An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793

By early January, 1794, the fever epidemic has ended and most Philadelphians hope to move on with their lives. However, it is difficult to ignore some of the major changes that have taken place in the wake of the outbreak. Many people lost family members and friends. The state government grants the governor special powers to enact laws and allocate funds in an emergency situation. That way, if other members of the government choose to flee, someone is still in charge. The federal government also passes a law allowing the president to call Congress into session outside of Philadelphia so another constitutional crisis does not ensue.

The city also adapts, as more efforts are made to keep out foul smells. Although doctors are still unsure of the cause of the fever, they agree that the smells that permeated the city were generally not good. However, major urban improvements to public health are slow to take off and do not gain significant momentum until the next century, when stronger ties are found between a dirty environment and disease. There are also few efforts to help the city’s poorer areas that had been particularly blighted by the fever. During later outbreaks, tents would be set up to keep poorer residents away from the city.

One of the biggest changes is the improvements made to the city’s water. Although physicians agree the city’s dirty water, which was filled with waste, had not caused the fever, many residents want it cleaned up. The system of public and private wells is replaced in 1799 with the nation’s first waterworks, designed by Benjamin Latrobe. It moves water by steam engine pumps through tunnels to enormous reservoirs, where it is then fed to houses and businesses.

Meanwhile, doctors remain divided over the cause of the disease. When Governor Mifflin returns, he asks the College of Physicians to write a report about the cause. The proponents who believe the fever was imported from elsewhere, rather than originating in Philadelphia, dominate the discussion because there are more of them. The continued dispute leads Benjamin Rush to resign from the College, though he stays in the city. When the fever returns in subsequent years, doctors continue to argue over the cause and cure. Although Rush still pushes his aggressive treatment of poisoning and purging, he is fiercely attacked by an English journalist who comes to Philadelphia named William Cobbett. Cobbett is a Royalist and is particularly angered by Rush because of his strong ties to the American Revolution. Although Rush eventually sues Cobbett for libel and wins, his reputation suffers. He spends the remainder of his life and career contesting his opponents.

While the committee members receive praise for their efforts during the fever, they are also criticized for taking control of the government. They also owe over $3200, having spent more than they brought in from donations. The members must personally pay back the money, with Matthew Clarkson, Stephen Girard, and Israel Israel paying the most. Israel Israel also tries to run for office but ultimately loses three times.

One of the biggest controversies to come out of the fever epidemic is the public feud between well-known printer and publisher Matthew Carey and the Free African Society. In November, 1793, Carey publishes A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia…, which quickly becomes a best seller. However, the book criticizes the African American nurses for allegedly hiking up their rates during the outbreak. He also downplays the challenges the nurses faced and the extent to which they were risking their lives. Absalom Jones and Richard Allen publish their own book that refutes Carey’s claims and attacks him for leaving the city. Carey defends himself and ultimately attempts to compromise by adding into his book that white nurses also raised their prices.