Every year at this time, when there’s a nip in the air and the leaves start to turn, Michael Yudell becomes nostalgic — for the Yellow Fever Epidemic of 1793.
That’s because for the past dozen years, the 51-year-old medical historian has been leading ambitious tours of the city’s historic area for his Drexel students, bringing to life the sights, the sounds, and the smells of Philadelphia’s worst of times in its best of times.
During the 1790s — when Philadelphia was not only the new nation’s largest and most prosperous city but also the U.S. capital — it was struck by the most horrific epidemic in early-American history. Just as Washington, Adams, Jefferson, and Hamilton were returning to town after summer vacation for the fall sessions of government, the city was struck by a relentless, raging yellow fever.
In only three months, 10% of the city’s population was killed. The bodies came so fast and furious — reeking of black vomit, eyes and skin an otherworldly yellow — that there was often no time for individual burials. Potter’s fields dotted the outskirts of town (at what are now prominent locations such as Logan Square).
So, what was the upside? The lessons learned from this disaster forever changed our nation’s health care — laying the groundwork for our entire system of public health. The episode was also a crucial but often overlooked or misinterpreted turning point in American race relations.
“I think people know very little about how fundamental this epidemic was to the formation of Philadelphia,” said Yudell, professor and chair of Community Health and Prevention at Drexel’s Dornsife School of Public Health. "It is the birth of our country’s notion of modern medicine and public health. It also played a huge role in our concept of fighting racism.”
Usually, Yudell gives this tour once every fall for his students. But this year he had an unexpected spike in demand. The national meeting of the American Public Health Association is at the Philadelphia Convention Center Nov. 2-6. About 10,000 public health-obsessed people will be descending on the city. A lot them want a yellow fever tour.
The tour begins at Elfreth’s Alley, which still looks like Philadelphia in 1793. It then heads to Dock Street near Third and Walnut, where there had been an open tidal creek crammed with sewage and animal carcasses. In one of the nation’s first decisive acts of public health, the creek was filled in after the epidemic, in the hope of preventing a recurrence, because nobody realized the fever was spread by mosquitoes and not by putrid air. But the first public-health gesture during the epidemic was publishing the competing methods of medical treatment in the newspapers, and encouraging patients to treat themselves if no docs were available.
The tour then heads to the Fourth and Walnut Street location of Rush’s home and medical office during the epidemic — which became a yellow fever hospital after Pennsylvania Hospital refused to admit stricken patients. (Eventually, philanthropist Steven Girard paid for an emergency facility at Bush Hill mansion — on what was then the outskirts of town, now 16th and Spring Garden.)
The tour proceeds to Mother Bethel A.M.E. Church at Sixth and Lombard, for a discussion of the complex racial issues surrounding the epidemic. When white doctors fled town, Rush enlisted the help of his friends in the African American clergy — with whom he was helping build the nation’s first free black church — to serve as nurse-practitioners and to help bury the bodies. Based on a published medical report, he believed African Americans were less likely to contract yellow fever than whites, which both he and the clergy members quickly realized was wrong when both Rush and Allen got the disease almost simultaneously (and miraculously survived to do heroic work).
After the epidemic, an “instant” book by journalist Mathew Carey unfairly accused the “black nurses” of overcharging patients and sometimes stealing from them. Rush defended them, and then Allen and Jones wrote their own book — the first copyrighted by African American writers. It not only refuted the charges against the black community and offered their powerful and pointed eyewitness account of the epidemic, but ended with an essay directly confronting white Americans about slavery and prejudice against free blacks.
The tour concludes at Christ Church Burial Grounds, where so many of the characters in the drama are buried.
The fascinating medical voices of the yellow fever tour include Penn professor David Barnes, who teaches American medical history and worked on an earlier version of the tour with Yudell and Temple professor Jennifer Ibrahim. (The tour originated with their yellow fever mentor, Drexel nephrologist and history buff Dr. Steven Peitzman.)
The intense commentary on race relations comes from the Rev. Mark Tyler from Mother Bethel and Arthur Sudler, historian and archivist of the African Episcopal Church of St. Thomas: the two churches for free blacks founded in the months after the epidemic. While Allen and Jones had originally planned to build one church, each ended up founding his own in July of 1794 — this year marks the 225th anniversary of that amazing landmark. (Disclosure: As the author of the new biography RUSH: Revolution, Madness and Benjamin Rush, the Visionary Doctor Who Became a Founding Father, I was invited to offer commentary for this tour about Rush and his controversial role in the epidemic.)
Yudell and Scott are excited about the yellow fever tour itself. But they are also intrigued by the idea that WHYY, which is right in the middle of the city’s historic district, could offer other free, self-directed sojourns for the tens of thousands who daily descend of the birthplace of America.
If this undertaking is successful, for example, Yudell wants to create a similar Legionnaires’ Disease tour. And David Barnes and I have talked about a tour of the Lazaretto (the quarantine facility in Tinicum, built to prevent yellow fever and other illnesses, which he has helped to restore) as well as a “Moral Mental Health Care Tour,” highlighting the largely unknown story of how Benjamin Rush and Pennsylvania Hospital gave birth to modern behavioral health and addiction treatment.
“There is so much early American medical history in Philadelphia that has gone unnoticed,” said Yudell. “We need to rescue it!”