Destroying Angel: Benjamin Rush,
Yellow Fever and the Birth of Modern Medicine
by Bob Arnebeck
In the summer of 1798, nature completely fooled what passed for science. The aedes aegypti mosquito breeds in clean water. As citizens inspired by theories of importation or local origin cleaned filth on board and on shore, the mosquitoes thrived. The theories of Rush and Currie failed to explain why 10,000 people died in Philadelphia, New York, New London, Boston, Wilmington and smaller ports in between.(1) It was a sad season for mankind and perhaps for that reason, as well as the complexity of unfolding epidemics in three major population centers, it has largely been forgotten.
But to the people who survived that season, it was a singular challenge and inspiration. There was enough death and devastation to prop up all manner of etiologies. Those based on the Bible flourished. While we clearly see the defeat of science, those who lived through the misery had to redeem it with convictions about cures and preventatives. That the heroic reaction to the crisis of 1798 was wrong in modern terms does not make it any less a manifestation of the heroic brand of medicine we still prize so highly. Four years of epidemics established medical science in American culture. As never before people became familiar with its terms, its promises, its costs, and its limitations.
Rush anticipated the sickly season with some trepidation. He didn't know if he and his family could survive another round of sacrifice and controversy. He promised his wife, children and brother (his mother had died in 1795) that he would not expose himself to another epidemic as he had done in the past.(2) He even bought a possible refuge, a small farm close to the city that he would call Sydenham.(3)
In this season of epidemics the social catastrophe eclipsed Rush's or any doctor's role in it. This was the year he should have made good his threats to quit, and cultivated his dogmas in retirement, taking advantage of the age-old tradition of prominent doctors fleeing danger with their prominent patients. Indeed in June his wife almost drowned when the carriage she was in flipped into the Schuylkill while crossing a bridge.(4) He could have nursed her at their summer retreat. Instead, he continued, as best he could, his creative response to the epidemic.
Rush did not make predictions. He observed the weather and noted the prevalent diseases of each season, but drew no conclusions. Others were not so shy. Citing the cold winter and chilly spring, Elihu Smith predicted a hot summer and bad fevers.(5) Importationists should have had an easier time prognosticating. The French and British were fighting in the West Indies. Just as in 1793, refugee ships were sailing north.
Actually, if the doctors' theories were right, the country was well prepared to ward off an epidemic. While not in the war yet the federal government put the country on a war footing. What history calls the Quasi-war with France was just beginning. America was expanding its army, creating a navy and organizing militias to ward off an expected French attack.(6) The Secretary of War solicited Rush's advice on forming the army medical corps. He urged that doctors seek a virtual veto over troop placements, movements, and even the time of battle. Because British commanders had not sought medical advice, a regiment of 950 men in St. Domingue lost 820 to fevers. Rush did not join up himself because "my late labors have worn me to the stump."(7)
There was a level of vigilance especially in Philadelphia and New York that seemed to rub off on health committees and quarantine officers. To begin with public health officials in both cities thought they had made progress in controlling yellow fever. New Yorkers boasted of defeating it two years running. Philadelphians thought they had successfully made it a disease, like most other epidemic diseases, merely a scourge of the improvident poor.
