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Yellow Fever Epidemic of 1798
in New York
[In an earlier draft of my on-line book about Rush and yellow fever, I discussed the New York epidemic in greater detail. Because Rush did not practice in New York, I did not write a complete and rounded history of the epidemic. In time I'll try to remedy that, and also try to continue the story in the primary documents that I will add to this site.]
By Bob Arnebeck
The first victims of yellow fever in New York, stricken at the end of July and early August, blamed the schooner Fox which arrived in late July from Jeremie. Doctors, however, did not take the accusation seriously. This was not a case of diagnosis being made difficult by the victims being poor and intemperate. Among the first deaths were prominent merchants. However, the area where the fever was centered, Coenties wharf, had been the site of a small epidemic in 1797. In vain, the health committee had pressed the common council to enforce a clean up there. That the fever returned to that very filthy spot seemed a proof of the local origin of the disease. Ships from the West Indies docked up and down the long waterfront. The coincidence of the fever returning to Coenties wharf also lulled the health committee into thinking that, just as in '97, the epidemic there would be short lived and unremarkable. Indeed, judging from his journal, Elihu Smith hardly paid any attention to it, though the first victim, 74 year old Melancton Smith was a friend. Instead Elihu Smith was busy getting out the first number of the second volume of the Medical Repository, forming a mineralogical society and enjoying the company of Charles Brockden Brown who was staying with him and his roommate, the lawyer William Johnson.
Brown was busy completing Wieland. Smith read and discussed the work with his friend and helped arrange for its publication. Very likely it was Smith who suggested a footnote in the novel which referred readers to the section of Darwin's Zoonomia in which mania similar to Wieland's was discussed. Not until August 25 did Smith and Brown take any notice of the yellow fever epidemic in the city. "The sickness increases in town," Smith noted in his journal. "Heavy rains, uncleansed sinks, and a continuance of unexampled heat," Brown reported in a letter to his brother in Philadelphia, "have within these ten days given birth to the yellow fever among us in its epidemical form. Death and alarms have rapidly multiplied, but it is hoped that now, as formerly, its influence will be limited to one place." Brown felt no concern for his own safety since he lived far enough from the infected wharf, "and my mode of living, from which animal food and spirituous liquors are wholly excluded, gives the utmost security." Living as Rush prescribed, the two young men were fearless. In his treatment of yellow fever patients, Smith bled, purged with mercury and induced salivation, always with good results.
Alexander Anderson, who had been staff physician at Bellevue Hospital during the 1795 epidemic, exhibited a fearlessness bordering on the blase. The summer of 1798 had not been an easy one for him. He and his wife's first child had died three months after birth. Struck by the frequency of infant mortality in the past, some twentieth century historians argue that 18th century couples accepted and adjusted easily to the occurrence. At his son's death Anderson was brave and "in perfect health and strength," but a few days later he began "to droop." He had a colleague "draw about a pound of blood." That afforded relief and he had it done the next day too. The morning after he "woke up mauling [his] wife thinking a beast at her breast." Within a week he began taking "a dose of nitre and calomel 5 1/2 grains," which "contributed to paint objects in fancy colors." Two weeks after that he began drinking wine in the morning "for medicinal purposes," and soon added opium to the dose. His wife fared no better and, as yellow fever spread, left to stay with her mother on Long Island.
Anderson had his first yellow fever patient on August 11, a man whose wife had left him then returned and sent for the doctor. She didn't think her husband would recover but begged Anderson to save him "for the sake of her poor children." "I must say," Anderson wrote in his diary, "I was somewhat pleas'd to see her punished for her cowardly flight." The man was sent to Bellevue by the health committee where he died. Dr. Rodgers called Anderson in for three consultations on other yellow fever patients. Soon Anderson found himself vomiting and feeling weak. He thought nothing of it, and took 8 grains of calomel which forced him to spend a day in bed. Then he wavered in his Rushite convictions, filling his empty stomach with a beefsteak, which "quite" cured him. On August 30 he bumped into Dr. Bayley, the city's health officer, who asked him to suggest a staff physician for Bellevue. Anderson went to the health committee and got the job himself. He tried to get a colleague, Dr. Chickering, to take his patients, two children with yellow fever, and was appalled when the doctor timidly refused.
