Colonial Conundrum: Divining the Diagnosis of a Mysterious Fever

In 1793, synchronous with an epidemic of yellow fever at Philadelphia, this then small village was attacked, by a disease that so closely resembled it, that a writer of the time, Alexander Graydon, esq., in his Memoirs, remarks upon it. Quartan ague also prevailed at the time.

—Hugh Hamilton, The Sanitary Condition of Harrisburg, Pennsylvania (1866)

Alexander Graydon (1752–1818) was appointed prothonotary of Dauphin County in 1785, a position he occupied for the next fourteen years after which he retired to a small farm near Harrisburg. He moved back to Philadelphia in 1816 and passed away at the age of sixty-six.¹ In his Memoirs in a chapter subtitled “Yellow Fever,” Graydon reports that “a malady not less fatal than that in Philadelphia was raging” in Harrisburg in 1793. The mortality of the two was comparable. The symptoms of the Harrisburg disease included affection of the stomach or nausea with violent retching, yellowness of the skin, and black vomit in some cases. Illness duration was perhaps a week, sometimes longer, and some died in two to three days. Other ambulatory victims with symptoms only of ague suddenly became quite ill and expired. Graydon himself was ill with a quartan ague in mid-September but had no other symptoms. He attributed the origin of the illness to marsh effluvia caused by “torrid sun acting upon moist soil, or upon impure and stagnant water.”²

In addition to Graydon’s first-hand account of the illness, several other sources reported accounts of both the fever and circumstances surrounding it.³ George H. Morgan’s Annals describes a sickness in Harrisburg in 1793 characterized by “a fever of violent character, similar to the yellow fever” that was especially prevalent among new settlers. High fatalities were reported among Irish immigrants and some residents as well; most families were touched by the epidemic. Philadelphia was experiencing yellow fever during this same time and patrols were “established at the lower end of the town to prevent infected persons from Philadelphia from coming into it.”⁴

The approximate population of Harrisburg, as listed in the census of 1790 was 875; it rose to about 1,300 in 1792–94.⁵ According to the census of 1790, Pennsylvania’s population of European origin was as follows: 35.5 percent English, 8.6 percent Scot, 14.5 percent Irish, 33.3 percent German, 1.8 percent Dutch, 1.8 percent French, 0.8 percent Swedish, and 3.9 percent “unassigned.”⁶

Several sources reported on temperature and weather for the time period surrounding the illness, but none are specific to Harrisburg. (Harrisburg is located in southcentral Pennsylvania along the Susquehanna River at latitude 40°16′ N and longitude 76°53′ W. Its nearest colonial neighbors in 1793 were Middletown, Manheim, Lancaster, York, and Carlisle.) A daily weather and temperature table for Philadelphia covering January to November 1793 is included in Rush’s “Account of the Bilious Remitting Fever of 1793” (see appendix).⁷ Webster in Epidemic and Pestilential Diseases reported general weather conditions of the world including the following notes for Philadelphia: In 1792 winter was “Cold”; in 1793 summer was “Dry & Very Hot” and winter was “Mild”; in 1794 winter was “Mild.”⁸

Benjamin F. Royer, Graydon, and Morgan all report that Peter and Abraham Landis’s mill dam on the Paxton Creek (near Harrisburg) was the cause of the great fever or sickness. The dam spread water over eight to ten acres within a few hundred yards of the middle of town and provided an excellent source for marsh effluvia. Fearing further infection, irate village residents subsequently tore down the dam and confiscated the land.⁹

Countless vectors are associated with fever in humans. By far the most common is the mosquito, known to transmit malaria, yellow fever, and dengue. Lice and fleas are associated with typhus and ticks with spotted fevers. Plague and brucellosis are passed through rodents and other animals. Leptospirosis may be contracted from spirochetes by swimming in fresh water.

Differential Diagnosis

Malaria

Darrett Rutman and Anita...