Man Helping Sick Person

By MICHAEL SCHREIBER

Slightly over 200 years ago, Philadelphia was devastated by recurring waves of yellow fever. The epidemic of 1793 wiped out a tenth of the population of the city and adjacent areas, and thousands more died from outbreaks of the disease throughout the next decade. With some similarities to today’s COVID-19 epidemic, proportionally far more died in the cramped houses and narrow streets of the poorer districts than in the wealthier areas where people had the means to flee the city.

When the epidemics of 1797 and 1798 arrived, the authorities already had some experience in caring for the stricken population. The 1793 epidemic, however, hit Philadelphia like a tsunami, without warning and without the least expectation. In fact, in the spring of that year, the mood in Philadelphia had been quite optimistic and gay. The burgeoning population of French-speaking refugees only added to the feeling that this city, the capital and metropolis of the United States, was on the cusp of new prosperity.

During the whole of July, French colonial families, refugees from the Black revolution in Saint Domingue (Haiti), continued to pour into the city—accompanied by whatever house slaves they had been able to muster. But toward the end of the month, ghastly stories began to circulate concerning some of the vessels that had come into port carrying the fugitives, as well as vessels that had returned from other islands of the West Indies. It was whispered that several passengers and members of the crews had become feverish and died soon after arriving.

An infection on Water Street

Some in the city, such as the physician William Currie, claimed that an infection had spread from the Sans Culottes de Marseilles, a French privateer that was tied up at Race Street, together with her British prize, the Flora. This was bolstered by the account of the French merchant Peter LeMaigre and other inhabitants of Water Street, who reported that they had seen dead bodies carried out of the cabins of both vessels and deposited onto the wharf.

In the middle of August, the physician Benjamin Rush was called to the bedside of Peter LeMaigre’s wife, Catherine, who was suffering with a fever that had lingered for some days. After consulting with other doctors, Rush learned that an unusual number of their patients in the tight canyons of Water Street and its nearby alleys had recently succumbed to fevers. Symptoms shared by many of the victims included bloodshot eyes, sallow skin, clammy hands in the early stages, and raging fever and black vomit in the day or two before death.

By consulting old medical texts, Rush noted that the observations made by his colleagues seemed to match the descriptions of a fever that had not been seen in Philadelphia for over 30 years. That pestilence of 1762 had been popularly named the Barbados Fever for its supposed source; doctors generally referred to it as the bilious remitting yellow fever.

In the meantime, the residents of Water Street and its environs had complained to the city authorities about an acrid odor that rose far above the usual stench of the neighborhood. The source was not difficult to locate, however. Some days earlier, the sloop Amelia had come into port carrying a cargo of coffee that had rotted on its voyage from the West Indies. The coffee bags had been dumped at Ball’s Wharf, above Arch Street, allowing the mass to putrefy in the heat.

Benjamin Rush and other doctors became convinced that a miasma, or vapor, emanating from the coffee had carried the fever throughout the dockside neighborhoods and even northward some miles to the village of Kensington—where the sailors on the Sans Culottes had died.

This was the outset of a bitter public debate among physicians and amateurs alike concerning the sources and nature of the disease, and the most efficacious preventatives and cures. The debate had strong political repercussions. Supporters of the Federalist Party tended to endorse the theory that the contagion had been carried here by French refugees and sailors. They considered the fever to be one more instance of how the pollution generated by the too radical French Revolution was now wafting over American shores. Jeffersonian Democrats, on the other hand, tended to line up with Rush’s view that the yellow fever had risen from conditions of filth and putrefaction in Philadelphia.

Doctors who agreed with Rush pointed to the graveyards as a source of the “corrupted air.” Other supposed sources were the tan yards and starch manufactories along the creeks, and the ditches that surrounded the city, from which clay was extracted for bricks and which were often filled with stagnant water.

Nobody could deny, of course, that the ditches were also spawning areas for the prodigious swarms of mosquitoes that summer. An uncommonly wet springtime had been followed by two months of drought, leaving numerous pools for the insects to breed in. Although some people felt, almost instinctively, that the mosquitoes had something to do with the disease, none of the doctors of the time assigned any importance to the matter. It took over a century for medical science, especially through the work of the Cuban scientist Dr. Carlos Finlay and a later U.S. Army team led by Dr. Walter Reed, to conclude that yellow fever is a virus spread by the female of several species of mosquito, especially the Aedes aegypti.

African American caregivers

In late August 1793, Benjamin Rush had a conversation with the African American religious and social leader Richard Allen, in which Rush proposed that the Black population play an important role in providing nurses and other caregivers during the yellow fever epidemic. The doctor went on to assure Allen that Black people were immune to the fever, and suggested that those beneficial attributes that God had bestowed upon the Black population left them with a moral duty to attend to those who were less favored.

Rush’s assumptions on immunity—which soon were shown to be erroneous—might have been based in part on the fact that illnesses among the Black population to date had not been reported to doctors or considered significant by them. The fact remained, however, that anyone who had once lived in latitudes where yellow fever was more prevalent might have gained immunity from previous exposure to the virus; this could have had an effect upon the sizable number of Blacks in Philadelphia who had been born in Africa or the West Indies or who had toiled on Southern plantations. As it turned out, unfortunately, the rate of infection in the Black population was probably increased by the fact that relatively few Blacks were able to flee the city. It has been estimated that the death rate among Black people was about 9 percent, as opposed to 14 percent among whites.

