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

A few weeks later, on August 19, doctors Hugh Hodge and John Foulke are called to the home of a dying woman named Catherine LeMaigre. Hodge and Foulke are part of the College of Physicians, and they try some mild treatments to help ease the woman’s pain. They give her wine and cold drinks and place a wet cloth to her forehead. When nothing proves to be effective, the doctors send for Benjamin Rush, who is also a member of the College.

Rush has been seeing a growing number of patients with the same symptoms as LeMaigre. They include chills, headaches, body aches, fever, and constipation. After a few days, just as the illness seems to be subsiding, the fever returns. The patient becomes weak and delirious, their skin and eyes turn yellow, and they vomit black blood. Rush also notices small red marks on the skin and observes that “they ‘resembled moscheto bites’” (15). He knows that there is nothing else that can be done for Mrs. LeMaigre and other patients in a similar condition, proclaiming to Hodge and Foulke “that ‘all was not right in our city’” (12).

Hodge believes the illness is due to the bad smells caused by the rotting coffee that was dumped in the water on August 3rd. The medical profession is still guided by the ancient Greek idea of humors. Good health is thought to be dependent on a balance of four bodily fluids known as the humors. Several factors could potentially throw the humors out of balance, including bad smells, which then lead to sickness and disease. Rush feels the illness might be yellow fever, an often deadly disease with no cure that he saw come through Philadelphia in 1762. It is commonly believed that yellow fever can also be spread through bad smells emitted by patients and their dirty clothes and bedding. Hodge and Foulke do not agree with Rush that it is yellow fever, marking the start of a rift within the College of Physicians.

Rush begins telling his friends to leave the city because it is in the midst of a yellow fever outbreak. While many residents in Philadelphia do not notice anything going on at first, the climbing death toll soon gets their attention. The mayor of Philadelphia, Matthew Clarkson, posts a notice in the newspaper warning people of a dangerous fever in the city. He orders the streets of the city be cleaned to eradicate some of the bad smells. Thomas Mifflin, the governor of Pennsylvania, also asks the port health officer, as well as the port physician, to investigate the situation and write a report. Although Clarkson and Mifflin are trying to maintain calm, both the fever and fear are spreading quickly.

Toward the end of August, hundreds of people begin leaving Philadelphia as the death toll grows even higher. Historical estimates put the number of residents who leave at around 20,000. Mayor Clarkson’s efforts to have the city cleaned up are moving slowly due to the large amount of people who are fleeing. Most of those who stay behind are poor and have no choice. However, some remain in the city to help, including Mayor Clarkson. Clarkson is 60 years old, his youngest child of nine has died of the fever, and his wife has recently become ill. Despite these factors, he decides he does not want to leave.

Clarkson asks the College of Physicians to gather, though only 16 of 26 doctors attend the meeting. Those who are present remain divided over the cause of the illness. One side is headed by Rush, who firmly believes the disease is yellow fever caused by the city’s foul smells like the rotting coffee. The other side is led by Dr. William Currie, who has written a book on yellow fever and feels that the sickness is something imported from the West Indies through those arriving from Santo Domingo. The division between the two camps only intensifies as the fever progresses.

At a second meeting of the College with only 11 doctors in attendance, a list of measures for residents to follow is issued and put in the newspapers. While the list recommends some precautionary measures like getting rid of bad-smelling clothes, it scares many people into leaving because it says to avoid anyone who is sick. The list also fails to offer a cure.

The city transforms as people leave, becoming emptier and quieter. Everything closes. Those who stay attempt to take a variety of preventative steps against contracting the fever. Some start smoking tobacco or chewing garlic, while others carry camphor, which is now an ingredient in insect repellant. Doctors and laypeople alike offer various remedies and concoctions in the newspapers. One named “A.B.” even advises readers how to kill off all the mosquitoes, which have been abundant in the city (28). Amidst the panic, Mayor Clarkson orders the city’s bells to stop tolling at each death because it is putting people further on edge.