In 1793, during a yellow fever epidemic in Philadelphia, Benjamin Rush adopted a therapy that centered on rapid depletion through purgation and bleeding. His method, especially his reliance on copious bloodletting, was at first widely condemned, but many American practitioners eventually adopted it. Although the therapy struck many observers as being radical, in large part it grew from premises that had substantial support. Rush was convinced that it worked and that heroic methods were the key to conquering disease. In particular, massive bleeding became central to his therapeutics.