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Viral. Infectious. Deadly.

Originated from the bite of a female tropical mosquito, Yellow Fever is an acute infectious virus that causes high fevers, hemorrhaging, and when untreated: death. The summer of 1793 saw a flash epidemic in Philadelphia–then America’s largest city and temporary capital. The fever killed ten percent of the population. Response to the disease helped establish protocols for how to respond to fatal outbreaks.

Rush Declares An Epidemic

Following an alarming number of feverish patients that summer, Dr. Benjamin Rush, a signer of the Declaration of Independence and leading physician, identified the culprit as the Yellow Fever. It had struck Philadelphia decades before. The city’s mayor, Matthew Clarkson, was swift to seek scientific advice from the College of Physicians on how to proceed. The College advised 11 measures for stopping the spread of the disease including: avoiding fatigue, sun light, night air, as well as too much liquor, and for those attending to the sick, to breathe through vinegar and camphor dosed handkerchiefs.

Combat, Controversies, and Scapegoats

There was no consensus on what caused the disease. Although everyone agreed that cleanliness was in everyone’s best interests. The city worked overtime to clean streets, wharves, and the market, and dissuade gatherings. Some believed the fever arose from unsanitary conditions like putrid rotting coffee shipments on the wharves, while others thought it was brought by Caribbean immigrants who were infected.

In a city that was fast becoming a morgue, the public health crisis revealed the best and the worst in humanity. Twenty-thousand people, including the entire federal government, simply fled the city, leaving the sick to die and the dead to rot. While others like Clarkson and Rush remained to provide leadership and organize medical care. The African Free Society, a faith-based benevolent group led by Richard Allen and Absalom Jones, inspired the city’s blacks to nurse the sick, carry away the dead, and dig graves. Yet, the fever workers were not above criticism. Rush’s purgative bloodletting practices were controversial, and some of Allen and Jones’s team were accused by Irish immigrant publisher Matthew Carey of charging exorbitant fees for services. Jones and Allen vindicated themselves by publishing a response to Carey. Apparently convinced, Carey later revised his indictment in a future edition of his best-selling account of the epidemic.


The Yellow Fever decimated Philadelphia’s population before cooler weather killed the infectious mosquitos. In a city of 45,000 people, 5,000 had succumbed to death. The Rev. J. Henry C. Helmuth, pastor of St. Michael’s Lutheran Church, recorded that 130 of his congregants died within a week in October. The Fever did not discriminate among the faithful, a Quaker named John Todd was also a fatality. His widow, Dolley Todd, would later remarry James Madison and become the nation’s First Lady.

Philadelphia survived this horrible plague. Its residents returned, and its economy recovered. It would live to fight more contagions including Yellow Fever again in 1798, the Spanish Flu in 1918, and Covid-19 most recently. Yet the precedent of the Yellow Fever in 1793 helped to establish public health protocols and institutions like the Philadelphia Lazaretto, the country’s first quarantine hospital. (“Lazaretto” is a term inspired by the biblical proper name Lazarus, a figure in the sacred text who Jesus raised from the dead.) These protocols and Institutions paved the way for better understanding infectious disease and how to contain epidemics.

The sick, the dying, and the dead were indiscriminately mingled together. The ordure and other evacuations of the sick, were allowed to remain in the most offensive state imaginable... It was, in fact, a great human slaughter-house.

Matthew Carey


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