Noah Webster returned to New York in August, and wrote editorials for the Commercial Advertiser, then managed by his nephew, which also demonstrated how in the eyes of Rush's disciples yellow fever completely lost its terror. (A revision the master was never able to make.) An August 22 editorial celebrated the country's lack of vigilance against supposed contagion. "It is a most agreeable circumstance that the citizens of the United States have become so well acquainted with the nature of the Yellow Fever, that they no longer cut off communication between the places where it prevails, and where it does not." Instead of night watches, guards and persecution, New York welcomed refugees from Philadelphia. Indeed New York was wise not to automatically quarantine ships as Philadelphia did because keeping ships loaded in the harbor only increased the likelihood of putrefaction on the ship which would make it unhealthy and dangerous to the community. New York's regulations were "more safe for the city, and less troublesome to the merchant; while we freely receive all fugitives from infected places, afford them all possible aid, and suffer no inconvenience from such acts of humanity." That said Webster soon returned to Hartford.
When addressing the fever, others bewailed Philadelphia's fate and discounted the threat to New York. On August 14 a torrential rainstorm flooded many cellars in New York prompting a call for the health committee to inspect every house and see that cellars were pumped out and purified. But for the next two weeks no one blamed any sickness on those floods. Judge James Kent wrote to his brother on August 15 that he thought that "such periodical alarms and confusion" in Philadelphia "must in the end go a great way to ruin the commerce and prosperity of that city." In an August 25 letter the Rev. John Rodgers, father of the doctor, implored God to save Philadelphia and shrugged off "some few cases of bilious fever with us." He thought the city "in general" was "healthy as much so as I have known it for many years at this season." William Robinson, a Quaker merchant, wrote to Philadelphia friends on August 16 that he had heard of "two or three people" dying of yellow fever, a typical occurrence for years. "On the whole," he added, "this city is in a very clean, sweet and healthy state -- and I know of no alarm and have not heard of a single family moving out except as usual on acct of the heat."
Robinson soon revised that estimate. "Within 6 or 8 days," he wrote on August 27, "twelve or fourteen persons have been attacked within my knowledge, five or six of whom have died." He listed five victims by name, and added, "a number of families in our quarter are moving out of town -- but the alarm is not yet general in tthe city." Robinson moved his wife and daughter from their east side home and tried the best he could to stay out too, but business usually kept him commuting in from their refuge in Greenwich, until he got the fever.
The Commercial Advertiser tried to keep those deaths in perspective. On August 30 it ridiculed a letter printed in Philadelphia that claimed one hundred died in one day on New York's Golden Hill and Cliff Street. Perhaps 10 people had died there but the western part of the city was "probably as free from sickness as it was ever known to be at this season." On the 28th the health committee congratulated the governor on the epidemic around Coenties wharf ending, but added that "unhappily" there was sickness elsewhere, "principally in unventilated situations." The committee did not think of ordering evacuations. It was content to go after merchants who did have putrefying beef in their cellars. A writer privy to the investigations of the health committee and supporting all their actions wrote a long report on the fever in early September. He cited clusters of cases and local causes for each: new made ground, crowded buildings, swampy lots and/or offensive sewers. He ridiculed claims that the fever was imported or arose from coffee thrown on a wharf. He argued that the death rate was not out of line for the season. On September 2 Elihu Smith wrote to his friend in Hartford that he thought the flight from the city was a reaction, "certainly disproportionate to the cause." He estimated that 600 were sick and that one in ten died. Since the evacuation the number of new cases was "small."
