Yellow Fever Epidemic of 1793 - Epidemic Declared

Epidemic Declared

After two weeks and an increasing number of fever cases, Dr. Benjamin Rush, a doctor's apprentice during the city's 1762 yellow fever epidemic, saw the pattern; he recognized that yellow fever had returned. Rush alerted his colleagues and the government that the city faced an epidemic of "highly contagious, as well as mortal... bilious remitting yellow fever." Adding to the alarm was that, unlike with most fevers, the principal victims were not the very young or very old. Many of the early deaths were teenagers and heads of families in the dockside areas. Believing the refugees- from Saint-Domingue were carrying the disease, the city imposed a 2-3 week quarantine on immigrants and their goods, but was unable to enforce it as the epidemic increased its reach.

Then the largest city in the US, with around 50,000 residents, Philadelphia was relatively compact and most houses were within seven blocks of its major port on the Delaware River. Docking facilities extended from Southwark south of the city to Kensington to the north. Cases of fever clustered at first around the Arch Street wharf. Rush blamed "some damaged coffee which putrefied on the wharf near Arch Street" for causing the fevers. Soon cases appeared in Kensington. As the port was critical to the state's economy, the Pennsylvania governor, Thomas Mifflin, had responsibility for its health. He asked the port physician, Dr. James Hutchinson, to assess conditions. The doctor found that 67 of about 400 residents near the Arch Street wharf were sick, but only 12 had "malignant fevers." Alarmed by what Rush and others told him, Mayor Matthew Clarkson asked the city's medical society, the College of Physicians, to meet and advise the city's government and citizens how to proceed.

Rush later described some early cases: On August 7, he treated a young man for headaches, fever and vomiting, and on the 15th treated his brother. On the same day a woman he was treating turned yellow. On the 18th a man in the third day of a fever had no pulse, was cold, clammy, and yellow, but he could sit up in his bed. He died a few hours later. On the 19th a woman Rush visited died within hours. Another physician said five persons within sight of her door died. None of those victims was a recent immigrant.

The College published a letter in the city's newspapers, written by a committee headed by Rush, suggesting 11 measures to prevent the "progress" of the fever. They warned citizens to avoid fatigue, the hot sun, night air, too much liquor, and anything else that might lower their resistance. Vinegar and camphor in infected rooms "cannot be used too frequently upon handkerchiefs, or in smelling bottles, by persons whose duty calls to visit or attend the sick." They outlined measures for city officials: stopping the tolling of church bells and making burials private; cleaning streets and wharves; exploding gunpowder in the street to increase the amount of oxygen. Everyone should avoid unnecessary contact with the sick. Crews were sent to clean the wharves, streets and the market, which cheered those remaining in the city. Many who could left the city.

Elizabeth Drinker, a married Quaker woman, kept a journal for years; her account from August 23 through August 30 tells the quickening story of the spread of the disease in the city and the rising toll of deaths. She also describes the many people leaving the city.