The formation and revitalization of the navy, army and local militias made the health committee's job easier. All ships from tropical climates arriving in the summer and early fall had to wait below the city for at least 10 days. On June 17 a ship crowded with refugees from St. Domingue tried to break quarantine. A naval vessel, fitting out for fighting the French, was able to keep the refugee ship at bay. The home guard stood ready to intercept refugees who might make it to shore.(8)
As for defeating pestilence on shore, by a law passed in March the New York health committee had the power to investigate any offensive smell in the city. It went after John Jacob Astor who owned a city lot that was "in a state of perfect nuisance," and got the city council to "renew" a side walk along Front Street, clean several wharves, to level some lots, and to pave parts of Water and George Streets.(9)
In Philadelphia, a new health law took effect in April and a new enlarged health committee was in operation by May. There was a complaint in the May 10 Porcupine's Gazette about smells, "chiefly from dead dogs, dead cats, and sometimes dead horses, but above all, the heads and entrails of fish." Evidently problems were corrected because it was widely thought that by the summer of 1798 the city was in a state of unparalleled cleanliness and order. Crews were sent out to clean the gutters three times a week.(10)
A man who worked on Philadelphia's docks died of yellow fever on July 2. The health committee ordered the victim's house thoroughly cleaned and whitewashed, his bedding buried at the City Hospital, and that all those living in the house leave it and those who had contact with the victim leave the city.(11) Temperatures were in the 90s on the 2nd and 3rd which increased anxieties. Then a cold front came through on the 4th, and the middle of July was uncommonly cool and pleasant. The sporadic cases of yellow fever did not spread.(12)
On July 8 the Deborah, a Philadelphia ship with a crew of 37 and 58 passengers, coming from Jeremie, Haiti, arrived at the fort below the city to undergo inspection and serve quarantine. Captain Edward Yard attributed five deaths on the voyage to dysentery. While it stood quarantine six people from the ship were sent to the marine hospital. "A French black girl" died. Two doctors, sent by the health committee on the 16th, found the others on the way to recovery. Their diseases did not appear contagious. Those who remained on board appeared healthy, and the ship very clean. Two ventilators had been used on it. On the 18th the doctors allowed the ship to unload at a wharf near Race Street. The doctors were concerned by reports that people had visited the ship. The health committee published a warning that ships visited while under quarantine would be required to serve an additional quarantine of five days.(13)
On July 20 Dr. Samuel Griffitts treated a merchant who had a store near Race Street. A veteran of '93 and '97, Griffitts recognized yellow fever and promptly bled his patient and administered enough mercury to bring on a salivation. While Griffitts cured his patient with Rush's methods, he was still secretary of the College of Physicians and suspected that the fever was imported. He noted that the victim's store was near the wharf where the Deborah was tied up. On the 25th the Deborah left the Race Street wharf to be taken to Kensington for repairs. Griffitts treated and cured another store keeper near the Race Street wharf, and then, on the 30th, had a fever patient below Walnut Street. The Deborah entered into that case too. The patient reportedly confessed that he had gone by boat down to the Deborah as it rode quarantine and brought up a sick man from the ship. Also on the 30th a carpenter in Kensington who had been working on the Deborah died of yellow fever. A mob reportedly tried to force the ship back into the river but Captain Yard had armed men protect it.(14)
Importationists like Currie thought they had their evidence, but the fever didn't seem catching. If it was contagious like small pox and measles, why didn't it spread like those diseases? Even after the return of hot weather, everyone agreed that the city had never been healthier.(15) The New York Daily Advertiser reported that "All the large towns are turning their most serious attention to maintaining CLEANLINESS in their houses, yards and streets. Their suffering experience has not been learned in vain."(16)
