Four illustrations showing the progression of yellow fever. Etienne Pariset and André Mazet, 1820.
National Library of Medicine
exhibit / science

Politics of Yellow Fever in Alexander Hamilton's America

Yellow fever ravaged Philadelphia in 1793, touching nearly everyone in the city.
Yellow fever ravaged Philadelphia in 1793. The deadly disease touched nearly everyone in the city: young and old, white and African American, wealthy and poor, religious and secular.

No one really knew what caused the disease or how to treat it.

As yellow fever consumed Philadelphia, politicians debated the disease’s origins, its treatment, and preventative measures. Secretary of the Treasury Alexander Hamilton, a prominent Federalist, believed that newly arrived, white, French refugees fleeing the revolution in Santo Domingo (now Haiti) were the source of the disease. Hamilton and other Federalists favored actions like closing the ports and restricting immigration to stem the epidemic. By publishing his opinions about the epidemic and its treatment in newspapers, Hamilton turned what had been a medical question into a political dispute.

The medical community disagreed on the causes and treatment for yellow fever. Dr. Benjamin Rush, a prominent physician, signer of the Declaration of Independence, and opponent of Hamilton’s politics, emerged as the figurehead for the faction of physicians who believed the epidemic developed from miasma, or impure air, in Philadelphia. Rush supported efforts to improve sanitation to eliminate yellow fever.

Rush’s ideas about the treatment of yellow fever were controversial among both physicians and the public. Although he drew on a medical tradition that employed aggressive bleeding, purging, and large doses of mercury to treat disease, these treatments were falling out of favor. Hamilton and his peers tended to favor the gentler bark and wine cure, sometimes called the “West India cure.” Because neither treatment plan was particularly effective, the decision to choose one or the other became linked to political preferences.

Within a month of yellow fever’s arrival in Philadelphia, the city, state, and federal governments had essentially stopped functioning. A group of private citizens came together to organize desperately needed relief services. Known simply as “The Committee,” this group ran Bush-Hill Hospital, operated an orphanage, and provided supplies to the poor.

Philadelphia’s free African American residents kept the city from total collapse. At the outset of the epidemic, white physicians erroneously thought that African Americans were immune from yellow fever and called on them for help. African Americans provided the bulk of the nursing care and manual labor required to sustain the city, although they were excluded from the official work and leadership of The Committee.
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