Brian Altonen, MPH, MS

Introduction

Between 1790 and 1810, the practice of medicine was strongly influenced by the religious philosophy related to trinity.   During the 1780s and 1790s, medicine was put to the test as the new medical schools reestablished themselves in the newly formed United States, and many of the old-timers in this field began to hold classes once again.  One of the most controversial parts of medical training was the use of  the cadaver to teach anatomy and physiology.   This required that corpses be acquired, which many members of society were not always in favor of. 

The requirement of cadaver dissection in an ampitheater meant that students would be able to better understand the body and how it is impacted by disease.  This benefit of cadaver training however did not satisfy the religious leaders, who considered the body to be a vessel for the soul, and its removal from a grave or the prevention of its burial was sacrilegious.  Nevertheless, the initiation of a human cadaver class was initated at the New York medical school and the expected public disputes and mob scenes followed.  This helped set the stage for the impressions that the upcoming yellow fever epidemics would result in beginning in 1793.  To religious leaders and many members of the general public, this epidemic was considered to be punishment for the lack of adherence to basic human religious rights and the related moral principles.   Only Yellow Fever could make such an event happen.  Religious or not, the behavior of yellow fever epidemics over time and space made these epidemics appear as though they were a form of God’s revenge, like the plagues of the Bible suffered centuries before throughout Africa, Europe and Asia.

Trinity

To understand the reasons common people were so devoted to divinity and the trinity, enough to use this piece of faith to define their living practices, we have to review the philosophic roots of trinity itself.  The development of a philosophical and theological argument for the devotion to trinity first came about during the second century post-anno domini (ca. 180 AD) when Theophilus of Antioch used the Greek term trias to refer to the three notions: God, His Word, and His Wisdom.   In 215 AD, Tertullian was one of the first to use the Latin term Trinitas (Trinity) to describe this doctrine, referring to Father, Son, and Holy Spirit.   A century later, the use of the word Trinity became an official practice supported by the Church’s leaders, at which time further clarifications were made stating that Jesus Christ was more than just a mystic or prophet with a special form of connection with the divine, a belief heavily promoted by Arianists and other early worshippers of Jesus in order to reaffirm and support their monotheist tradition. 

In place of monotheism, the Christian churches decided that Jesus was to be interpreted as another form of  God Himself, the Physical Form or Son, to which a third representation or presentation of God was added, the Spirit, thus forming the Trinity.  This understanding is important to understanding the interpretation of disease and health in general as it was professed by mystics, seers and healers because it provides us with the insights needed to better understand the ongoing clashes between science and religion. 

A simple physical interpretation of disease suggests that it is possible for us (or the physician) to eliminate an illness by way of physical healing.  Physicians could conceptualize this form of healing fairly well, although they relied heavily upon their imperfect understanding to support their ideology of the universe, the world and the human body in some sort of introspective philosophical fashion, some  of which are still practiced today.  Their traditional viewpoint was that a physical healer allows metaphysical philosophy to be included in their construct of health and the body, but follows the teachings on how to intervene with the body primarily is some sort of physical way, with a unique take on the metaphysics of this practice.   Most physicians perceived illnesses as being physicial, others relied more upon the metaphysics of the ailment whenever a physical caused could not be defined.  Still others, serving as a doctor both physically and metaphysically, sometimes took the role of the healer/mystic.  To the metaphysician and the mystic,  each metaphysical diseases can be treated using some form of power, usually one that is not exactly Divine in nature.  Some of these healers only acted out the part as a metaphysician, taking on some form of pseudo- or semi-divine healing power, a method that appeared to onlooker to work, but through some invisible method of healing.   Applying this philosophy to traditional practice in healing in later years and generations, we can conclude that a healer who treats the psyche of the individual isat least  involving the spirit and body in this process.  A healer who treats just the spirit(s) of the body, is trying to balance physical healing with spiritual healing, emphasizing mostly if not entirely the latter.  The various forms of metaphysical and higher (Divine) forms of healing required the healer be trained in the non-science parts of medicine; such healers were usually the theologians.

For the most part, the healer, including the colonial physician, probably did not interpret his role in treating the soul of the individual.  The colonial physician who received significant amounts of medical training did not usually interpret his role as that of a metaphysician.  Such was not the case for many metaphysicians however.  There were many times when some of the more utopian-like thinkers in religion who considered themselves “Doctors” in both the physical and metaphysical sense, on occasion attempted physical healing to such an extent that they failed in their attempts.  So, although engaged in the physics and at times the metaphysics of healing, such healers in early American colonial history are perceiving their actions as the best, most effective way to provide his or her healing services. 

Science defined for the combination physical and metaphysical healer a unique philosophical conundrum to deal with by the time the 18th century came about.  Whereas during the 16th century and earlier, the physician/healer delved mostly into a practice that treated the body and its single energy source or form, with the establishment of two forms of force or energy for the body by the late 1500s, by defining the nervous energy as existing in a different form from the total energy that percolates through the blood vessels and various tissues and organs, we have a healer who can set aside any completely metaphysical notions pertaining to the soul and parts of the spirit, medical actions which religious leaders were supposed to provide to the patient.  But by the 1700s, a third spirit or power of the body was about to become popular.  What was once a practice based mostly on Paracelsian notions of the three parts of the body–Mercury, Sulphur, Earth–a philosophy heavily popularized by those well read in Hermann Boerhaave  and Jacob Boehme’s writings, has now become a trine consisting of the vital energy, the nervous energy, and once again that electric form of energy philosophers often had a hard time placing in either of these two classes, the universal or natural form of electricity showing itself every now and then in nature as well as in man and the body.

It is important to note that also during this time, physicians were becoming what modern historians often liken to atheists, but who are perhaps more appropriately labeled as “critical agnostics,” an type of people with an uncertain philosophy that did not totally discount the notion of God completely.  Instead, they simply did not talk about God, did not go to churches, but performed their church-related social duties whenever such needs arose, such as serving as a god-parent at a baptism or a witness to a marriage.  Parallel to this development of a pseudo-atheistic philosophy was the development of the sciences between 1550 and 1700, in which we find the role of the physician as a doctor to the soul not only disappearing, but also being replaced by an emphasis on healing practices involving the use of alternative spiritual force-like entities.  Metaphysical alternatives recently developed due to more modern takes on the Paracelsian philosophy, enabling some changes to be made on the alchemical definitions popular for the time. 

