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

Bush Hill is an abandoned mansion that the mayor, along with the Overseers and Guardians of the Poor, decide to turn into a hospital for yellow fever patients. The owner is in England and the caretaker is unable to stop them from taking control of the mansion. The hospital is set up a few weeks after the disease begins to spread and is initially very disorganized and poorly run.

However, wealthy merchant Stephen Girard and barrel maker Peter Helm soon step in to manage the hospital. They bring in a regular doctor, separate the dying from the sick and recovering, station more nurses in the building, and find a way to pump in fresh water. Bush Hill “became a pocket of calm and hope” (76), and at its peak it houses over 100 patients.

The College of Physicians is a prestigious medical society comprised of the country’s best doctors of the time. They are called upon by Mayor Clarkson to assemble a few weeks after the yellow fever epidemic begins and provide leadership and guidance to the city. However, the College, which includes Benjamin Rush, becomes divided over the cause of yellow fever. One side, headed by Rush, believes the source of the outbreak is local, while the other, led by Dr. William Currie, thinks it is imported. This disagreement lasts for the duration of the epidemic and beyond.

While the number of members quickly dwindles as many flee the city or fall ill, the College remains divided and continues to argue. When Governor Mifflin asks them to reconvene in late October to write a report about the cause, the divisions run so deep that Benjamin Rush ends up resigning. The College continues to argue over the disease’s origins and an appropriate cure.

In 1947, the Pan American Sanitary Bureau begins spraying the pesticide dichloro-diphenyl-trichloroethane, or DDT, to try to rid the Western Hemisphere of Aedes Aegypti. However, it fails to kill all the mosquitoes and leaves many of the survivors, as well as their offspring, resistant to DDT. The environmental impact of spraying DDT is also criticized in the 1960s, most notably in the 1962 book Silent Spring by Rachel Carson, because of its potential health risks. DDT is banned in 1972.

Established in Philadelphia in 1787, the Free African Society is the first organization created by African Americans to help other African Americans. It is headed by a group of elders that includes Absalom Jones and Richard Allen. During the epidemic, Benjamin Rush asks them to assist with yellow fever patients. Despite having faced racism from white Philadelphians, the Society agrees to help. They send out nurses and volunteers daily to tend to the sick and dying.

During and after the epidemic, the Society deals with complaints about African American nurses raising their prices and taking advantage of the sick. In January 1794, Jones and Allen pen a response to Matthew Carey’s criticisms on this matter in his best-selling book, debunking his inaccurate claims. Although he apologizes to Jones and Allen, Carey’s compromise is to simply add into the final edition of his book that white nurses also drove prices up, rather than giving the African American nurses their proper credit.

Like yellow fever, malaria is disease that is carried by mosquitoes. While it is different from yellow fever, Murphy draws some important similarities between the two. The discovery in 1898 that mosquitoes carried the malaria parasite led to doctors making the same link a few years later with yellow fever. There is also no cure for Malaria, and it remains a deadly disease in many parts of the world, including Africa, Asia, and South America.

The “Ten-and-Ten” is a controversial cure for yellow fever offered by Benjamin Rush during the height of the epidemic. Initially, it calls for mixing 10 grains each of calomel, which is mercury, and a toxic root called jalap. The mixture poisons the patient, forcing them to violently purge their bodies. It is then followed by intense bloodletting. Doctors at the time believe that the body holds 25 pounds of blood, but it holds much less, so people often pass out from Rush’s treatment. However, this is simply seen as an indication that the cure is effective.

When the treatment appears to work on a patient, Rush increases the dose to 10 grains of mercury and 15 of jalap to make the process go faster. He recommends it three times daily, with the goal of inducing five major purges. After Rush uses the cure on himself, demand for it dramatically increases. He recruits the Free African Society and other volunteers to help him administer it. However, the cure is immediately considered highly controversial for its excessiveness, driving further divisions within the College of Physicians. Eventually, it permanently tarnishes Rush’s reputation.