Unlike their colleagues in Philadelphia, New York doctors exuded confidence. On September 6 Dr. Samuel Bard wrote to the newspapers heralding a remedy for the most feared symptom of yellow fever, black vomit. His partner Dr. David Hosack had shown that "lime-water mixed with an equal quantity of new milk" had cured three cases in which black vomiting had begun.
Several articles appeared in New York papers attesting to the virtues of alkaline medicines and lime as a disinfectant. "LIME has subdued the poisonous vapor issuing from the sewer of Burling-slip...," boasted a September 7 article. "LIME WATER, soda and pearl ash are capable of restraining the black vomit." Dr. Samuel Mitchill, the chief promoter of alkaline remedies, had by September united his new understanding of the fever with Rush's ideas. There were three states of yellow fever. In the bilious and vomiting state, alkaline remedies were called for; bleeding was proper when the patient was in a state of high excitement; when the patient was a stupor, Mitchill thought the disease should be treated like acute scurvy and an effort had to be made to get oxygen into the system and "septon" [his word for nitrogen] out. To do that he prescribed "neutral mixtures, lemonade, cider, peaches, pears and apples."
The trio of Brown, Johnson and Smith maintained their devil may care attitude about the epidemic despite Smith confining himself to bed after getting too much sun on a sail to Long Island to see a patient. They wrote a joint letter to their friend William Dunlap, the painter and theatrical producer who as always in the late summer was in Perth Amboy. Brown joked about "this plaguey fever at our doors, in our cupboards & in our beds." Johnson marvelled at the fever's "unaccountable origin,... amazing attributes, and... inexplicable operations," leaving it to Smith to explain what was going on. From his bed the doctor assured Dunlap that while it was unsafe to be on certain East Side streets, the fever was not as mortal as it was in 1795. One in ten died, "& that not more than one in a hundred would perish, with early attention & faithful nursing." On the same day Brown wrote to his worried brother in a more serious vein. Smith assured him that not one out of nine died when properly nursed. Brown thought it would be wise to leave if the fever reached their end of town. By becoming sick he would become a burden. However, he knew Smith would never leave. "If I run the risk of requiring to be nursed," Brown reasoned, "I must not forget that others may require to be nursed by me, in a disease where personal attentions are all in all."
Out at Bellevue, Alexander Anderson was his old sardonic self once again, while he tried to deal with 20 patients, four of whom died on his first day there. With 14 newly admitted patients, Anderson had to fend off "an Irishman who ask'd to stay and nurse his sweetheart at night." He returned to town to see his patients there, and was amused to find that Dr. Chickering had taken the fever. They joked that when he recovered he would "practice without fear." Unfortunately Anderson was too busy to put much color in his diary. A patient he dismissed as cured came back sick and promptly died; a nurse got sick. Then on the afternoon of September 5, his father came to report that Dr. Chickering had died and Anderson's brother was sick. Faced with his own brother in a dangerous condition, Anderson lost his confidence. He conferred with Dr. Bayley about a better way to treat patients, but the older doctor seemed "at a loss." As his brother got worse, his father became ill. On the 8th after going to Bellevue thinking his brother better, he returned to find him dead. As his father got sicker, Anderson sought out Dr. Dingley for consultation. Anderson had bled him twice, and was disappointed when Dingley only prescribed "innocent things." Anderson saw to it that his father got calomel. On the 10th his father was so ill that Anderson had to resign from Bellevue to spend all his time with him and when able "practic'd among the neighbors many of whom are taken ill."
His father died on September 12. Finding that his mother showed "heroic fortitude," Anderson went to see his wife on Long Island. To his shock he found her looking ghastly, emaciated and spitting blood. She died the next day. Then he returned to his mother, and was surprised at both her and his own composure. His mother was even lively until the 16th when she was seized with the fever. He gave her medicine immediately and for awhile thought she would recover. A black nurse helped care for her which allowed Anderson to see other patients. His mother became difficult, complaining of being neglected and refusing to take medicine. She died on the morning of the 21st, "delirious all night and suffered much pain."