One of the more important changes in alchemical philosophy to happen in North American colonial history pertains to the teachings of George Starkey, an alchemist of the New World and New way of alchemical thinking who takes on this popular 17th century chemical philosophy enabled this philosophy to continue to be taught as part of scientific and medical thinking in the colonial setting.  The single most important evidence supporting this local definition of trinity to New York-Hudson Valley healers is seen in a recipe penned by Cornelius Osborn around 1759.   In this recipe for a missed or late menstrual period, Osborn recommends the use of a medicine rich in the entia or ens (being) of the body and individual, in particular, the ens of venus or ens veneris.  This method of treating the colonial take on this menstrual concern or issue was in part the result of the teachings of Boerhaave, at the psychology-philosophical level, and Helmontianism, at the chemistry and medicine level.  During the late 1600s and early 1700s, the  practice of a new form of alchemy was being defined, based on Boyle’s teachings for the most part, but as many skeptical historians currently like to claim, primarily the result of George  Starkey’s philosophy and teachings, which focused on the Sol and Luna (Sun and Moon) of every illness and its medicine.   In Starkey’s materiam medica, every agent has its Corpus and Spiritus (Body and Spirit).  On occasion this duality has added to it its Mercurius or Mercury component (“Component of Life”), referring to the Paracelsian concept of mercury as some sort of spiritual, light etherform entity.   Other times he focuses a lot upon the Ens veneris, Sal Antimonii, Ladanum Opii (laudanum of Opium) and “Oil of Sulphur by a bell.”  Each of these entities and  their philosophies and times of origin lack any sign of the religious trinity concept, and only offer scanty evidence for links to all three parts of the Paracelsian trinity as a trine-based ideology (mercury, sulphur, and salt or earth).   Nevertheless, Starkey does have the necessary compnenets needed to make potential religious worshippers also pay heed to his metaphysical writings.  Starkey refers to God throughout his writings, and in his letters to other scientists and friends.  He ends his recipe for the Philosopher’s Stone, produced using mercury, with “God permitting.”  In his various letters to Boyle about the ens, he thanks God for his success. Starkey’s letter to Boyle dated 26 January 1651 includes discussion of his devotion to God, for opening “the gates of nature” for him, from which came his udnerstanding of another of his recipes, the alkahest; he wrote: “now finally, I sing a hymn to God, since only he is worthy.”  Throughout the next several dozen lines of text, God is mentioned as a sign of fidelity once again nine more times.  In his description of how he obtained the recipe for alkahest, he explains to Boyle of his visit by God during a deep sleep, who referred to Himself as Starkey’s “Eugenius,” or good spirit and divine revelation provided in ‘tutelary genius’ form.  OF this important Paracelsian recipe he wrote: “I confess that even if I had studied my whole life, I could not have found it without the immediate finger of God.”  In all styles and all forms, Starkey’s writings on Alchemy were very much a writing of Christian nature and intent, and not the anti-divine writings of a chemist excluded from church settings due to this beliefs and practice.  Starkey was trained in the Dutch sciences and medicine and in the Dutch traditions, and engaged in many of his experiments and endeavors into this changing field of science, alchemy to chemistry, in the only way he could, he practiced both, but focused mostly on the philosophy of the former to produce more effective remedies.

In the late colonial and post-Revolutionary war years, this philosophy once again underwent several changes.  Starkey’s alchemical interpretation of medicine began to fade in popularity, although metaphysical claims about how medicines worked would continue to be promoted.  

Countering metaphysics was the more down to earth physical reasoning which was beginning to take center stage as a philosophy of science.  Two medical teachers and writers of the post-colonial years, Brown and Thacher, provided their own definitions or takes on the vital and nervous energies of the body.   In both of these types of teachings on the energy of the body, God played a lesser role when it was up to the physician to interpret the natural history of a disease and its victim.   In a fairly short time their emphasis on the sciences led to criticisms, followed by claims of atheism, a label better off interpreted as critical agnosticism.  As medical doctors beleived more and more in the science of medicine, and less on the metaphysivs of medicine, two routes began to form for practitioners of medicine to follow during this period in medical history.  Both physical and metaphysical forms of alternative medicine became popular amongst the masses during the early 1800s.  New philosophical reasoning was developed at first to enable these events to happen but later to hasten their growth in philosophy and popularity, ultimately enabling these professions to continue to the evolve to the extent that they did in New York history.  Were it not for the phenomenon of electricity being introduced once again as a alternate form of medical practice in New York and the Valley, it is possible that trinity and the value of trines as part of a medical philosophy would never come to play the way it did in Hudson Valley medical history.  The impacts these traditions, philosophies and ways of practice had on personal and cultural beliefs enabled people to decide how to interpret their disease and its most proper treatment, based on trinity symbolism and trinity faith. 

Understanding the meanings and variations on trinity and the relationship many of its causative social and intellectual movements had on the development of atheism or “critical agnosticism” are important to understand due to impacts these movements had on religion and science in the years ahead.  Philosophy and religion played an important role in the history of the changes about to take place in medicine between 1790 and 1810 approximately.   Science had yet to obtain total control of a physician’s philosophy, although some scientists felt pretty confident in their abilities to provide an alternative philosophy about God and the existence of things, based on events not told or explained by the Bible.   Science existed as proof that many the claims doctors were making were self-evident.   Yet to the more devoted people, this same science, based on scientific discovery and findings, could not alone prove that God was non-existent and did little to intervene with any teachings the trinity-based Christian leaders had pertaining to the body, health and its healing process.   In the  minds of some scientists and physicians, this part of the human philosophy even reached a point where individual acts of accomplishment and success as an experimentalist or a physician were in themselves divinely produced.

Still, there was a change and movement in the beliefs of physicians who practiced medicine and their form of “occult” thinking during the first years of the 1800s, was hastened by the impacts of French Reformation on scientists and physicians globally.  This change in medical thinking took its time in forming but ultimately gave way to a new completely form of teaching and practicing medicine that had both positive and negative impacts on the people and their physicians.  The positive impacts related to improvements made in treatment, diagnostic and scientific research methods.  The negative impacts were that science was stubborn and tended to be typically wrong in its initial lines of reasoning when it came to the use of reworded ancient or out-of-date philosophies when deciding how to treat a particular disease. 

In constrast to the French Reformation movement was the new loyalist movement now that the time since the Revolutionary War had sufficiently passed.  This latter movement consisted of anti-reformists who believe that all the evidence they needed to prove that God existed and contest the well-trained, highly experienced physician was already apparent, and increasing in its frequency of returns, recycling in such a way that trinity had to be its underlying reasons.  

It was the new forms of pre-plague and plague-like epidemics that provided the anti-reformists with the strongest evidence and opportunities they needed to bring up the possibility of Divine origin and use these arguments to begin to engage in various public, political and professional debates about such claims.   The most notorious of these pre-plague epidemics was yellow fever, the recurring epidemics of ywhich made religion a more powerful and reliable method to cure the patient than regular medicine.  Were it not for the Yellow Fever history of the early United States, regular medicine and its counterparts (“irregular” medicne and religion) may not have undergone the changes that they did.

