An American Plague Summary
An American Plague by Jim Murphy is a 2003 nonfiction book about the yellow fever epidemic that afflicted Philadelphia in 1793.
- Dr. Benjamin Rush noticed a host of symptoms arising in several Philadelphians, including fever, yellowing of skin, and emission of bile. Rush notified the government of a plague.
- As the epidemic took its course over several months, 4,000–5,000 victims died. Numerous citizens, physicians, and nurses worked together to care for the ill and distribute resources as needed.
- In the century after the epidemic, several generations of scientists worked to uncover the origin of yellow fever, finally finding the Aedes aegypti mosquito responsible.
Summary
Philadelphia in the summer of 1793 was a particularly hot and uncomfortable place to be. The sun had been relentless since May, and many cats were dropping dead. Flies and mosquitoes buzzed everywhere but especially near “sinks,” which were holes dug at street corners to help with waste runoff. There were no covered sewers.
Over at Richard Denny’s boarding house on North Water Street, a French soldier (whose was not recorded) had become very ill with fevers and “violent” seizures. In only a few days, he lay dead. There were eight similar deaths in two separate houses within a week.
In another sickroom, Catherine LeMaigre lay dying. Her husband called two doctors: Dr. Hugh Hodge and Dr. John Foulke, both notable physicians. Both doctors did what they could for LeMaigre, but there was little solace they could offer. Hodge and Foulke decided it was time to call Dr. Benjamin Rush, a figure of great energy, talent, and drive.
Gradually, patterns of symptoms emerged. A patient would experience chills, headaches, and aches in the back, arms, and legs. Next came a high fever followed by constipation. Then after the fever finally broke, it would seem that the patient was recovering. Yet then the fever would begin anew, and the eyeballs and skin would turn yellow. Vomiting of dark, stale bile soon followed, and patients’ tongues would turn a dry brown. The patient would swiftly become depressed and confused. Lastly, tiny red spots would erupt on their skin.
Dr. Benjamin Rush had seen enough. He announced that Philadelphia was in the midst of a yellow fever plague. He informed the mayor and the governor of the danger at hand. Fear spread quickly, and the city emptied out.
Matthew Clarkson, mayor of Philadelphia, stayed in the city, even though yellow fever had already claimed his wife and son. Clarkson immediately convened the College of Physicians. This group, although sometimes in internal disagreement, made quite a few recommendations, such as putting a few drops of vinegar on a handkerchief and burning gunpowder to purify the air.
Within days, government of any kind ceased to be. The state legislators were scared and handed over power to the governor. The governor turned the entire problem over to Mayor Clarkson. Clarkson called a meeting of the “Overseers and Guardians of the Poor.” Neither the mayor nor these guardians had a legal right to commandeer the vacant Bush Hill mansion and turn it into a makeshift hospital, but they did so anyway.
By September 10 of 1793, George and Martha Washington were headed south to Mt. Vernon. By leaving Philadelphia, Washington sparked a Constitutional crisis. Thomas Jefferson and James Madison believed that Congress should be convened only in Philadelphia, but many wondered how the business of the government could be done in the midst of a yellow fever epidemic.
Dr. Benjamin Rush wrote to the city’s Free African Society for help. Though members of this group had many valid reasons to not want to help their white neighbors, they did so willingly with great generosity of spirit. Two of the group’s elders, Absalom Jones and Richard Allen, directed many of their members to begin home visits right away.
In such a dire situation, white patients began bidding up the prices for nursing visits. Even though many individuals in town were complicit in price gouging, Black nurses bore the blame for the escalating costs and were sometimes attacked. Yet they continued to nurse the sick.
Now even the famous and energetic Benjamin Rush had yellow fever. Still he carried on trying to help his patients with interventions such as...
(This entire section contains 1286 words.)
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“mild purges and moderate bleedings,” but patients continued to die in alarming numbers. It was time to step up the intensity of his interventions.
Many doctors disagreed with Rush’s strong purges and bloodletting procedures. These disputes were quite public and also recorded in the newspapers. Dr. Rush ultimately prevailed, and, to his credit, he did use his own cures to heal himself.
Many patients continued to expire, and something radical had to be done. Mayor Clarkson and twelve committee members took control of the city to perform crucial duties. They borrowed money to buy food, medicine, and coffins, and they paid caregivers and gravediggers.
Into the midst of this chaos, a dedicated doctor named Jean Devèze came to serve at Bush Hill. Dr. Devèze’s cures were gentler and more moderate. Bush Hill became known as a “pocket of calm and hope” even as fear spread to Philadelphia’s neighbors, who soon closed off all points of entry.
In addition, the crime rate was up, and many tenants were turned out of their homes because they were too sick to work. In the midst of continued crisis, Dr. Benjamin Rush became ill with yellow fever for a second time.
It had now been six weeks since Washington had received any news of Philadelphia. He had put Secretary of War Henry Knox in charge of reports from Philadelphia, but Knox took his family away to Manhattan Island instead. The vague reports that Washington did get were contradictory. Washington was now in a “very delicate” situation. He did not have a firm grasp on affairs in Philadelphia, and he had to make a decision about convening Congress in December in the midst of a plague.
On October 28, Washington set out to see the city for himself. Thomas Jefferson also made this journey to serve as secretary of state. What they found was encouraging: Philadelphia was finally coming out of the grips of the epidemic. It was also a generally cleaner and more hospitable place. The city could now welcome Congress in December.
Government changed in a number of ways because of the epidemic. The state legislators made provisions for the governor to spend money and make laws in case another epidemic occurred, and Congress passed a law “giving the president power to call [Congress] into session outside the nation’s capital whenever a grave hazard to life and death existed.”
When Governor Mifflin returned to Philadelphia in late October, he commissioned a report on the origins of the yellow fever. Approximately 4,000-5,000 men, women, and children perished in the epidemic. Doctors argued fiercely about the cause, but because there were more doctors who believed the disease was imported from afar, the disease was deemed not to have any specific origin in Philadelphia.
This conclusion was generally good for business, but Dr. Benjamin Rush was “incensed” at the finding, which he saw as eminently unscientific. He, along with many other doctors of the College of Physicians, would write books explaining their own theories. The arguments, often quite contentious, would continue anew each time yellow fever visited the city—in 1794, 1796, 1797, and 1798.
No major progress on the disease’s origins was made until 1848, when Dr. Josiah Nott in Alabama noticed that yellow fever cases dropped when the surrounding swamps were drained. He first asked whether the mosquito could be the source of infection. Dr. Carlos Finlay of Havana, Cuba, thought that this hypothesis was likely, although his colleagues thought little of his theory. Twenty years later, Dr. Jesse Lazear tried again to prove Finlay’s hypothesis. Unfortunately, Lazear was bitten by a mosquito that was not part of his experiments, and he succumbed to yellow fever.
More experiments followed, and less than a month after Lazear’s death, Walter Reed was able to announce that the female Aedes aegypti mosquito transmits yellow fever. In the absence of a recently produced vaccine, the United STates remains to this day vulnerable to another outbreak of yellow fever. There is no known cure, and, once bitten, patients today will endure many of the same symptoms as their predecessors in Philadelphia in 1793.
