![A white man carries a sick white man across a street, while two other men watch](images/spacer.png)
Man Helping Sick Person, ca. 1900
Courtesy Getty Images
After the city and federal governments all but collapsed, residents of Philadelphia during the 1793 yellow fever epidemic were forced to care for their sick neighbors. The epidemic killed over 4,000 people and caused tens of thousands to flee the city.
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An Account of the Bilious Remitting Yellow Fever, as It Appeared in the City of Philadelphia, in the Year 1793, Benjamin Rush, Philadelphia, 1794
Courtesy National Library of Medicine
Dr. Benjamin Rush, a prominent Philadelphia physician and signer of the Declaration of Independence, split from many of his medical peers over the suspected origins and best treatment of yellow fever. In his book, Rush chronicled his approach to the disease and experience treating yellow fever patients.
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Congressional Pugilists, 1798
Courtesy Library of Congress, Prints and Photographs Division
Both the Federalists and the Republicans, America’s first political parties, sparred over a variety of national as well as local Philadelphia issues. Members of each party seized on the yellow fever epidemic to advance their respective agendas. As a result, Philadelphia’s sick and dying received medical care informed as much by politics as by the best available science.
![A 4-panel lithograph of a white man with worsening symptoms of yellow fever, including bleeding from the nose and mouth](images/spacer.png)
Four illustrations showing the progress of yellow fever in Observations sur la fièvre jaune, faites à Cadix, en 1819, Etienne Pariset and André Mazet, Paris, 1820
Courtesy National Library of Medicine
Yellow fever is a viral infection that damages the liver. The resulting jaundice, or yellowing of the skin, is how the disease gets its name. Symptoms include a high fever, fatigue, body aches, chills, nausea, bleeding, and black vomit.
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Illustration of Stegomyia fasciata (now known as Aedes aegypti) in Mosquitoes: How They Live; How They Carry Disease; How They Are Classified; How They May Be Destroyed, Leland Ossian Howard, New York, 1901
Courtesy National Library of Medicine
The Aedes aegypti mosquito transmits yellow fever, a fact not known to doctors in 1793 Philadelphia.
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Washington’s Inauguration at Philadelphia, painting by Jean Leon Gerome Ferris, ca. 1947
Painting by Jean Leon Gerome Ferris, courtesy Library of Congress, Prints and Photographs Division
George Washington took the oath of office for the second time a few months before yellow fever arrived in Philadelphia. During the epidemic, he and many other politicians fled the city for the safety of the surrounding countryside.
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Transactions of the College of Physicians, of Philadelphia: volume I; part I, College of Physicians of Philadelphia, 1793
Courtesy National Library of Medicine
Members of The College of Physicians of Philadelphia, established in 1787, came together to study diseases and their remedies. During the yellow fever epidemic, members met to debate its causes.
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Town Street Scavengers from Life, drawing by Augustus Kollner, 1844
Courtesy Free Library of Philadelphia’s Print & Picture Collection
Philadelphia was dirty. Like other urban centers in this era, sewage flowed through the city’s streets, animals (and their wastes) were common, and there was no regular garbage removal.
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Portrait of Dr. Benjamin Rush, engraving by L. Le Met, Philadelphia, undated
Courtesy National Library of Medicine
Dr. Benjamin Rush was both a politically active republican and a prominent physician in Philadelphia. He contracted yellow fever during the epidemic but survived, an outcome he credited to the treatment plan he developed.
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“Arch Street Ferry, Philadelphia,” in The City of Philadelphia, engraving by William Russell Birch, Philadelphia, 1800
Courtesy Library of Congress, Prints and Photographs Division
When yellow fever emerged in Philadelphia in 1793, Dr. Benjamin Rush linked the epidemic to a shipment of coffee beans left to rot on the Arch Street wharf. The “putrid beans had emitted [a] noxious effluvia,” a miasma or bad smell, that seemed to sicken people.
![A lithograph of arms and an ankle with visible veins, an arm and a leg wrapped in a tourniquet, and surgical instruments](images/spacer.png)
Techniques and tools used in bleeding patients, plate in Traité complet de l’anatomie de l’homme : comprenant la médecine opératoire, avec planches lithographiées d’après nature, J. M. Bourgery and N. H. Jacob, Paris, 1832–1854
Courtesy National Library of Medicine
Dr. Benjamin Rush employed bleeding, purges, and doses of mercury in his treatments for yellow fever. He may have used tools like these to open his patients’ veins and bleed them in “copious” amounts.
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Portrait of Benjamin Rush, MD, undated
Courtesy National Library of Medicine
Dr. Benjamin Rush was both a politically active republican and a prominent physician in Philadelphia. He contracted yellow fever during the epidemic but survived, an outcome he credited to the treatment plan he developed.
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Letter from Dr. Benjamin Rush to his sister, Philadelphia, September 18, 1793
Courtesy National Library of Medicine
In this letter to his sister, written during the yellow fever epidemic, Dr. Benjamin Rush described the “deep and universal distress” in Philadelphia. He mentioned “190 fresh graves” in the churchyard and “nearly deserted” streets.
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“An account of the origin, symptoms and treatment of the epidemic fever, which now prevails in the city of Philadelphia: in a letter from Dr. Benjamin Rush to Dr. John Rodgers” in The American Mercury, October 21, 1793
Courtesy National Library of Medicine
People outside Pennsylvania followed developments in Philadelphia. During the height of the epidemic, this Connecticut newspaper dedicated three columns to a letter in which Dr. Benjamin Rush outlined his suggested treatment plan.