Interpreting the Yellow Fever

When yellow fever became a major problem, it did not result in as many deaths as its Biblical equivalent in religious minds–the Plague.  All plagues have their precursors, events which indicate the plague is about to begin.  To the most devoted, various natural signs are interpreted as clues to an impending palgue, like an earthquake or a volcanic eruption or the falling of a meteor from the sky.  Severe epidemics are also indicators that the current social condition is in such awry that people are getting sicker and sicker, over time, and in numerous ways, often impacted or taken from their physical form due to such events as the influenza or various types of fevers, events that in many people’s eyes seemed to precede and elude to the actual plague.

To the people of New York, and many of its surrounding states, Yellow Fever was the pre-plague event.  Even the msot reputable physician of the time, Benjamin Rush, referred to Yellow Fever as the “Plague” in his letters to friends and associates.  Whereas the epidemics preceding the actual plague were defined as pivotal events, taking many lives, the plague itself took innumerable lives and had a tremendous impact on the local social make up.  At times, Rush considered the Yellow fever simply an epidemic and perhaps a pre-plague event.  But with time, his experience and the large numbers of deaths it ultimately came to cause in urban setting, led Rush and others to view the Yellow Fever epidemics as the plague itself, not its predecessor.  

The major impact on how the Yellow Fever would come to be interpreted dependeing on the popular views and conceptions of the plague and epidemics in general public terms, and how this led their public, religious and political leaders to interpret the impact of a Yellow Fever epidemic each time it happened and returned.   In a typical urban setting, as few as a few dozen deaths might be witnessed and/or heard about by a religious leader, in the beginning, this could still be perceived as a symbol of a much larger event about to happen.   A review of the Yellow Fever deaths demonstrated periods when absolute fear set in due to dozens of deaths in a single community, followed by news of hundred of deaths citywide, and thousands of deaths once other urban settings were included in the county.   In very short time, such numbers would lead most public leaders and even some medical professional to claim that these deaths could only be matched by the Plague.

Evidence for the resemblances of this epidemic to the plague were contained in the historical writings.  Although not too many individuals were familiar with each and every past Plague catastrophe, there was enough common knowledge out there in the beginning, that was being shared between believers, over enough time to allow fears about and family reminiscences of the plague to resurface once again.   Once it became clear that one of the worst events was about to take place in an urban setting once again, the public could only conclude that the plague was about to become a part of United States history.  

Noah Webster’s Plague and Yellow Fever

We are best informed that this was the case for the 1790s and early 1800s American culture by the famous writer, and inventor of a Dictionary in his name,  Noah Webster.   Webster carried out a lengthy review of the plague, one induplicable even in modern times.  He published his findings and conclusion in A Brief History of Epidemic and Pestilential Diseases, published in 1800.

In his review of the 1349 epidemic that struck London, Webster wrote:  “It is found that the plague is always preceded, for some months, and in some instances, for two or three years, by other malignant fevers, which increase gradually to the violence of the true plague” (A Brief History of Epidemic and Pestilential Diseases, vol. 1, p. 134).    He again refers to the urban cause for the Plague in his review of Maitland’s writings on this part of London history, retold in his book History of London.   In this book, Maitland’s comments on the 1580 epidemic are perhaps what led Webster to blamed it on the multitudes of Londonians of various incomes and living conditions.  Both Maitland and Webster seemed to conclude that it was the crowding of the city with various tighty knit dwellings packing one or two families, in combination with abject poverty, that led to the ability of this epidemic to have such an impact on an urban setting.

“[Su]ch great multitudes of people, brought to inhabit in small rooms, whereof a great part are very poor, yea such as much live by begging, or by worse means, and they heaped together, and in a short, smothered with many families of children and servants, in one house or small tenement, it must needs follow, if any plague or population sickness should, by God’s permission, enter or amongst those multitudes, that the same would not only spread itself, and invade the whole city and confines, but a great morality would ensue the same, and the infection be dispersed through all other parts of the realm. ”  (ibid. vol. 1, 165-166)

Of course, Webster did not only blame the cities for the plague.  But suffice it to say that one popular notion about the cause for the plague was that tightly packed communities was one of its major causes.  Everyone who attended school and learned about large towns and cities would have learned these interpretations of changes in the social and community setting.  If not, there were still many who themselves probably heard about such events as the Plague, either by word of mouth at home, or by their older teachers at school or in the workplace. 

Suffice it to say, that by the late 1700s, it once again became common knowledge that numerous causes could exist for past plagues, and that yellow fever could be one of the chief predecessors in the the urban setting.  By 1800 the yellow fever was indeed directly associated with the plague, and given the name “malignant fever”, by some, a name already used for precursors of past plagues.  In his Brief History . . . , Webster blamed every possible and imaginable topographic and geographic feature related to cities, ranging from nearby swamps, stagnated creeks, small ponds and lakes, and even the basic town layout itself, including the placement of such places as merchants’ homes, prostitution abodes, grungy captain’s quarters,  and the sole cause for many such event, the stinking, dirty shipping ports. 

In the case of another late 17th century London epidemic,  the smoke put out by chimneys was blamed for the unhealthy air, pre-plague, and plague conditions preceding epidemics.   In the largest towns and cities situated throughout the mainlands of Europe, Webster blamed the electricity in the air common to these places, brought about by the impact peoples’s daily living practices had on the local atmospheric conditions.   No matter what location Webster referred to in his thousands of brief sketches on each of these medical events, he typically recapitulated this part of medical philosophy as to how and why epidemics take place.  In theory, there was still just one cause ultimately for the deadliest of epidemics–the plague.  The events preceding the plague could have individual causes for each event, defined mainly by the various features of the local regions infected.  But in the end, these events somehow were translated into processes that altered to local electricity in the air.  

For Webster and his followers, these associations of the vaporous or “mephitic” air, the local miasma, to the plague were common sense.  Most likely, many of the people untrained in medicine even considered these as possible causes in local urban setting.  Like in Constantinople, cities once emptied due to the first signs of an impending plague erupted locally, such as a comet, lightning storm, severe swarm or mosquitoes, or a small epidemic of worms, were now being just one step more cautious about immediately jumping to such conclusions.  It wasn’t these natural events and manmade living settings that were responsible for the plague.  It was the change in local electricity that all such events were now considered clues to according to Webster’s philosophy.

These same events in even the most rural settings could cause the plague as well.   In the surrounding countrysides, soil, elevation and topography, “noxious exhalations” produced by the local dwellings, and even the cultivation of the natural countryside to produce crops were potential causes. (vol. 2, p. 325)   Meteors and comets filled the earth’s atmosphere with their orbs energized by fire and electricity, and the materials that formed their tails brushed off by the atmosphere only added to the electricity already present in large quantities.   The aurora and lightning storms were rich in similar powers, as well as volcanic eruptions,  earthquakes,  the steam and effluvium of volcanoes before they erupt, the events preceding and following floods, natural processes that cause animals to die in place and insects to swarm, were all signs of the “pestilential fevers” about to come.  Livestock disease, the sickness and death in local fish populations, individuals “seized by a disease” for no reason, and the onset of small pox, measles and influenza in large numbers were all signs adding further support to Nature’s/God’s clues.