On August 1, Rush saw his first yellow fever patient in consultation with Dr. Physick. After five fever victims were buried on the 4th, Griffitts and Wistar called for a meeting of the College of Physicians.(17) Griffitts saw Margaret Morris and told her that he had sent his family out of town to avoid the fever. She sent word to Burlington to prepare a place.(18) That week Rush noted ominously that a disease called "yellow water" was reported in horses.(19) He did not note when Julia and his daughters left for Princeton. By August 6 Rush was writing letters to her.(20)
Although disagreeing as always on how the fever was introduced into the city, the College of Physicians and Academy of Medicine both agreed that the infected area on Water Street between Walnut and Spruce should be evacuated and the city be kept scrupulously clean. The health committee followed the recommendations. The area evacuated was small enough, so the consternation of the year before was avoided.(21)
Then someone died on Walnut Street beyond 3rd Street, and trust in scientific control of the epidemic ended. "The fever spreads like wildfire," Margaret Morris wrote on the 8th. "It is now at the corner of 4th and Walnut Street - and the corner of 3rd and Walnut so that we cant go out of doors without danger. It is appearing in every quarter of the city."(22) Rush thought the fever spread more in one week than in three weeks in '93 and '97. He began telling the families he regularly cared for to leave the city.(23)
Rush had to respond to the epidemic in a way that would placate his family. In their correspondence, the Rushes kept reminding each other how little they owed to Philadelphia after the treatment of the previous year. Citing his obligation to his patients Rush promised to leave by mid-August or until all his old patients were out of town or danger. He promised not to take new patients. If a family could not remove, he would "visit them if required, from his intended place of retreat, a few miles from the city." Julia demanded that he really leave the city and join her as promised.(24)
He didn't. He was soon obsessed with the epidemic. It was the same terrible fever, yet different. The cases he handled were even more difficult than those of '97. After bleeding and mercury his patients seemed near the point of death. Sydenham had taught that no two epidemics were the same. Rush tried different remedies. Not that he tried to stimulate the patient, thus turning his back on what he had been preaching for the last five years. He decided that poison must still remain in the body. Recalling the remedies of Dr. Mitchell, the Virginian whose essay had inspired him in the '93 epidemic, Rush decided to try further depletion with a powerful emetic to force vomiting, a combination of four grains of tartar emetic, and twenty grains of calomel.
These were not purely theoretical calculations. Rush tried the new approach as a last effort to save a life. His patient would not salivate. "On the fifth day of his disease, his pulse became languid and slow, his skin cool, a hemorrhage had taken place from his gums, and he discovered a restlessness and anxiety which I had often seen, a few hours before death." He did not bleed as a last resort. The new medicine "operated powerfully, upward and downwards, and brought away a large quantity of bile. The effects of this medicine were such as I wished. The next day he was out of danger."(25)
"I have discovered a new remedy... which has I think snatched five persons from the grave," he wrote to his wife on August 9. The treatment was "harsh and distressing but the effects of it have given me great pleasure." He added that he had told other physicians about it, who said they would try it. "God grant it may be universally successful!" He had lost one patient but did not see him until the 4th day of his disease.(26)
Rush's disciples were also troubled by their inability to cure the fever. Drs. Physick and Samuel Cooper, who had been appointed attending physicians at the city's fever hospital, found copious bleeding ineffective. Autopsies of patients revealed "inflammation of the stomach [that] exceeds anything we have before observed." They tried Rush's emetics on three patients. "Each of them died a few hours after." "What is your success," they asked Rush, "what that of others?"(27)
On the 13th Rush replied with a long letter revealing his new approach. He avoided theoretical considerations and based the new therapy on morbid anatomy. The autopsies reported by Dr. Mitchell convinced him that in bad cases of the fever poisonous bile hid in the gall bladder of victims. By "shaking the gall bladder," the emetic brought up that bile and relieved the patient. There had long been thought to be a "blistering point" in fevers. He had discovered that there was "an emetic point" in yellow fever. Bleeding was necessary to bring the patient to that point.