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Engraved portrait of Alexander Hamilton, undated
Courtesy Bureau of Engraving and Printing
Secretary of the Treasury and leading Federalist Alexander Hamilton contracted yellow fever but survived. Although he was not a doctor, Hamilton waded into heated public and medical debates about yellow fever.
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St. Domingue, prise de la ravine aux couleuvres, undated
Courtesy Library of Congress, Prints and Photographs Division
Alexander Hamilton and his Federalist peers thought that yellow fever was an imported disease. Hamilton identified the sick, white, French refugees fleeing the Haitian Revolution as the source of yellow fever in Philadelphia.
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Facts and Observations Relative to the Nature and Origin of the Pestilential Fever, Which Prevailed in this City in 1793, 1797, and 1798, College of Physicians of Philadelphia, 1798
Courtesy National Library of Medicine
The College of Physicians determined that yellow fever is an imported disease. Their stance affirmed the Federalists’ point of view.
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“Cinchona officinalis” in Medical Botany, engraving by James Sower, London, 1793
Courtesy National Library of Medicine
The bark of the Cinchona tree, a source of quinine, was the bark in the “bark and wine” cure. Madeira wine was the wine portion of the cure. Secretary of the Treasury and leading Federalist Alexander Hamilton favored the “bark and wine” treatment for yellow fever.
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Letter from Alexander Hamilton to the Federal Gazette, New York, September 14, 1793
Courtesy Library of Congress – Chronicling America
Secretary of the Treasury Alexander Hamilton and his Federalist peers used newspapers to publicize their understanding of yellow fever. These newspaper articles, and others like them, linked treatment approaches to specific political figures and their party.
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Minutes of the Proceedings of The Committee, Robert Aitken, Philadelphia, 1794
Courtesy of the National Library of Medicine
Philadelphia’s residents answered the call to help their suffering neighbors. The Committee published this detailed record of their meetings, financial dealings, and efforts on behalf of the sick, orphaned, and poor. Despite this documentation, Philadelphia’s residents grew skeptical of The Committee’s spending.
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Copper cent, Philadelphia, 1793
Courtesy The American Numismatic Society, 1946.143.9
The Committee, a group of private citizens, came together to organize desperately needed relief services. They accepted small financial contributions and donated supplies from Philadelphians and concerned Americans in other cities. They also took out a loan to pay for the relief work.
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“Bush-Hill, the seat of William Hamilton Esqr. near Philadelphia,” engraving by Cornelius Tiebout, Philadelphia, 1793
Courtesy Library of Congress, Prints and Photographs Division
A vacant estate just outside Philadelphia, Bush-Hill, became a public hospital operated by The Committee. Hundreds of sick people were treated there during the yellow fever epidemic.
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Portrait of Stephen Girard, lithograph by Albert Newsam, 1832
Courtesy Library of Congress, Prints and Photographs Division
Stephen Girard, a wealthy merchant, took over administration of Bush-Hill Hospital in mid-September 1793. By the end of the yellow fever epidemic, Girard’s work to improve hospital conditions made him a local hero.
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A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia, Mathew Carey, Philadelphia, November 14, 1793
Courtesy National Library of Medicine
Matthew Carey, a printer, bookseller, and member of The Committee, documented the epidemic in his popular book.
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Absalom Jones, painting by Raphaelle Peale, 1810
Courtesy Delaware Art Museum
Absalom Jones and Richard Allen, both ministers and former slaves, founded the Free African Society in 1787 to provide social services to free people of color in Philadelphia. This experience prepared the Society to respond to yellow fever on behalf of all Philadelphians.
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Richard Allen, Bishop of the first African Methodist Episcopal Church, undated
Courtesy Schomburg Center for Research in Black Culture, Photographs and Prints Division, The New York Public Library
Richard Allen and Absalom Jones, both ministers and former slaves, founded the Free African Society in 1787 to provide social services to free people of color in Philadelphia. This experience prepared the Society to respond to yellow fever on behalf of all Philadelphians.
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“Bethel A.M.E. Church, the first Colored Methodist Church in Philadelphia, established in 1787” in Philadelphia Colored Directory, 1910: A Handbook of the Religious, Social, Political, Professional, Business and Other Activities of the Negroes of Philadelphia, Philadelphia, 1910
Courtesy Schomburg Center for Research in Black Culture, Photographs and Prints Division, The New York Public Library
Reverend Richard Allen’s parishioners were deeply involved in the response to yellow fever. Work on the congregation’s new building stopped during the epidemic. The church, Bethel African Methodist Episcopal Church, was not dedicated until one year after the epidemic ended.
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“Dead House on the Schuylkill During the Yellow Fever in Philadelphia in 1793,” watercolor by David J. Kennedy, Philadelphia, undated
Courtesy Historical Society of Pennsylvania
This structure stored some of the bodies awaiting burial during the epidemic. During Philadelphia’s 1793 yellow fever epidemic, African American volunteers removed bodies from homes and buried the dead.
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An Account of the Rise, Progress, and Termination of the Malignant Fever, Lately Present in Philadelphia, James Hardie, Philadelphia, 1793
Courtesy National Library of Medicine
James Hardie, a Quaker, observed that yellow fever complicated social hierarchies. He noted that, as the disease spread, white residents became ever-more dependent on the charity of “the poor; the despised blacks.”
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A Narrative of the Proceedings of the Black People, during the Late Awful Calamity in Philadelphia, in the Year 1793, Absalom Jones and Richard Allen, Philadelphia, 1794
Courtesy National Library of Medicine
Reverends Jones and Allen reported the heroic work done by Philadelphia’s African American community. They also used the book as an opportunity to respond to critics of their community.
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