Tuesday, April 7, 2020

An American Plague

Book Review
An American Plague
The True and Terrifying Story of the YELLOW FEVER EPIDEMIC of 1793
By Jim Murphy

Review by Jim Vail



The corona virus epidemic today and the Yellow Fever epidemic that hit Philadelphia in 1793 have so much in common. 

People were quarantined and did not go out in public ... People fled the big city ... Doctors and nurses put their lives on the line trying to save people. Doctors died ... So many people were dying that they were scrambling to find places to put the dead ... The city fought for resources to help the sick. Prices surged. Stores and workshops closed. People panicked. Foreigners were blamed.

This was 1793! George Washington was President, the U.S. had just defeated the British in the American Revolutionary War and Philadelphia was the United States capital before the government moved to Washington D.C.

The book ¨An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793¨ published in 2003 is a must read today as we hunker down to avoid the corona virus. Every teacher should consider using this book to teach the children today about an historical event that repeats. I know one teacher who read it in class and she said her 5th grade students were so riveted that they kept asking about it. And that was before our current crisis. It is suspenseful, fascinating and filled with amazing historical facts that will captivate those turning the pages!

The book begins on August 3, 1793, a very hot day that was buzzing with mosquitoes and insects amidst the stench of spoiled coffee that was dumped into the Ball´s Wharf which feeds from the Atlantic Ocean. People noticed cats were dying in the streets. Then people started getting sick. The sickness began with chills, headache and a painful ache in the back, arms and legs. It was followed by a high fever and constipation for about three days. Then the patient appeared to recover for a few hours. But the fever returned, the skin and eyeballs turned yellow as red blood cells were destroyed, causing the pigment bilirubin to accumulate in the body. The nose, gums and intestines began bleeding and the patient vomited stale, black blood. As the pulse grew weak, the tongue turned a dry brown and the victim became depressed and delirious. 

They thought the repulsive smell in the air caused by the rotting coffee caused the sickness.

They tried the damnedest things to cure themselves - they shot off guns and canons believing the smoke would clear the air; families including children smoked cigars even. They scrubbed floors, walls and ceilings and rooms were whitewashed and sprinkled with vinegar. 

The science of medicine at the end of the 18th century still relied a great deal on ancient myths and folk remedies. But despite the precautions and various remedies that included herbal teas, bloodletting and rest, people kept dying and panic spread.

Advice 200 years ago is the same today, ¨... keep at a distance from infected persons and places.¨ Both the city legislature and the federal government headed by President George Washington fled the city. Even our founding father Alexander Hamilton got yellow fever. Mayor Clarkson, along with Dr. Benjamin Rush, Stephen Girard and the Free African Society members were among the fearless heroes who fought the disease head on despite the enormous risk to their lives. They can be compared to our valiant doctors, nurses and health care workers battling against the corona virus today!

As I mentioned earlier, there are so many similarities of the yellow fever epidemic in 1793 and the corona epidemic today. In 1793 people thought black people were magically immune to the disease, just like people thought today black people were immune to the corona virus at the start. The reality was some black people back then who had grown up in either Africa or the West Indies had the disease as children and built up antibodies to fight it, but most blacks in Philadelphia did not have this natural immunity and later suffered greatly. The same today where black people are dying in high numbers because they have diabetes, high blood pressure, and other debilitating health conditions that make them weak in fighting off the corona virus. As Mark Twain wrote: ¨History does not repeat itself, but it often rhymes.¨

In Philadelphia at this time there were 3,000 free blacks and 200 slaves, and one half of them served as caretakers and cleaners. They were well positioned to help, but like their white counterparts, some of the black nurses profited off their dreadfully needed services by raising their rates.

There was a debate in the medical profession over how to cure yellow fever. Dr. Benjamin Rush, who tirelessly traveled everywhere to attend to the sick and dying and was considered the most famous and respected doctor in the U.S. at the time, said the cure had be aggressive blood letting and even pour a poison into people so that the induced vomiting and diarrhea would clean the body. Doctors who disagreed with this method ridiculed the doctor and said the cure was worse then the disease. Usually medical treatment was very gentle at this time, with herb teas and a glass of brandy the preferred methods. However, the bloodletting (a trusted medical practice for 2,500 years) and poison did in fact begin to show results, although it was not the cure and probably did more harm than help.

The idea that illness was caused by microscopic organisms such as bacteria and viruses, was not known at the time. Instead, doctors based their medical thinking on the 2,500-year-old Greek humoral theory. This concept stated that good health resulted when body fluids, called humors, were in balance. The humors were phlegm, choler, bile and blood. 