True to form, Rush did not urge caution in using the violent remedy. In one case he had given it three days in succession. Also true to form, Rush did not say how many patients he had treated, only that "I have not, as yet, lost a single patient to whom I have given this powerful remedy." That said, he allowed that he might lose one 16 year old boy who had 30 grains of tartar emetic without any results. The exchange of letters was published, though with some pointed deletions from the letter to Rush. There was no mention of the autopsies at the hospital, nor the unsuccessful use of emetics there.(28) In an August 15 letter to Webster, Rush claimed the fever yielded to his new remedies "in every case."(29)
After Rush's letter was published two patients at the hospital, where 14 of the first 22 patients had died within three days, recovered. Rush's new therapy got the credit. "V" wrote in Brown's Gazette on the 17th: "Let Philadelphians reflect on this, and refuse, if they can, the meed of gratitude and esteem to him whose public virtue, talents, and perseverance in dangerous duty, are again exterminating from our city the severest scourge it can possibly experience."(30) Then on the 18th Rush lost three patients.(31)
Rush seemed to take the setback in stride, perhaps because, unlike in other years, no one seemed disposed to make an issue of his treatment. Cobbett only expressed satisfaction at the report that most of the city's bleeders had resolved to leave town. "If they should abide by this pious resolve, the horrors which await us are considerably diminished."(32) When it became apparent that "shaking the gall bladder" was not a cure-all, the community avoided controversy by recognizing that all remedies were failing. A writer in Fenno's Gazette observed that, "the disease... has not been managed with desirable success; and there is some knowledge required beyond the sphere of present observation to conquer so terrible an enemy."(33)
Rush certainly didn't subscribe to such defeatist ideas. He still searched for better remedies. By August 31 his latest enthusiasm was sweating. "I have at last found it to yield more generally to profuse sweating than to any other remedy," he wrote to his wife. "In moderate cases I begin with it, and in violent cases, prescribe it after reducing the pulse by previous bleeding and purging and emetics." The hot bricks, vinegar soaked blankets and hot drinks sometimes made the skin "as dry as a mahogany board." In closing he did temper his enthusiasm: "I am sorry to say there are cases which resist even this powerful remedy."(34)
He also published guidance to the anxious public, this time in a way designed not to excite controversy. He refrained from passing on testimonial for his remedies, and sought another doctor's endorsement of his advice. Griffitts endorsed the letter printed on the 5th, and not a few papers around the country reprinted it.(35)
The advisory began with Rush's old principles. Avoid the exciting causes of the fever - fatigue, intemperance, violent passions, etc, and above all else avoid the night air. There was only one disease in the city. What might seem like the onset of a cold must be treated with moderate bleeding, a purge and a sweat. With the on-set of the fever, 10 to 12 ounces of blood must be taken away three times a day; the bowels should be purged with calomel at the same time; if the stomach was sick a vomit must be taken and after the 3rd or 4th day a stronger emetic, provided the pulse had been reduced by bleeding and purging; frequent doses of calomel must be given to excite salivation; if the calomel caused too much purging laudanum should be used to calm the stomach; if the disease did not yield, a sweat must be induced by wrapping the patient in blankets with "five or six hot bricks, wetted with vinegar, applied to different parts of the body;" blisters should be applied to the wrist and ankles; in case of delirium with weak pulse a poultice of "raw garlic with a little mustard" should be applied to the feet; fresh air should be admitted to the room at all times; the patient's hands washed 10 or 12 times a day with cold water; the linen changed frequently and offensive matter removed; and the patient should drink plentifully and eat lightly. The doctors listed proper food and drink for various stages of the fever.
This was not a simple regimen. "It will be improper to depend exclusively upon any one of the above remedies," the doctors concluded. "The combined force of them all is barely sufficient in many cases to overcome this formidable disease." There was no assurance, as Rush had made in '93, that the fever could be cured, except "we have seen no death" when mercury has "produced a salivation."(36) (That said he soon attacked the efforts of "an itinerant quack" who severely poisoned patients in an effort to salivate them.)(37)
