A certain amount of regionalism existed around 1800 in United States medicine. This regionalism was due to conflicting philosophies between the three major east coast schools–New York, Philadelphia and Transylvania. New York had Samuel Mitchell making his claims to the septon theory of disease that he had developed. Philadelphia had Benjamin Rush with his own variety of this philosophy, but without any claims laid to a unique name for this form or source of miasma. In Transylvania, Charles Caldwell had become the local leader in the medical field, touting his own theory again very much focused on the American miasma theory.
One of the things about this period of time is that several yellow fever epidemics had just taken place, in 1793 and 1794, and 1797 through 1799. All of the evidence was pointing to local causes, even though the source for this fever was abroad in the tropics. There were suspicions out there stating that the ships coming in were somehow bringing the cause for this fever to the local ports. But nobody could find solid proof for such a contagious or infectious agent in the ports. Interestingly, the common theme for a possible cause often pointed to bags of spoiled coffee beans on board. This theory, made popular by Benjamin Rush, was as credible as theories claiming rotting beef, floating carcasses, and left over spoils from a butcher as the possible reasons this disease struck in the late summer.
Sometimes this evidence pointed to the ship as a cause. One of the most common themes to recur in the nineteenth century, especially for cholera, was that water brought over from abroad serving as ballast in the ship was the culprit. Other times blame was laid on water stores on board should passengers and the crew become ill during their travels. Since many passengers were migrating into this country for the first time, their temperament and locally bred weakness from their points of origin became the common claim.
As for the experts in this disease, in Philadelphia, the site of the very first large scale epidemic of yellow fever, Benjamin Rush blamed it on the rotting coffee beans lost to poor storage on board or discarded into the harbor just outside the perimeters of the local been roasters operating near the docks. Further south in Virginia, Caldwell blamed it on the various forms of miasma being generated by local topographic features such as marshes and
inlets, combined with the typical, local warm humid weather that existed whenever this disease seemed to erupt. New York’s Samuel Mitchell was more creative than the other two. He had the diverse education in numerous fields to needed back up any claims he might make, with arguments that had a knowledge base, scientific claims, and a vocabulary that seemed irrefutable to most of his associates. It was his probably candor, voice and sometimes combined stubbornness and diplomatic nature that most often allowed him to win his claim that this new, yet to be discovered chemical or element was the cause for such diseases–septon, a term derived from the term sepsis usually associated with the ammonia-based smells that often occurred with rotting organic matter.
The following is a case of African workers engaged in an occupation not normally considered when we think about city life around 1800. Someone had to be engaged in these processes essential to city life, and the African people residing in and around the city were responsible for many of the most filthy of these occupations. The onset of illness in the African workers managing the latrines is an example of proof for Mitchell when it came to his philosophy regarding the septon theory for disease and the cause of illness by exposure to this mythical chemical emitted by decaying carcasses, rotting flesh and human waste.
The septon theory led to the state’s first passage of a law requiring meats to be completely inspected by public health police. Anything capable of producing and emitting septon or sepsis material had to be monitored, and it was the responsibility of the medical police to do so. This resulted in the passage of such laws throughout the New York Hudson valley area, as a State and as a result of local legal actions taken by certain communities like the city of Poughkeepsie. By 1798, when such a law passed by the State Senate it appeared in the local newspapers resulting in similar actions taking place elsewhere in this country.
Still, regionalism and faith in your local government was now just as important to locals of New York and the Hudson Valley as much as American Nationalism was to United States
citizens as a whole. This influenced much of New York medical practices in a way that at times seemed slightly different from the forms of medicine taught, learned and practiced elsewhere in the country. This was due to the personal scientific and natural philosophy of the leaders in each of the three regions mentioned–New York City, Philadelphia, and the Mid-Atlantic states of Virginia (then both Virginias), Delaware, Kentucky and Tennessee. Interestingly, this dispute about theories always seemed to exclude Harvard and Yale from the published events.
The other schools that taught medicine like Harvard, Yale, and soon Dartmouth, remained distant from this ongoing political dispute of the Mid-Atlantic states. The following two articles help represent this period of time in New York medical history and the New York attitude about ‘negro servants’ work’ in the region. In the first, negros are the primary victims due to the nature of the job. In the second, no mention of negros is made. .
*********************************************
. 
*********************************************
Brian Altonen, MPH, MS 
Leave a comment