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New York 1795 (Part One)

"It is a clean, healthy town," an English traveler wrote of New York City in 1794. "The streets pitched with pebbles, and the foot-way paved and raised as in our principal towns; in some places with broad stone, in others with brick only." But a tourist's view was oriented toward the west side of Manhattan island from the Tontine Coffee house at the foot of Wall Street, up to Nassau Street and Federal Hall and then to Broadway, which was the civic solution to the winding narrow streets of the old Dutch city. Broadway extended from the Battery, the old fort site converted into a park, for a straight mile due northeast. Most of the principal buildings, the Governor's House, Trinity Church, St. Paul's Church, Columbia College, the hospital, jail and work house were either on or within a block of it.

A fire during the British occupation of the city hurried the transition from the gabled wooden houses of the Dutch to English brick. But one Dutch talent had not been lost, that of extending the land into the river with wooden dikes. In the early 18th century Queen Street which paralleled the East River had, like Front Street in Philadelphia, overlooked the quays and warehouses. By 1795 one could stand on Queen Street (renamed Pearl Street after the Revolution) and look east over Water and Cherry Streets. The island had been widened some 500 feet along just over a mile of waterfront. The "new ground" eased the expansion of the city's mercantile establishments and a proliferation of cheap houses on the "flat" also provided a haven for the laboring and transient population attendant to such commerce. The expansion preserved the stately five and six story brick houses of Queen Street as suitable residences for bankers, lawyers, doctors and newspaper editors.

As was demonstrated in 1791 and 1794, people could die along New York's Water and Cherry Streets and attract little concern from the rest of the city. The disparity economically between rich and poor was probably much greater in Philadelphia. But with so many of the poor living in the alleys behind mansions, the rich and poor in Philadelphia were in the same boat. In New York the poor were more out of sight. "The several classes of people mix very little," wrote a 1787 American visitor. (In 1793 when the city was fending off refugees from Philadelphia, Mayor Richard Varick was injured while trying to defend the city's whore houses on Chatham Row off upper-Broadway from an unruly mob of sailors, blacks and white youths. The city had whores to suit all pocket books but the vices of the poor were confined to the sink east of Queen Street, a world apart from where the gallant mayor made his stand.)

Founded by the most blatantly commercial country in the western world, New York had no legacy of moral perfection through brotherly love and honesty to live up to. New York would never inflict wounds on its own commerce and real estate as Philadelphia had done in 1793. John Broome, the chairman of the city's health committee, had been president of the chamber of commerce from 1785 to 1794. He had been appointed chairman of the health committee by Governor George Clinton and when Clinton's rival John Jay took the reigns of power, he kept Broome on, despite Broome's prominence at a partisan rally to oppose the treaty Jay had just negotiated with the British. Health was not a partisan issue.

Health was very much a civic issue among the rival Atlantic seaports. Baltimore had a new health committee, new quarantine laws and a hospital at Hawkins Point outside the harbor to receive sick sailors and immigrants. In New York, news that fever had appeared in the West Indies in the spring of 1795, prompted passage of a rule that made the port's pilots responsible for reporting ships that presented a health hazard. The city also purchased a house called Bellevue about a mile up the East River to serve as a fever hospital. Philadelphia began planning a quarantine hospital south of the city. The College of Physician asked the state legislature to give physicians more control in responding to an epidemic. It predicted that whenever yellow fever broke out in the West Indies, it would get into Philadelphia no matter the precautions. Once in the city it would again be "highly contagious." Measures could be taken to limit the contagion but a committee of doctors rather than one of laymen should be in charge. The governor soon had power to appoint four doctors to advise and assist the port physician who had increased powers to remove infected people and quarantine and purify vessels." Rush did not offer any public opposition to those measures. Indeed, he endorsed the need for vigilance against contagion on ships in a published letter in which he lauded the virtues of Benjamin Wynkoop's new pump for ventilating ships.

That ports were readied to handle incoming yellow fever cases, did not make city officials any more ready to admit that the fever had indeed reached their port. It was as if cities took preventative measures to make their assurances of continued health more plausible. In late July New York's port physician, Dr. Malachi Treat, got the fever immediately after inspecting the Zephyr, a ship from the West Indies that had three crew members sick with fevers. The ship's boy died the day Treat boarded the vessel. The doctor looked into a sack that held the corpse and thought he died of "bilious remitting fever." Yet his diagnosis was controverted at every turn. The captain of the Zephyr, who was anxious to land his cargo (he had unceremoniously dumped water damaged coffee into the East River to hurry along inspection of his ship,) described his own fever as dysentery, and claimed the boy died of worms. Alarmed at the putrefying corpse, Treat had himself rowed out to Nutten Island to assure its proper burial. Opponents of importation pinpointed that exertion in the hot sun by a man known to have a chronic stomach disorder as the source of his fatal fever, not his exposure to contagion on the Zephyr. The health committee's minutes toned down Treat's report, noting only that the boy had "suspicious symptoms." The ship's passengers were allowed to land.

Then the ship William hauled up next to the Zephyr and several crew members soon had a bad fever. Common report described it as yellow fever. The port warden talked to the owner of the William who said there had been much sickness on board during its passage. The health committee kept the warden's report to itself.

