Philadelphia 1793: Yellow Fever, Race, Medicine and Politics
This curriculum unit will examine Philadelphia in the year of 1793. Philadelphia was the
capital of the United States, the center of politics of the day. Immigrants were pouring
into the city of “brotherly love.” George and Martha were living in Robert Morris’
mansion, a short distance from the more crowded, filthy streets of the bustling port city.
The French Revolution and its politics were felt in the city with its large French
population. The esteemed Dr. Benjamin Rush was teaching his students at the University
of Pennsylvania and discussing public education with Noah Webster. Then there was the
deadly illness that spread through the city like wild fire. The year of 1793 and its yellow
fever epidemic would forever change Philadelphia.
In Philadelphia, 1793, the debate over the cause and cure of yellow fever dominated all
else. Benjamin Rush, signer of the Declaration of Independence, was the leader of the
medical profession and the first American physician to gain international recognition. It
was his reputation, buttressed by his distinguished colleagues of the medical school of the
University of Pennsylvania, which attracted students from all over. With the American
Philosophical Society publications, the young nation looked to Philadelphia for the latest
reports on scientific and technological development. Yet, only one event dominated all
else in Philadelphia throughout most of 1793, a yellow fever epidemic.
In the middle of the summer of 1793, people started dying in unusual numbers. At first
only the poor living closest to the river were affected. It was not until the wealthier
Philadelphians started to die that those in power took note. The doctors were quick to
recognize the plague as yellow fever, but they had no idea what caused it. Miasma, a
poisonous vapor in the atmosphere from decaying matter that was believed to promote
disease, the refugees from Santo Domingo, and filth were among the causes suggested.
In the end, they concluded that the epidemic was carried to Philadelphia aboard a ship
from the West Indies. Philadelphia had no sanitary inspections of vessels arriving at its
port, nor quarantine arrangements. As the disease spread, at first dozens, then hundreds,
died. Anyone of means fled the city of Philadelphia. President Washington and most of
the new government officials administered the affairs of the nation from outside
Philadelphia, in Germantown.
A Committee headed by Mayor Matthew Clarkson and including merchant Stephen
Girard, the publisher Mathew Carey, and others stayed in town and managed civic affairs.
They established a hospital at the Hamilton estate of Bush Hill and tried to maintain order
in chaos. By December 1793, five thousand people died in what has been called the
worst health disaster ever to befall an American city.
The black community in Philadelphia provided the manpower to do what others did not
want to do: collect and bury the dead. Reverend Absalom Jones, founder of St. Thomas’s
African Episcopal Church, and Reverend Richard Allen, founder of Mother Bethel AME
Church, were important leaders who volunteered and helped the white community during
the crisis. In the early and middle stages of the epidemic it appeared that the black
population was immune from yellow fever. Thus, they did not leave the city.
Dr. Benjamin Rush remained in Philadelphia and treated hundreds with his only method
of healing, bleeding and purging. While his treatment was useless, his presence in the
city was heartening. He was heroic in his caring of the sick. There were other physicians
who favored a milder treatment than that given by Dr. Rush—fresh air, a mild diet, and
rest—and seemed more successful. In any case, with the cold weather of autumn, the
fever abated. The Yellow Fever Epidemic of 1793 was filled with horror, intrigue,
powerful players and politics.
I chose to focus on this event in American history because my students live in
Philadelphia and, of course, with this horrific event, I would easily capture their interest.
I also felt that the period between the establishment of the Constitution and the Lewis &
Clark Expedition is an empty space in the American history textbook. Students know
little about government and social affairs/events of the last decade of the eighteenth
century, a time when the new nation was still being established.
The unit is designed for fifth and eighth grade students who are studying American
history. It could also be used with fourth grade students studying Philadelphia history.
The curriculum will examine the catastrophe, important Philadelphia leaders,
medical/health views of the time period, the important role of African Americans and
other minority groups, and the political ramifications of the yellow fever epidemic in the
most cosmopolitan city of the era. There is also a strong emphasis on using primary
source documents in their understanding of this historic event. Students will use maps,
charts, lithographs, newspaper articles, diary entries, public documents, and paintings to
explore this topic. It is a unique opportunity for students to study an extraordinary time
in American history.
“This afternoon we were agreeably surprised by the arrival of H.D.
My Husband informs of the death of Reuben Haines Senr, who died this
morning rather suddenly—many have gone off within these few days.
