5. Broadside

Given the place and time, Philadelphia, five years after the ratification of the Constitution, it is not surprising that efforts were made to put the best face on the situation. Hutchinson's death did not stop the drumbeat of published optimism. Mayor Clarkson announced that only 140 people had died in the city, of all causes, since August 1, not a high number at all for the sickly season. "The disorder must soon be checked," a New York newspaper quoted "a Philadelphia physician" as writing, "such are the precautions used by all who are here; and I assure you the number of sick is comparatively small, the population of our city considered."

Judging from the letters of the young merchant's clerk John Welsh, who stayed at his post on South Front Street shipping gin and cheese, optimism thrived on Kuhn's theory that while many were sick, very few had yellow fever. "Every street in the city has a share of it...," Welsh wrote. "Every house in Pear Street [where his clerk Josey Gill lived] but Mrs. Gill's and one other, contains sick persons, but the doctors call the most of their complaints the remitting and intermiting fevers. The generality of the people believe it to be a species of the contagion less dangerous." 

Rush thought such ideas nonsense. In a postscript to one of the letters he wrote to his wife that weekend he noted that "the yellow fever has chased it and nearly all other diseases from our city." At the onset of any discomfort one had to take his medicines. Not that Welsh felt no alarm. His daily letters throbbed with desperate reflections on the fever: "The almost certain estrangement of relations and friends, when their services are most wanted, is truly shocking;" "people shun each other as if death was the invariable follower of a touch, or as if they perceived a baneful fume breathed from the others nostrils." Welsh felt weak, but attributed it "to inhaling so much camphor and debilitating scents," and the 89 degree heat.

Thomas Jefferson came to town that Saturday still taking the epidemic lightly. When he heard why his rival Hamilton would miss the cabinet meeting on Saturday, he joked in a letter to James Madison about Hamilton's inveterate timidity, adding that  "his friends, who have not seen him, suspect it is only an autumnal fever he has." Then after the Saturday cabinet meeting, Jefferson scouted opinions and found reason for concern beyond the death of his friend Hutchinson which he owned was a blow to the Republican cause. "The yellow fever increases," he reported to Madison. "The week before last about 3 a day died. This last week about 11 a day have died; consequently, from known data about 33 a day are taken, and there are about 330 patients. They are much scattered through the town, and it is the opinion of the physicians that there is no possibility of stopping it." Jefferson concluded from the safety of his rural retreat, "I would really go away, because I think there is rational danger."

Evidently he had not talked to his friend Rush, perhaps upon the doctor's advice. Rush was sure he carried contagion that might overwhelm someone just in from the countryside like Jefferson. He had dedicated himself to healing the sick. He saw Margaret Morris and dozens like her that weekend, not Jefferson.

On Friday evening a servant informed Morris that her son Dr. John Morris was sick. The relationship between them was strained. Like Ephraim in the Bible, he had "joined himself to Idols," i.e. he was a drunkard. She forgot his transgressions and rushed to his Pear Street house. She found two doctors there, Thomas Parke and Samuel Powel Griffitts, both Quakers like Morris. They had prescribed a blister and Rush's calomel and jalap. They thought he had favorable symptoms and would recover. Margaret thought her son "struck with death."

All the doctors' prescriptions worked exactly as they should. Still on Saturday morning "his skin was as yellow as gold." He had convulsions and was delirious. The family maid had left two days before to attend her sick mother, leaving only a 10 year old indentured servant girl to help John's wife Abby care for four children including a baby. Margaret took charge of the situation, sending the two older children to their grandfather Benedict Dorsey, a respected Quaker grocer who lived four blocks away. Heeding Rush's initial alarms, he refused to take them in, afraid they were carrying the disease. The children's mother, Abby, went to change his mind. While she was gone, her husband had one of his strongest fits. Margaret could not call on the frightened children for help. When Abby returned she provided no relief. She never told her mother-in-law what her father said to her. She simply "went upstairs, undrest and went to bed, saying she had got the disorder and she'd die." She lay in the room next to her husband. 

Margaret sent the baby to a wet nurse, the toddler to her house, and again sent two children to their grandfather. When they didn't return, she felt more encouraged as she faced the difficult task before her. As she scouted the Morris house, in which she had been a stranger since her estrangement from her son, she found the Morris boy cowering in the cellar. His grandfather had only taken his sister. Margaret sent him to Benjamin Smith with a message that she needed help.

The mayor's letter relaying the offer of the Free African Society to provide nurses, appeared in all the newspapers at the end of the week. As the letter instructed, Smith applied to Absalom Jones and William Gray who both lived near Pear Street, and by the evening a man and woman came to help Margaret Morris. As was the case in most of the letters describing their help, the nurses remained nameless.