There was no Rush along the New York waterfront, much to the relief of the health committee. Shortly before he died on July 29, a colleague visited Treat. He "knew me when I entered the room," Dr. William Smith wrote to a doctor in Philadelphia a month later, "he looked yellow, red, and bloated - his extremities cold - his pulse irregular - he raised himself in bed, and seemed willing to make unavailing efforts to get on the floor, which I dissuaded him from - he said if he could stop his gulping he should do well - it was a mixt spasmodic affection, I could hardly tell whether most a hiccup or an effort to vomit - it produced no evacuation -I inquired of him whether he thought himself under the influence of infection -he answered, and nothing more was said on the subject - 'Ah Dr. I don't know' - 'sometimes I think - But don't you think' - his debilitated intellect labored under a gloomy incertitude!" He died eight hours later. In the week after he died there were eulogies in the newspapers, but no mention of nor speculation on the cause of his death.

During the whole of August the health committee encouraged the quick burial of fever victims, a vigilant lookout for infected ships and urged "moderation, regularity and cleanliness" both personal and civic. Particular mention was made of cleaning the "streets, yards, cellars and markets" near the East River. Yet it insisted that these were wise precautions for any hot season. The committee denied that there was a yellow fever epidemic. On August 15 it reported that only 14 had died from fever the week before "in this large and populous city." It didn't report that 8 of the deaths were near the intersection of Dover and Water Streets. As evidence that the fevers were not contagious, it noted that "nurses, servants, friends and attendants very generally escape with impunity." Unmentioned was that it had banned a supposedly cured patient at Bellevue, the fever hospital, from entering the "compact part of the city."

Then the doctor at Bellevue got the fever. When he returned to the city, the alarmed committee ordered him to either leave the city or return to Bellevue. Yet three days later the committee issued its usual upbeat assessment. Seven had died in the last three days. Any remaining apprehensions arose not from actual sickness and death, but from "the peculiar sensibility of the public mind, arising from the late suffering of Philadelphia, New Haven and Baltimore." Unmentioned was that they put a coffin maker on Maiden Lane to work.

Doctors cooperated with the committee. On August 15, they met, and reported to the newspapers "that no CONTAGIOUS fever, in any particular different from what this city has been accustomed to, for some years past at this season, exists at present." Soon after the meeting a young doctor went into the infected area of the city and by applying an analysis along Rush's principles did his might to calm apprehensions. Dr. Valentine Seaman ignored the considerable anecdotal evidence of the family and friends of victims that blamed visits to noxious ships along the wharves. For example John Camp who died on the 7th was said to have taken the fever after working on board an infected ship. Instead Seaman reported to the health committee that he had found "the cause of the present complaint,... a fruitful matrix generating the seeds" of the fever. The city corporation had built up Water Street in that area with landfill without requiring lot holders along the street to fill their yards to a level with the street. "Hence, the refuse water and offal substances from the families occupying these places are left to stagnate and putrefy." Even a rain shower which contributed to the health of well drained areas, only made matters worse in that sunken plain where each building housed "several families." Seaman thought if the problem was "not properly cared for," more would die in the vicinity.

Newspapers couched calls for vigilance with assurances that an epidemic was impossible in the city. It would be a "disgrace...," one essayist exhorted, "if New York, which is certainly one of the most healthy spots on our continent, should become the seat of contagious disease merely through the negligence of its inhabitants;" indeed, there was no place on the "globe, where the inhabitants have less reason to apprehend the fatal effects of those fevers which have so long harassed other parts of the world." Vigilance in this case meant cleaning up filth and refraining from throwing dead animals in the street. While this could be cited as a reaction based on Rush's theory of the local origin of the disease, it only replicated the successful campaign that kept fever out of the city in 1793 when streets were carefully policed for cleanliness.

After Seaman's report members of the health committee investigated an alley off Pearl Street where water was backed up. The next day, August 19, it asked the owner of Fitch's store to fill up the morass under the store, less out of Seaman's concern than to "ease the minds of neighbors." On the 22nd it ordered the cotton and coffee in Mott and Lawrence's store, which was giving off a stench, removed from the "compact part of the city."

Urging that action was Dr. Samuel Mitchill, a 31 year old chemistry professor at Columbia College who received his degree from Edinburgh after the advances in chemistry made by Antoine Lavoisier and Joseph Priestly. Mitchell was putting the finishing touches on an essay arguing that since nitrous gas, which Lavoisier had shown could kill a bird, was produced by putrefaction in cities and in stomachs, it was the likely cause of contagion. How much oxygen and azote (or nitrogen, which to sow even more confusion Mitchill wanted to call septon) made up mephitic gas could be known, therefore it should be easy to identify and control. "Since we are become acquainted with its production and composition, it is very much in the power of individuals to guard themselves against it, and for magistrates to protect cities from its ravages." Dr. William Smith, who replaced Treat as the new port physician, was persuaded by Mitchill's ideas, and thought rotting cotton the principal culprit in making the deadly gases. He was perhaps responding to a report "that a man had thrust his arm into a bag of damaged cotton, and that, when he withdrew it, the arm, from the virulence of the contagion, was of a livid color."

