Yellow Fever - The Color Disease

Benjamin Rush, MD, of Philadelphia was the most famous American doctor in the 18^th Century. He was a signer of the Declaration of Independence and never lost interest in politics. He was a professor, author and social reformer. He was also known to be impatient, humorless and self-righteous. Despite these shortcomings, his renown was such that when he advocated a given treatment, others followed. Unfortunately the treatment he prescribed for infection was often harmful, and, in the opinion of many, caused a perpetuation of medical error that persisted for decades.

When a yellow fever epidemic hit Philadelphia in 1793, Dr. Rush launched a fierce war against it. Philadelphia at that time was the national capital, a cultural center, and, if suburbs were included, the largest city in the USA. Its port was actively involved in international trade. Yellow fever had first arrived in the city in 1699 and had hit periodically ever since, but the epidemic of 1793 was the fiercest and most deadly yet.

The conventional treatment for the fever at that time was largely supportive: fluids, a soothing diet and rest. For Dr. Rush this was not heroic enough. He practiced what is known as depletion therapy. This consisted of purging and bleeding. When several of his early patients died, he was devastated. Rather than question his treatment, he became even more pro-active, purging and bleeding repeatedly. Before the epidemic ended, he was recommending that up to 80% of the patient’s blood be drained. Several other Philadelphia doctors followed Dr. Rush’s methods but the majority rejected them.

Dr. Rush was tireless in his efforts, seeing up to one hundred patients a day. Today the belief is that the death rate among those stricken was 33% while 46% of Rush’s patients died. For his heroic efforts Dr. Rush has on occasion been hailed as the “savior of Philadelphia.”

There is one action that Dr. Rush took that almost certainly saved lives. An evangelical Christian, Rush was opposed to slavery and worked to have it outlawed. When yellow fever hit epidemic levels in 1793, he called on the black community to be of service to the whites, to act as nurses and to dispose of corpses. Rush believed that blacks were immune to yellow fever, a belief widely held by the blacks themselves.

James L. Dickerson, a present day historian, scoffs at the notion that the Africans had a natural immunity. The immunity they had was an acquired immunity that came with prior exposure. They’d experienced yellow fever of so mild a nature that there were few if any symptoms, but this had produced sufficient antibodies to make them immune. He fails to note that white Philadelphians had also had ample opportunity for prior exposure, yet it was the whites who were dying and the blacks who were taking care of them.

Yellow fever, the most dreaded of all plagues in the Americas, first traveled to the New World on slave ships in the 17th Century. Victims turned lemon yellow and then the terrifying black vomit started.

Epidemics swept through the New World’s port cities. Between 1702 and 1800, the deadly fever struck thirty-five times. It is estimated that half a million people fell ill with the fever and one hundred thousand of them died.

During the 19th Century, despite all the precautions taken, the epidemics worsened. The fever struck ports from Boston to New Orleans and was rife throughout the Caribbean.

In its Declaration of Independence, the young republic had declared that all men are created equal. This did not stop early Americans from participating in the African slave trade. But what if – what if – the suspicion began to creep in that Africans weren't wild animal creatures after all, but were instead fully human, people who had every right to be treated as equals, with respect and dignity? How did a slave-owning population deal with that, especially in the port cities where the importation and sale of slaves flourished right under its nose? How could it face and deal with such devastating guilt?

In the epidemic of 1793, Dr. Rush, who was an astute and careful observer, wrote this description of his yellow fever patients:

(Yellow fever) was as much unlike that which is exhibited in the common bilious fever as the face of a wild is unlike the face of a mild domestic animal. The eyes were sad, watery, and so inflamed in some cases as to resemble two balls of fire. The face was suffused with blood, or of a dusky color, and the whole countenance was downcast and clouded... sighing attended in almost every case.

This reads like a portrait of anguish and deep-seated guilt.

Mary Caldwell Crosby in her book The American Plague, The Untold Story of Yellow Fever, The Epidemic That Shaped Our History, wrote that every European country that participated in the African slave trade experienced yellow fever epidemics. Asia had the perfect climate for the fever and the right mosquito to carry it from one victim to the next, but it never took part in the African slave trade and has never experienced a yellow fever epidemic.

While the slave trade was legal in the north, there were repeated yellow fever epidemics. Once the north outlawed slavery, they never experienced another. The slave trade moved south, taking yellow fever with it. Southern port cities soon had one epidemic after another.

The above establishes a connection between yellow fever and slavery that seems hard to dispute. If those white Christians who were buying and selling human beings began to have doubts and feel guilt, this would depress their immune systems and leave them prey to disease. Once the collective guilt was no longer a factor in daily life, with a general recognition by the white Christian world that the enslavement of their black brothers was an evil not to be condoned ever again, yellow fever was conquered throughout that part of the world that no longer countenanced slavery.

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Excerpted from Plagues Past and Present, A Mind/Body/Approach by J. H. Hacsi. Paper, $14.

Available at Baker and Taylor, www.Amazon.com or on order from any bookstore.

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J. H. graduated from the University of California at Berkeley, is a member of Phi Beta Kappa, and earlier in her life wrote short stories (over 200 published) and romance novels (eight published). Throughout her life she has been greatly interested in history and science, also the role of the mind and mysticism and has read widely in these fields. She is a widow with five sons and five grandchildren and lives in Claremont, CA.