A few blocks to the west, Elihu Smith and his friends were still sanguine. Smith recovered from his indisposition ascribing "his preservation from death entirely to his vegetable diet" and to not visiting patients when he was sick. Smith sent a long report on the New York epidemic to Rush written very much in the style of the master, a potpourri of incisive generalizations.
More natives were getting sick than in 1795, which led to their being fewer deaths because natives, better educated and wealthier, were quicker to get medical attention. He thought the number of sick decreasing and since "the complaint being in great measure local, and the inhabitants of the pestilential district having mostly fled, the extension of the sickness is not greatly to be apprehended." There was no question of the fever being imported. Even importationists like David Hosack agreed. Few doctors thought the fever contagious and even the general populace agreed. People left "not from fear of the sick, but of the town." There was no hesitation to nurse a sick friend, "likewise one great cause of the less mortality among us." As for remedies, alkalies such as soda, potash and lime water invariably relieved victims of "all commotions of the alimentary canal." Smith asked Rush about his experience with emetics and promised to publish his letter on them in the Medical Repository.
Like Anderson, Smith was soon humbled by the epidemic. A young Venetian nobleman, Dr. Joseph Scandella, had come to America to broaden his education and took a particular interest in yellow fever. Smith had befriended him, as did a number of men of science including Rush. In August Scandella sailed for Europe from Philadelphia, then the leaky ship returned to New York. Early in the epidemic Scandella joined Smith on his rounds. Then in early September he returned to Philadelphia telling Smith that he went "in search of his baggage." On September 11, Smith learned that Scandella had returned to New York and was ill with the fever. He rescued him from unfriendly inns, and he, Brown, and Johnson nursed the unlucky Italian.
On the 13th Smith wrote to Rush again, reporting that the mortality had increased. He blamed that on the fact that most of those getting sick were poor people who didn't call for doctors in time. His confidence in Rush's depleting remedies in combination with alkalies had not diminished. He thought that the alkalies aided the cure by "partially decomposing the calomel and thus diminishing the tendency of this latter medicine to irritate the stomach." He revealed that Scandella was his patient and closed the letter by assuring Rush that "all that the faculty of New York can do for his relief will be attempted." Smith noted in his journal that after being very ill, Scandella seemed better. On the 14th he seemed "much better, to all appearance." On the 15th Smith decided his friend could not recover. On the 16th Smith himself was very ill.
The day after the publication of Wieland, his first novel, Charles Brockden Brown, a frail and sickly man, had to share duties with Johnson as they nursed Scandella who lay in Smith's bed and Smith who lay in a bed in the next room. Before his attack Smith had made a sobering reassessment of the dangers of yellow fever. Distraught at the havoc the fever made in a house where he had six patients, with two so sick they had to be sent to Bellevue where one died, Smith "became sensible of the disproportionate hazard which he incurred, and... determined, as soon as his friend Scandella had recovered or perished and his present patients had been gotten rid of, to withdraw from town." The best Brown and Johnson could do, after Scandella died, was to remove Smith to the "spacious, healthfully situated" house of Johnson's brother Horace. In a letter written the 17th Brown tried to describe how bad it was in New York, how much worse than Philadelphia. A greater proportion of the population died and "the victims to this disease have been in innumerable cases selected from the highest and most respectable class of inhabitants."
On the 18th Brown also seemed to take the fever. Dr. Miller, who along with Smith's other co-editor, Mitchill, tried to treat Scandella and Smith, took Brown to his own house. In Smith's case the new alkaline treatment did not work. Nothing could "compose his stomach." Most of the time he was in a stupor, but when revived he could answer questions rationally. Smith pressed upon his colleagues the importance of inducing salivation. Like Smith, Miller was an old student of Rush's and followed his prescriptions. Heroic measures failed Smith. Because of his vomiting, calomel would not stay in his system. Mercury rubs failed to bring the hoped for soreness and saliva. He revived enough mid-day on the 19th to see that his vomit was black, "pronounced the word 'decomposition' and died."
