With a population of approximately 55,000 in 1793, Philadelphia was America’s largest city, its capital and its busiest port. Philadelphia was the home to United States founding fathers, Thomas Jefferson, George Washington, and Alexander Hamilton. It was also the site of the most fearsome epidemic to strike the young nation.
In the spring of 1793, French colonial refugees, some with slaves, arrived from Cap François, Saint-Dominque. When 2,000 immigrants were fleeing the slave revolution in the North of the Island. They crowded the port of Philadelphia, where the first yellow fever epidemic in 30 years began in the city August. It was likely the ships carried the yellow fever and mosquitoes. It is transmitted from mosquito bites. The mosquitoes easily breed in small amounts of standing water.
The first two people to died of yellow fever in early August in Philadelphia were both recent immigrants, on from Ireland and the other from Saint-Domingue. After two weeks and an increasing number of fever cases, Dr. Benjamin Rush (a doctor’s apprentice during the city’s 1762 yellow fever epidemic and one of the signer’s of the Declaration of Independence), saw the pattern; he recognized that yellow fever had returned. Dr. Rush alerted his colleagues and the government that the city faced an epidemic of “highly contagious, as well as mortal… bilious remitting yellow fever.” Adding to the alarm was that, unlike with most fevers, the principal victims were not the very young or very old. Many of the early death cases were teenagers and heads of families in the dockside areas.
Believing that the refugees from Saint-Dominque were carrying the disease, the city imposed a 2-3 week quarantine on immigrants and their goods. Dr. Rush blamed “some damaged coffee” for causing the fevers. Some neighboring towns had patrols on the roads to prevent entry by refugees. The major ports of Baltimore and New York prevented refugees from entering and quarantined them and goods from Philadelphia for weeks. The death of Dr. Hutchinson from yellow fever on September 7th, started a panic throughout the city of Philadelphia and people began to flee. Between August 1 and September 7, 456 people died in the city. On September 8, 42 deaths were reported. An estimated 20,000 people left the city through September, including United States President George Washington and his cabinet. The worst 7-day period was between October 7-13, when 711 deaths were reported. The daily death toll remained above 30 until October 26.
As the rich fled, the poor was left behind. The guardians of the poor took over Bush Hill, a 150-acre estate outside the city, who owner William Hamilton was in England for an extended stay. Vice President John Adams had recently rented the main house, so yellow fever patients could be placed in the outbuildings. Young nurses from the city were hired to treat the ill. Like all hospitals at the time, the Pennsylvania Hospital did not admit patients with infectious diseases.
Dr. John Lining’s observation in the 1742 yellow fever epidemic in Charleston, South Carolina, that African slaves appeared to be affected at rates lower than whites; he thought Africans had a natural immunity. Dr. Rush suggested that the city’s people of color had immunity and solicited them “offer your services to attend the sick and help those known in distress.” Despite Dr. Lining and Dr. Rush’s theory, most of the city’s people of color were not immune to the virus was wrong. Many of the African slaves in Charleston in 1742 could have gained immunity before having been transported from Africa, by having been exposed to yellow fever in a mild case. People who survived one attack gained immunity. In the 1793 yellow fever epidemic, blacks died at the same rate as whites.
In late October, after temperatures cooled and the mosquitoes was died off, a newspaper reported that “the malignant fever has very considerably abated. “Stores began to reopen October 25, many families returned, and the wharves were “once more enlivened” as a London-based ship arrived with goods. The Mayor’s Committee advised people outside the city to wait another week or 10 days before returning. It published directions for cleaning houses which had been closed up, recommending that they be aired for several days with all windows and doors open. “Burning of nitre will correct the corrupt air which they may contain. Quick lime should be thrown into the privies and the chambers whitewashed.” On the 31st, a white flag was hoisted over Bush Hill with the legend, “No More Sick Persons Here.”
But, after some warm days, fever cases recurred. The white flag had to be struck. Finally on November 13, stagecoaches resumed service to the north and south. A merchant reported that the streets were “in an uproar and rendered the wharves impossible by reason of the vast quantities of wine, sugar, rum, coffee, cotton & c. The porters are quite savvy and demand extravagantly for anything they do. “On November 14, the Mayor’s Committee recommended purifying houses, clothing and bedding, but said that anyone could come to the city “without danger from the late prevailing disorder.”
An Official register of deaths listed 4044 people as dying between August 1 and November 9, 1793, making the epidemic in the city of Philadelphia one of the most severe in United States’ history.