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Yellow Fever in Baltimore, 1794

On August 7 the president issued a proclamation giving the tax rebels until September 1 to disperse their armed bands and obey the law. The crisis couldn't keep news of fevers out of the papers. There was an alarm in Baltimore that "the West India yellow fever did prevail very generally at Fell's Point, and was accompanied with its usual mortality." An investigating committee quickly corrected the rumor. Drunkenness and the heat, not an epidemic fever, caused the deaths, which were not excessive for that time of year.

On September 17, a letter in Brown's new Philadelphia Gazette, sent from Baltimore six days earlier, reported "that we have yellow fever among us is denied now only by ignorance." The writer ridiculed doctors who gave the dangerous fever other names and reported that doctors who treated the fever with Rush's methods were falsely accused of killing patients: "When the enlightened Dr. Coulter bled freely at the Point... it was whispered that he bled his patients to death. He has now only one regret, and that is that he did not bleed more freely in some cases." Given the endorsement of bleeding, it was easy to surmise that Rush or one of his apprentices gave the letters to the newspaper. The writer was Thomas Drysdale, a young doctor who had studied with Rush.

Baltimore was one of the fastest growing cities in the country with a population of around 15,000. The area Drysdale referred to was Fell's Point occupied almost exclusively by the sailors, laborers, tradesmen, their families and attendant low life that flocked to a booming port. When people died there, it was easy to blame rum. The judicial, governmental, ceremonial, social and commercial center of the city was across a quarter mile of marsh and sand. It was as if Philadelphia's Water Street had been pushed away from everything else.

Drysdale continued to report on the plight of the city and the virtues of Rush's remedies. On September 20, he extolled "the evacuating system in yellow fever." "I disregard this fever as much as any disease I ever contended. A very few visits, and a good nurse, ensure recovery." He still attacked myopic colleagues for misidentifying the disease, and celebrated the wisdom of the people: "Those ignorant fellows, who deny our having the disease, are laughing stocks, when called to a bad case. They, while denying the real nature of the disease, and its contagion, stand aloof, and stuff their mouths and nostrils with their handkerchiefs. The people are more wise, and of one opinion. They never saw such a disease, and therefore unanimously admit, it is the Yellow Fever." Up to 23 people had been dying a day, 30 in the last 24 hours. Dr. Coulter was seeing 150 patients a day. "The mortality in proportion to the number on the Point, exceeds the melancholy multitude which died in Philadelphia." People were dying within 12 hours of getting the fever. At the Point streets were deserted and "every person who remains looks as if a Thunderbolt had bursted over his head."

Opinion makers in Philadelphia like editor Mathew Carey, who had been treated so rudely by Baltimore authorities the year before, were prompted to engineer revenge against the rival port. However as long as rumors abounded about yellow fever in Philadelphia action against Baltimore was not advisable. Baltimore newspapers while not mentioning sickness in their city did publish letters from Philadelphia describing yellow fever there. Drysdale was probably the source for one letter because it came from some one close to Rush who described how that worthy was being persecuted for reporting yellow fever cases. "They circulate with great assiduity that he is mad, and have even proposed to drum him out of the city for 'disturbing the quiet of the inhabitants' - in other words - lessening the sale of fall goods."