Out at his Perth Amboy retreat William Dunlap had just replied to his jolly friends, inviting Brown and Johnson to come to Perth Amboy and "to Elihu, my apprehensions for his safety & my confidence in his doing his duty." When he heard of Smith's imminent death, his usually flinty diary betrayed some emotion: "Notwithstanding my firmest attempts this stroke bears hard upon me." Just after he learned of Smith's death, Dr. Rodgers, who weakened by fatigue had left the city, called with the news that Amasa Dingley, with whom Smith had first explored the nature of yellow fever three years before, had died of the disease.
Brown recovered, and before he and Johnson came to Amboy, he wrote to Dunlap, "Most ardently do I long to shut out this city from my view...." And to his brother, he wrote the day Smith died: "O the folly of prediction and the vanity of systems."
Drs. Miller and Mitchill did not make a case study of Smith's death. Miller told Brown that "no case was more dreadful and infinitely malignant." While lessons were often drawn from their recoveries, the deaths of doctors were seldom detailed. The hazards they faced during an epidemic explained the high mortality in their ranks. Though men like Scandella and Smith, for whose cleanliness, temperance and morality he could vouch lay on the verge of death, Mitchill blamed "the inhabitants [who] have really poisoned their city by the accumulation of excrement, putrid provisions and every unclean thing," plus their "gross animal diet" and intemperance. "If some of our citizens breathed air as pure and balmy as the breezes of Eden," Mitchill wrote to Noah Webster on September 17, "they would engender this sickness by their way of life. They would breed it within them. To get the better of these visitations will therefore require more than municipal regulations. An alteration, and a considerable one too, of housekeeping and modes of life will be necessary." Rush's reaction to Smith's death is not known. A letter he wrote to Smith's parents is not extant.
New Yorkers did not dwell on the accumulation of sorrows. With no family to flee to and with friends calling for his services, Anderson resolved to stay until the epidemic ended. He gave up Rush's mode of practice, began using laudanum and stimulating medicines, and was surprised and gratified by his success. (Once the epidemic did end, he stopped being a doctor and devoted all his energies to engraving. Dr. Young, his first teacher, was surprised at his decision. But as Anderson, who became one of the country's most beloved engravers, wrote in his memoirs fifty years later, "the succession of calamities" he experienced in 1798 "seemed rather too severe.")
The health committee, the city's editors, doctors and even citizens in candid private letters continued to think that the crisis was manageable. New Yorkers clung to every healthy block as evidence that it did not have as bad an epidemic as its rival port. Rev. Samuel Miller wrote that he avoided the docks and wharves; a broker wrote that as long as he confined himself between Trinity Church and the upper part of the Battery he felt safe. Throughout September the health committee dealt with local nuisances like sewers and bad smells emanating from cellars.
Here indeed was a community living and dying by Rush's principles, although certainly commercial considerations inspired the city's leaders, more than devotion to the ideas of Rush, Webster and most of the city's doctors. That brave front was easier to put up because of the headlines that came from Philadelphia. Many ports were stricken but none could rival the misery of Philadelphia. For the first time, banks left the city, prompted not only by sickness and death among employees but by a robbery of the Bank of Pennsylvania on September 2. Two days later the bank moved its offices and valuables to a school house in Germantown. On the 5th the Bank of North America followed. By September 6 the city's market had moved ten block to the west at Market and Broad Streets. On September 11, James Smith's store was robbed. A week after that, only the quick shooting of Alderman Robert Wharton, who was supervising the jail after the jailor fled from fear of the fever, prevented an escape by several convicts.