After providing a detailed description on how to raise the perfect city, such as to cause the plague to recur in such crowded living settings, Webster provides his “plan of a city.”  He requires the city to be situated alongside an sizeable water body, with a slope edge tapering “fifteen or twenty degrees” into the water in order to allow for a rapid descent of any water used to wash the city of its infectious filth and debris.  Wharves are to be set up so everything that descends them, including our waste and want nots, can be washed away with the next tide.  Warehouses built alongside these wharves have to be “built in a strait [sic] range”, at  a suitable distance from the water.  “The streets should be strait, intersecting each other at right angles, and forming the city into squares of at least 500 feet on a side.”  All personally-owned lots have to be at least 60 feet wide, with no more than 40 feet of this breadth blocked by buildings.  Outhouses have to be placed behind the frontmost building, surrounded by 100 feet of open space to the front and back, and another 150 feet of garden space onto which shade trees need be planted.   There should be public meeting squares placed throughout the urban setting, streets need to be 100 feet wide and shaded by three rows of tree (with one row in the center), and no city shall be raised on ground that is flat or level, to prevent the water from gathering in steetside and yard walking spaces.  His final request: “No pains should be spared to supply a city with fresh running water.” 

Given the urban setting of New York on Manhattan Island, there no less healthy of a place than perhaps the most populated portions of this main thoroughfare.  The same could be said for such cities as Providence, Philadelphia, Baltimore, and even parts of Boston.   If it was the ships that carried Yellow fever into the city, why not interpret this version of the plague as the consequence of mankind’s desire to significantly modify a formerly pristine pastoral setting?  This is one of the claims many observers had along with their concerns about overpopulation, reducing food stores and the lesser role church seemed to be playing compared with a few generations ago.  Webster voices his concerns about these chagnes in one of the more important conclusions he drew about the Yellow Fever epidemics, taking place as a global event by infecting many if not most of the major cities: “it is not possible, I speak it with zeal and confidence; it is not possible, under the operation of the present laws of nature, for men to be healthy in many of our cities….”

In his very next paragraph, he then revelas too his readers one major reason why he felt certain parts of the United States were more healthy than other parts.  Those parts of the country most healthy to its settlers were defined relative to the Hudson River.  He began his geographic description of where to travel and where to settle with the Hudson Valley:

“All the shore of the Atlantic, from the Hudson north-eastward will admit of healthy cities.  If the commercial towns on that portion of American were constructed on the foregoing plan, I would answer for it, that they would never be raged with yellow fever.  Individual cases might occur; but the disease could not, without a miracle, become epidemic.    But as our towns are now built they will at times be partially affected.  In ordinary seasons and with a vigilant police they will escape, with the yearly loss of only ten, fifteen, or perhaps fifty citizens, the unfortunate victims of the negligence, the folly, and the crouded populations of cities.  In very unfavourable seasons, the number of victims will be increased.  Such is the fate of our northern cities.” (vol. 2, p. 252)

In terms of the readership, for readers to make the best of Webster’s suggestions, the reader had only to find an inhabitable location that, as inferred by Webster, was thinly populated, situated on a rise placed well above the local waters, postitioned in such a fashion by its local topography that it was blessed by healthy winds, and bore the terrain needed to produce an adequately supply of fresh flowing mountain water.   The only problem was, Webster didn’t really tell these readers where this place could be.  It was up to the reader’s imagination and knowledge of the local geography to be able to identify such a safe haven, in the event that a future escape had to be planned.  Webster did inform his readers, however, that this place would have to be some place located northeast of the Hudson River in the Middle Atlantic and New England States setting.   Some of the followers of his teachings, needed a little more evidence than just a collection of places on a map to tell them where the safest place was to be whenever the yellow fever (or plague) was about to strike.  Once again, religion filled in many of the gaps in their logic.

The Religious Cause and Trines

The fact that physicians had no idea as to the cause for such deaths made them appear, to some religious leaders, as though they imagined their work as some sort of intervention, taking place in harmony with an otherwise totally Divine activity.  Although not verbalized as such, this was most certainly a problem according to many church elders, and it was an important part of any arguments they posed behind closed doors in an attempt to intervene with such “ungodly” practices.   At times, they shared this concern of theirs with the doctors, who replied by stating they simply felt they were trying to eradicate God’s curse upon the peoples, using their own skills, provided to them the will of God Himself.   They stated this with a certain sense of Enlightenment and self-absortion.  to the most politically savvy physicians, these feeling may have even been associated with some sort of sense of conquest and their passion for power.

Due to local upwellings of religious philosophy and seekers, Yellow Fever became one of the most outward if not sole causes for the increased devotion to trinity in the Hudson valley.  This change in faith was common to laypeople during the 1790s and early 1800s, but not so common to physicians, scientists and well-informed political and economic leaders.   On the Christian side of this ongoing social and political dispute was the yellow fever.  So long as Yellow Fever kept returning, often in three year stints or in cycles situated about 3 years apart, each epidemic reminded the people of the possibility that God and God-alone may be the one to ultimately answer to.  This was not so much the case during the 1793/4 and perhaps even 1797 epidemics.  But by the third time this pre-plague malady made its debut to the states, the common people were ready to initate their change in this part of their personal philosophy.  In short time, this was supported by the many religious leaders and strong followers who claimed God was causing these epidemics, either as a consequence any past “sins” or “poor decisions” we made both personally and professionally, or due to a mere act of faithless fate.  

Accompanying this ideology about the trinity nature of yellow fever was the uncertaintly as to whether or not such epidemics were related to the great epidemics of the Bible, such as the plague.  If plague was not a major argument during recent epidemics now passed. it was most certainly the centerpiece upon which  the first decisions were made as to how to deal with this plague the third time through. By the third time this epidemic came and exerted its complete impact, the failure of physicians to heal those afflicted by this disease led them to take another route towards finding the cure.   The 1797 epidemic made it clear that bloodletting wasn’t the way to treat this fever, especially a few days into the disease, heading into its final stage.  Even the most skills doctors could not determine whether the yellow fever was more than just a fever-related event.  Some physicians like to call this fever the “Malignant Fever” due to the severity of its attacks on healthy people and the symptoms and appearance it often left them with in the hours to half-day just before the demise.  Even one of the most respected physicians of the time, Benjamin Rush, referred to this epidemic as the Plague often enough, instead of Yellow Fever or some form of Bile Fever.   Such a fatalist interpretation of the Yellow Fever might even lead listeners to now have a legitimate argument to voice about their impressions of this malady, one that soon was used by preachers to prove to their remaining skeptics that their previous claims were true.  