An ad hoc committee of citizens met in Philadelphia to decide if goods and people from Baltimore should be quarantined. The city's health committee first gave Philadelphia a clean bill of health. In his notebook Rush labeled that report "false and scandalous," but he did not attend the general meeting of citizens on October 2 at which the health committee's all clear allowed a call for measures against Baltimore. The meeting was sparsely attended, but a full report was in Brown's Gazette. The only doctor to speak was Currie, who, a reporter noted, "spoke so extremely low, that it was with difficulty he could be heard." His diffidence may have arisen because he was taking an unpopular position. He doubted that there was a contagious disease in Baltimore, and thought yellow fever was in Philadelphia. Carey insisted that Baltimoreans were the best judge of the state of their city and they were fleeing. William Sansom said he had seen a sick man all yellow in a carriage from Baltimore and memories of '93 were too painful to risk infection from that city. John Connelly quoted an alarming letter from Baltimore. One of the Hollingsworth brothers wrote: "Our town is in great confusion. Every one are removing to the country who can procure a place to go. Benjamin May [a prominent merchant] is dead and this day buried; yesterday the deaths were about 20.... Every street in town has now more or less the disease in it.... All business is stagnated and the bank demands are very oppressive." Miers Fisher, who was getting reassuring reports from his son Thomas, urged moderation, only one person had died on the young man's street. The upshot was the formation of committee to ask the stage companies to stop bringing passengers from Baltimore. No official quarantine could be instituted because the governor had gone west to be closer to the military action against tax rebels.

For the remainder of the month Baltimore and Philadelphia traded charges. The former insisting Philadelphia was cutting off intercourse to hide its own epidemic. Philadelphia contrasted its responsible actions - any passenger stopped would be comfortably accommodated while waiting out a quarantine - with Baltimore's callous treatment of Philadelphians in 1793. On October 2, a cold front made the dispute moot. The Baltimore health committee attacked "the false and exaggerated accounts" of sickness in the city, which it blamed on "a young man desirous of establishing his own reputation at the expense of truth and of the town in which he lives." Only 344 people had died in August and September, many children with small pox, and with "the present happy change of weather... the health of the town will be speedily re-established."

Soon Drysdale had to agree with that. His last death was on October 6. Then he devoted himself to answering Rush's request for a history of the epidemic. On December 4 he sent off a bound hand written document of over three hundred pages divided into 12 letters discussing various aspects of the epidemic with 23 case histories appended. It was loosely modeled on Rush's memoir of the 1793 epidemic. Drysdale described how the shifting winds over putrefying vegetable matter under wharves and houses spread the fever, how the fever proved contagious, and how calomel and bleeding cured most patients. He displayed a wide reading of ancient authors, adding more authority to Rush's epidemiology and therapeutics. In retrospect, the most interesting observations Drysdale made were in two case histories where he noted "a great number of small red spots" which he "would have called... pestechia [evidence of putrid fever] had not the mosquitoes been so numerous, from whose bites perhaps they arose."

Rush did not pass the manuscript on to a publisher until 1804, after Drysdale died. Rush never explained why he waited that long. The whole work was couched as a personal letter to him with frequent attestations to his genius, and it went over much of the same ground Rush had. But Rush was working on his own book.

Bob Arnebeck

Primary Document

Account of the Yellow Fever in Baltimore, in 1794, by Dr. Drysdale

Letter I.

To Benjamin Rush, M.D.

Dear Sir,

You have requested a history of the yellow remitting fever, as it lately appeared in Baltimore; and I have, perhaps inconsiderately, promised to gratify your wish. The difficulties, which necessarily accompany such a task, increase in number, as I travel in imagination through the region before me

"...Hills peep o'er hills, and Alps on Alps arise:"

and when I contrast them with the powers of my youth, I am almost disuaded from the attempt. But I now enter on the undertaking with these pleasing reflection, that you will indulge the deficiency of execution, where the critic would condemn: for I am convinced with Dr. Moore, that "those, who have the greatest knowledge in their possession, are best acquainted with its uncertainty, and most indulgent to the mistakes and errors of others."

An account of the weather, which preceded the appearance, and accompanied the progress of this awful disease to the close of its career, will be given more properly in another place. But it may not be unnecessary to mention here, the principal diseases which characterized the summer and autumn. In the town, the cholera made its appearance among children as early as the months of April and May; but it is very remarkable, that this disease was unknown through the summer upon Fell's Point. On the lower part of Baltimore, the month of May was unusually healthy, a catarrh only affecting many children. In the beginning of June, intermittents and dysenteries became more general, and as the season advanced, remittents also made their appearance. These three diseases, especially the first and last, ranged through every part of the country, and infested even the highest ground.