Soon after the nurses arrived Rush came to see his colleague. Dr. Griffitts had the fever and asked Rush to attend his patients. Rush was gratified to see the black nurses. The Free African Society had provided nurses for most of his patients. He gave Dr. Morris more calomel and jalap, and while not much encouraged, judging from the patient's pulse rate, he told Margaret that his fever was lower. He did not see Abby in the next room. Evidently Margaret viewed her as afraid, not sick with the fever. Still she had to be attended during the night. Margaret wanted to stay with her son and decided that she would feel more comfortable with the woman nurse. The male nurse sat by Abby. Shortly after one o'clock Margaret gained the first sleep she had had in two days.

Around 3 a.m. the cry of fire rang out. A soap house on 2nd Street between Market and Chestnut Streets was ablaze. One man roused by the alarm recalled the gloom that spread over him. He wondered what was to become of his city, then he bathed his temples and forehead with "proper vinegar," took some into his mouth "and went forward." When he reached the fire only one line of buckets had been formed. He followed cries to form a second and found himself next to a lad cursing enthusiastically as he passed the buckets. "I said audibly," the man recalled, "that this was a serious time, and intimated the impropriety of such language." The lad fell silent. Sailors from French ships moored nearby brought up pumps and put out the fire. Two people died in the blaze, and most of the copies of Currie's pamphlet were burned in a nearby printing shop.

Pear Street was oblivious to that drama. Margaret Morris woke at about 5 a.m.. felt her son's pulse, and "thought the fever gone off." She tried to give him medicine but he could not take it. She feared the worse, sent the male nurse to get Benjamin Smith and had the woman stay with Abby. Three weeks later she recalled her son's last moments. He was sensible for the first time in three days and mother and son were able to reconcile: "he spoke to me in a manner that poured balm into my wounded heart, lamenting errors of his past life and had hopes of mercy. This was all I had presumed to ask for, and my chastened spirit said 'thy will be done.' A convulsion fit followed, and after that a sweet composure took possession of his features and he departed without sigh, groan or struggle." She knew that her son had to be buried within hours to save all from the smell of his corpse. That the morning was cloudy and cooler was a blessing, but she decided not to wait for family to help her prepare the body for the grave. 

Rush began his morning rounds by visiting the Morris house, arriving soon after the doctor died. "His excellent mother rushed from his bed into my arms," Rush wrote to his wife that night, "fell upon my neck, and in this position gave vent to the most pathetic and eloquent exclamations of grief that I have ever heard. I was dumb and finding myself sinking into sympathy, tore myself from her arms and ran to other scenes of distress."

Margaret managed to prepare her son for the grave and even see him buried promptly, with the help of the Free African Society that organized a group of black men to handle infected corpses. But Benjamin Smith saw that she was "scarcely any longer herself." She collapsed in complete prostration. Benjamin had her carried back to her own house and sent for Rush. Smith also arranged to move Abby Morris. When her father refused to take her in, the business-like Smith didn't recriminate against the most un-Quakerly act and solicited the help of the relative who had the most commodious house, Richard Wells, cashier of the Bank of North America. Wells polled each member of his household on North Third Street and they all agreed to take Abby in.

Rush was unable to see Margaret until the morning. He found her resting comfortably and determined that she was only exhausted. The death of John Morris did not weaken Rush's belief in his cure. Morris, after all, was a drunkard, and that weakened his resistance to any disease.

Sunday sermons had set off lamentations that flattered Rush's belief that his mission was a holy one. There was a growing conviction among preachers that the epidemic was heaven sent. One exhortation appeared in a daily newspaper on Saturday. An anonymous writer asked "whether he that rides the whirl-winds" was not "humbling a proud and idolatrous generation." He cited "the prodigality of this place,... our playhouses, circuses, palaces, carriages and costly edifices.... Our souls are delighted with the perishing things of this world." Citizens should not flee but "humble themselves under JEHOVAH'S awful rod...." Quakers recalled a visiting Quaker from England who had predicted "that he who sitteth on the pale horse whose name is death would be sent through the streets of Philadelphia."

Rush girded himself with religious metaphors. "Hereafter my name should be Shadrach, Meshach, or Abednego," he wrote to his wife Tuesday evening, "for I am sure the preservation of those men from death by fire was not a greater miracle than my preservation from the infection of the prevailing disorder." Rush saw himself as marshaling the forces of good, and so did others. Richard Wells stopped him on the street on Sunday and told him "Doctor, you have been highly favored in your discovery and success. Be humble and thankful." In reply Rush quoted the Bible, "who am I and who am I from, that I should have been so highly favored."