The best way to convince the people of your philosophy is to produce a legitimate argument with numerous proofs to convert the non-believers into believers.  This what just what many interpreters of this epidemic event accomplished by turning to trinity to make their point.  The problem with this evidence is it is pretty much lacking in any medical journals or writings.  Devoted Christian or not, it is unlikely a physician would make such as claim.  This kind of teaching was not found in the medical books he was trained with.  So, it was  up to the common people to promote this philosophy and initiate the changes such a philosophy can result in.

The ways in which Philadelphia dealt with this epidemic provide us with sufficient detail to demonstrate the reasoning used to create social change.  It was commonly believed that Yellow Fever was the first major disease sent to the United States by God, for purposes of correcting whatever social injustices were already taking place.  This philosophy of the Yellow Fever epidemic is  supported by similar claims made by religious leaders in other cities, townships, states, cultural settings, and regions of this country.   Even though medicine in general almost never referred to such popular cultural superstitions, the evidence for their existence in public and professional writings can still be found–in the forms of personal diaries, letters, newspaper stories and articles written or published about this disease and the behaviors these claims often resulted in.   In Philadelphia, New York and Poughkeepsie, public and professional reactions to Yellow Fever reveal much about the professional and social beliefs regarding these recurring epidemics.   The reasons for these social responses and political outcries to physicians were obvious.  The masses were disatisfied with science and medicine, and as a result became somewhat distrusting of the physician’s claims about his/her abilities to be both a practitioner of physic, and a practitioner of religion.

Social Injustice

So, what kinds of social injustices were out there about this time?  enough to finally cause God to pay closer attention to the United States population and then decide to create a direct form of retribution and intervention for everything wrong that we were doing?  

It would be too easy to go on and on about this type of question.  By reviewing the local newspapers, we might get the impression that crime was up, people were no longer in control of their passions, politicians were only befriending other politicians and giving up on their dealings with the poor, etc.   One could also select to review at the various sermons then being published, by the numerous types of churches, synagogues and meeting houses raised in the states.   With numerous forms of direct proof of these claims available to skeptics of the time, it might be concluded that within the most populated regions of the states there also exist the worst victims of these social tragedies, alongside the bulk of the perpetrators of these misdoings.  This social injustice was even more apparent in cities where churches of all sorts and teachings could be found in every community, often situated along major thoroughfare where both the most devoted religious followers and the most “atheistic” natural philosophers and neophytes intermingled.   With such a social setting already present, and quite active in the public mindset, it is easy to conceptualize the possibility that some believe that all of these injustices have to change.  Someway and somehow, God has to stop these wrongful, misguided deeds from happening.  This is why the Yellow Fever came.

But it may have not been just this socially-targeted  philosophy that made way for the establishment of some religious interpretation of the increasing yellow fever epidemics.  There were also the popular culture groups with religious backgrounds that tended towards beliefs in the unusual and supernatural.  The 1790s was prime time for these “seers, soothsayers and millenialists” to once again begin preaching their astrological and numerological-based arguments, implying such things as the end is near or an important religious reformation and revivial was about to take place.   These millenialists did not require that the end of a one-thousand years period was about to take place, after all, this only happened once of twice during the span of mankind’s history since it began be documented in writing.  The turn of the century was enough at times to spur on this ssort of thinking.  Also important were the truly unique trinity years, months, dates and times, such as the years 1666 and 1667 to the early English And Dutch spiritual revivalists –the 1000 year time span didn’t matter, the trinitarian-based symbol that the end is near, ‘666’ did make a difference (however, the Dutch disagreed enough to argue and believe in 1667 instead).  Going back to the dawn of Manhattan for a moment, and the Bohemian and Dutch Boehmites occupying the New York, Yonkers and Westchester areas and parts of Philadelphia, the Second Coming was due in 1667 and astrologic-worshiping Christians had their telescopes set, waiting to see Jesus arrive from the heavens, perhaps even by way of the 7 sisters constellation (Pleaides). 

In retrospect, one Jewish leader confessed to his listeners about his own use of the trinity in order to spur on more help from G-d.  In a public speech given a couple of decades following the Revolution, he professed that Jewish leaders along with leaders from two others combined their skills to symbolize their reason for forming this “Union. ” They formed it with hopes of making not only the best use of their finances, but also to symbolize its authority by one God, to help meet their goal of feeding the poor and healing those taken ill.  

In yet other townships in New England, the church became the place to take refuge from the disease as it passed through the local households, taking one entire family whilst sparing it neighbors.  Even in the church setting, one reverend claimed to bear witness to a epidemic making its way through the church in the form of a white misty cloud, directing itself straight towards those families who visited the church only on occasion, but now using it simply to escape their predetermined plight.  According to the Reverend preaching this sermon, they became the chief victims of their own infidelity.

Religion, Spirit and Soul

A families’  belief in trines, trinity and trinitarianism was already an important part of Hudson Valley history once the States began their recovery from the Revolutionary War.   As early as 1780, just prior to the end of the war, yellow fever possibly struck the New York-New Jersey-Pennsylvania port locations, an obvious trine although not very evident or meaningful at the time.   The first well-documented Yellow Fever epidemic was until 1791 and infected New York.  The first well-published and highly identified yellow fever epidemics took place around 1792 and 1793, in at least two different harbor settings–New York and Philadelphia.  Still the first two years did not provide the Yellow Fever epidemic struck needed to draw upon local religious leaders to began to associate this epidemic with a Divine cause. 

Immediately following the onset of the Yellow Fever epidemic in Philadelphia in 1793, one popular viewpoint now became common knowledge due to local religious leaders.  During their masses and during any conversations they had with physicians, they made their point about these periods of onslaught being of Divine nature.   The members, families and groups that made up their  churches were already willing to accept this conclusion.  To many, it was the less-faithful members of the churches and the “atheists” of the time who were the cause for these wraths.  Supporting this notion assigning most of the blame to the atheists were the popular writings and teachings of writers and philosophers related to the early French Socialist movement underway and the upcoming French Reformation movement.  Famous writers like Boyle, Hooke, Hume, and Kant had their greatest impact during this time on some the most elite of the elite in American society.  (To some extent, this movement was not that different from the influence of the writings of Boehme on the early Dutch settlers as well.)  

Also during this time, there were a number of important spiritual fraternities forming at this time, like the Masons whose teachings and philosophy helped its follower to set their religious practices aside in exchange for promoting a philosophy that was more unitarian and utilitarian in nature, a society in which mysticism and religion helped to form bonds between believers in the Old Testament, the Qaballa, the Bible, and the occult, whatever belief you followed. 

