Epidemics of Ordinary Time Emily Waples (bio) 1793 It begins when a three-year-old girl, the daughter of a doctor, dies at her family's home in Philadelphia. Within a week, yellow fever infections have been reported throughout the city. "Tis a sickly time now in phila.," the diarist Elizabeth Drinker notes on August 15; "there has been an unusual number of funerals lately here." It begins when the first infected Aedes aegypti mosquito injects its virus-charged saliva into the body of its first susceptible host, stimulating the urban cycle of the disease. It begins with the circum-Atlantic slave trade, with the traffic in human bodies from Africa to North America and the Caribbean, with the Haitian Revolution and the scores of French colonizers who succumb to fever in what is then known as Saint-Domingue. It begins with violence, viral and imperial. Or, as the early republic's preeminent medical authority, Dr. Benjamin Rush, believes, it begins with some rotting coffee that has been left to fester in one of the city's wharves. The miasmatic theory of disease, postulated by Hippocrates around the fourth century BCE, understands sickness as caused by pestilential substances released into the atmosphere from the putrefaction of organic matter. This will remain the predominant explanation of disease causation until the emergence of germ theory at the end of the nineteenth century. Breath infects; air terrifies. As jaundiced and vomit-stained bodies are carted in carriages to the quarantine hospital at Bush Hill, or dropped in Potter's Field for eventual burial, the College of Physicians issues guidance on how to check the progress of the deadly epidemic. Among their eleven recommendations is a directive to "put a stop to the tolling of the bells." The near-constant death knells, the order implies, are inciting an anticipatory frenzy, marking the mortal motions of this "sickly time." Shutting down the sonic index of death's omnipresence will help. It is [End Page 214] about more than mental health: prevailing medical theory holds that the disease can be incited by fear itself. Meanwhile, some 20,000 Philadelphians—including George Washington and his government—flee the infected capital, abandoning their fellow citizens to the city's insalubrious atmospheres. It begins with chills and body aches, a slight fever, fatigue, nausea. In some cases, this is the worst of it; in some cases, it lasts only a few days. Others are not so lucky, experiencing symptoms of escalating severity: high fever, hemorrhage, hepatitis, shock, multisystem organ failure. Two symptoms in particular are unmistakable signifiers of the dreaded disease: the jaundice that gives it its name, and the telltale "black-vomit": an excretion, observers note, that looks peculiarly like coffee grounds. What they are seeing is in fact the dried blood that has accumulated in the stomachs of the sick. Rush's medical philosophy posits that all diseases, whatever their origin, ultimately wreak their havoc in the body by disordering the operation of the circulatory system. Accordingly, he champions venesection as the remedy to almost anything. He opens the veins of his countrymen until the cobblestone streets outside his shop are stained red. Emboldened by a racist scientific theory, he recruits free Black men and women to serve as nurses, declaring that their imagined immunity to the disease affords them a "noble opportunity" to demonstrate their gratitude, their worthiness for citizenship. But of course, they, too, sicken and die, joining the capital's mass graves, and Rush admits—too late—that he'd been "mistaken" on the matter of African immunity. In the end, the disease takes its leave inexplicably, or it seems. But the epidemic quite literally decimates the city. By the end of November, when the weather has cooled and the mosquitoes have died, 5,000 of the capital's 55,000 residents are dead too. But it is not the end. The fever will return, summer after summer, a curse without a cure. In the account he published the following year, Rush would reflect on the way the epidemic had altered his perception of the passage of time: it was, he noted, "uncommonly slow." This sense of deceleration lent him a novel perspective on...
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