1793 or 2020?
History doesn’t repeat itself, but it often rhymes. (Attributed to Mark Twain)
In the summer and fall of 1793 yellow fever gripped Philadelphia, the capital of the United States. Benjamin Rush, the most prominent doctor in Philadelphia, wrote to his wife Julia Stockton in Trenton on September 13, 1793.
“My Dear Julia,
Alive! And tho I slept but three or four hours last night, am still thru divine goodness in perfect health. Today was a day of triumph for mercury, Jalap, and bleeding.” (Mercury and Jalap were strong laxatives. In pill form known as Rush’s thunderbolts.)
In the same letter Rush claimed that he had saved dozens of lives in the previous six weeks. He warned, “where the above medicines are not used, certainly death follows.” Rush then complained, “Besides combatting with the yellow fever, I have been obliged to contend with the prejudice, fears and falsehoods of several of my brethren, all of which retard the progress of truth and daily cost our city many lives.”
The brethren Rush referred to were his fellow doctors, some of whom thought his methods far too harsh.
One of those doctors was Dr. Edward Stevens, a boyhood friend of Secretary of the Treasury Alexander Hamilton. In place of strong laxatives and bleeding, Stevens recommended lots of water, cool baths, herbs, rest, and wine.
In one edition of the Federalist Gazette Hamilton commented, “I myself have been attacked with the reigning putrid fever and with violence, but now am completely out of danger due to the skill and care of my friend Doctor Stevens.”
Hamilton added that Stevens’ method was far less hazardous than the purging and bleeding used by Rush. Hamilton claimed that if Stevens’ methods are “adopted and if the courage of the citizens can be roused, many will be saved and much ill prevented.”
While Hamilton of the Federalist party preferred wine and rest, Secretary of State Thomas Jefferson of the Democratic-Republican party preferred Rush’s remedies.
In a Democratic-Republican newspaper Jefferson, a good friend of Benjamin Rush, claimed that Hamilton had not really contracted yellow fever but only a common autumnal fever.
Today it is obvious that those preferring Doctor Stevens remedies were the lucky ones. At least Stevens’ remedy follows one of the rules of the Hippocratic Oath: First do no harm. In 1793, however as the fever raged killing at least four thousand out of a population of fifty thousand, it was far from obvious, and many had total faith in Rush, who never left Philadelphia or the hundreds of patients he ministered to for three horrific months.
All sides did agree on thing. The best response to the fever was to leave the city. On August 25, 1793 Rush wrote to his wife at her uncle’s home in Trenton, “I hereby request you remain for a while where you are. Many are flying from the city and some by my advice. Pray for me.”
Twenty thousand fled the city.
Yellow fever and COVID 19 are very different, but the fear they created and people’s response to that fear are similar. Perhaps they even rhyme.
Maybe the best advice in 2020 or 1793 came from Elizabeth Graeme Fergusson. While thousands died in Philadelphia, Elizabeth Fergusson was safe from the yellow fever-carrying mosquitoes at Graeme Park. She and Rush wrote to each other regularly during the epidemic. Elizabeth commented on all aspects of the fever from its origins to its treatments. In one letter quoted in Anne Ousterhout’s biography, The Most Learned Woman in America, Elizabeth, wrote, “I know your candor so well that you would be glad to receive any information though such information might mitigate against an hypothetical you had previously supported.” She added, “clear the eye of prejudice, and fling all the light you can on a disorder extraordinary, fatal, and epidemical.”