How the Philadelphia pandemic of 1793 foreshadowed the social problems of the COVID-19 era

The last two years of the pandemic have laid bare a deep misunderstanding of public health among our compatriots. As evidenced by the widespread and conspiratorial resistance to vaccination – as well as the constant trickle of misinformation about the pandemic, from social media, pundits and podcasters – contemporary Americans might seem to possess little understanding of statistics, biology and of the scientific method.

Yet it turns out that this distinct mark of medical ignorance is nothing new. On the contrary, it’s as American as apple pie. More than 200 years ago, one of the most famous doctors of the revolutionary period made the exact same logical error as Joe Rogan, who falsely attributed his recovery from Covid to a ‘kitchen sink’ cocktail of drugs and snake oil supplements.

The doctor in Rogan’s mold was founding father Benjamin Rush, the “father of American psychiatry”, who despite his medical genius mistakenly believed that yellow fever could be treated with bleeds and purges. Many of Rush’s colleagues urged him to see the error in his ways, but Rush literally practiced what he preached. The experience of treating his own infection, as he described it, was heartbreaking. His student “bled me profusely and gave me a dose of mercurial medicine,” Rush said. Although his fever initially subsided, it later returned and Rush’s pupil “bled me again… The next day the fever left me, but in such a weak state that I woke up two successive nights with an illness that threatened the extinction of my life.”

Yet Rush eventually recovered and, like Rogan, falsely attributed this to his dangerous methods.

Rush’s ordeal occurred during one of the most significant crises of America’s early years as a fledgling republic. A yellow fever epidemic hit Philadelphia in 1793 – at the very start of President George Washington’s second term – and the American public was terrified.

Although no one knew at the time, yellow fever had been brought to American shores from Cap Français to Santo Domingo (now Haiti). Among the French colonial refugees and their slaves who invaded the ports fleeing a slave insurrection, there were individuals who had been bitten by mosquitoes carrying the yellow fever virus. Mosquitoes themselves were also among their ranks, transmitting more of the deadly disease with each new bite.

It was Rush himself who recognized the disease pattern and declared that there was an epidemic. Philadelphia had a population of around 50,000, most of them clustered in houses near the harbor. Between late August and early September of that year, the infection spread rapidly through the community, whose panicked residents tried to flee for their lives.


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It’s no surprise that poor Philadelphians were less fortunate than their wealthier counterparts. While most Common Council members fled for their lives, Mayor Matthew Clarkson stayed and led efforts to establish hospitals, food banks and other facilities to help those infected and others who suffered and had been left behind. The federal government did not have the resources at that time to provide significant assistance; Moreover, even if it was, the prevailing political philosophy in America was that local governments should take responsibility for helping people. Within the narrow limits allowed to him, Clarkson actively used his political power to try to help people.

Yet the question of How? ‘Or’ What to help people was not cut and dried. Scientists at that time did not understand the cause of infectious diseases. Some scientists believed that diseases were the result of miasma or bad odors such as those produced by corpses, biological waste, and other disease-carrying substances. Others believed that diseases were passed from person to person and were brought here by ships. Notably, neither side was entirely incorrect: the disease was linked to something people find disgusting (insects) and had been imported. Much like the response to the COVID-19 pandemic, however, people have interpreted existing scientific knowledge in politically practical ways. Democratic-Republicans, who lamented cities and wanted a rural America, supported the miasma theory because they could then blame the pandemic on the unhealthy physical climate of cities. Federalists, who were xenophobic, blamed the ships because it reinforced their anti-immigrant ethos. The parallel with today’s political parties, and who they blame (rightly or wrongly) for various aspects of the pandemic, is striking.

These divergent views manifested themselves then, as now, in different political approaches. Rush was a Democratic Republican and urged city officials to focus on improving sanitation to make Philadelphia cleaner. The city government rejected Rush’s ideas and instead isolated the infected patients. The quarantine proved unpopular, as every ship that approached the city was subject to mandatory quarantines and sick people were isolated from healthy people. Taking the lead from Philadelphia’s leaders, other cities have also imposed controversial quarantine policies. Other major port cities like New York and Baltimore have imposed their own quarantines for people and goods arriving from Philadelphia. While cities sent food and money to help those infected, many also refused to accept refugees. And there were about 20,000 refugees, as Philadelphians fled en masse to escape the disease.

RELATED: How Washington handled a pandemic – in the 18th century

The pandemic has also brought out ugly bigotry. Just as hate crimes against Asian Americans skyrocketed when President Donald Trump and other political leaders blamed China for COVID-19, many Americans blamed African Americans during the fever pandemic. yellow. Some doctors claimed that blacks were immune to the disease because of their race (they actually died at rates comparable to whites), while others singled out black nurses who exploited sick people for the crisis while ignoring that many white nurses were doing the same thing. .

When the dust finally settled on the pandemic, 10% of Philadelphia’s population had perished from yellow fever, or about 500 people. In the process, he exposed many of the same cracks in American society that have been exposed by the COVID-19 pandemic.

All this to say that Americans may not have changed much. Indeed, the Americans in 1793 designated similar scapegoats for their pandemic; found similar fake remedies; and reveled in medical practices just as bad as their 2020s counterparts. There is perhaps more truth than we care to admit in Marx’s old maxim that history repeats itself – first as tragedy , then as a stuffing.

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About Hector Hedgepeth

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