A Fever prevails in the City, particularly in Water St. between Race and
Arch Sts. Of ye malignant kind; numbers have died of it. Some say it was
occasioned by damaged Coffee and Fish, which were stored at Wm. Smiths’;
others say it was imported in a Vessel from Cape Francois, which lay at our
wharf, or at ye wharf back of our store. Doctor Hutchinson is ordered by ye
Governor to enquire into ye report. He found, as ‘tis said, upwards of 70
persons sick in that square of different disorders; several of this putrid or
bilious fever. Some are ill in Water St. between Arch and Market Sts., and
some in Race Street. ‘Tis really alarming and serious time.”
Yellow Fever is a mosquito-borne viral disease that occurs in tropical and subtropical
areas. The symptoms are a “black vomit” caused by bleeding into the stomach,
hemorrhages, fever, backache, headache, and yellow skin. As the disease progresses, the
pulse slows and weakens, and there is bleeding of the gums and blood in the urine. The
disease can affect either gender, and all ages and races. Symptoms occur within three to
six days after exposure. People who have had yellow fever, and survive, develop a
lifelong immunity to the disease. Most victims usually died within several days of the
Philadelphia was the major port in the United States. Ships from the Caribbean arrived
regularly. In late spring, early summer of 1793, yellow fever had been raging through the
West Indies. Many French refugees arrived in Philadelphia from Santo Domingo, fleeing
a bloody slave rebellion. Ships arrived at the Philadelphia wharves without sanitary
inspection or quarantine. The onset of the epidemic has been traced to late July, along
Water Street, near the docks. Philadelphia was the largest and most cosmopolitan city in
the United States but its sanitary conditions were deplorable. The flies and mosquitoes
swarmed around the dock area near the stagnant water. In fact, the conditions that spring
and early summer, hot and dry, along with the millions of mosquitoes, provided the
perfect “storm” that spread the disease quickly. However, it was not until August that the
epidemic attracted attention from its the citizens and officials of the city.
The first official recognition that yellow fever was rampant in Philadelphia was by the
mayor, Matthew Clarkson, on August 22. Four days later prominent physicians of the
city united in an address to the public defining the nature of the disease. They
recommended measures of precaution and proper remedies for the treatment of the
disease. When the people began to realize the alarming and deadly consequences of the
disease, a panic ensued, and by August 25 a general exodus of the population began.
Most Philadelphians, with the exception of the poor, along with members of Congress,
President Washington and his Cabinet, abandoned the city. Germantown became the
location of the capital during this summer of 1793. The President lived part of the time in
Germantown while Jefferson, it is said, fled to the King of Prussia Tavern, further from
the city. During the months of August and September, an estimated 17,000-20,000
persons left the city. Mayor Matthew Clarkson, remained as did Dr. Benjamin Rush and
many of his medical colleagues, along with Stephen Girard, a Philadelphian who would
become the wealthiest man in America.
Yellow fever was first diagnosed on August 5, 1793. Internationally known physician
Benjamin Rush was called to the house of a fellow physician, Dr. Hugh Hodge, to
examine Dr. Hodge’s young daughter. Her skin had turned yellow and within two days
she died. Interestingly, the good doctor’s family lived on Water Street. Then, shortly
thereafter, Dr. Rush was called to the home of Mrs. Peter LeMaigre on Water Street,
located near Ball’s Wharf on the Delaware River. Almost immediately Dr. Rush
declared that the cause of the disease was the rotting coffee on the wharf. He demanded
that the streets of Philadelphia be cleaned. Much talk ensued as to how trash should be
disposed of and the mayor invoked an old ordinance requiring homeowners to sweep
their walks and gutters. This was all well and good, but, in fact, Dr. Rush’s treatment of
yellow fever victims may have caused them their demise. All the while, the mosquitoes
multiplied in the stagnant rainwater of the hot, wet, and humid summer.
This was not the first time Philadelphia, or any port city along the Atlantic coast, had
seen yellow fever. This was, however, the worst epidemic ever known in the United
States. The citizens of the city looked to the esteemed Dr. Rush for help. Benjamin
Rush, medically trained in London and Edinburgh, founder and teacher at the College of
Physicians, believed in only one treatment, “bleeding and purging.” On September 11,
1793, Rush published his prescribed treatment for the disease in the city’s newspapers.
