Mysterious disease overwhelms medical system (in 1793)

Commentary. By Dick Levinson, AMNews contributor. Oct. 22/29, 2001.

Imagine this chilling and eerily contemporary scenario: A deadly disease appears without warning in the nation's capital. The region's best physicians disagree about the origin of this illness and the best way to treat it. As the death toll mounts, a growing number of residents flee for their lives.

This is exactly what happened during Philadelphia's yellow fever epidemic of 1793. During a period of four months, nearly 10% of the city's population of approximately 55,000 perished, making it one of the most deadly epidemics in U.S. history. The impact of this disaster was compounded by Philadelphia's status as the capital of the United States at the time.

Walter Reed, MD, did not prove that the Aedes aegypti mosquito was responsible for transmitting the disease until 1901, and physicians of the 1790s faced a difficult challenge. Lacking the knowledge and tools to establish the epidemic's cause, the medical community was bitterly divided. Benjamin Rush, MD, one of the most respected physicians in the nation, was convinced that poor sanitary conditions in Philadelphia caused the outbreak. At a time when medicine and politics were closely linked in Philadelphia's daily life, Dr. Rush also believed that a regimen of bleeding and purging would restore harmony to "the Republic" of the body. [...]