perfect conditions for the virus to spread rapidly and destructively. It is also the reason Haitian and African immigrants who had already survived the disease became essential to the city’s epidemic response. In 1793, however, physicians did not know the mode of transmission and had a poor understanding of immunity. This is reflected in the various prevention and treatment regimens they prescribed which, because of their differences, became sources of professional bitterness and public confusion. Benjamin Rush’s general stance was that good moral standing and personal temperance were highly effective in preventing illness. He argued that sobriety and abstinence from rich foods were the best means of protecting one’s health (Golinski 153). While his equation of physical health and morality were relatively uncontroversial at the time, the same cannot be said about his therapeutic practices and his understanding of Yellow Fever’s origins. Rush remained a revered physician and educator, but his treatments were unconventional and painful over and above the symptoms his patients were already suffering. They were often made to purge with mercury and were subjected to extreme bloodletting – up to four-fifths of the body’s blood. His reasoning, published in “A Defence of Blood Letting, As a Remedy for Certain Diseases” (1815) was that the practice left the patient in a state of “relaxation.” His treatments drew much scrutiny after the epidemic and he was accused of murdering more patients than he cured, leading to a lawsuit questioning his credibility as a physician. Even more controversial was his assertion that Yellow Fever was not contagious. He did not believe that infections were passed directly from person to person. Rush pointed to the climatic conditions as key to the fever’s spread, basing this stance on the observation that outbreaks generally began in the summer and declined with seasonal changes and cold winter rains (Golinski 153). He suggested that a pile of rotting coffee in Ball’s Wharf was the likely source of the epidemic, and that the crowded and unhygienic conditions on Philadelphia’s waterfront contributed to its spread. He pointed to trash and stagnant water as a possible mode of transmission. His last observation has some merit, given that mosquitos breed in standing water. Rush’s anti-contagionist views put him in opposition with most of his colleagues at the College of Physicians, and William Currie soon emerged as their strongest voice. Currie suspected the disease was imported, and traced it back to refugees from Saint-Domingue who allegedly exhibited symptoms. He observed that initial patients all had sea travel from the West Indies in common and reasoned that the source of the contagion was therefore foreign. His supposition led to strict quarantine methods and the isolation of infected people. He specified that the principal means of transmission was contagion, through “confinement for any length of time in the bedchamber of the sick . . . [or] receiving the breath or the scent of the several excretions of the sick” 57
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