At the onset of pain, nausea, chills or fever, the patient should use a laxative “every six
hours until the bowels had been amply evacuated several times… drink fluids and lie in
bed sweating. Once the bowels had been thoroughly cleansed, and if the pulse were rapid
and full, the patient should be bled of eight or ten ounces, more if the pulse were strong
enough. This basic regimen was to be accompanied by a light diet, fresh air, blisters on
the sides of the body, and continued cleanliness of the body and intestines.”1
There was great outcry against this procedure by the public and newspaper publishers.
Nevertheless, Rush was not for want of patients with yellow fever. As for newspapers,
by the end of the summer all newspapers but one, Andrew Brown’s Federal Gazette,
ceased publishing their daily newspapers. They, too, fled from Philadelphia and the
yellow fever epidemic.
There were other physicians in the city that suggested another, less aggressive and more
conventional treatment. Dr. William Currie proposed mild doses of medicinal barks and
restorative liquids. The French physician David Nassy used a mild treatment and is
said to have lost only a few patients to the plague compared to Benjamin Rush. However,
it was another French doctor, Jean Deveze, who became a hero during this time. He had
arrived from Santo Domingo the summer of 1793. He had had much experience with the
disease in the West Indies.
Dr. Jean Deveze’s treatment was considerably more humane than Rush’s. “Small
amounts of sweetened wine would be given to a patient to stimulate the blood…for
nourishment patients were given broth, creamed rice…Let the body do its own
healing…clean up the patient and sickroom to remove noxious odors. Provide tea and
broth and nontoxic medicine to help the body fight off the fever.”2 Deveze himself had
had yellow fever from a previous epidemic in the Caribbean and thus was immune.
Rush, Girard, Clarkson, and other prominent people who remained in the city contracted
the disease and they, too, survived.
The focal point of the epidemic, during August and September, was Bush Hill Mansion
Hospital, a quarantine center established by the city under the capable mayor, Matthew
Clarkson. Bush Hill was the unoccupied mansion of Andrew Hamilton. He was in
London, his mansion was on the outskirts of the city, and it was illegally taken over by
the city to house the poor, indigent citizens who had contracted yellow fever. Stephen
Girard and little known citizen, Peter Helm, had volunteered to manage Bush Hill on
September 16. This was good news to Philadelphia, for everyone was in despair as
President Washington had left the city five days earlier.
Stephen Girard was in charge of the inside management of Bush Hill, nursing the sick,
ordering supplies, cleaning the facility and executing general administrative duties. Helm
supervised the grounds and outbuildings. He was responsible for receiving and burying
the dead, cleaning the sanitary facilities, and providing quarters for the staff. They were
provided with funds for supplies from the city. All the while, what of the premier hospital
in Philadelphia, Pennsylvania Hospital? It should be noted “throughout the siege the
Pennsylvania Hospital tried to protect its patients from infection by banning yellow fever
Mayor Clarkson had created a “Committee” that volunteered to “oversee the poor, the
starving, and the sick, to transport victims to Bush Hill, to give relief” 3 to the city during
this disastrous time. They obtained a loan of $1500 from the Bank of North America to
appropriate funds for supplies and wages. Citizens made financial contributions,
including Stephen Girard. As Bush Hill was set up, simultaneously the Committee
organized a food, clothing and medicine distribution effort to aid the poor who remained
in the city. They also set up an orphanage for the hundreds of children without parents.
The most gruesome task, without doubt, was collecting the abandoned corpses en masse
and burying them. Clarkson’s guidance and visibility were, by all accounts, not to be
underestimated. He had been elected just a year earlier and would then serve for three
successive terms as a result of his bravery.
During the early months of the Yellow Fever Epidemic of 1793 it appeared to Dr. Rush
that most African American in Philadelphia were immune from the disease. In fact, by
September they, too, were impacted as greatly as the white population. Nevertheless, Dr.
Rush asked the Free African Society, started in 1787 as a society of blacks helping other
blacks in need, to assist with their ill & dying white neighbors. Prominent leaders of the
black community, Absalom Jones and Richard Allen, agreed. The Free African Society
provided a variety of services to the white community during the epidemic: nursing,
washing, cleaning, collecting the dead, and burying the dead. At first the services were
free and then, as the epidemic took a larger toll on the city, and as thousands fled, the
workers, white & black asked for a fee for their services. Mayor Clarkson agreed to this
arrangement as the city was in need of workers.
