During the hot and humid summer of 1793, thousands of Philadelphians fell horribly ill, suffering from fever and chills, yellowish skin, stomach pain and vomiting tinged with black blood.
By the end of August, as more and more people began to die from this mysterious disease, the wealthiest residents of the nation’s capital were fleeing en masse. The free black community in the city, for its part, remained largely behind and many were enlisted to help care for the sick.
“It’s called yellow fever, but it doesn’t sound like anything known or read by doctors,” wrote Secretary of State Thomas Jefferson in September 1793.
Debate on the causes of yellow fever
Arch Street Wharf in Philadelphia, where some of the first cases have been identified.
Bettmann Archives / Getty Images
At the time, no one knew what caused yellow fever or how it spreads. Some thought he had been brought to Philadelphia by a ship carrying French refugees from a slave rebellion in Santo Domingo (now Haiti). Others – including the city’s chief doctor, Dr. Benjamin Rush – believed it was caused by poor sanitation and the contaminated air of the city itself.
However the disease had arrived, the Philadelphians in 1793 were desperate to avoid catching it. They began to keep their distance from each other and avoided shaking hands. They covered their faces with handkerchiefs dipped in vinegar or smoked tobacco, which they said would prevent them from breathing contaminated air.
Leaving the wealthy city
Those who could afford to leave town quickly did so, including Jefferson himself. President George Washington, who returned to his beloved Mount Vernon estate, blamed his exit on the concerns of his wife, Martha.
Alexander Hamilton contracted yellow fever at the start of the epidemic, and he and his family left town for their summer home a few miles away. Hamilton’s wife Eliza quickly fell ill too, and their children were evacuated from Eliza’s parents in Albany, New York. They both recovered under the care of Dr. Edward Stevens, a childhood friend from Hamilton’s of St. Croix, whom he met again in Philadelphia.
WATCH: “Hamilton: Building America” on HISTORY Vault
Among the mass exoduses of some 20,000 Philadelphians – nearly half of the city’s total population at the time – during the yellow fever epidemic were many doctors in the city, who were terrified of the idea to get sick themselves. But Rush, the country’s largest health professional and signatory to the Declaration of Independence, stayed behind, working tirelessly to treat the rich and the poor. Rush lost his sister to illness and even fell ill himself, although he recovered.
Controversial treatment methods
Despite all of his efforts, Rush just had the wrong understanding of yellow fever like anyone else at the time. His undeniably harsh treatments – including blood bleeding, “mercurial sweat powder” and forced vomiting – did not stop the spread of the disease, and critics argued that this only added to the suffering of his patients. These critics included Hamilton, who took up his pen to publicize the milder methods prescribed by his own doctor, which consisted of taking cold baths, drinking Madeira wine and hot brandy, and ingesting large amounts of quinine ( aka “Peruvian bark”), according to biographer Ron Chernow.
Stevens’ homeopathic approach, however, has proven to be little more effective than more traditional Rush methods, and yellow fever has continued to spread. By the time of its disappearance in November 1793, the disease had killed 5,000 people, about a tenth of the population of Philadelphia at the time, and infected hundreds of thousands more. Despite extensive research into the disease in the decades following the epidemic, it will take more than a century – and a savage epidemic among troops fighting the Spanish American War – before Dr. Walter Reed proved in 1900 that the mosquitoes carry yellow fever.
Philadelphia’s Free Black Community Care for the Sick
“Parents abandon their children as soon as they are infected, and in every room you enter, you see no one but a lonely black man or woman near the sick,” Rush wrote to his wife, Julia , who was in Princeton, New Jersey, with the couple’s children during the epidemic of 1793. “Many people push their parents onto the street as soon as they complain of headaches.”
As his letter indicates, Rush has recruited members of the free African-American community in Philadelphia to care for many of the victims of the fever and to do much of the essential work necessary to maintain the city during the epidemic. He and other white doctors initially (and wrongly) thought that African Americans were immune to yellow fever due to supposed biological differences based on race.
Rush was an ardent abolitionist and had supported the efforts of the city’s black community to form their own churches to protest the segregation of white-led churches. Led by Richard Allen, the co-founder of the African Methodist Episcopal Church, and his colleague Minister Absalom Jones, black volunteers did crucial work during the yellow fever epidemic in Philadelphia.
When publisher Matthew Carey, who was part of the city’s health committee, published his account of the epidemic from October 1793, he accused members of the free black community in Philadelphia of taking advantage of the epidemic, and even robbing the homes of victims of fever. In response, Allen and Jones published their own pamphlets in early 1794 refuting these charges in detail. By including eyewitness accounts of the work done by black Philadelphians to treat patients, as well as detailed documentation of payments and expenses, the two ministers forced Carey to revise his chronicle of the epidemic in later editions.
The work of Allen and Jones was the first copyright-protected pamphlet written by black authors in the history of the country. Titled An account of the procedures of the black people, during the end of the terrible calamity in Philadelphia, in the year 1793, he documented the racism and abuse that free African-Americans suffered, even though they played a crucial role in fighting the epidemic of the most serious disease in the history of this still young nation.
