An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793

In early September, the Free African Society gathers to discuss how they can help fever patients. Benjamin Rush has written a letter to the Society, which was founded in 1787 by African Americans to care for other African Americans, particularly “widows and fatherless children” (47). Rush turned to the Society for assistance in part due to the false belief that African Americans are immune to the fever. While some who grew up in the West Indies or Africa may have developed an immunity, many will soon be stricken with the disease as well.

In the meantime, the Society meets to debate the situation. Many are former enslaved people and recognize that racial discrimination is still pervasive, especially since more than 200 African Americans in Philadelphia remain enslaved. Two of the Society’s most prominent members, Richard Allen and Absalom Jones, had previously been asked to leave their church by its white members. Despite these circumstances, members of the Society head out in pairs to observe the dire situation throughout the city. They then go to Mayor Clarkson and agree to offer their services.

Volunteers from the Society make rounds every day, gathering homeless children to find them shelter, taking care of those who are alone, and sending patients to Bush Hill. However, as demand for African American nurses begins to exceed supply, the cost for their services increases and they face harassment and criticism. After the Society clarifies to Mayor Clarkson that it is white patients who are driving up the prices by out-bidding one another, rather than African American nurses demanding more money, Clarkson issues a statement supporting the Society and places an ad in the paper urging people to stop their harassment.

Although volunteers from the Society put forth their most courageous efforts, African Americans soon begin to fall sick as well, including Richard Allen. The city worries about what will happen if the volunteers also succumb to the fever, fearing there will be no one left to care for the sick.

On September 12, Benjamin Rush has fallen sick with the fever but continues to see patients. While other doctors have left the city or died of the sickness, Rush remains “a tower of energy and care” (58). He also claims to have discovered a cure, which came about after he visited Mrs. LeMaigre. Rush’s cure is in line with the dominant medical thinking of the time, known as vis medicatrix naturae (59): that the body will naturally heal itself and dispel poisons from the humors. The role of a doctor is mainly to provide gentle cures that can aid the body in this process. One of the most common cures is the 2500-year-old practice of bloodletting, in which a vein is opened and the blood let into a bowl. The rationale behind it is that less blood allows for better blood flow.

While Rush initially practices light bloodletting and purging with the sick, his sees patients like Mrs. LeMaigre still dying. After examining medical literature, he finds a letter from a gentleman named John Mitchell about yellow fever patients in Virginia 50 years ago. Mitchell wrote that the intestines and stomach had to be emptied of blood or they would “turn putrid” (61) and interfere with the body’s healing processes. At Mitchell’s recommendation of extremely aggressive purging, Rush puts together one of the strongest known purges called the “Ten-and-Ten” (61). Containing 10 grains each of mercury and jalap, a poisonous root, the cure effectively poisons the patient, forcing them to purge, and is then followed by bloodletting. After it appears to work on a patient, Rush increases the dose to 15 grains and recommends administering it three times daily.

Although Rush claims he has saved dozens of patients due to his cure, it quickly attracts several critics, including Dr. William Currie, who recommends only light purging, and Alexander Hamilton. Some of the city’s doctors who reject the cure call Rush the “Prince of Bleeders” (65). When Rush falls ill in early September, he immediately uses his own cure on himself and is visiting patients again after five days. Despite Rush’s persistent cough and low energy, hundreds of people begin demanding his cure. Due to the high demand, he trains members of the Free African Society to bleed patients.

Although Rush’s cure is controversial, and some of the people around him still die of the fever, he never loses faith that it works. It is deeply rooted in common medical practices of the time and is indicative of the transitional state of medicine, which has begun seeking science-based causes for illnesses but still looks to the traditional folk remedies of the past. Rush’s belief in the cure give many people hope, serving as evidence that the fever can be overcome. He becomes a hero and now tackles the fever with confidence.

By mid-September, the city is in total chaos. Nearly everything has stopped operating and Bush Hill is in complete disarray. Mayor Clarkson takes the drastic and illegal step of appointing a committee to take control of the city government. While the committee is initially comprised of 26 members, its numbers are soon reduced to around 12. They immediately borrow money to use for several essential items and personnel, including medicine, coffins, doctors, nurses, and gravediggers. Ultimately they spend over $37,000, which they are personally responsible for paying back because they were not legally authorized to spend it in the first place.