But the most remarkable disease was the natural small-pox. It appeared very early in the summer and soon became epidemic. It advanced with the year, and made such devestation among its unfortunate victims, that Baltimore, perhaps, never before experienced so severe a scourge from this disease. Even they, who were inoculated in the spring, required peculiar attention; for it was si unusually insidious, that many unexpectedly suffered from it malignity.

The first case of yellow fever, that I saw, was on the 7th of August. The patient was in the fourth day of the disease, and had been harassed several hours with the vomiting of that dark fluid, so greatly resembling strong coffee muddy with its grounds. His eyes had been very red, but were now, together with his skin, yellow: the latter was dry and cool; his pulse was slow and full. He was either oppressed with stupor - or deranged with a mild delirium. In a few hours he was dead. I could not pause a moment in believing his disease to be the yellow fever. I mentioned freely what I had seen, and expressed my apprehensions that this case might prove the prelude of a scene of calamity. The Point was now becoming considerably sickly, and many deaths occurred there suddenly, or after a very short indisposition.

The several deaths that had occurred, together with the report, that the yellow fever had made its appearance, excited alarming apprehensions in the minds of the people. An inquiry was consequently made, by three of the most respectable physicians, into the state of the health of Baltimore. On the fifteenth of August they reported that, "Conformably to a request made by the grand jury, we yesterday proceeded to inquire into the grounds of a report, which for some days past has created serious alarms among the inhabitants of this town, viz. that the West India yellow fever did prevail very generally at Fell's Point, and was accompanied with its usual mortality; that there are no grounds for believing that the yellow fever is yet among us.

"After a careful examination of several persons, confined with fevers, and the most minute inquiry respecting those cases, which have lately proved mortal, we are unanimous in the following conclusions: - That the prevailing fever of that place is the common epidemic of this season, which annually visits our southern and middle states, viz. the bilious remitting fever; that the late mortality at that place, which has been greatly exaggerated by report, has not been owing to any one class of diseases in particular; that during our late very hot weather, most of the instances of sudden death arose from accidental causes. Many of the laborious class of the people were destroyed by the extreme heat of the sun, while employed in their useful labors. Intemperance was the cause of death to some, whilst indiscretions of different kinds proved destructive to others.

"On the whole we are of opinion, that the mortality of this season has not exceeded that of many former ones, which passed unnoticed, & c. & c.

Signed by Doctors George Brown, John Coulter, Lyde Goodwin."

Every funeral recalled to the minds of the Baltimoreans the late calamitous situation of Philadelphia. With the hearse and the grave they invariably associated the idea of the yellow fever, which had destroyed so many thousand citizens of a rival city. It is therefore not wonderful, that an alarm should have been excited, disproportionate to the mortality, that had yet occurred. The agreeable assurances they had just received, (and I am confident, that the physicians who gave them, had not met in their search a single case of yellow fever,) calmed the apprehensions of their minds. It is indeed to be deeply lamented, that any subsequent misfortune should have broken this tranquil situation of the town.

On the fourteenth of August, MasterMcC-----, (who lived on Bowley's wharf, in the same store with the gentleman who died on the seventh,) became diseased. He recovered from his fever; but on the nineteeth, a yellowness was very observable over his body, and soon became as intense as in jaundice. On the morning of the twentieth of August, Mr. M----n called on me for advice. On the first evening of his disease, I suspected the real nature of his fever, and did not hesitate to mention my apprehensions. I attended this gentleman in company with Dr. George Brown, my former preceptor in medicine; - a person, who truly combines all the merits of a professional character, with all the endearing and respected virtues of a gentleman. Mr. M-----e was attacked on the morning of the twenty-second; Mr. A------ on the evening of the same day; and Mr. A------n on the following morning. These four gentlemen were engaged in commercial business on teh same part of Bowley's wharf. Some other persons living at the same place were also diseased at this time, but they did not fall under my observation.