For all the doubts evident in his shifting ideas on remedies, he communicated confidence to individual patients. A Marine Corps lieutenant from the new base on Marcus Hook south of the city came to him. Rush ordered immediate bleeding and calomel every two hours "which" the lieutenant wrote, "effectually conquered the infernal disorder." "But," he added. "my mouth, tongue, and throat [are] excessively sore from the salivation occasioned by the mercury and a general debility." He took his medicine because other soldiers who got infected at the same time went to town for a physician and all died. Rush assured the lieutenant that he could have "saved" some of the others.(38)
But as much as he trumpeted his successes -- one patient was "out of danger, an emetic armed with the force of an 18-pounder saved him,"(39) the failures of his remedies were as apparent. Two friends, whom he presumably helped treat, died. One of his apprentices, a boy from Georgia, died. In addition Drs. Otto, Sayre, Cooper and Proudfit, bleeders all, were ill.(40) Cooper and Sayre would die. Rush had lured Sayre to Philadelphia to practice. Cooper was the only colleague he allowed to proof read his manuscripts.(41)
But, as always, during the epidemic, death could not give him pause. To his wife's increasing anxiety for his safety, he assured her, "I have escaped a lion and a bear in 1793 and 1797. Why should I fear to meet our present Goliath?" And this year, there was no controversy raising his hackles. "Public confidence is again placed in me," he told Julia, "and my opinions and advice have at last some weight." He was "honored" to be placed by God "in that situation... now open and smooth for my usefulness."(42)
On September 9 Rush accepted an appointment as a consulting physician at the hospital(43) gaining access not only to observations and experimentation on over 100 patients, but also to the dissections performed by Physick, who was fast becoming the nation's most famous surgeon. A fillip to the appointment was that from the hospital door he could see the place where Julia had been saved from drowning. "The sight of it affected me," he explained to her, "and determined me with more zeal than ever to show my gratitude to God for having given me your life, by attempts to save the lives of his distressed creatures a part of whom are now committed to my care."(44)
He was also prompted to make that association because Julia was so adamant that he leave the city. In late August she came to town to get him. He compromised by sleeping at his country retreat and visiting his remaining patient and the hospital during the day.(45) But his reasons for working there entailed more than convenience in continuing his charity work.
After his only previous experience with emergency hospitals, 20 years before during the war, Rush roundly condemned bringing fever patients together.(46) Although he never condemned Bush Hill in his writings, all his students knew how dangerous he thought it had been for patients. In taking the appointment Rush proved once again how curiosity always overcame his dogmatism. For various reasons his previous method of research was stymied. He was out of the city; his apprentices, one dead and another very sick, were unable to help; he himself no longer had the energy to see 100 patients a day by traveling on foot and in carriage. In addition the fever was proving more untreatable. Morbid anatomy, in most cases the autopsies reported by other doctors, formed the inspiration for many of his new ideas.
At first Rush was surprised at how much easier working at the hospital was than private practice, thanks to the help provided by Physick and his staff.(47) But he soon found that the hospital was not a place to flatter any doctor's estimation of his effectiveness, or even his respectability. He soon lamented that he witnessed "more suffering in one hour than I have been accustomed to see in common times in a year."(48) Rush was shocked by women patients who left their bodies uncovered when men were present. Rush's reaction cannot be dismissed as that of a prude. As the physician most habituated to the insane wards of the Pennsylvania Hospital he was not unfamiliar with women abandoning morals and clothes. This fever induced lust and lasciviousness were far more menacing, and in his account he quoted Boccaccio on the plague: "It suspended all modesty, so that young women, of great rank and delicacy, submitted to be attended, dressed, and even cleansed by male nurses."(49)
The concentration of death and immorality that was the hospital challenged the premises that had made Rush such an indefatigable practitioner during epidemics. He lost his sense of being the healing hand of God. In private practice the medicine and consolation he dispensed so often at least helped the worried family if not the patient. But in a two room hospital filled with suffering souls, half of whom were bound to die, it was difficult even for Rush to conjure any epiphanies and precious few observations for one who placed such importance on the context of symptoms.