Just like today in the scramble to buy ventilators and masks, in 1793 the government had to borrow $1,500 to purchase medicine and coffins and pay doctors, nurses and gravediggers, many of whom became infected. And just like today, the massive Javits Convention Center in NY and the McCormick Convention Center in Chicago have been turned into overflow hospitals. In 1793, Bush Hill was turned into a makeshift hospital for the overwhelmed hospitals in Philadelphia. It was first called the ¨great human slaughter-house¨ and considered a death sentence to those who were transported there, but it soon became a model for wonderful care at this precarious time. Stephen Girard, one of Philadelphia´s wealthiest citizens, could have fled the city with his fellow rich folk, but instead chose to stay and risk his life to saving the afflicted at Bush Hill. One witness saw him clean himself up after a patient threw up black vomit all over him, and then comfort the patient in return. We live for heroes!

Remember the cruise ship that the Florida governor was refusing to allow to dock because there were corona virus patients aboard? Same thing in 1793, citizens in a Delaware town refused to allow one ship from Philadelphia to land and take on fresh water. They even attacked and sank another! 

Today ice rinks are turned into temporary morgues. Back then grave diggers set up tents to take short breaks with their nonstop work to bury the escalating numbers of dead. Today we believe the summer months will kill off the deadly virus, then they believed the rain and cold would kill off the deadly fever. Neither have it exactly right.

How bad was the yellow fever epidemic?

¨One man named Collins had lost his entire family - his wife, his two daughters, his son, and his son´s wife and child - early in the plague. He married again and his new wife promptly died. Finally, at the height of the fever, his will to survive gave out. Mr. Collins caught the fever, and a few days later he joined the rest of his family members in the crowded potter´s field.¨

Whole families were wiped out. Dead bodies lined the streets. People starved amid cries of agony because nobody was around to help them. In all about 4 to 5,000 perished in Philadelphia, but just like we suspect about the real number of corona virus infections and deaths, the real numbers of yellow fever are probably much higher. One headstone from 1793 reads: ¨Stay Passengers see where I lie, As you are now so once was I, As I am now so You shall be, Prepare for Death and follow me.¨

The housing crisis that resulted from people losing their jobs and being threatened with eviction was no different 200 years ago.  Tenants who were made jobless by the fever were evicted for lack of rent money. The city could not stop the evictions, but they did attempt to assist renters with small cash advances meant only for the short term. Today many who has lost their jobs are wondering if they will too be evicted or will the city provide some relief. The verdict is still out!

The business of the nation was put on hold while the plague raged in Philadelphia. President George Washington was not in the capital and did not know if he could make government decisions. Alexander Hamilton told him he could, stating that the government cannot stop functioning if an enemy captured the capital, which in this case was the plague. However, Thomas Jefferson and James Madison disagreed, arguing on behalf of states rights who were wary to give away too much power to the president, for they had just defeated the British King.

And just when you thought it was safe to go back into the water, wand Bush Hill proclaimed: ¨No more sick persons here¨, signs of the fever reappeared. The disease had not been completely wiped out, and the city told people to continue to clean their homes thoroughly, burn gunpowder to purify the air, dump lime down their privies and whitewash every room. We dread the same thing now - when will we be entirely clear of the corona virus? But the reemergence of the deadly fever (it began in August, and people returned home by January) did not stop people from returning, and eventually getting back on with their lives. The same thing will happen here!

The next suspense that keeps you riveted was the hunt to find the cause of the yellow fever. The people knew that when next summer´s hot, humid weather  returned, yellow fever might return as well. 

And it has. Yellow fever has terrorized many major cities throughout the 1800s, including NY, Boston, Baltimore, Mobile, Norfolk, Charleston, Jacksonville, and others. And it continues to devastate. Over 30,000 workers and engineers died from yellow fever while working on the Panama Canal for the French from 1881 - 1889. Eventually scientists discovered that it was the mosquito that carried the yellow fever and infected people. It originated from tree-dwelling monkeys. 

Countries attacked the mosquitoes to contain the fever, the pesticide dichlorodiphenyl-trichloroethane, or DDT, being particularly effective. But using DDT is also highly destructive to the environment and people´s health. Today we know mosquitoes, animals, and human disease go together. ¨As new roads are cut into virgin rain forests, more and more people enter areas where they can become infected. A car ride takes that newly infected person to a major city, where more mosquitoes wait to feed on him, then carry the disease to another and another and another person. A plane ride carries one of these infected persons to a new country, where still more mosquitoes wait to feed and fly off.¨ 

So far no company here has produced the vaccine in recent years. Some estimate it could kill 10,000 people in a city like New Orleans. Scientists say it is a modern time bomb waiting to explode.

Sound familiar?

¨If the history of yellow fever tells us anything, it is that this is a struggle with no real end. Yellow fever as we know it now might be conquered, but another version of the disease will eventually emerge to challenge us again. And when it does, we will have to overcome our fears and be prepared to confront it.¨

Amen!

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