But it was not just this social movement that was impacting the thought of the ministers and priests, as much it was the influence of science once again on the medical doctors’s changes in thinking pertaining to science and religion.  Physicians were some of the strongest advocated of the French Reformation teachings.  They were heavily influenced by French physician’s practice and teachings, for which reasons psychiatric patients were no longer jailed next to criminals, but were instead placed in special facilities to treat their psychological problems.  It was also the French who helped establish the interest in metaphysical ways of healing such as the use of medical electricity, batteries or galvanic devides, electrified acupuncture needles, static electric charge generators to heal the body (vital) and nervous system forces, and even the skills of mesmerism to heal the human psychic force or energy.   [Note there was very little taught as a part of this philosophy about how to “heal” or impact the soul and it’s power or force.]

One of the major disputes between members of the medical community and religious leaders and their followers was already taking place on an off during this time.  The single most effective cause for the recurring arguments between these two groups pertained to the use of the body and possible desecration of the soul.   Medical students needed bodies to learn the science of their “art.”    Cadavers were the only way to view the body internally in order to learn about it various parts and their functions.   Often these cadavers were legimitimately obtained or provided.   On occasion, families handed over their deceased elder’s bodies, but even more common was the use of the bodies of criminals to assist in this important part of the learning process.  And even though some medical schools probably most of their bodies in a legitimate way, it was often the case that surviving relatives of an unearthed body were angered by the removal of a relative from a cask already placed in the cemetery.  It was also not that unusual to find cases where bodies were “accidentally remove’ as part of an effort to remove the body of a criminal from the cemetery.   This ongoing dispute regarding the training of physicians was already taking place, resulting in much socio-political turmoil at times.  With the religious symbolism interpreted for the Yellow Fever epidemic, the political fire that was taking place between religion and medicine was now being even more heavily stoked. 

Philadelphia : The Reverends versus Doctor Rush  

In Philadelphia, we learn much about these discussions and arguments between medicine and religion by reviewing the experiences of Dr. Benjamin Rush.   We can then use this to better understand how New York reacted to the yellow fever epidemics.   During the 1790s, Philadelphia was a city with a major shipping port.  It was located south of the New York harbors, and required considerable inland transportation before a landing could be made in the most heaily populated urban center.  For many of the years in which Yellow Fever epidemics developed, Philadelphia was just a few degrees warmer than New York City on the average, some years enabling it to receive the yellow fever before the ports in New Jersey, New York and Boston became infected.   It was not unusual for Yellow Fever to come into a major port one year, and skip the ports in the adjacent states, only to infect one or more of its neighbors a year later. 

This is exactly what happened when the yellow fever epidemic that struck New York in 1792, apparently resurface in Philadelphia a year later.   In September 1793, the Lutheran Minister J. Henry C. Helmuth wrote a memoir of his experiences with the 1793 epidemic entitled Short Account of the Yellow Fever in Philadelphia for the Reflecting Christian.   Most of his experiences with the victims of this disease were also noted in a diary he kept during an epidemic that struck the Lutheran Seminary neary Mt. Airy, Philadelphia.    This diary was translated and reviewed by Rush Historian Bob Arnebeck, who made considerable efforts trying to understand Rush’s role in controlling the epidemic and determining its causes.  

Amongst members of the Lutheran community, Reverend Helmuth was very much a hero to Lutherans in the local community.  His influences were reviewed in an article entitled “Pastoral Heroism in a Panic,” , published in the Lutheran Church Quarterly sometime in 1940.   [See http://www.geocities.com/bobarnebeck/helmuth.html for Helmuth’s notes on the local yellow fever cases.]

It was not unusual for Helmut to visit several families a day, with two or more taken ill per family and two or more recently deceased.    In his notes on these visits beginning early September 1793, he noted about 4 victims per day.  These victims were of all ages.  On Tuesday Septemner 17th, he included in his daily notes “Weather changed, fresh wind from the north. Will hopefully change the hardship. Went to P.Schmidt – opened the windows in the church – went to see the sister of Wagner in the Moravian Alley, but she was already dead. Preached and prayed at Zion, crowded.”   The next day, he visited several homes where he met or conversed with 14 people, 6 taken ill, adn 3 recently deceased, whom he then buried.  He conversed briefly with Dr. Benjamin Rush that day.  Neither he nor Dr. Rush were taken ill.  On thursday he wrote: “Smelled the breath of death for the first time since all this hardship began, was scared.”

Helmut performed daily services, prayers, visits, child baptisms, burials and last rites over the next few weeks, with deaths per day nearly tripling over the next month.   On the 13th of October, Sunday, he wrote  “Strong Northwestwind during the whole night. Perhaps God wants to help this poor city and bring back it’s health by this wind.”    One week later, on October 19th he wrote: “This week 101 members of our congregation were buried. /line skips/ The weather changed, strong wind, but no rain.”    The weather on “28.Oct. Monday Cold northwind.”

Deaths continued through the rest of the month into November, decreasing considerably on a per week basis by November 3rd.    Helmut has had the time now to reflect on what he has witnessed, and so begins to prepare a sermon on this experience, which he referred to in his notes by writing “Sermon: The Lord brought all this dying to our town. He makes no differences in his punishment.”  

On the 3rd of November he entered into his diary:

3.Nov. Sunday Heralds of coming punishment in this city: the theater [Commodien Haus] plays the new theater, Sabbath breaking, making fun of the gospel, perjury – miserliness – deception

 . . .  and on the following day “The sickness declines, but it was very warm yesterday and many people were afraid of the consequences.”

In another letter reviewed by Rush historian Arnebeck, this time written by Quaker Benjamin Smith, a description of how the yellow fever impacted his daughter was provided:

“When I wrote to Jno. yesterday morning I mentioned my Debby being unwell and I supposed getting the complaint. After I wrote the fever she then had increased rapidly. It was attended with a violent pain in the head, so much that I became a good deal uneasy. I could not help thinking of this prevailing infectious disorder which occasions so much alarm here & has followed in as upon the heels of the other which I mentioned first – however tho her fever continued high remitting at times this day & night, towards morning it abated & she is now pretty free from it & much better, so that we hope she will soon do well again. – I attribute much to the good care that has been taken of her by her valuable mother who was here all yesterday and has come again this morning.”

Then, the following discussion of its natural history and possible causes were penned for the reader:

“I hope this rain may be very seasonable & have a great tendency to destroy those noxious particles which it is generally allowed have of late charged our atmosphere. Some idea of the alarm which this opinion has spread among us may be gathered from this circumstance . . . Tho the disorder is called “the yellow fever”, I do not find the physicians will allow it to be any thing unusual they says it[s] the “bilious remitting fever” & owes its present degree of violence & supposed infection to the predisposed state of the air, the nature of which may perhaps be thoroughly altered by the present change in weather.”

