Reading Those Classics #17

Classic Plague Narrative. The author released this popular history in 1949. Though it avoided footnotes and read as easily as a novel for non-expert readers, historians and epidemiologists regarded it as a model examination of a season of yellow fever in Philadelphia, the capital city of the USA in the days of Our Early Republic.

Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793 - J. H. Powell

In 1793, Philadelphia was the busiest port in the USA. As such, it was the natural center of the banking, finance, and insurance industries. It was a major center for learning in the natural and medical sciences.

The winter of 1792-93 had been mild. The summer of 1793 brought a drought. Because the city had no water system, people caught and stored rainwater in rain barrels. Perhaps the mosquitos that carried yellow fever bred in those barrels of standing water. Or, perhaps the mosquitos were brought on ships that carried Francophone refugees away from an uprising of enslaved people that had started in 1791 in Haiti.

Per what was surely an undercount, Yellow Jack killed 5,000 people from August through November. Its symptoms start suddenly with fever, chills, headache, backache, nausea, and vomiting. It gets its name because jaundice makes the skin and eyes look yellow. There is no specific treatment beyond supportive care and attentive nursing, neither of which were available due to labor shortages caused by people fleeing the city in fear for their health and lives.

At the time a tiny number of observers wrote to the papers with the theory that mosquitoes transmitted the disease among humans, but doctors did not pay any mind because they were so embroiled in their own controversy as to the origin and treatment. Dr. Benjamin Rush and his supporters thought that the disease was caused by foul miasmas that in turn brought about imbalances among the four bodily fluids (blood, phlegm, black bile, and yellow bile). So patients with yellow fever were to be treated with purges, such as bloodletting, vomiting, and pooping. French physicians, who fought the virus in the Caribbean and theorized it was contagious, used gentler palliative treatments. The public prints saw diatribes and screeds between the two points of view, so many that lay readers complained they were tired of reading about the controversy.

Powell judiciously tells about people who left the city and people who heroically stayed to do what they could. Leavers included the Governor of Pennsylvania, Alexander Hamilton, Thomas Jefferson, and George Washington. And, unsurprisingly, the entire U.S. Congress left the stricken city, thus demonstrating the courage we have come to expect from politicians.

The Mayor of Philadelphia, Matthew Clarkson, stayed to cope with the crisis despite a lack of governmental institutions. At the Mayor's request, volunteers from various walks of life came forward to work in their Assembly. From scratch, they arranged care for the sick, the old, the poor and the orphaned.  Powell also relates the heroic work of Black Philadelphians and Francophone refugees. Much to his credit, Powell does not express elation over heroism or wax indignant over people acting - shall we say - less than human.

In conclusion, this is a great read, especially in light of the clear social, economic and psychological parallels to our own pandemical experience. I’ve been a long-time plague buff, reading In the Wake of Plague in 2014 and Defoe long before this blog. But our pandemic only sharpened my interest, given my – our – first-hand experience: see The Great Influenza (John M. Barry); Flu (Gina Kolata); The American Plague (Molly Caldwell Crosby); The White Castle (Orhan Pamuk);  The Forgotten Plague (Frank Ryan); Year of Wonders (Geraldine Brooks); and Pandemic (Sonia Shah).