Tuesday, February 2, 2021

Pernick's "Politics, Parties. and Pestilence" has Problems

They kept count during the epidemic. The Mayor's relief committee that sat daily at City Hall on Independence Square reported the number of patients sent to the Bush Hill fever hospital and the number of coffins provided for the dead. Toward the end of the epidemic, they sent a man to count the cases and deaths in every street and in every alley. Each religious denomination counted the number of burials. Newspapers still publishing reported a daily count of the dead.

Immediately, after the epidemic, Matthew Carey's instant history went through four editions with each succeeding edition listing the names of more dead. The Mayor's Committee accounted for the money it had expended and provided an inventory of all the beds, bedding, pills and potions that remained at Bush Hill. Dr. Deveze published accounts of cases at the hospital, patients kept anonymous. In his account, Benjamin Rush revealed the names of his patients both dead and living which lent some credibility to the outlandish claims of the number of people he saved.

Although congress was not in session during the epidemic, no city was more enmeshed in the political battles arising from the federal government's policies than Philadelphia which would be the nation's capital until December 1800. Yet in none of the contemporary accounts of the epidemic were any distinctions drawn between the two political parties, then known as Republicans and Federalists, or pro-French and pro-British, or Jeffersonians and Hamiltonians, or Democrats and Monocrats. It took a 20th century political scientist, Martin Pernick, to do that with a series of four tables in his William and Mary Quarterly article "Politics, Parties and Pestilence." 

They are:

Table I 1793 Party Affiliation of Physicians Who Expressed an Opinion of the Cause of Yellow Fever, Republican, Federalist, or Uncommitted;

Table II Opinions About the Cause of Yellow Fever Held by the Political Leadership of Philadelphia, Importationist, Domestic Origin or Unknown; 

Table III Opinions About the Cure of Yellow Fever Held by the Political Leaders of Philadelphia, Bark and Wine, Mercury and Bleeding, and Unknown

Table IV Personal Reactions of Philadelphia's Political Leadership: Stay, Flee or Unknown.

Pernick argues that in response to the epidemic "influences quite removed from medical science entered into the debate." Even though political parties were just forming as the comity in President's Washington's cabinet ended, neither side put politics aside just because people were dying.

Pernick briefly describes how Republican fortunes took a turn for the worse in the summer of 1793 when the extreme demands of the new French ambassador, wildly welcomed by Republicans in May, threatened American neutrality. The French Republic had just declared war on Britain and demanded American aid. Few Americans wanted war with Britain, yet. 

Then in August the influx of 2000 colonial French refugees from a slave rebellion and revolution in what would soon become Haiti offered more trouble for Republicans. "Unlike the earlier royalist refugees," Pernick writes, "the new arrivals included many white radicals and moderates...." They were natural allies of American radical Republicans.

In late August, the doctor sent by the governor to investigate the extent and source of the malignant fever in the city was also one of the leaders of the Democratic Society and organizer of a mass rally that greeted ambassador Genet back in May. After his investigation, on August 26, Dr. Hutchinson wrote to the governor: "It does not seem to be an imported disease; for I have learned of no foreigners or sailors that have hitherto been infected.... The general opinion both of the medical gentle|men, and of the inhabitants of Water-street is, that the contagion originated from some damaged coffee, or other putrified vegetable and animal matters;..." 

Hutchinson protected his French allies from any blame for bringing disease to the city. Another Republican doctor fed Hutchinson the theory that absolved the French. In a letter to Hutchinson sent August 24, Dr. Benjamin Rush suggested damaged coffee as the source of the disease. On August 19, he had been the first to identify the disease as yellow fever. Rush was a signer of the Declaration of Independence and, although not a street orator like Hutchinson, remained a publicist for republican causes.

By early September, Rush began administering and publicizing a "cure" for yellow fever which involved severe purging with an inorganic mercury compound called calomel (it taste like honey) and ever increasing amounts of blood letting. 

At about the same time, Secretary of the Treasury Hamilton, leader of the Federalists, got the fever and was cured by a boyhood friend. Hamilton publicly endorsed the remedies of Dr. Stevens which included Peruvian bark, wine and cold baths or at least frequently throwing cold water on the patient. Stevens then publicized his remedies.

Despite the rival cures, the fever spread and the members of the city council, save for the mayor, fled the city. Mayor Clarkson called a general meeting and a committee of more or less 18 active members took over the supervision of burial, running a fever hospital, providing relief to the poor and caring for orphans. The Committee met daily save for the two member running the Bush Hill hospital which was just outside the city limits. According to Pernick, although Mayor Clarkson was a leading Federalist, the majority of the members of the Committee were the city's leading Republicans.

If all that was true, Pernick's four tables carry some weight. As rapidly as the fever spread, there was a political division over the response to it.

There are problems with Pernick's thesis. When Hutchinson toured Water Street, the crowded low access road between the harbor and the plateau on which the city extended, there was no medical debate allowing him to weigh the evidence from both sides. Hutchinson recognized that he didn't have all the evidence. He also reported that there may have been cases in Kensington, just north of Philadelphia, before the fevers struck Water Street. If that was true,  rotting coffee may have not caused the outbreak in the city.

Pernick identifies Dr. William Currie and Dr. Isaac Cathrall as importationists.  In August 1793 neither Currie nor Cathrall were convinced that the fever was imported. They were not sure it was contagious and did not call it yellow fever, Cathrall excused his slow recognition of that to the fact that in early August when he found victims in houses and families only two people got the disease while other boarders and family members remained healthy.

Currie did epidemiological research that encompassed more cases, and he quizzed family members who didn't get sick and talked to the Catholic priest. He knew of two French sailors who got sick but was unable to talk to their French doctor so he had no evidence that they died of yellow fever. When he stopped writing his report on the September 3 and sent it to the printers. he declined to say if the fever was imported or like the jail fever was bred in crowded places.