The newspapers that spread the stories of the city's crisis were decimated by the epidemic. Fifty-one men in the printing trade got the fever. The two leaders of the partisan press died; Bache of the Aurora on September 11, and John Fenno, Sr., of the Gazette of the United States on the 16th. Fenno's wife died on the 6th. (No one made any issue of the medical treatment Bache and Fenno received. Republican though he was, Bache did not take Rush's cure. A French doctor gave him baths and gentle medicines. That dismayed Bache's sister who when she visited found the house virtually flooded because the tub leaked. She worried that the damp would harm Mrs. Bache who was in the last days of pregnancy with the family's fourth child. Perhaps taking a lesson from that, when Bache's assistant William Duane got the fever he took 212 grains of mercury and though his "gums [were] inflamed, teeth loose and [his] face swelled," he survived to marry Bache's widow and carry on the Republican traditions of the Aurora.) The most affecting token of Philadelphia's despair was the death of Mayor Hillary Baker, who had stayed to relieve the distress of those who remained in the city.
"Compared with this dreadful situation," the New York Daily Advertiser pointed out after describing the devastation of Philadelphia, "the inhabitants of New York have little grounds for murmuring. Large districts and several principal streets have remained almost untouched by the fell destroyer. A great number of rich families have continued in the city, who had ample means of removal. Many gentlemen, particularly the collector and deputy collector, and those belonging to the insurance offices, and various other public departments and branches of business, have been in the constant habit of spending five hours in town every day. The banks have not thought of moving, and not more than four-sevenths of our inhabitants, if that many, have left town."
Only Philadelphia's rival for political pre-eminence exceeded New York for tasteless commentary during the crisis. A letter from the new city of Washington, where a plunge in real estate prices had crippled development and threatened progress on the Capitol which had to be ready for Congress in 1800, extolled the site of the new capital. It was "remarkable for the salubrity of its air, the purity of its water, and the cheapness of provisions and fuel; and that whilst the yellow fever stalks with desolating strides in some of the principal towns of the Union, the Federal City, destined at some future day to rival the glory of ancient Rome, bids fair to be secure from this ravager of cities, and to enjoy from its peculiar situation and construction an envious scene of health."
Most in the nation did not indulge in making invidious distinctions as the sickly season progressed because no place seemed safe from yellow fever. In late September the fever flared up again in Boston causing a new panic. A new arrival at a suburban refuge reported on the 24th that "the number of new cases was 40, many dead and a dying, greatly beyond any preceding time and the people preparing to remove and that the doctors now call the disorder the Plague." Portsmouth, New Hampshire, and Wilmington, Delaware, began providing counts of fever cases and deaths. In the northern port only a handful were victims. Between August 7 and September 23, Wilmington counted 127 dead, all but 8 of those adults. On the 23rd alone 10 died. Chester, Pennsylvania, then a small village, also reported deaths.
New London, Connecticut, was also hit by yellow fever. Congressman Joshua Coit was one of its victims. A September 9 letter from nearby Norwich reported that based on the proportion of victims to New London's population, the epidemic was "greater... than has ever been experienced on our continent." The city was nearly deserted and yet people still died. "The skill of our physicians though many of them are eminent in their profession, appears to be wholly baffled with this fever; and there seems no other security but flight."
In a September 20 letter to his brother, William Russell, a Boston merchant, contemplated "the dreadful calamity with which this country is now visited in each of the commercial cities to a degree beyond all former precedents. Distressing and alarming as it has been upon former occasions it is far more so upon this and the direful consequences have attained an excess which has spread alarm through the whole continent." Alice Cogswell who was recovering from a cancer operation in Princeton might have been expected to ignore the epidemics in light of her own troubles. Her brother in New York had fled in time, and her brother who was a doctor was out of harm's way in Hartford. But the epidemic served as a metaphor for her own insecurity: "What sad havoc does this pestilential fever make with the inhabitants of this world, wives torn from their husbands, husbands torn from their wives, and in some instances whole families swept to eternity without one relict left to mourn their loss. It is enough to make ones heart weep drops of blood, or rather streams, my soul turns with horror from this scene of wretchedness and misery to the world beyond the grave where there is no more sorrow or grief. It is the god of heaven that thus desolates the world and he has just reason for it...."