But whether or not Richard Allen feared there would be a high mortal risk to Black people, he agreed to consider Rush’s request for aid. He was grateful, of course, that Rush had been highly supportive of the efforts by Black people to organize their own community institutions, such as the Free African Society. For example, Rush had signed the petition that the Free African Society had issued to rent and fence off a distinct section of the Potters’ Field for Black burials, and he had helped in the crucial task of raising funds for the African Church. Only a couple of days earlier, he had been one of the guests of honor at the momentous groundbreaking for the African Church on S. Fifth Street—what later became the African Episcopal Church of St. Thomas.

On the other hand, Richard Allen and other Black leaders such as Absalom Jones were mindful that Rush was representative of only a small minority of figures in the white population who were actively supportive of their aims. In recent months, moreover, the Black community had been confronted by the spectacle of slave ships entering the port of Philadelphia without challenge—that is, ships containing wealthy whites fleeing the revolution in Haiti together with their enslaved Black servants. And that outrage was compounded by the fact that many white people who might have been sympathetic toward donating funds for the African Church instead gave funds toward the cause of the Haitian refugee slaveholders.

Nevertheless, Richard Allen and Absalom Jones put those indignities aside, perceiving the situation as an opportunity to prove the mettle of the Black community and perhaps win recognition from those whites who had been prejudiced against them. On Sept. 5, they placed Rush’s proposal on the agenda of a meeting of the Free African Society, and having gained approval from the membership, volunteered their services the next day to Mayor Matthew Clarkson.

Allen and Jones soon placed advertisements in the newspapers for members of the Black community to step forward against the yellow fever. Their notice in the General Advertiser states, “As it is a time of great distress in this city many people of black colour under a grateful remembrance of the favours received from the white inhabitants have agreed to assist them as far as is in their power for nursing of the sick and burial of the dead.” In an ironic and tragic juxtaposition, the Black ministers’ expression of gratefulness for “favours from the whites” appeared in the Sept. 14, 1793, edition of the paper next to another ad by one “Citizen LaSalle, living near the Hospital,” who promised eight dollars reward for the apprehension of “two runaway Negroes.” One of the men, the ad noted, was about eighteen years old and “stamped” (branded) on his right breast. The other was about fourteen years of age.

It is unfortunate that the Black caregivers often received little thanks for their efforts. After the epidemic had receded, journalist Matthew Carey returned to the city and soon published a pamphlet on the horrors of that summer. But the accuracy of his account was tarnished due to the fact that he used the pamphlet to lash out at the Black nurses and carters for allegedly charging their patients exorbitant prices and for theft. The Reverends Allen and Jones quickly wrote their own pamphlet, “A Narrative of the Proceedings of the Black People during the late Awful Calamity in Philadelphia in the Year 1793,” which defended the Black community. They pointed out that many of the caretakers offered their services for free and that others, who treated thousands of victims, only earned a combined total of slightly over $200. In regard to theft, the authors said, while there might have been pilfering here and there, it was certainly no more than that committed by white citizens.

The Bush Hill hospital

Since Pennsylvania Hospital refused to admit yellow fever victims for fear that the contagion would spread to its other patients, a new hospital was set up within the enclosure for Ricketts’ Circus. Bill Ricketts had been performing for the summer season in New York City, and his open-air arena was vacant. But neighbors of the circus quickly raised a cry against housing fever victims in their vicinity. Accordingly, William Hamilton’s Bush Hill mansion, which currently had no tenant and was located in a semi-rural district, was acquired by the city for use as an asylum, with the French physician, Dr. Jean Deveze, in overall charge. Yet the mounting and unexpected rise in casualties overwhelmed the arrangements that had been made for their care and treatment. Complaints were received that piles of coffins were left unburied and unattended in the Potters Field.

Mayor Clarkson called a public meeting at City Hall for Sept. 12 to attempt to deal with the growing disaster. An executive committee of twenty-seven men was organized at the meeting, which then had its first session on Sept. 14. The young doctors Isaac Catheral and Philip Syng Physick reported on the situation at Bush Hill: “That the Hospital is without order or arrangement, far from being clean, and stand in immediate need of several qualified persons to begin and establish the necessary arrangements.” This was approved and steps were taken to procure more supplies, a chief physician, a barber/ bleeder, and eight more nurses—and to raise money for these purposes.

Other measures were also taken, such as appointing a large sub-committee of citizens from different parts of the city, Southwark, and Northern Liberties to aid the sick and distressed in their neighborhoods. The task of the volunteers was to go house to house to ascertain the needs of the residents. They were to determine whether anyone needed transport to Bush Hill hospital—or a death cart. Houses containing sick persons were to have an X painted on their doors. The committee members were to make certain that the public ways were clean and sanitary.

Yet for a while, many public functions continued unimpeded. Mayor Clarkson called a public meeting at City Hall for Sept. 16. All constables were ordered to report to court on that date. When Sept. 16 arrived, however, it became clear that normal court business would have to be suspended until the plague had lifted. By that time, lines of wagons and coaches could be seen, carrying out of town all those who could afford to flee.

But many stayed to help. The Rev. Justius Heinrich Christian Helmuth, pastor of St. Michael’s and Zion German Lutheran Church, informed the dwindling congregation of his determination to stay behind in order to comfort the sick and healthy alike. The minister proclaimed from the pulpit, “You see before you today a dead man.” He survived, although over 600 others from his congregation lost their lives in the epidemic.

Yellow fever still causes misery today. The World Health Organization estimates that some 200,000 yellow fever cases occur each year, with 30,000 related deaths—despite the existence of a vaccine. Most cases occur in tropical regions of Africa and South America, but with persistent global warming due to climate change, the range of yellow fever is likely to spread—along with other mosquito-borne diseases, such as malaria, dengue fever, West Nile virus, and Zika. And now with COVID-19, Philadelphia—this time with the rest of the world—is once again standing in the crosshairs of a raging epidemic.