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Epidemic in Philadelphia, 1793

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In 1793 Philadelphia was the nation's largest city and its capital, home to prominent citizens like Thomas Jefferson, George Washington, and Alexander Hamilton. It was also the site of the most fearsome epidemic to strike the young nation.

The First Cases
Benjamin Rush Dr. Benjamin Rush, one of the city's most prominent physicians and a signer of the Declaration of Independence, was called to the home of Dr. Hugh Hodge on August 5. Hodge's young daughter was jaundiced, suffering from a high fever, and vomiting blood. She died that day. Over the next two weeks, Rush saw many more patients with the same symptoms, several of whom also died. On August 21, he told Mayor Matthew Clarkson that unsanitary conditions in the bustling city were causing a yellow fever epidemic.

Conflicting Theories
Not everyone agreed on the cause. While Rush determined that the illness originated locally, the governor blamed foreigners from the West Indies. Other doctors argued that the disease had arrived on boats from the Caribbean and supported a quarantine of the vessels and passengers. Doctors also disagreed about treatment, with some advocating bleeding and purging while others proposed milder remedies such as teas and cold baths. Regardless, nothing was working to stem the crisis.

"Quit the City"
Alexander Hamilton The mayor convened the College of Physicians, which on August 27 advised people to avoid infected cases if possible and keep the streets clean, among other measures. Rush beseeched all "that can move, to quit the city." About 20,000 people fled, including George Washington, who explained that "as Mrs. Washington was unwilling to leave me surrounded by the malignant fever which prevailed, I could not think of hazarding her and the Children any longer by my continuance in the city, the house in which we lived being, in a manner, blockaded, by the disorder." Thomas Jefferson observed: "Everybody who can, is fleeing from the city, and the panic of the country people is likely to add famine to the disease." Treasury Secretary Alexander Hamilton left also but not before contracting the disease. He recovered but as he fled to Albany was treated as an outcast, a treatment typically afforded sick refugees.

Fear Rushes In
As the deadly disease spread, Irish American publisher Mathew Carey chronicled the reaction of city residents who remained: "The consternation of the people of Philadelphia, at this period, was carried beyond all bounds. Dismay and affright were visible in almost every person's countenance." Acquaintances and friends avoided each other in the street, he noted. In some households, family members were banished into the street when they complained of a headache, a common precursor to yellow fever. "Parents desert their children as soon as they are infected," lamented Rush, "and in every room you enter you see no person but a solitary black man or woman near the sick."

Serving the Afflicted
Independence Hall Indeed, most of the black residents of Philadelphia remained in the city and helped the stricken white residents. Members of Philadelphia's African Society, who held the common belief that black people were immune to the disease, offered their services to the mayor, fulfilling many responsibilities abandoned by white residents. The mayor would later write of the volunteer effort among black residents: "Their diligence, attention and decency of deportment, afforded me, at the time, much satisfaction." The belief in immunity turned out to be unfounded; 240 black residents died of yellow fever.

A Welcome Frost
On September 12, Mayor Clarkson warned a group of citizens that the city was approaching anarchy. At the time, the epidemic was worsening, with deaths ranging from 67 on September 16 to 96 on September 24. The city's burial grounds were nearly filled. Meanwhile, cities in surrounding states established quarantine houses or roadblocks to stop Philadelphians from entering. October brought higher death tolls but also relief. At the end of the month, a welcomed frost, which had been known to end previous epidemics, arrived. On October 31, a white flag flew over the city hospital, signifying that no yellow fever patients remained. The disease caused an estimated 5,000 deaths that year in Philadelphia, about a tenth of the residents of the city and its suburbs.

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