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A white man carries a sick white man across a street, while two other men watch

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.

A page of text in a book

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.

A drawing of a roomful of fighting, screaming, angry white men in 18th century clothing

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

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.

A mosquito

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.

A large assembly of white women and men in 18th century clothing conversing, and a horse-drawn carriage in a city street

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.

A page of text in a book

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.

A drawing of two dogs, a pig and a piglet, and a horse milling about a city street

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.

A portrait of a white man in profile

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.

A scene of sailboats and people at a wharf

“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

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.

A portrait of a white man

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.

A handwritten letter

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.

A page of newspaper text

“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.

A profile of a white man

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.

An 18th century battle scene between black revolters and white soldiers in the tropics

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.

Two pages of text from a book

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.

A lithograph of a plant

“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.

A page of newspaper text

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.

A page of text from a book

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.

The front and back of a coin

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.

A bucolic scene of a man, a cow, and a dog in a large field in front of three buildings

“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.

A portrait of a white man

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.

A page of text from a book

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.

A portrait of an African American man

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.

A portrait of an African American man

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.

A drawing of a church

“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.

A small wooden shack stands on a river bank

“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.

Two pages of text from a book

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.”

A page of text from a book

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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