As he crossed Arch and Third Streets in his carriage, people stopped him, and he was dragged  "to six different and new applications." Dr. John Penington ran across Third Street to tell him that the disease yielded to strong purges "in every case." He visited and prescribed for upwards of 100 people a day. John Connelly, a prominent auctioneer, took him by the hand and "with a faltering voice and his eyes overflowing with tears told me that he carried me on his heart to the footstool of his Maker." Rush seemed almost joyous at times. He bumped into an African American woman he knew, and cried "Hah! Mama, we black folks have come into demand at last." She squeezed his hand. Of course he constantly reminded himself of the misery, pledged not to forget the poor, and prayed for cleansing heavy rains or frost. But this was his moment. He felt that God was steadying him. He had health and "uncommon tranquility of mind." He did not have to hide the truth from patients. He simply told them "you have nothing but a yellow fever, and mercury and jalap are as certain a cure for it as bark is for an intermittent."

Rush had one rival for popular esteem. "Doctor Nassy, a frenchman, has almost made a monopoly of praise," John Welsh wrote. "It is said he has lost but one patient." As for Rush, "there has been great talk of his sovereign medicines, calomel & jalap, but it seems now to die away." David Nassy, a French Jew who had wide experience in the West Indies, had been in the city for several years and was a member of the American Philosophical Society. He responded to the epidemic by opening an office, and while he used remedies not much different than what Kuhn, Currie and Stevens offered, he added bleeding to his arsenal. When a patient sent for him, Nassy sent a bleeder ahead to take 6 or 8 ounces of blood out of the patient's vein. A friend who had taken refuge along the Schuylkill wrote to Rush about another French doctor, who had just arrived from St. Domingo, who "lets blood plentifully."

Rush bled two patients on Sunday, but, as he told his wife "not until they had been thoroughly purged." He justified bleeding by noting that with cooler weather, "the disease has put on in some cases inflammatory symptoms." Many doctors then viewed an epidemic disease as a protean entity literally saturating the air and, through that medium, the body. Just as a body exhibited changes with the changing seasons, so did a reigning epidemic. Rush had identified his enemy and to his own satisfaction determined that calomel and jalap could cure it, but a drop in temperature of ten degrees could radically alter the situation, giving the epidemic new life and requiring new remedies.

For the moment, in most cases, all that was needed was mercury and jalap. That's what he and his apprentices gave to the 120 patients a day who came to his house. Two more of his apprentices, John Coxe and Edward Fisher, moved in with him. Rush almost considered them his equals. His wife Julia worried that the disease might come to Princeton. He respected her fear, even their sons might be carrying the disorder. Since the fever could spread across a street, "and perhaps much further," if it did come to Princeton, she must "keep out of the way of it." He would send out his apprentice John Coxe to treat people, as he was "master of the symptoms of the disorder as well as of the remedy, and has cured several persons whom I have never seen." The sudden indisposition of Coxe and Fisher did not daunt him nor them. "They have seen so much of the efficacy of mercury in the disorder that they treat their complaint with as much indifference as a common cold."

That weekend he learned that another one of his five apprentices, Warner Washington, had the fever. His situation put Rush into a dilemma. Washington, a 21 year old nephew of George Washington, did not send for Rush out of shame. He had been strickened at his mistress's house outside the city. Rush sent Stall out to treat him, but expected the worse. "From the violence of the symptoms and the progress of the disease," Rush explained to Julia, he feared Washington would not recover. He cautioned her that 99 out of 100 who took his medicine "on the first day recover, and all would recover probably, had I time to attend closely to them after the expulsion or extinction of the poison by the mercury." He couldn't explain to her that Washington's immorality placed him in grave danger. The constitution of the patient and all that affected that constitution, food, drink, air, fear, anger, etc., bore heavily on the outcome. Often the disease itself was only secondary, only that which debilitated the body so that it could not survive a glass of cold water or a remembered sin. Yet by the next day Stall seemed to have Washington on the road to recovery.

As the new week began the case that terrorized the city and stirred Rush's ambition was Alexander Hamilton's. "The condition of this town is, in my opinion, truly alarming," wrote a Treasury clerk reflecting on the news that his boss was near death. The fever proved "fatal in almost every instance." He knew of five deaths, three near the office on Chestnut Street between Second and Third Streets. The disease was so contagious it was impossible to say, how slight a communication with infected persons, or their attendants may convey it." When the chief auditor left for a scheduled vacation, his 20 clerks fled. (Yet the Treasury stayed open. Joseph Nourse, the register, refused to give any of his 39 clerks leave. Interest payments were due on government bonds October 1. Nourse reasoned that if he let one clerk go, they all would flee. The customs house also stayed open. Otherwise the port would have to close. The clerks there went to the office, but kept the doors locked, only collecting documents through a narrow slit in a window.)

