The Yellow Fever Epidemic in Philadelphia, 1793

Observations Upon the Origin of the Malignant Bilious, or Yellow Fever in Philadelphia. From the holdings of Center for the History of Medicine/Francis A. Countway Library of Medicine—Harvard Medical School.

Yellow fever is known for bringing on a characteristic yellow tinge to the eyes and skin, and for the terrible “black vomit” caused by bleeding into the stomach. Known today to be spread by infected mosquitoes, yellow fever was long believed to be a miasmatic disease originating in rotting vegetable matter and other putrefying filth, and most believed the fever to be contagious.

The first major American yellow fever epidemic hit Philadelphia in July 1793 and peaked during the first weeks of October. Philadelphia, then the nation’s capital, was the most cosmopolitan city in the United States. Two thousand free blacks lived there, as well as many recent white French-speaking arrivals from the colony of Santo Domingo, who were fleeing from a slave rebellion. Major Revolutionary political figures lived there, and in the first week of September, Thomas Jefferson wrote to James Madison that everyone who could escape the city was doing so. The epidemic depopulated Philadelphia: 5,000 out of a population of 45,000 died, and chronicler Mathew Carey estimated that another 17,000 fled.

Benjamin Rush: Coffee and Blood

Benjamin Rush, a Philadelphia physician and signer of the Declaration of Independence, became highly regarded for his work during the 1793 epidemic. Rush thought that the outbreak had originated in a pile of rotting coffee beans left on the docks. He developed a very aggressive approach to treatment, copiously bleeding his patients and administering large quantities of mercury. These aggressive therapeutics became known, not always favorably, as “heroic medicine.”

As the population fled or died, few were left to attend to nursing and burying duties. Rush, who believed that blacks were immune to yellow fever, asked members of the African Society to come forward and care for to the sick and the dead. Absalom Jones and Richard Allen, two free black men, volunteered. In a few weeks Jones, Allen and others were bleeding hundreds of people a day under Rush’s direction, as well as nursing patients and carrying coffins.

About two months into the epidemic, however, Rush was proven wrong and blacks began to fall ill, dying from yellow fever at about the same rate as whites. Their efforts, though praised by Rush, were scorned by the white public as being profiteering and extortionist. In response, Jones and Allen published their own description of their experiences.

The Santo Domingan Influence

The Bush Hill Hospital, which housed the sick poor, was desperately understaffed. When Philadelphia’s mayor asked the public for help, a French-born merchant from Santo Domingo named Stephen Girard stepped up and recommended his compatriot, Dr. Jean Devèze, to head the hospital. Devèze refused to believe that yellow fever was contagious and he disapproved of Rush’s aggressive treatments. Devèze later became a world authority on yellow fever.

Selected Contagion Resources

This is a partial list of digitized materials available in Contagion: Historical Views of Diseases and Epidemics. For additional materials on the topic “The Yellow Fever Epidemic in Philadelphia, 1793” click here or search the collection’s Catalog and Full Text databases.