The expanding population represented a challenge to the health care establishment, but Philadelphia, with some established infrastructure and rapidly evolving treatment and education facilities, was perhaps the best equipped to handle a crisis. Benjamin Franklin had established the first public hospital in the U.S. in Philadelphia in 1751. The city’s physicians were esteemed members of society, whose supposed learning afforded them great influence, especially after the establishment of the American Philosophical Society in 1768 and the College of Physicians of Philadelphia in 1787. The latter of these two was formed specifically to study and investigate causes of and remedies for incidences of disease in the United States (Kornfield 190). These medical societies created intellectual communities that aimed to establish uniform protocols and practices for public health crises. By the end of the 1780s, Philadelphia was the epicenter of growing optimism about medical advancement in America. Dr. Benjamin Rush, the city’s most highly-regarded physician and medical educator, reflected the confidence of the era after the American revolution, writing that “human misery of every kind [was] evidently on the decline” (190). Rush’s optimism was typical of the urban doctors of the northern states of that era, as they had been relatively spared by major disease outbreaks. Rush’s colleague, William Currie, for example, attempted to prove to Southern colleagues that remitting fevers and illnesses were uncommon in the North, relative to Southern States. He did concede, however, that the rigorous lifestyle of farmers awarded a “vigour of body and resolution of mind,” while the mechanics and city workers were “condemned to vegetate in cellars and closer apartments, breathe infection, and their minds become contracted” (Currie 1792). Though he loved the city and attributed declining mortality rates in poorer districts to the efforts of medical societies, Currie had to admit that Philadelphia had shortcomings, such as its narrow streets, slaughterhouses, and tan-yards. Despite such difficult conditions, Philadelphia continued to draw people in. The population surge shifted the demographics of the city. Economic opportunity and the increasing prominence of abolitionist organizations (such as the Free African Society founded in 1787) suggested to many former and escaped enslaved people that Philadelphia would provide them better living standards. The number of Black people in Philadelphia tripled in between 1790 and 1800, from 2150 to 6436, even as the general population grew by only a third (approximately) in the same timeframe – from 44,096 to 67,811, according to the federal census (Sivitz and Smith). Then, in mid-August of 1793, cases of Yellow Fever began to appear in Philadelphia. Though the city experienced the seasonal fevers in late summers through the fall, this outbreak was marked by severe cases with such unusual symptoms as jaundice and black vomit (Maienschein). The fever first 54
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