The committee mostly consists of individuals from society’s middle ranks, including artisans, teachers, and merchants. For the most part, they are not wealthy. They divide up the city’s most urgent needs, each taking responsibility for an essential task such as providing food to the city, taking the sick to Bush Hill, and burying the deceased. One of the most notable members is Israel Israel, a tavern keeper and merchant who helps in several different capacities. He heads the Committee of Distribution, which is tasked with storing and handing out food, firewood, and clothes. It is one of several subcommittees that the committee creates to handle specific aspects of the epidemic.

One of the most necessary and urgent subcommittees is the one sent to deal with Bush Hill. The doctors and nurses there are overwhelmed and there is little supervision of the premises. At the time, there are over 100 patients, with the sick, dying, and deceased all packed in together. The two committee members who step up to take charge of Bush Hill are wealthy merchant Stephen Girard and barrel-maker Peter Helm, who has done work several times for President Washington. They use their strength, courage, and work ethic to make major changes to Bush Hill.

Helm and Girard divide up their tasks at Bush Hill, with Helm handling the outside of the premises. He sets up a system for admitting new patients and taking away the deceased. He also creates an area for making coffins, sets up housing for nurses and staff, separates the newly ill from those in recovery, and repairs the pumps so fresh water can be provided to the patients. Girard, who is assigned to deal with the inside of Bush Hill, has the interior cleaned, separates patients by the degree of their condition, and puts nurses in each room and hallway. Girard and Helm also recruit a new volunteer doctor, Jean Devèze, who contracted yellow fever twice while previously living in the West Indies. Devèze ignites some controversy because he is French and openly rejects Rush’s cure, but ultimately he helps to improve the reputation of Bush Hill, along with Girard and Helm.

Although Bush Hill is now in much better shape, the city of Philadelphia still faces many difficult challenges. Neighboring states ban travel to Philadelphia, and mail and newspapers are dipped in vinegar to clean them. A woman and her African American servant from Philadelphia are attacked in Delaware, demonstrating that travel outside of the city may not be safe. Although some surrounding areas provide assistance through donations of money and food, Philadelphians are essentially trapped in the city.

Although citywide efforts to tackle the fever are more organized by mid-October, over 100 people are still dying every day. The city’s streets and alleys are abandoned and silent. At night, it is completely dark without lamplighters to light the streetlamps. Those who walk around avoid each other so as not to contract the sickness, particularly steering clear of those who work at Bush Hill. Reverend Helmuth walks the city and observes the emptiness and smell of death. He ponders “this unmerciful enemy” (79), as it has ravaged his Lutheran congregation. He holds firm to the belief that Philadelphians have brought the fever on themselves.

There are indications that crime in the city has increased, with thieves targeting medicine and food supplies. Landlords have raised rents but jobless or dying tenants are unable to pay them. The committee attempts to help some renters avoid eviction by providing small amounts of cash to get them through the days or weeks ahead. However, they give the money directly to the landlords, who keep it and force tenants to leave anyway. October seems to have brought the city to its lowest point.

Benjamin Rush contracts the fever for a second time but initially opts not to use his cure. He continues to see sick people but collapses twice while visiting patients. Finally, he submits to his cure but is bedridden for six days. While he is indisposed, the fever reaches its peak in the city. It also spreads to the surrounding suburbs, despite everyone’s best efforts to keep it contained. Those who are dedicated to providing assistance, including the committee, the staff at Bush Hill, and the Free African society, continue to do what they can.

While there are many different means of coping with the situation, Philip Freneau, the editor of the National Gazette, often uses humor. Although he has shortened his newspaper to one page due to a shortage of paper, he mostly avoids news about the fever. He leaves that to Andrew Brown’s Federal Gazette, which remains the only paper that is published every day. Freneau uses humorous verses and dialogue to make light of the epidemic, attempting to provide a distraction from the horrors of the disease.