11 Things You Might Not Know About Philly’s 1793 Yellow Fever Epidemic

A series of 19th-century images depicting the development of yellow fever. | Images courtesy of Wellcome Images via Wikimedia Commons

The summer of 1793 was unusually dry and hot in Philadelphia. The city founded by William Penn — the largest in the nation, with some 50,000 residents — was still the capital of the United States, pending completion of the new city of Washington being built to the south. On the Continent, the French were at war with a number of countries, including Great Britain, Spain and Austria; Napoleon Bonaparte had just been appointed artillery commander of the Republican forces at the siege of Toulon. The American people largely supported the Republican cause, though President George Washington hewed to neutrality.

John Adams would later write that 10,000 citizens were marching in Philadelphia’s streets, threatening to drag Washington from his house and force him to “declare war in favor of the French Revolution.” Adams was convinced that only the arrival of the yellow fever prevented complete political chaos. If so, the cost of prevention was fearfully high. Here are 11 things you might not know about the four months of deadly terror that swept our city:

1. Though an effective vaccine now exists, yellow fever still kills some 30,000 people every year, about 90 percent of them in Africa. A bout of the disease typically begins with fever and chills, after which the patient seems to recover. But following this remission, which may last several days, the sufferer’s skin turns yellow and he or she falls into a stupor, throws up black vomit (another name for the illness), becomes incontinent and wastes away.
2. Philadelphians initially blamed the 1793 outbreak, which started with two deaths in August, on shiploads of refugees from the French colony of Saint-Domingue on Hispaniola, who were escaping that island’s slave revolution. It was believed that the disease spread from person to person rather than via bites from the Aedes aegypti mosquito — the same one implicated in Zika fever.
3. Philadelphia was considered the hottest and dampest of all the cities on the Atlantic seacoast — even worse than Charleston or Savannah. The city was surrounded by marshes and swamps. The Dock Creek was the single (open) sewer; in the rest of the city, liquids and waste (including offal and dead animals) were thrown into holes dug into the ground that also captured rain runoff. Residents stored rainwater in barrels. All of this provided a perfect breeding ground for mosquitoes. The 1793 epidemic — which was followed by lesser outbreaks in 1794, 1797 and 1798 — propelled the establishment in 1800 of the first municipal water system in America, designed by Benjamin Latrobe at Centre Square. But this wasn’t because people realized that mosquitoes were the problem; they simply connected the fetid environment with sickness.
4. Among the recommendations for staving off the fever were smoking tobacco, cleaning the house and/or one’s person with vinegar, carrying a tarred rope, covering the floors of rooms with a two-inch-deep layer of dirt (to be replaced daily), chewing garlic, hanging a bag of camphor around one’s neck, and lighting bonfires and/or setting off guns in the streets.
5. The city’s 16-member College of Physicians strongly disagreed on how to treat the disease but managed to come up with 11 recommendations that included the immediate silencing of the church bells that were constantly tolling for the dead and getting on everyone’s nerves. Among its other duties, the College of Physicians managed a singular Philadelphia institution, “The Humane Society for Recovering Persons From Suspended Animation &c.,” which was founded to treat victims of drowning (the “Suspended Animation”) but had expanded to deal with sufferers from heat, cold, lightning strikes, suffocation and the like (the “&c.”).
6. A rush of paupers with the fever impelled the city’s “Overseers and Guardians of the Poor” to requisition for their housing an enclosed amphitheater at 12th and Market that had just been built by famed Scottish equestrian John Bill Ricketts to house his circus. When nearby homeowners threatened to burn the place down because of the “repulsive sick” it contained, the Guardians commandeered the vacant Bush Hill estate north of Vine Street, built by prototypical Philadelphia lawyer Andrew Hamilton, for a hospital.
7. Twenty thousand people, including the nation’s political leaders — mostly those with country houses or friends with country houses — vacated their homes in the city because of the epidemic. Left to deal with the crisis were the middle class, the ever-present poor, and a small cadre of physicians, most prominently Benjamin Rush, who though he lost a host of patients never wavered in his recommended treatment: copious bloodletting — he falsely believed there to be twice as much blood in the human body as there is — and purging via heavy doses of mercury, which turned the teeth and mouths of those who survived it black. On one occasion, when Rush was recommending this regimen to several hundred citizens gathered in Kensington, a voice cried out from the crowd: “What, bleed and purge every one?” The doctor shouted back: “Yes! Bleed and purge all Kensington!”
8. At the start of the epidemic, it was (falsely) believed the city’s 2,500 African-American residents were immune from the fever. Among the heroes of the calamity were preachers Absalom Jones and Richard Allen, founders of the Free African Society. The two men — who’d been born in slavery but bought their freedom — transported the sick, buried the dead, bled the ill under Rush’s direction, and convinced Mayor Matthew Clarkson to free black prisoners from the Walnut Street Jail to serve as nurses at Bush Hill.
9. Among the city’s citizens was a young Quaker lawyer, John Todd Jr., who had handsome prospects, a beautiful young Southern wife, née Dolley Payne, and two sons, ages two and just-born. He took his family to a Grays Ferry farmhouse during the epidemic while he remained in the city to draw up wills and settle estates; he also cared for his mother and father after they fell ill. According to legend, when stricken himself, he rode to the farmhouse, collapsed on the threshold, and gasped to Dolley’s mother: “I feel the fever in my veins, but I must see her once more.” Dolley hurried down the stairs and gathered him in her arms. He died that night. Dolley and the rest of the family took ill as well; the baby died, but the others recovered. Eleven months later, Dolley wed the distinguished Congressman James Madison, 20 years older and considerably shorter than she was. In 1809, Dolley Payne Todd Madison became the fourth First Lady of the United States.
10. French financier Stephen Girard took charge of Bush Hill during the epidemic, staffing it with a number of his countrymen, spending much of his vast fortune on its provisioning and maintenance, and keeping meticulous records of the sick and dead. Patients there were cared for by physician Jean Devèze via the “French treatment,” which involved making sure everything was very clean and drinking lots of lemonade and wine. While the city’s sick at first were loath to be sent to the Bush Hill “lazaretto,” by the tail end of the epidemic it was so popular that potential patients were required to prove they had yellow fever.
11. At the height of the epidemic, in mid-October, more than a hundred people perished every day. President Washington dithered over whether Congress should convene here for its fourth session, since the Constitution dictated that its meetings had to be held in Philadelphia. Finally, in late October, the death toll started downward as colder weather killed off the mosquitoes, and the city’s far-flung residents began to return home. Former U.S. Postmaster Ebenezer Hazard wrote that he hoped the epidemic would prove instrumental in countering the “prevailing taste for enlarging Philadelphia, and crowding so many human beings together on so small a part of the earth.” It didn’t.

Follow @SandyHingston on Twitter.