Philadelphia got a taste of terror from germs in 1793

Newly found documents tell of city's bout with yellow fever

November 18, 2001|By Gina Kolata | Gina Kolata,NEW YORK TIMES NEWS SERVICE

PHILADELPHIA - The nation's capital was struck by a plague so terrible that 10 percent of the population died in a matter of months. People panicked. Everyone who could fled the city. Politicians seized the moment to try to gain advantages over their opponents.

An instant book appeared and became an international best seller, snapped up by some who wanted to read the gruesome details of the disease and its accompanying social disruption, and by others who wanted to pore over its list of the dead.

The city was Philadelphia in 1793, and the disease was yellow fever. No one knew where the illness came from or how it was spreading. No one knew the best treatment or how to clean up the city. It was a hemorrhagic fever, Ebola-like in many symptoms.

Cache of letters

Now, researchers at the College of Physicians of Philadelphia have found a cache of letters and documents from that terrible time, written by such historic figures as Alexander Hamilton and Dr. Benjamin Rush, a signer of the Declaration of Independence and a professor at what is now the University of Pennsylvania.

While the letters do not change the general picture of the epidemic, they offer new details and give the events immediacy.

Reading the letters, said Charles Greifenstein, the college's curator of archives, he felt "the vicarious archival thrill," adding "you can really feel like you're there, like you are part of the community."

In an odd twist, one of the letters - undated - from a Dr. Benjamin Say describes a case of anthrax in a farmer, Nathaniel Browner. His disease began as a blister on his back.

Say treated Browner with poultices, complained that he was not called in early enough and asked two other doctors to consult. Then, said Greifenstein, the letter "just sort of ends." Say never tells whether Browner recovered.

The cache of letters had lain unnoticed in a locked drawer of a battered wooden box that looks like the slanted top of a lectern. It had been tucked into a corner of a vault on the second floor of the old brick building that houses the college. In June, needing storage space, Greifenstein decided it was time to throw the box away. He asked Leroy Green, the facilities foreman, to remove it.

"I was about to put it in the Dumpster, but I heard items moving around inside," Green said. He decided to break the lock on the drawer and investigate. To his astonishment, he saw a packet of yellowed papers tied with a string.

85 documents

The 85 documents, dated from 1787 to 1889, included medical case studies, articles, meteorological data and letters. They are originals, Greifenstein concluded, after examining them and consulting other experts in the months since they were found. And the ones discussing the yellow fever epidemic seem eerily timely now, when the nation is reeling from anthrax attacks.

"The message to really consider when you look at the yellow fever in 1793 and anthrax today is that panic results from a lack of knowledge," said Dr. Allen R. Meyers, president of the College of Physicians of Philadelphia and professor of medicine at Temple University.

"In the 1790s, we had useless treatment and we certainly had no understanding of the epidemiology of the disease," Meyers said. "In the case of anthrax, we know a great deal about the organism but we're really trying to understand more about the transmission."

Of course, the anthrax attacks, while terrifying, have had nothing like the death toll of that yellow fever epidemic, which killed about 55,000 people in Philadelphia.

To put it in perspective, said Dr. Marc Micozzi, the executive director of the College of Physicians of Philadelphia, it would be as if a disease were to sweep through Washington and its suburbs today killing about 400,000 people between late August and November.

In a paper for a 1996 symposium on the Philadelphia epidemic, Dr. J. Worth Estes, an emeritus professor of pharmacology at the Boston University medical school, described the symptoms of yellow fever.

Patients would complain of headaches and abdominal pain, but the disease, he wrote, was easy to spot by its colors: "yellow eyes and skin, purple hemorrhages into the skin, red blood pouring from the nose and mouth, black vomit."

A Philadelphia printer and bookseller, Mathew Carey, chronicled the epidemic in a self-published book. The first edition, which sold out in days, was dated Nov. 14, 1793, and by Jan. 26, 1794, it was in its fourth "improved" edition.

Carey wrote that patients would get sicker and sicker for four or five days. "If these symptoms were not soon relieved, a vomiting of matter, resembling coffee grounds in color and consistency, commonly called the black vomit, sometimes accompanied with or succeeded by hemorrhages from the nose, fauces [the oral pharyngeal passage], gums, and other parts of the body - a yellowish purple color and putrescent appearance of the whole body, hiccup, agitations, deep and distressed sighing, comatose, delerium, and finally death."

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