Rush never wrote about the affects of his remedies on hospital patients. The example Deveze had set in 1793 of giving the case histories of patients was not followed. Between August 9 and September 19, 535 patients had been sent there and 276 of them had died, roughly the same mortality rate as experienced at Bush Hill in 1793.(50) Then Rush had attributed such a high rate to Deveze not using his remedies. In 1798, Deveze was in France. Rushites had full sway at the hospital. (Stephen Girard was content to do his might from his Front Street home including curing five members of his household with lemonade, barley water, chamomile tea, and "sweet medicines.")(51)
Although Rush ended his stint as consulting physician to the hospital without being able to point to any marked reduction in mortality, he took away a great lesson from his experience. Like Deveze and all others doctors who treated yellow fever patients in a hospital removed from the area of the epidemic, Rush noticed that healthy people working in the hospital and patients with other diseases did not exhibit the symptoms of yellow fever. He finally saw through the personal aches, pains and fears that he had when treating patients that he had blamed on contagion. He saw that the fever was not contagious. As he would soon tell his medical students: "I think I was too much disposed to admit of contagion in 1793."(52)
However this new insight did not endear him to the situation. Presented with what Foucault would argue was the birthplace of modern medicine, the hospital clinic where patients were available for observation and experiments and too often autopsy, Rush shrunk in horror from the scene. Private patients were his highest priority. "I sleep two miles from the city," he wrote to a friend on September 15, "but visit from 12 to 20 patients daily in the city and spend some time afterwards with Dr. Physick at the city hospital."(53) He seems to have found it uncomfortable even to suggest that he might have spent some time with patients at the hospital. But he did not rise in opposition to the clinic as the doctrinaire advocate of the theory of the unity of fevers might be expected to do. He would serve in the hospital again in 1799 for the duration, and offer to serve yet again in 1802.(54)
But at the time, while he never admitted the shock of the hospital experience, it seems evident. In a September 19 letter to President Adams urging the appointment of his brother Jacob to the Supreme Court, Rush closed by saying that, "nothing new appears in the progress of our fever...."(55) For Rush to write that was unprecedented. This was not an uninteresting epidemic. In his diary Dr. Samuel Griffitts, who stayed in the city, recorded the visceral commentary that was typical of Rush's letters when he was truly engaged in the battle: "Very hot calm weather. Musketoes tormenting," he wrote on September 17. "mortality greatest amongst women, children and old people." The next day he noted, "Today and yesterday hot, heavy fogs in the morning, no wind, scarcely a house escapes." He noted a change in the fever. It was more like typhus and required bark. He visited 43 patients that day. On the day Rush told Adams there was "nothing new," Griffitts wrote: "A good deal of rain today weather very sultry. I do not remember any time in which disease, misery and death seemed to me so prevalent as today. My fatigue has been great and yet I am favored to keep up under it."(56)
By September 28 a new addition at the hospital, that Rush urged be build, was ready for patients. Rush reported that mortality began to decline,(57) but if it did, it occurred too late to make Rush eager to fight the fever at the Wigwam, as the hospital was called. By then Rush had largely withdrawn from the fight. On September 21 he suffered what he called a gout in the stomach. Forty drops of laudanum eased the pain.(58) On September 26 the sheriff asked him to visit the debtor's prison south of Walnut Street to see what could be done to check the spread of fever there. Rush paid a visit but Peter Helm and Dr. Benjamin Duffield, who had helped run Bush Hill in 1793, went, stayed and were credited with checking the mini-epidemic there.(59)
In his September 27 letter Rush described a trip through the Northern Liberties. There it was like '93 once again with poor people stopping his carriage "every five minutes imploring me to visit a sick husband, wife or child." He "generally" yielded and gave them medicines that he carried in his pocket.(60) But he made no heroic stand in the city or the Liberties.
His heart was in perfecting his country retreat. On September 28, he revealed to his wife that he was remodeling their "little farm," and supervising the work himself because he was told that would save money. He had a 16 by 12 foot brick kitchen built, with a room over it. He added a story and a half to the old brick house and remodeled its cellar. He planned to pull down the old frame kitchen and build a new brick building to connect the new kitchen to the old house. "The building when finished will be convenient, cool, tight, and large enough to accommodate all such of our family as it will be proper to leave the city in warm weather. The many cases of fever which have occurred in persons who left our city in July have determined me to imitate the examples of Mr. Peters, Mr. Conyngham, and Mr. Ross by sending my family out of town in May or June."