Hamilton's illness put Rush in a quandary. He was the professed enemy of the Treasury secretary's policies, and no friend of the man personally. Hamilton put himself in the care of Dr. Stevens, a boyhood friend from St. Croix where both were born (likely by the same father). But Rush put saving the city above politics and professional scruples. He called on Stevens in hopes that his methods if not his hands could cure his political enemy. Stevens, however, was well satisfied with his gentle remedies, bark, wine, small doses of "oil of peppermint and compound spirits of lavender," and "infusing" chamomile flowers into the secretary's body. When the secretary's condition worsened Stevens's had him held up in a tub every two hours as cold water was splashed over his naked body. After that he sipped a little brandy burnt with cinnamon, and, while he lay in bed, flannel cloths soaked in "wine impregnated with spices" were applied "to the pit of the stomach and changed frequently."

Rush had more success trying to save other symbols of the city's stability. Thomas Willing, president of the Bank of the United States, sent a note to Rush on Monday: "the weak state of my stomach and heavy sweats in the night require some immediate check." Rush was soon at his side with purging medicines. Then a drama played out in the parlors of two of the city's most famous families that showed how Rush anchored the courage of one city leader.

George Washington had an abiding affection for Philadelphia because some of his best friends lived in the city. By and large most had already fled the epidemic. The Powels, perhaps his and Martha's closest friends, had not. As a leader in the Pennsylvania legislature, Samuel Powel had to stay through Friday, but now was free to leave. His wife Elizabeth called on the president Monday, and he invited her and her husband to accompany the presidential party to Mount Vernon. The Powels had visited in 1787 and Elizabeth, with whom Washington had such a special chemistry that biographers would accuse them of having an affair, liked the idea. Samuel Powel did not. His reason for staying was in essence his confidence in his doctor, Rush. As Elizabeth explained in a letter to the Washingtons, Samuel argued that it was foolish to leave "the only spot where physicians [were] conversant with the disorder." Powel did not forbid his wife such a pleasant escape. She decided to stay, and follow "duty" over "inclination." If her husband got sick, not being at his side would be "a lasting source of affliction."

Washington had never used Rush's professional services. During the war the doctor had written a letter to Patrick Henry suggesting that Washington was not the man to continue to command the army. Henry had shared the letter with his fellow Virginian. When Washington made William Shippen, Jr., Rush's victorious rival for control of the Army Medical Corps during the war, his private physician in Philadelphia, Rush took the slight personally. Actually Shippen had married into the Lee family, a sterling qualification in the eyes of Virginians. Washington also respected Rush's courage. He decided leaving on Tuesday as scheduled would be a blow to the city's morale. Then his wife insisted that she would stay too. Rather than hazard her life, he left.

Powel was one of the few public official who stayed in the city. Save for the night watchmen, city services ended. Of the 20 overseers of the poor, only 3 remained to oversee poor relief in the city and operations at Bush Hill, the fever hospital. A correspondent in a newspaper complained that people "refuse to suffer their friends to be carried thither, because it is at present conducted mysteriously." Actually it was conducted scandalously. The two young physicians in charge, Physick and Cathrall, did not reside there. They visited patients once a day at 11 a.m., leaving nurses in charge the rest of the time. Later the nurses were accused of having "rioted on the provisions and comforts prepared for the sick." On Monday afternoon, the three remaining overseers went to the mayor and told him they needed help. In Tuesday's newspaper Mayor Clarkson summoned citizens to a Thursday meeting at the State House to discuss the crisis.

Rush's reaction was instantaneous. He wrote a broadside to answer the crisis. He realized that the hospital offered no hope, and that all who needed him could not see him or even one of the several other doctors who were using his methods. His solution was to recommend self-medication. "Dr. Rush's Directions for Curing and Treating the Yellow Fever," was printed and distributed to newspapers and apothecary shops.

"As soon as you are afflicted (whether by night or day)," it began, "with a pain in the head or back, sickness at stomach, chills or fever - more especially if those symptoms be accompanied by a redness, or faint yellowness in the eyes, and dull or shooting pains about the region of the liver, take one of the powders in a little sugar and water, every six hours, until they produce four or five large evacuations from the bowels..."

The powders were his mixture of calomel and jalap which his apprentices and areas druggists made up whenever they had a moment free from seeing patients. Then he recommended taking 8 to 10 ounces of blood from the arm if, after purging, the pulse was full or tense. To bolster the body after all those depleting remedies, he was prolix in his descriptions of various weak drinks and gruels that could be taken along with fruit in season, nor did he neglect blisters and blankets soaked in hot vinegar wrapped around the lower limbs. Vinegar should also be sprinkled around the floor.

Rush cut a remarkable figure. "The pleasure of the Lord continues to prosper in my hands," he began his Wednesday letter to his wife. But yellow fever was as remarkable. Sixteen hours later, Rush wrote in his notebook, "an awful day."

Go to Chapter Six