Yellow Fever Epidemic of 1793 - Controversy Over Treatment

Controversy Over Treatment

Given the limited resources and knowledge of the times, the city's response was creditable. The medical community did not know the natural history of yellow fever, a viral infection spread by the Aedes aegypti mosquito. Efforts to clean the city did not defeat the spread of the fever as that mosquito breeds in clean water. Philadelphia's newspapers continued to publish during the epidemic, and through them doctors and others tried to understand and combat the epidemic. On September 7, Dr. Adam Kuhn advised patients to treat symptoms as they arose; he had studied medicine at the University of Upsala in Sweden.

Rush claimed that he tried Kuhn's and Steven's stimulating remedies, and his patients still died. He recommended other treatments, including purging and bloodletting, and published his theories. The hope offered by any of these treatments was soon dashed when it became clear that they did not cure the disease, and the doctors' competing claims demoralized patients.

In his 1794 account of the epidemic, Matthew Carey noted that other doctors claimed to have used calomel before Rush and that "its efficacy was great and rescued many from death." Carey added that the "efficacy of bleeding, in all cases not attended with putridity, was great." Rush taught the African-American nurses how to bleed and purge patients. Allen and Jones wrote that they were thankful that "we have been the instruments, in the hand of God, for saving the lives of hundreds of our suffering fellow mortals." Rush's brand of medicine became the standard American treatment for fevers in the 1790s and was widely used for the next 50 years.

Rush's claim that his remedies cured 99 out of 100 patients have led historians and modern doctors to ridicule his remedies and approach to medical science. Some contemporaries also attacked him. The newspaper editor William Cobbett attacked Rush's therapies and called him a "Sangrado," after a character in Gil Blas, who bled patients to death. In 1799 Rush won a $5,000 libel judgment against Cobbett.