After the epidemic passed, in November 1793, publisher Mathew Carey published
A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia. This book was
distributed widely and became quite popular. In it, Carey attacked the services of the
black community. He accused them of extortion, theft of property in homes in which
they serviced, and overall publicly vilified them. He condemned them for taking money
for their services at such a disastrous time. He spoke nothing of white citizens who did
Richard Allen and Absalom Jones responded with their own publication in January 1794:
A Narrative of the Proceedings of the Black People, During the Late Awful Calamity in
Philadelphia. In the Year 1793: and a Refutation of Some Censures, Thrown upon Them
in some Late Publications. This publication is the first published document by African
Americans responding in defense of themselves and their community. They directly and
publicly confront their accuser. They respond to every negative account of blacks in
Carey’s publication, systematically and emphatically.
The political arena in Philadelphia earlier in the year of 1793 was lively and raucous.
Philadelphia had become obsessed with the French, politically and socially. The city
seemed to be under the complete influence of Paris. Men and women of respectable
social standing wanted the latest French clothing and even began assuming French
manners. Philadelphia actually had a large French colony living on Front Street from
Spruce to Pine Streets. Many were exiles from France and its colonies in the Caribbean.
These supporters of the French Revolution took to the streets with demonstrations. They
wanted sympathy for their Revolution and they wanted the new United States
government to support their cause. This was not to be. In fact, Philadelphia, like Paris,
was on the verge of a great political upheaval.
In James Dickerson’s account of the political climate of 1793, he notes “also filling the
newspapers were political debates about the cause of the epidemic. Republicans
maintained that the disease was caused by local factors, while Federalists blamed the
ships that arrived from foreign ports, and Federalists used the disease as an excuse to
block trade with the French, especially as it applied to goods imported from French-
controlled islands. Republicans interpreted the Federalist position as an attack against
their right to trade with the West Indies.”4
The heated and sometimes violent disagreements between the Federalists and the
Republicans during this disastrous summer included social and medical issues.
Philadelphia’s new Irish, British, French and other immigrants supported the French
Revolution. The Federalists, consisting of many New Englanders and southern plantation
owners, a rather “patrician” group, disliked the urban capital of Philadelphia. They hated
the diversity, the congestion, the filth and decay of urban living, and the French
Revolution. They were pleased to assist the British any way they could. In fact it was
primarily the Republicans who dominated the relief work during the summer of 1793.
Federalists most often joined the ranks of the refugees.
Not surprisingly, religion wove itself into politics during the yellow fever epidemic. A
religious Republican viewpoint was that yellow fever was God’s response for all of the
sins the city had committed. They appealed to the urban population to change their ways
so that good health would come back to Philadelphia.
The Federalists opposed Benjamin Rush and his colleagues in the medical community.
“Rush identified the Federalist criticisms of his cures with the French Revolution,
comparing his situation to that of the French Republic, surrounded and invaded by new as
well as old enemies, without any other allies. He maintained that the cure for yellow
fever would be determined by the will of the majority and not by political elitists.”5
In the end, the yellow fever epidemic helped abate the violence that was escalating in the
spring of 1793 between the two political parties. The Federalists did get their wish,
probably as a result of the continuous yellow fever epidemics in Philadelphia, of the
capital city moving to a quiet, rural location, to be called Washington, D.C.
By the end of the outbreak, over 5000 people, one-tenth of the population of
Philadelphia, were dead and nearly 200 children were orphaned. This epidemic and
others that followed in the 1790s, brought about the first public water system in the
United States. Additionally, in 1799 Philadelphia created the Lazaretto Quarantine
Station, the precursor to Ellis Island.
The lessons in this unit are primarily designed to use in fifth and eighth grade American
history classes. The activities clearly reflect a multidisciplinary approach whereby
history, geography, reading, writing, math, science, government, and culture are
integrated. These lessons may be used independently in order to enrich lessons on the
early republic or Philadelphia history. There are several lessons that could solely be used
for geography, math or science class.
This unit is integrated into the American history curriculum when teaching the early
republic or early government. The major concept is for students to understand the yellow
fever’s impact on the most important city in the United States in 1793, Philadelphia. It
was the city where both the state and federal government were located. It was, in fact,
the largest city in America.
The main objectives are:
• to use a wide variety of primary source documents, written and graphic
• to examine the response of the community to volunteer efforts during a
• to understand the relation between water and disease
• to become aware that health crises occur throughout the history of
• to understand the differences between primary and secondary sources
• to analyze, organize, and interpret information
• to use latitude and longitude coordinates to find specific locations on a map
• to calculate actual distance on a map using scale
• to make inferences
• to analyze photographs
• to evaluate informational resources for relevance and accuracy
• to identify and analyze historical images
• to synthesize information presented in images and documents
• to compare and contrast the response of the three levels of government to the yellow
This unit will be taught as an interdisciplinary study, although history is the main
discipline. It will also incorporate reading, speaking, listening, art, geography, science,
and mathematics. Each lesson begins with a whole group lesson that leads to an
exploration of the topic or a document. Students will then work in small groups to
complete a task. Each group will be organized with a facilitator, recorder, and reporter.
