geeky
The first outbreak occurred in August of 1793 in Philadelphia, the city which served as the nation’s capitol from 1790 to 1800. The first two people to die of yellow fever in early August in Philadelphia were both recent immigrants, one from Ireland and the other from Saint-Domingue. By the middle of that November of 1793, yellow fever spread throughout the city, killing over 5,000 of the city's 50,000 residents. President George Washington and his cabinet left the city, relocating the seat of government temporarily to neighboring Germantown. On November 11, Washington visited the city before the official order was made for safe return (that order was made on November 14), but he did not reoccupy the President's House until December. As temperatures cooled, and the mosquito population diminished, the wave of the disease subsided.
About two years later, New York City was hit particularly hard by this disease. Its first recorded patient was Thomas Foster. On July 6, 1795, he sought medical attention from Dr. Malachi Treat, who was the health officer at the city’s port, on July 6, 1795. Another doctor who worked with Dr. Treat recorded that Foster’s yellow skin was “covered with purple spots, his mind deranged, his tongue covered with a dry back sores.” Three days later on July 9, Foster died. Dr. Treat himself soon followed Foster to the grave. By mid-August, New Yorkers were dying at the rate of two a day. The order was given for all afflicted patients to be quarantined at Bellevue Hospital. Dr. Elihu Smith, noted in his diary in September: “The whole city, is in a violent state of alarm on account of the fever. It is the subject of every conversation, at every hour, and in every company.” By late November this outbreak one again subsided with the cooler weather, but by this time 730 New Yorkers had died, out of a population of about 40,000.
In late October that year, he published a circular in his paper, The American Minerva, addressed to the physicians in the cities most affected by the fever over the past three years. Those cities were Philadelphia, New York, Baltimore, Norfolk and New Haven. He urged them to share and pass along whatever information that they had gathered about the diseasefrom their own practices. Webster's call for information sharing was the beginning of recognition of a key strategy in addressing a pandemic. Webster told his intended readers, “we want evidence of facts”. He called on medical professionals to work together to understand the disease and how to cure or contain it.
In 1794, Webster published his findings in a 250-page book, which he titled "A Collection of Papers on the Subject of the Bilious Fevers, prevalent in the United States for a Few Years Past", The book had eight chapters authored by experts scattered across the country, including Dr. Elihu Smith. Lacking the sophistication of modern science, these accounts were lacking in hard data or information that would be of much use today. But it was still a good strategy, even if it contained some unfounded hypothesis. For example, Dr. Smith speculated that, as poor immigrants constituted a large percentage of the dead, “the sudden intermingling of people of various and discordant habits was a circumstance favoring the production of the disease.” Webster himself theorized that the cause had something to do with urban grime. He said that Americans should “pay a double regard to the duties of order, temperance and cleanliness.” But even Webster acknowledged that more study and data was required to reach a definitive conclusion.
Much like the CNNs and Fox News of today, partisanship in the media was as pervasive then as it is now. Webster, a Federalist, was ridiculed by his political opponents. Webster’s paper supported President Washington. Benjamin Franklin Bache, a grandson of Benjamin Franklin, edited Philadelphia’s Republican paper, and was the mouth piece for Thomas Jefferson's Democratic-Republicans. Bache attacked Webster, writing that Webster merely sought for himself “the honor and the glory to triumph over a malady.” Today some might say that "karma is a bitch" as, in a cruel irony, Bache died from the disease three years later at the age of twenty-nine.
In the summer of 1798, yellow fever one again came back and once again many people died from the disease. By then Webster had moved to New Haven. He wrote in his diary: “The disease assumes this year in Philadelphia and New York more of the characteristics of the plague, is contagious and fatal beyond what has been known in America for a century.” That round of yellow fever ended with the cold weather's return in early November, by which time another 3,400 had died in Philadelphia, 2,000 in New York and 200 in Boston. One of those taken by the fever was New York’s Dr. Elihu Smith, who was only twenty-seven. The fever would return periodically throughout the 19th century, but never again with the same vigor.
At the end of 1798, Webster published another book about the illness, entitled "A Brief History of Epidemic and Pestilential Diseases with the Principal Phenomena of the Physical World Which Precede Them and Accompany Them and Observations Deduced from the Facts Stated". At over 700 pages, it certainly was not a "brief" history. Webster traced the history of epidemics from biblical accounts to the present, but once again he could not arrive at any firm conclusions about the cause of yellow fever. He wrote:“More materials are necessary to enable us to erect a theory of epidemics which shall deserve full confidence."
Webster did contribute something of value to combatting the disease. He had created a protocol that future medical professionals could follow, which involved gathering as much evidence as possible by pooling together the efforts of numerous experts on the front-lines and sharing these findings with everyone. Dr. William Osler, the famed late 19th century physician credited Webster’s book as being “the most important medical work written in this country by a layman.”