young readers ten years old and up.
Brown, Charles Brockden. Arthur Mervyn, or, Memoirs of the Year 1793, 2 Vols. Port Washington, N.Y.: Kennikat Press, 1963.
This novel was originally published in two sections in 1799 and 1800 and provides an eerie look at a city abandoned by most of its citizens and isolated from the surrounding world by disease.
Fleischman, Paul. Path of the Pale Horse. New York: HarperCollins, 1983.
Another good book for young readers.
DOCTORING IN THE OLD DAYS
Cooper, David Y., III, and Marshall A. Ledger. Innovation and Tradition at the University of Pennsylvania School of Medicine: An Anecdotal Journey. Philadelphia: University of Pennsylvania Press, 1990.
Includes a section on the medical accomplishments of Benjamin Rush, as well as describing the contributions of other doctors from his era.
Duffy, John. From Humors to Medical Science: A History of Medical Science. Chicago: University of Illinois Press, 1993.
Follows the practice of medicine in America from its rather primitive beginnings to the present. Includes discussions of eighteenth-century “do-it-yourself” medicine and very early ideas of germ theory.
Flexner, James Thomas. Doctors on Horseback: Pioneers of American Medicine. New York: Fordham University Press, 1992.
Has a chapter on the life and work of Benjamin Rush entitled “Saint or Scourge.” This is a balanced view of the man’s actions during the 1793 epidemic, taking him to task for his headstrong, bullying ways but reminding readers that his medical decisions were not so outlandish at the time, especially to the desperate and trapped citizens of Philadelphia.
Gates, Phil. Medicine. History News series. Cambridge, Mass.: Candlewick Press, 1997.
A lively, illustrated look at medical care throughout the ages. After reading this history, you will be very happy you are living in the twenty-first century.
Meyer, Clarence. American Folk Medicine. Glenwood, Ill.: Meyerbooks, Publisher, 1973.
Contains hundreds of cures using herbs, roots, oils, and tree barks for just about anything that ails you. In 1805 Dr. Samuel Thomson recommended that people chew ginger root and swallow the juices to guard the stomach against getting yellow fever.
Murphy, Lamar Riley. Enter the Physician: The Transformation of Domestic Medicine, 1760–1860. Tuscaloosa, Ala.: The University of Alabama Press, 1991.
Shows the relationship between the at-home healer and the medical profession, in which even someone like Benjamin Rush sought advice on doctoring from his patients and their relatives.
Nuland, Sherwin B. The Mysteries Within: A Surgeon Reflects on Medical Myths. New York: Simon & Schuster, 2000.
Has a very nice discussion of the humoral theory and the effect of humors on different organs of the body.
Starr, Douglas. Blood: An Epic History of Medicine and Commerce. New York: Alfred A. Knopf, Inc., 1998.
How people viewed their own blood, from ancient times to the present. Includes mention of Benjamin Rush and his fame as a bleeder.
Williams, Guy. The Age of Agony: The Art of Healing, 1700–1800. Chicago: Academy Chicago Publishers, 1975.
A very appropriate title. This survey of doctoring in the United States and Europe makes it clear why people often turned to neighbors for painless (and free) medical advice.
——. The Age of Miracles: Medicine and Surgery in the Nineteenth Century. Chicago: Academy Chicago Publishers, 1981.
Explains how medical techniques slowly changed for the better, including a discussion of the discovery of insects as disease vectors.
PHILADELPHIA, THEN AND AFTER
Benjamin, Lewis Saul. The Life and Letters of William Cobbett in England & America, Based Upon Hitherto Unpublished Family Papers. New York: John Lane Co., 1913.
Cobbett was the spiritual father of the “agrarian movement,” which is still preached today by some; in addition, his writings, especially those about Benjamin Rush, are often taught in college courses as examples of slashing prose.
Blake, Nelson Manfred. Water for the Cities: A History of the Urban Water Supply Problem in the United States. Syracuse. N.Y.: Syracuse University Press, 1956.
Cotter, John L., Daniel G. Roberts, and Michael Parrington. The Buried Past: The Archaeological History of Philadelphia. Philadelphia: University of Pennsylvania Press, 1992.
A truly remarkable book. While describing the many digs in and around Philadelphia—including those of privies—the authors reveal a great deal about this city and its people from prehistoric times to the present. Includes details about Washington’s residences in Philadelphia and Germantown, the markets, what typical houses looked like, and the creation of the city’s water system.
Davies, Benjamin. Some Account of the City of Philadelphia. . . . Philadelphia: Richard Folwell, 1794.