The peculiar symptoms, attending the fever of Mr. M----n, from its commencement to its fatal close, called from Dr. Brown an unequivocal declaration of its nature. His apprehensions were increased by the occurence of other cases at the same time and at the same place. The declaration I had made near three weeks before, was now seconded by an authority of the most indisputable ature. A town meeting was in consequence summoned, which terminated in the nomination of a committee of health. Their chairman, Gustavus Scott, Esq., was a gentleman of the highest honour and integrity; and it is therefore to be regretted, that his necessary avocations from the town, soon took him away from the regulation of their conduct through the scenes that followed.

Fell's Point was now becoming very unhealthy, and many cases of disease had terminated there speedily in death. On the thirty-first of August, I visited with Dr. Allendre, Mr. J. R. in the seventh day of his disease. He had now a constant hiccup, and a copious vomiting of the coffee grounds; his eyes were very yellow, his skin cool; his pulse full but so irregular, as to beat sometimes three pulsations in one-sixth of a minute; sometimes fifteen in the same period of time. He died the next morning. On the same part of Baltimore, I attended with Dr. Brown, Mr. Thomas L---- who was taken ill on the twenty-sixth of August; his apprentice boy on the twenty-seventh; and his maid servant on the thirty-first. Mr. C----'s son Thomas was attacked on teh twenty-eighth; himself and his son Robert on the following day. A boy of captain F----'s was attacked on the twenty-seventh. In the town, three persons, who had contracted their fever on the Point, came under my observation on the twenty-ninth and thirtieth of August. All these cases, except one, terminated favourably.

While this scene of disease was extending on the Point, the town became unusually healthy. Some took advantage of this circumstance, to oppose the assertion that a yellow fever had appeared among us, and to ridicule the authors of such a declaration. But the disease soon extended itself so widely, that incredulity ceased, and even the tongue of calumny itself was almost silent.

About the sixth of September, the healthy tranquility of the town of Baltimore was again ruffled by the return of remitting fevers, which, together with the intermittents of this season, were almost universally accompanied with catarrhal symtoms. The tenth of the month will be long remembered by the inhabitants of Baltimore, as the day which deprived them of Mr. Stephen Wilson. He died of a bilious colic. His unshaken patriotism, as a citizen; the rectitude of his conduct, as a great commercial character; the liberality of his soul, as a humane and virtuous christian; teh dignified simplicity of his manners, as a man; and the sincerity of his heart, as an inestimable friend, have left on every heart an impression, which can wear away only with life itself.

The yellow fever continued to increase on the Point in extent and malignity. Doctors Allendre and Richard Griffith, and Degraffenreidt were at the same time in imminent danger of falling victim to it. Dr. Dorling had lately died in town, and Dr. ---- Griffith, sen. on the Point, was carried off after thirty hours indisposition. The reverend Mr. Buston, of the Roman catholic church, who had been much engaged on the Point in administering the last offices to the dying, was now dangerously ill. So great was the number of the sick about the twenty-fifth, that Doctor Coulter visited and prescribed for more than a hundred and twenty persons daily.

Before the close of September, a panic spread through the town, and drove a great number of families to seek refuge in the country. As I rode on the morning of the thirtieth, through the Point, I was struck with the melancholy change induced by a very few days. The streets were no longer crowded, and noisy with business or festivity. The eye would scarcely meet a dozen persons in its longest street. In the rooms of the sick, I more particularly observed the stillness of the streets. But a little time before, even when the reduced violence of disease would have permitted them to doze, every slumber was broken or banished by the noise without. The whole day resembled in silence the hours of night.

A happy change of weather at this time, checked the rapid progress of the fever, and rescued the town from sharing the general misfortune of the Point. The disease declined; and by the middle of October, the health-committee closed the accounts of the dead. The citizens returned to their homes and business; and in very short time, a person passing through the Point itself, would be reminded of its late situation only by observing in some alleys the bodies of a number of dead cats.

(more to come)

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