Benjamin Rush, a professor at the local Medical School, began drawing his own hypotheses as to the cause and origins of Yellow Fever in just a few weeks after treating his first cases in Summer 1793.   As part of  treatise on this topic that he wrote and was later published,  he provided a substantial list of causes, but due to the number of years that passed before this postscript was published, it seem more appropriate to conclude that this list of causes is probably more contemporary in nature to the publication year, 1815, than the actual philosophy that he engaged in nearly 20 years earlier.

A more appropriate interpretation of his philosophy as to the causes for yellow fever is obtained from a letter he wrote in August 1793: 

“[Its] symptoms are very different in different people. Sometimes it comes on with a chilly fit and a high fever, but more frequently it steals on with headache, langour, and sick stomach. These symptoms are followed by stupor, delirium, vomiting, a dry skin, cool or cold hands and feet, a feeble slow pulse, sometimes below in frequency the pulse of health. The eyes are at first suffused with blood, they afterwards become yellow, and in most cases a yellowness covers the whole skin on the 3rd or 4th days. Few survive the 5th day, but more die on the 2 and 3rd days. In some cases the patients possess their reason to the last and discover much less weakness than in the last stage of common fevers. One of my patients stood up and shaved himself on the morning of the day he died. Livid spots on the body, a bleeding at the nose, from the gums, and from the bowels, and a vomiting of black matter in some instances close the scenes of life. The common remedies for malignant fevers have all failed. Bark, wine, and blisters make no impression upon it. Baths of hot vinegar applied by means of blankets, and the cold bath have relieved and saved some. Mrs. Chaloner owes her life to the former remedy. She caught it from her husband, who caught it in Water Street near the place where it originated. He too is upon recovery. This day I have given mercury, and I think with some advantage. Dr. Wistar and myself consult much together, and I derive great support and assistance from him in all my attempts to stop the progress of this terrible malady….

Throughout most of the remaining time this epidemic remained a problem in the Philadelphia area, Rush’s attitudes about his role and responsibility was fairly heroic in nature, a personal impression of his work and value to the community which he seemed to express too much at times to his counterparts in local religious politics.     He ended his August letter with the following interpretation he made of his purpose and value in the handling of this local public health problem. 

 August 30th. Another night and morning have been added to my life. I am preparing to set off for my daily round of duty, and feel heartily disposed to say with Jabez, “O! that the hand of the Lord may be with me,” not only to perserve my life but to heal my poor patients.

 In the public eye Rush’s work did a lot to help with the understanding of Yellow Fever behavior in urban setting ports but accomplished little to identify an actual cause for these epidemics, leaving the door open for religious seers and interpreters of the epidemic to come up with their own response to this recurring social problem.

On September 7, 1793, the local newspaper for Philadelphia, The Federal Gazette, posted a statement made by the local preachers proposing that this epidemic may have religious reasons for its activities.   Supporting this claim were some other disasters that recently took place in the city, like a recent building fire that took two lives, at 3 AM on Sunday Morning, September 1, 1793, a day and time that bore trinity symbolism due to its numerology.  There was also the destruction of an important public health pamphlet destroyed by this fire, information on the epidemics produced by physician William Currie and his theory regarding its causes.  In the religious eyes, this may have been destroyed through Divine intervention as a symbol of its erroroneous reasoning and suggestion about how to avoid a loss of life due to yellow fever.   They also reminded members of the community about a recent foretelling brought to them by a local Quaker passing through the city, who predicted that “he who sitteth on the pale horse whose name is death would be sent through the streets of Philadelphia.” [Letters, S. Dillwyn to father, Sept. 9, 1793, HSP.  See Rush historian Arnebeck’s writings.] 

In Rush’s own writings, Rush went so far as to turn God’s message into news to God’s people about his own attempts as a physician to eliminate the city of this disease.  For a moment, Rush got the fame he was searching for.  Writing about how Richard Wells, a Quaker elder, who stopped him one Sunday during one of his epidemiological expeditions about the town, stating to him, he recalls the following Wells said to him: “Doctor, you have been highly favored in your discovery and success. Be humble and thankful”,  to which Rush replied by quoting the Bible to the best of his memory: “who am I and who am I from, that I should have been so highly favored.”   With this statement Rush is probably referring to the only physician to write a gospel, Luke, for in Luke 1: 26-38, “Highly Favored and Greatly Troubled”, similar words appear resembling those extracted one of Rush’s Notebook entries dated Sept. 8, 1793. 

Following this discourse, Rush then tried to cross Arch and Third Streets in his carriage when still more people stopped him in his tracks, and then guided his horse and carriage over to where there were “six different and new applications” of his regimen for treating Yellow Fever to make note of.  It was at this time that Dr. John Penington informed him that this form of yellow fever yields well to the administration of strong purgative medications, “in every case.”(see Butterfields reprint of Rush’s Letter, p. 655).

No doubt in some of the people’s eyes, Rush was a great physician.  To those still focused on God’s message to use by way of bringing about the yellow fever, impressions were different.  Rush’s decision whether or not to practice religion and believe in God was not the issue here with the local people.  To some he appeared as though he had an attitude which suggests he perceived himself as the “gifted one”  as a physician.  Rush may have considered himself as the one selected for this epidemic, and for its elimination from Philadelphia.   This type of arrogance Rush expressed does not necessarily mean his Rush’s intent was misguided or misconstrued, but it does suggest he had a general attitude about himself and about the religious advocates he often had to contend with during their arguments about the reason for yellow fever.    For such medical and political leaders like Rush, a physician who placed medicine and public health at times ahead of his decisions to be a practitioner of religion along with medicine did not always sit well with the commonfolk.  To some historians who have reviewed Rush’s history in the past, he was perceived as a physician who allowed religion to sometimes rule over science, or vice versa, but this was never the case.  Rush used religion to help explain why he convert to preaching about God’s role in this current epidemic and how this Grand plan intermingled with his own life experiences.  It was already known for the most part by anyone who discussed the yellow fever events with Rush that he  believed the yellow fever epidemic was in fact heaven sent, in some way, shape or form.   He just didn’t know how, and so concluded it was for an unknown cause that somehow had to involve his own interventions as a physician. 

Like most of the physicians for this time, Rush never successfully linked the yellow fever to its true cause—the mosquito.  The notion that an organism like a mosquito already prevalent locally could suddenly become a carrier of a disease never really became the focus of doctors’s research on the cause for this recurring epidemic.   Instead, many physcians including Rush considered Yellow fever to be a product of the passengers on board ships already infected by the disease, or a result of the ship itself carrying it some sort of product, materials, or ballast contaminated by the agent responsible for yellow fever.  To many physicians, this “agent” linked to the disease was simply some sort of “effluvium,” be it in the form of the odor emitted by the bodies of people infected with yellow fever, or the smelly air or gas emanating from ships docked at the local piers.  Even by mapping out the locations of the first people infected by the yellow fever, they could only relate the fever to such things as the types and nationalities of people on board the ship they travelled, in an attempt to relate climate, acclimation and heritage to their susceptibility to the disease, and these early epidemiologists could link the disease directly to the ship itself.   In some cases, attempts were made to related the individuals, ships and disease to the condition of the port and waters which the ship was docked in.  At times this even led to feelings of certainly as to what the cause for yellow fever actually was, the famed founders of which often proposed to be the debris, rubbish, human waste and other forms of flotsam and jetsam found floating alongside these infected ships as they remain docked in the ports.

