In lieu of an abstract, here is a brief excerpt of the content:

>> 95 6 New Nation September 11, 1793. Philadelphia, the temporary capital of the United States, had suffered for weeks from (in the parlance of the day) a bilious malignant fever. The victims had black grainy vomits, nosebleeds, and headaches. Their skin and eye whites turned yellow. In a matter of days, sometimes hours, death followed the first symptoms. Most of the early cases were clustered near the dock where, Elizabeth Drinker noted in her diary for August 16, disintegrating coffee beans, recently unloaded from a ship, had emitted a strong stench that added to the smells of the usual rotting foods. Clearly that was the source of infection. Both public opinion and the medical profession understood that strong smells explained the presence of a deadly miasma. But what was the disease? In late August, Dr. Benjamin Rush, one of the most respected physicians in town, diagnosed the malady as the dreaded yellow fever. At first he urged people to leave the city. The Philadelphia medical community could not agree on the cause of the disease—one camp argued that a miasma at the dock caused the humoral imbalance that led to the disease, another argued that the fever was 96 > 97 communicated through person to person contact and was a “contagion.” The source of the infection probably was most likely at the waterfront, but it was the presence of people with yellow fever traveling from the West Indies and the mosquitoes that came with them that started the epidemic. That summer several vessels filled with refugees from the island of Santo Domingo had arrived at the Philadelphia port. A slave-led rebellion on the western, French-speaking side of the island in 1791 (Haiti today), inspired indirectly by the 1789 Revolution in France, frightened many whites into abandoning their sugar plantations. They looked for refuge in likely American cities and thus their arrival in Philadelphia. Quarantine was very lax between epidemics , and little note was taken of the sick on board in the waters near the city. Yellow fever was always present on the island of Santo Domingo as in most of the West Indies, and it often created havoc in the southern states. Many people in warmer climates were immune because they either survived a course of the disease or were the children of women who had been sick. The mother’s antibodies can cross the placenta, giving the infant temporary immunity and the possibility of a milder case later on as a child. Like malaria, mosquitoes communicate yellow fever. The insect vector is harmless until it feeds on the blood of someone with the disease and then feeds on the body of another person. A bite from that mosquito would then infect a human being. The last time yellow fever had appeared in the Philadelphia area was in 1761, and after more than thirty years free of the disease few people carried the necessary antibodies. Unsanitary conditions in the town, stagnant water in the streets, and rotting garbage provided the breeding grounds for the mosquitoes. The disease slowly spread beyond the confines of the dock area as people moved about and mosquitoes proliferated throughout the city. By early August doctors were dismayed by the death rate. They bled and purged, but the sick died anyway. The toll in lives kept rising from a few each day at the beginning of August to more than twenty a day by the end of the month. On September 8, forty-two deaths were reported. Most governmental officials as well as the upper, more affluent classes left town. Philadelphia was not only the capital of the state of Pennsylvania, it was also the temporary capital of the United States. The members of the state legislature left first followed by the governor. President George Washington and most of his cabinet had abandoned the city by September 10 when Rush declared that the “disorder was now past the Art of man or medicine to cure.” When Washington went to Mount Vernon, he left Henry Knox, the secretary of war, in charge of the federal government, but even he thought it wise to leave after a few days. Most of the officials in the city government also fled, leaving only the mayor, Mathew Clarkson, and a handful of Guardians of the Poor 98 > 99 background, as well as the poor relegated to the pest house at Bush Hill, argued for more moderate treatment. At Bush Hill where French doctors held sway, those stricken with the...

Share