Pestilence Prevails...Fever in Philadelphia
That same MOSQUITO species makes news AGAIN!
The Zika virus now reported throughout Latin and South America is carried by the Aedes aegypti mosquito. In 1793—223 years ago—Philadelphia was devastated by a Yellow Fever epidemic. The Aedes aegypti mosquito carried the virus that caused the fever. Presently in the United States due to modern, sound public health practices the incidence of mosquito borne illness has significantly declined. Populations of the Aedes aegypti species do not flourish in the Philadelphia area.
When Pestilence Prevailed – Philadelphia History
It was not the first time, nor would it be the last, but it was the worst. It is generally accepted that in 1793, 10% of the local population perished from the Yellow Fever epidemic.
The terrifying symptoms came on quickly: fever, stiff neck and muscle pains, nausea, bloody nose and sometimes hemorrhages in the whites of the eyes (i.e. the whites of the eyes turned red). Followed by a remission phase, when the sufferer seemed to recover, and sometimes did. If not, the toxic phase ensued, with higher fever, jaundice of the skin and eyes (hence “Yellow Fever”) from liver and kidney failure, and uncontrollable bleeding from mucous membranes and GI tract (“black vomit”). Recovery at that point was rare, and death was usual.
The fever visited in the warmer months—late spring until frost. The only hope of avoiding this pestilence was to leave town. Those who had the means, transportation and a destination left – Germantown being a popular haven. Those who remained endured the choking smoke of burning barrels of tar and gunpowder fumes from cannon fire, as smoke was thought to “purify the air.” Citizens doused themselves with vinegar and wore camphor bags around their necks. Those nursing the sick attempted to keep patients in large airy rooms, changing their clothing and bed linens as often as possible. They tried to keep the streets clean—with corpses transported in closed carriages and wagons—they buried the dead.
Most physicians of the time were as frightened of Yellow Fever as was the general population, the cause of the scourge being unknown, so that the protective measures taken were guesswork. Refusing to help the sick, many doctors fled the city. Among those who courageously remained were Dr. Benjamin Rush (perhaps at that time America’s leading physician), his protégé, young Dr. Philip Syng Physick, newly returned to Philadelphia from his medical education in England and Scotland, and Drs. Cathrall, Hutchinson, Currie, Stevens and Jean Deveze. “Cures” were attempted, of course. The doctors disagreed with one another about the most effective methods. Dr. Rush and young Dr. Physick believed bleeding and purging to be the most effective, while Drs. Deveze and Currie advocated a regimen of rest, cooling compresses, tea, wine and a quiet, darkened room.
There was an attempt to quarantine the afflicted and eventually a hospital was provided for their care: Bush Hill, an empty mansion originally built by Andrew Hamilton, and chosen by Mayor Clarkson because it was on the city’s northern outskirts. Not realizing that “the contagion” was not spread from person to person, Philadelphia’s citizens feared the Yellow Fever victims close proximity!
Contribution of African Americans
It was suspected that Philadelphia’s African American population may have had some degree of immunity to this fever. Early on, Dr. Rush supported this theory. He asked his friends, Richard Allen and William Gray, members of the Free African Society, to recruit other African American citizens to help attend the sick. Generously, Allen and Absolom Jones toured parts of the City to view the disaster and reported what they found, and also at Rush’s request, reported to the Society’s elders. Absolom Jones and Richard Allen, both were respected ministers and became the first two volunteers. Alas, in about a month’s time evidence that Philadelphia’s black citizens were not immune surfaced. In spite of this, the African American citizens continued to nurse and transport the sick and bury the dead. Richard Allen and Absolom Jones, along with many other courageous black citizens, performed an enormous service to Philadelphia’s larger community in its time of crisis. In gratitude, and at Rush’s recommendation, Philadelphia gave Allen’s congregation a good piece of land on which they built a house of worship, Mother Bethel African Methodist Episcopal Church.
Later Knowledge of Cause and Spread of Yellow Fever
One of Yellow Fever’s most frightening aspects was its mysterious cause. Why it would appear, then burn itself out, could not be explained in the 18th and 19th centuries. It was suspected that trade among Africa, the West Indies and America somehow brought this unwelcome immigrant , Yellow Fever, nicknamed “Yellow Jack” because it caused profound jaundice in its victims.
Following the Spanish-American War, the United States federal government understood the necessity of protecting American servicemen from contracting Yellow Fever. Those stationed in parts of the Caribbean and in Cuba were at great risk. A panel comprised of doctors and public health officials was appointed to address issues of tropical diseases. Among those appointed was Dr. Walter Reed. This panel promoted the principles of mosquito control based on the theories of Cuban physician Dr. Carlos Finlay, the first to guess that Yellow Fever was a mosquito-borne disease. In 1901, military surgeons Dr. Walter Reed and Dr. William Gorgas proved Finlay’s theories and instituted swamp drainage and window screening on the housing of workers building the Panama Canal, which effectively prevented mosquitoes and Yellow Fever from defeating the construction of the Canal.
Now, with superior microscopes, we can actually see the virus that is carried by the female mosquito of the species Aedes aegypti, the natural vector. Infected mosquitoes remain lifetime carriers (lifetime being spring until frost). Feeding every three days, they spread the virus with every blood meal they take.
Yellow Fever – Still with Us Today
Philadelphia was not the only American city to be plagued by Yellow Fever epidemics; the disease was reported throughout the United States, most often in the southern port cities. The last Yellow Fever epidemic to strike in North America was in 1905, in New Orleans. Today, there is a vaccine against Yellow Fever. It is a preventative, not a cure. Many nations in the tropics demand that visitors have proof of being vaccinated against the fever. The vaccine is expensive, and most cases now worldwide are in Africa, among unvaccinated populations whose nations cannot afford a comprehensive vaccine program. There is still a high mortality rate, treatable only by supportive care. No cure exists.
August 12, 2016 thru October 30, 2016
ALL Physick House tours will feature a visit to the "sick room"... come see first hand how 18th century doctors treated their Yellow Fever patients!
We recommend these sources for further information:
Powell, J.H. Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in
1793. Philadelphia: University of Pennsylvania Press, 1949 with reprint 1993.
James E. Colberg, M.D.
Stacey Peeples, Curator-Lead Archivist, Pennsylvania Hospital
Robert Hicks, Director of the Mütter Museum and the Historical Medical Library, The College of Physicians of Philadelphia
Howard M. Snyder, III, M.D.
The Physick House Management Committee
The Physick House Site Managers: Suzanne Seesman and Ben Stout
In memory of Philip Syng Physick Randolph, III