Yellow fever is known for bringing on a characteristic yellow tinge to the eyes and skin, and for the terrible “black vomit” caused by bleeding into the stomach. Known today to be spread by infected mosquitoes, yellow fever was long believed to be a miasmatic disease originating in rotting vegetable matter and other putrefying filth, and most believed the fever to be contagious.

Rush, Benjamin. Observations upon the origin of the malignant bilious, or yellow fever in Philadelphia, and upon the means of preventing it :addressed to the citizens of Philadelphia. Philadelphia: : Printed by Budd and Bartram, for Thomas Dobson, at the stone house, no 41, South Second Street., 1799. Page: page 1 (seq. 1). From the Center for the History of Medicine in the Francis A. Countway Library of Medicine.

The first major American yellow fever epidemic hit Philadelphia in July 1793 and peaked during the first weeks of October. Philadelphia, then the nation’s capital, was the most cosmopolitan city in the United States. Two thousand free Black people lived there, as well as many recent white French-speaking arrivals from the colony of Santo Domingo, who left the islands as a result of rebellions of enslaved people during the Haitian Revolution (1791-1804). Major Revolutionary political figures lived there, and in the first week of September, Thomas Jefferson wrote to James Madison that everyone who could escape the city was doing so. The epidemic depopulated Philadelphia: 5,000 out of a population of 45,000 died, and chronicler Mathew Carey estimated that another 17,000 fled.

Benjamin Rush, a Philadelphia physician and signer of the Declaration of Independence, became highly regarded for his work during the 1793 epidemic. Rush thought that the outbreak had originated in a pile of rotting coffee beans left on the docks. He developed a very aggressive approach to treatment, copiously bleeding his patients and administering large quantities of mercury. These aggressive therapeutics became known, not always favorably, as “heroic medicine.”

As the population fled or died, few were left to attend to nursing and burying duties. Rush, who believed that Black people were immune to yellow fever, asked members of the African Society to come forward and care for to the sick and the dead. Absalom Jones and Richard Allen, two free Black men, volunteered. In a few weeks Jones, Allen, and others were bleeding hundreds of people a day under Rush’s direction, as well as nursing patients and carrying coffins.

About two months into the epidemic, however, Rush was proven wrong and Black people began to fall ill, dying from yellow fever at about the same rate as whites. Their efforts, though praised by Rush, were scorned by the white public as being profiteering and extortionist. In response, Jones and Allen published their own description of their experiences.

The Bush Hill Hospital, which housed the sick poor, was desperately understaffed. When Philadelphia’s mayor asked the public for help, a French-born merchant from Santo Domingo named Stephen Girard stepped up and recommended his compatriot, Dr. Jean Devèze, to head the hospital. Devèze refused to believe that yellow fever was contagious and he disapproved of Rush’s aggressive treatments. Devèze later became a world authority on yellow fever.

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