A saving grace of his remodeling during the crisis was that he could hire the man who had saved Julia from the Schuylkill the past summer. He was out of work. Rush theorized that unemployed laborers, who appeared to be of good moral character, still got the fever because, without work, they did not sweat as much as they customarily did.
Rush did not lose sight of the fever. "The deaths, alas! this day have been 106," he added before closing his letter to Julia. But apparently the only patient he saw that deadly day was a servant at the British minister's summer retreat nearby. Rush was more country gentleman than practicing physician. The big news he relayed to Julia was that "Old Mr. Willing," the rich banker, was thinking of building on the adjoining 36 acres.(61)
Go to Chapter 15
1. Gates to Fenwick Nov. 5, 1798, NYPL.
2. Rush to wife Aug. 7, 1798, Duke; Jacob Rush to Rush Sept. 8, 1798, Rush Papers.
3. Butterfield p 804.
4. Butterfield pp 805-6.
5. Cronin p 455.
6. e.g. Phil. Gaz. June 18 & 30, 1798.
7. Butterfield pp 800-1.
8. Phil. Gaz. June 18, 1798.
9. Bayley (2) pp .
10. Condie pp 30ff.
11. Condie pp 35-9.
12. Rush 1815 vol. 4 p 40.
13. Condie, op. cit, & Phil. Gaz. July 28, 1798.
14. Griffitts's diary undated introduction, COP; Morris to sister Aug. 4, 1798, Haverford.
15. Por. Gaz. Aug. 2, 1798; Drinker Diary July 31, 1798.
16. Amer. Daily Adv. Aug. 8, 1798.
17. Griffitt's diary Aug. 1798.
18. Morris to sister Aug. 10, 1798, Haverford.
19. Rush Notebook Aug. 4, 1798.
20. Butterfield p 803. rush98new.html
21. Condie pp 47-8.
22. Morris to sister Aug. 8, 1798, Haverford.
23. Rush to wife Aug. 7 & 9, 1798, Duke.
24. Wife to Rush Aug 27, 1798, APS: Rush to wife Aug. 9, 1798, Duke.
25. Rush 1815 vol. 4, p 46.
26. Rush to wife Aug. 9, 1798, Duke.
27. Physick and Cooper to Rush Aug. 12, 1798, Rush Papers.
28. Condie pp 58-61.
29. Rush to Webster Aug. 15, 1798, Webster Papers.
30. Phil. Gaz. Aug. 17, 1798.
31. Rush Notebook Aug. 18, 1798.
32. Por. Gaz. Aug. 13, 1798.
33. Gaz. of U.S. Aug. 25, 1798.
34. Rush to wife Aug. 31, 1798, Duke.
35. Griffitt's diary Aug. 30, Sept. 1 & 3, 1798, COP.
36. Phil. Gaz. Sept. 6, 1798.
37. Rush 1815 vol. 4 p 50.
38. Quasi-War vol. 1 p 376.
39. Butterfield p 803.
40. Butterfield p 804.
41. Caldwell Eulogy p 39.
42. Butterfield p 805.
43. Rush Notebook Sept. 8, 1798.
44. Rush to wife Sept. 1798 (misdated by another hand) Duke.
45. Wife to Rush Aug 27, 1798, APS.
46. Rush 1815 vol. 1 p 150.
47. Rush to wife Sept. 9, 1798, (misdated) Duke.
48. Butterfield p 807.
49. Rush 1815 vol. 4 p 49.
50. Currie 1799 p 120.
51. Girard to Bentalou Sept. 20 & to Deveze Sept. 21, 1798, Girard Papers.
52. Rush lecture 1799 p 271.
53. Butterfield p 806-7.
54. Rush Notebook Aug. 2, 1802.
55. Rush to Adams Sept. 19, 1798, MHS.
56. Griffitt's diary, COP.
57. Butterfield p 809.
58. Rush Notebook Sept. 21, 1798.
59. Ibid. Sept. 24, 1798;
60. Rush to wife Sept. 27, 1798, Duke.
61. Butterfield pp 808-9.