An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793

Published in 2003, Jim Murphy’s An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793 is a historical nonfiction book for young adults that provides a detailed look into Philadelphia’s yellow fever epidemic of 1793. As Murphy documents how yellow fever emerged and spread throughout the city, he demonstrates how society operated in what was then the nation’s capital and largest city in the late 1700s. He focuses on urban power dynamics, race relations, class structure, and concern for public health, which was guided by an elite group of doctors known as the College of Physicians. Among its many accolades, An American Plague was a Newbery Honor book and a finalist for the National Book Award.

Summary

In the opening chapters, Murphy introduces the city of Philadelphia in August 1793. He focuses on a few of its prominent inhabitants, the major political issues of the day, and the everyday operations of the city. Amid this environment of markets, shops, businesses, entertainment, and bustling activity, yellow fever emerges, though doctors immediately disagree on its identification. When it starts killing people at an increasingly rapid pace, the city devolves into full-scale panic. Many people flee, particularly those from the wealthy and middle classes, leaving the city in disarray and without a functioning government.

Over the course of the subsequent chapters, the initial chaos induced by the spread of the fever is confronted by several individuals who choose to stay in the city to help, including members of the College of Physicians. As many members of the federal, state, and city government leave, including President George Washington, individuals derived mostly from the middle classes provide their time and money to restore order. The mayor and a committee he appoints seize control of the government and are aided in their efforts by members of an influential organization of African Americans known as the Free African Society. Most of those left behind are poor and; in addition to needing basic resources, they also require medical care as they fall ill. Volunteers establish a hospital called Bush Hill and work to clean up the city.

Benjamin Rush, one of the most prominent doctors in the College, also stays behind to help patients. He is the first to identify the disease as yellow fever, though doctors initially remain divided on this point. He falls ill twice and peddles a controversial cure that involves poisoning, purging, and bloodletting. Heated debate among the College of Physicians erupts, at first due to disagreements over the identification and cause of the disease, and later over Rush’s cure. Medical practices at the time are still rooted in ancient ideas and remedies, which adds additional challenges to confronting and containing the disease. The rift within the College created by the fever becomes permanent.

In the final chapters, the fever finally subsides. By November 1793, order is being restored to the city. Members of the government return home and enact laws to avoid another crisis in leadership during an emergency situation. Certain aspects of the city are improved, such as the attitude toward public health, while others, like the racial and class structure, stay relatively unchanged. Some of those who stayed behind, like the Free African Society, Benjamin Rush, and members of the mayor’s committee, are negatively judged in the aftermath.

The end of the book examines developments around yellow fever since 1793. Much of the chaos in Philadelphia stems from a fundamental lack of understanding of the disease, as well as any effective treatment. Major scientific advancements in medicine toward the end of the 1800s and early 1900s allow doctors to definitively determine the female mosquito Aedes Aegypti as the cause. While these efforts have made containing the disease easier and helped bring about a vaccine in the 1930s, there is still no cure.