Most of the lessons will use primary source documents. Students will learn how to
explore a variety of documents: a 1793 map, broadside, charts, painting, diary entry,
newspaper excerpt, and a political cartoon. After reading the documents, students are
asked to analyze, interpret and make conclusions based on the evidence. It is expected
that the immersion into the use of primary source materials will enable students to
become more thoughtful and critical readers. In addition, the examination of primary
source materials will, hopefully, stimulate interest in history.
Lesson 1: Map It!
• textbook map of the world
• class set of map labeled “The City of Philadelphia, 1793” (see appendix)
• class set of “Map Analysis Worksheet” (see appendix)
Time: 1-2 class periods
Draw the following chart on the chalkboard. Review locations of Paris, London and the
Atlantic Ocean with the class. Have students copy the chart format into their notebook
and complete the chart using the political map of the world. Explain that these locations
were intricately related to the yellow fever epidemic and politics of the time.
City,Country Continent Latitude/Longitude Miles to Philadelphia
3.Port-au-Prince,/Haiti(Santo Domingo )___________________________
Orientation is probably needed before using the 1793 map of Philadelphia. Determine
north, east, south, and west directions. Determine the location of New Jersey. Have
students identify the following important locations in 1793 Philadelphia:
•Delaware and Schuylkill Rivers
• Front Street
• Dock Street
• High (Market) Street
• City Hall
• State House
• Benjamin Rush’s house
• Pennsylvania Hospital
Distribute copies of the “Map Analysis Worksheet.” Have students work in small groups
of 2 or 3 to complete the Worksheet on the map “City of Philadelphia, 1793.” At the
conclusion of the lesson, group reporters should report on their groups’ responses to the
analysis worksheet. .
Lesson 2: Dr. Benjamin Rush vs. Dr. Jean Deveze
Benjamin Rush kept a detailed journal of his daily encounters with victims of the plague.
He documented intriguing personal observations of people and places in Philadelphia
during this time. For weeks he was ill with symptoms of yellow fever while many of his
friends and family members died from this devastating disease. The Library Company,
located in Philadelphia, holds the Rush Papers.
Rush strongly believed in the more aggressive treatment of bleeding and purging.
Bloodletting was the procedure of opening a vein and drawing blood into a bowl. The
theory was that the remaining blood would become normal and flow freely through the
body. Purging was a dramatic treatment that essentially poisoned the patient so that they
would have extreme diarrhea and vomiting. In this way the body would purge itself of
the disease. This was a harsh treatment that often saw many patients die from the cure.
Another important doctor remaining in Philadelphia during the yellow fever epidemic
was the French doctor, Jean Deveze. His treatment consisted of rest and liquids in order
to heal the infected body. This treatment was actually more like the current treatment for
• brief fact sheet for teacher with description of Yellow Fever
• class set -- excerpt from Dr. Benjamin Rush’s prescribed treatment for yellow fever,
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 (1799)
• class set – excerpt from Jean Deveze’s prescribed treatment for yellow fever, An
enquiry Into, and Observations Upon the Causes and effects of the Epidemic Disease,
which Raged in Philadelphia from the Month of August Till towards the Middle of
December, 1793 (1794)
• class set of the Document Analysis Worksheet
• account of the yellow fever epidemic
website: http://xroads.virginia.edu/~cAP/WW/fever.html (scroll down to section:
1793: Disaster in the Capitol
Time: 1-2 periods
1. The teacher should set the stage for this activity by reading aloud the account from
1793 as to the treatment of yellow fever.
2. Divide the class into groups of 5-6, smaller if you have less than 30 students.
Distribute a copy of the excerpt from Dr. Rush’s treatment to half of the groups, and the
remaining groups will receive a copy of the excerpt from Dr. Deveze’s treatment. Using
a group facilitator, have the students read together their document and complete the
Document Analysis Worksheet for better understanding of the document.
3. After analyzing the document students are to prepare for a debate on which method
was best to treat yellow fever in 1793. Each group should select several members to
debate an opposing group. The teacher should pre-arrange the groups making certain
there is diverse grouping. Also predetermine which groups will be debating each other.