The Quaker Interpretation of Yellow Fever

It was due to their discussions with Rush that religious leaders ended up split in terms of their belief as to why these recurring yellow fever happened.  Was this series of epidemics another example of God’s disgust with the world?  an example of one of the great plagues perhaps?   Some physicians felt it was essential for the churches to close their doors in the wake of this epidemics.  In the minds of the Reverends, the church served to not only heal them of any past sins possibly responsible for their susceptibility to the contagion, the church also prevented the disease from being able to take more victims, either through direct Divine intervention due to attending a church and confessing, or due to the prayers and blessings you received by behaving like rational people, instead of like the atheistic scientists and doctors residing throughout each and every community.   As a consequence of this dilemma, churches usually decided to remain open (see Gen. Adv. Sept 23, 1793), signifiying their trust in God over their trust in physicians and medicine.   One of the best examples of this use of the church was provided by Reverend Helmuth, who had his practitioner sense the glory of the experience of being in God’s house during such a tragic event. He states: “My God! what hours were these! What comfort pervaded our otherwise distressed congregation!” (see J. Henry C. Helmuth [Lutheran], Short Account of the Yellow Fever in Philadelphia for the Reflecting Christian, pp 42, 44, 45, see more on the notes at http://www.geocities.com/bobarnebeck/helmuth.html; for a brief biog, see http://www.archives.upenn.edu/people/1700s/helmuth_justus_h_c.html). 

As for the Quakers, this interpretation of God’s role in the development of the epidemic and in the elimination of pasts sins, people and disease carriers, led to a different take on this important public health concern.  The yearly meeting for The Society of Friends was planned to be held in the city durign the midst of the epidemic period.  It went as scheduled in spite of the local epidemic history and public encouragement from non-Quakers not to do so.  The Quakers claimed the epidemic was merely an act of predestiny, one which we could barely change even if we were to try to elicit such a human intervention.   Epidemic or not, this meant the Quakers would hold their meeting regardless of what was already predestined to take place and in spite of “the rod” of God being laid down upon them.  To change the time or place of their meeting might imply to God that they wished to avoid this test of devotion and piety, a fact of life which most Quakers felt could not be changed.  There was no way to change your fate, no way to finalize your escape. (see for example a personal expression of this attitude from Morris to daughter dated Aug. 31, 1793, and Haverford Yearly Meeting Epistle 1793, by Swarthmore).

One of the most popular theories for the early nineteenth century regarding the cause for yellow fever had to do with the weather.  People who liked to add an act of God onto their plate were also at times willing to place Nature in God’s hands, meaning God must have had something to do with the development of the epidemce, for example through an act of nature, using this “Act” as the means to define just how the ‘Rod of God’ played into Yellow Fever natural history.  Was Yellow Fever merely the results of a series of natural events, overseen by God, such as changes in climate and weather patterns?  Was it due to the sending forth of a flood, although much slower than that which Noah had to content with?  Was it caused and sent through a provision of very warm, humid temperatures for the summer?  Was it due to more a simple act of change, with or without Divine intervention, an event that could cause the Yellow Fever to first rise and then propagate throughout some chosen population?

Instead, as time would tell, it was man’s own behaviors and activities, in combination with God’s natural events, that enabled this disease to reproduce from time to time in any given social setting.  When we apply this thinking to Rush and the Yellow Fever problem in Philadelphia in 1793, we find considerable support for Rush’s claims at the professional level, that is to say between doctors, but a total lack of support at the popular level and amongst religious leaders.  In the end, once enough epidemics hit a particular region, the church’s impressions of why the epidemic s were taking place won out over Rush’s philosophy.  In spite of the Quaker’s teachings that this epidemic may in fact be an act of some for of fate that cannot be avoided or escaped from, the bulk of the city population scattered from the urban setting to avoid this new version of “the Plague.”  In due time, they temporarily re-established themselves in other places, well distanced from whatever deaths were taking place.   This is made most evident for the city of Philadelphia in a letter written to Rush by New York physician Dr. Rodgers, who wrote “Unless Providence sends an heavy driving rain or a very great change in your atmosphere in point of cold and moisture . . . I see nothing but absolute destruction for your deserted city.” To those paralleling the Yellow fever with the Biblical Plague, if climate was in fact the cause and not Divine Intervention, then the epidemic should cease once wintertime and weather rolls into the urban setting.   The chief characteristic of the plague on the other hand enabled it to stay an active events, causing tragedies to rise in preselected families for whatever reason.  According to the history of past Plague epidemics, this meant the disease could be spread by rodents, and last the entire winter (Rodgers to Rush Oct. 14, 1793, Rush Papers).

About the end of September 1793, once the influx of this epidemic appeared inevitable, some churches eventually closed their doors and city officials began their journeys to places far from city hall .   Eight of the 28 serving the council (28%) remained in Philadelphia over the next few months.  Some of the community stores and marketplaces remained open, as they attempted to meet the demands of an increasingly ill population.  Bakers still had to produce their breads and other provisions.  Druggists still had to supply the physicians with their much needed supplies.  Other essential markets and stores were kept open and operating, and non-essential markets were either closed or transferred to other much healthier parts of the city, such as the post office.  All of these store front changes were communicated to the public either indirectly through local government and community leader channels or directly through the local newspaper (Fed. Gaz. Oct. 5, 1793). 

At the peak of the deaths this season from Yellow Fever, it appeared as though nothing the physicians had accomplished had any impact on the numbers and ages of deaths that ensued.   Many of the residents of the city by this time deserted their homes and business, and made their way to healthier climates and living conditions.  The requirements for their new residential location were numerous, but tended to focus on just a few climatic and topographic features felt by many to be disease-free and accommodating to specific health-related climatic needs.  First, they had to be a considerable distance from the center of the epidemic, which typically meant a half- or full-day’s travel along a major travel route in most cases.  Second, the other sources of the effluvium often associated with disease patterns also had to be unequal is not completely absent from the new living setting.  Third, it helped to find an area where adequate services could be obtained, including medical services and the typical day-to-day living needs such as foods and recreational products.  Finally, the best in health improvement accommodations had to be available, such as healthy climate and weather patterns, healthy foodstuffs and farming settings, healthy water and springs facilities, and healthy recreational provisions.