At the moment Mitchill had no instrument to measure contagion; only the very subjective nose evaluated the danger. The store owners protested that there was nothing rotten. When the committee learned that 11 people had died of the fever on the 25th, it stopped bickering with store owners, and ordered the cotton removed and the store cleaned because the public was "too alarmed." It also ordered Fitch's and another store cleaned and sent a subcommittee to investigate Dover Street. In its report on August 28, the committee noted those clean-ups and re-iterated that "the disorder which exists principally, if not altogether, along a part of the Eastern shore of this city, is a local malady." Twenty had died in the past week, but only 2 in the last 24 hours. The committee sensed that once again it had defeated an epidemic. It noted in its minutes on August 30, that the fever had abated.

On the 26th Pennsylvania's governor asked his health committee if New York should be quarantined. On the 28th the lead article in the Philadelphia Gazette recalled how slowly the 1793 epidemic began and warned: "it is too well known how the malady spreads. Let not the good people of New York... be too sanguine." On the 29th the Philadelphia health committee recommended a quarantine since "the prevalence of a contagious fever in New York is sufficiently substantiated by a number of letters from several merchants in that city." On the 31st Governor Mifflin ordered a quarantine for ships from New York and Norfolk, where yellow fever was also reported. His action was applauded in Philadelphia. A correspondent in the Gazette chided the New York health committee for wasting so much energy calming people's fears, when it should be getting people to "fly the contagion."

New Yorkers were dumfounded. One writer blamed Philadelphians for habitually fabricating "falsehoods about ghosts, pestilence, death! Ever since that awful calamity overshadowed [their] city, fear has been your pole star!" A man wrote from Peck Slip objecting to suggestions that his neighborhood was sickly. "There has not an individual, except two, in the whole slip, been ailing, and they had but trifling colds, and are now perfectly well. Indeed there has not been for years a more healthy season in this place." A merchant with a store in the infected area reported that "business continues there as lively as ever: men, women, and children continually walking the streets, under no apprehension of danger. For heaven's sake what has created such alarm?" One newspaper wit wrote to "A Friend in Philadelphia" that "We are all popping off here like rotten sheep. Two hundred carcasses have been burned at the Battery - 500 hanged for fear of catching yellow fever, and about 35 or 40 guillotined - all the windows in town are broken by the firing of cannon.... Pray send us about 100,000 dollars to stop the contagion, and it may compensate us in some measure for an attempt to make our vessels ride 40 days quarantine in European ports."

Governor Jay orchestrated the official reaction, collecting letters form the health committee, medical society and common council. The latter proclaimed that the city had never been healthier at that time of year. The medical society assured that the fever had never been contagious, and with cloudy, cooler weather, was fast disappearing. The health committee went beyond generalities and described Treat's case, the cases on the Zephyr and William, and the cases in the neighborhood where those ships were anchored. Forty-four persons had been sent to Bellevue, 20 died, 16 were discharged and the 10 remaining patients were all convalescent. It suggested that Gov. Jay ask Gov. Mifflin to send a "confidential person" to the city to see how healthy it was. In its weekly report of September 6, the committee noted that no one had died of the fever the previous day.

No one at the time nor in the immediate aftermath of the epidemic double checked to see if the committee's statement on September 6 that the 10 patients then at Bellevue were convalescent was accurate. A somewhat dreamy 20 year old doctor then in charge of patients at Bellevue was not the kind to call attention to misstatements of his superiors even if he recognized them as such. But he did leave a diary.

Alexander Anderson was the son of a Scot auctioneer. His passions were wood engraving, poetry and playing the violin. His father decided Alexander would become a doctor and apprenticed him to Dr. Joseph Young when he was 14 years old. In his diary Anderson wrote more about art, poetry, religion and nature, than medicine. Yet it is in his diary that one can see how Rush's new remedies changed the practices of typical doctors.

Anderson began work at Bellevue on August 24 and found six patients and a staff of six: a steward and his wife, an old black gardener, a black nurse and two white nurses. Over the next two weeks, the situation there did not mirror the reports of the health committee. Anderson described a steadily worsening situation. On the 27th, he met the full force of yellow fever. A patient came who was "in a shocking condition - 10th day of the disease - vomiting blood by the mouthfuls." He died in two hours. A young girl who had nursed someone with the disease in town was brought out only to die despite Anderson's using Rush's remedies. On the last day of August one of the hospital nurses became sick. Suspecting fever, Anderson bled her, but the committee evidently decided her drinking problem, not the fever, was to blame. Then another nurse quit after a fight with the steward's wife. Patients had to take care of each other.

Anderson thought seriously about quitting the hospital. He regained his equilibrium by taking a day off to sail down and visit his father one day, and take tea with his mother on another. On September 4 he counted 16 patients, then "5 or 6" more were admitted. One patient died the evening of the 6th, two died on the 7th. Then in the evening a patient came from his old master Dr. Young, as well as news that the doctor's Indian servant George had died and the doctor's brother was dangerously ill. The health committee needed only consult with its own doctor at Bellevue to learn that the epidemic was not over.

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