He included a newspaper essay by a doctor who remained anonymous that blamed the filth of Water Street for transforming the summer flu that had swept through the city into a more dangerous fever. Thanks to " the situation of the houses on the west side, being half buried under ground, the number of sailor taverns and huxter's shops, which are receptacles of all kinds of filth, dirt and nastiness, and which from their situation are excluded from the benefit of free ventilation," there was less pure air on that street than in any other parts of the city.

There was no evidence on the scene to persuade Rush and Hutchinson that the disease was imported. However, Pernick loads other ammunition to zero in on the Republican doctors. In a  1789 publication and his medical school lectures, Rush promulgated the theory that all diseases had a local origin which effectively closed his mind to the evidence around him.

However, in his account of the epidemic, published in February 1794, Rush credits the French refugees for bringing influenza to the city: "During the latter part of July, and the beginning of this month, a number of the distressed inhabitants of St Domingo, who had escaped the desolation of fire and sword, arrived in the city. Soon after their arrival, the influenza made its appearance, and spread rapidly among our citizens." Rush was no stranger to the city's wharves. From 1782 to 1792 he served as "one of the Inspectors of Sickly Vessels for the Port of Philadelphia." (Corner, Autobiography of BR, page 216)

Rush also thought the fever was contagious. When he changed his mind, he revised his account taking out all references to contagion. Since any contagious disease can be imported into a city, Rush could not categorically believe that yellow fever could not be imported. It's also fair to note that the refugees began arriving in late July, not in August at the same time yellow fever cases began to be treated by doctors. They also arrived in other US ports, especially Baltimore and New Orleans and there were no reports of yellow fever there.

Pernick also mistakes the politics of the refugees. He cites Child's French Refugee Life in the United States, but Child actually says that while the refugees supported the Revolution, they bitterly opposed the Girondin party then controlling France. They  blamed that party for freeing the slaves and igniting the violence in Haiti. Genet, the Girondin's man in America who was the darling of the Democratic Society, distrusted the refugees

If Rush and Hutchinson had blamed the refugees, one could argue that the Republican doctors did so to help Genet marginalize them. Plus, since both Rush and Hutchinson were prominent in the Abolition Society, blaming them would punish the refugee slave owners who soon made it clear that they had no intention of freeing the 800 slaves they brought to Philadelphia, despite the laws of Pennsylvania. 

However, Pernick suggests that Jefferson dominated the doctors. They participated in "Jeffersonian councils." By August Jefferson saw that Genet was hurting the Republican cause, so the less said about the French the better. Did Rush and Hutchinson get the word?

Indeed, in 1793 Rush wrote in his commonplace book: "Mr. Jefferson's conversation on all subjects is instructing. He is wise without formality, and maintains a consequence without pomp or distance." (Corner, page 228) But during the conversation preceding that observation, Jefferson chatted about regional variations in spoken Italian and French.

During July and August, Jefferson slept in a house along the Schuylkill and commuted to his office and cabinet meetings in the city. He invited Rush out for dinner in early August and Hutchinson on August 30. It would helped Pernick's thesis if Rush had been invited after he saw cases of yellow fever, and Hutchinson came before he reported to the governor. 

Jefferson invited the doctors to his dinners because he liked to talk about science as a relief from politics. The doctors were fellow members of the American Philosophical Society. Jefferson also liked a diversity of scientific opinions. He  invited Dr. Benjamin Smith Barton to dinner on the 30th. Pernick identifies at Barton as the sole Republican doctor who thought the fever was imported. 

Jefferson did talk politics with Hutchinson and was relieved to learn that Hutchinson recognized the danger Genet presented to the party. He passed on Hutchinson's observations about the epidemic in a letter to James Madison. He dealt with political news in another paragraph.

Jefferson left the city without any more communication with the doctors there. He rued Hutchinson's death as also bad for the party but did not establish contact with Dr. James Mease who replaced Hutchinson as Port Physician. In an earlier letter to Madison about the epidemic he mocked Hamilton's claim that he had the disease. In his last letter, he reported that Hamilton "had truly the fever, and is on the recovery, & pronounced out of danger." He listed prominent men who had died, noted the inefficacy of all treatments and that he would be in Virginia as soon as possible.

Hamilton's September 11 letter, sent as he left the city, was soon in the newspapers. He didn't mention politics. He expressed alarm at both the deaths in the city and flight from it: "It is natural to be afflicted not only at the mortality which is said to obtain, but at the consequences of that undue panic which is fast depopulating the city, and suspending business both public and private." He hoped Stevens' cure would stem the crisis. He was persuaded that "where pursued, [it] reduces [the fever] to one of little more than ordinary hazard." 

At least one person took that as a political statement. Rush blamed political animosity for what he thought was a blatant attack on his remedies. Rush was expecting the College of Physicians to endorse his remedies. Suddenly, Hamilton's letter addressed to the College appeared. 

However, Hamilton did not refer to Rush's treatment. He wrote that Stevens' "mode of treating the disorder varies essentially from that which has been generally practised...."

Rush had announced the efficacy of calomel at a meeting of the College on September 3. Dr. Adam Kuhn published a description of his remedies which were essentially the Stevens' West Indian cure on September 7. He credited Stevens for advising him. However, Kuhn recognized the need to purge constipated patients but recommended cream of tartar or castor oil, not calomel. 

Rush had also conferred with Stevens to learn the finer points of timing cold baths. Then Stevens wrote a letter to the College which was printed in the General Advertiser which happened to be the radical Republican newspaper published by Benjamin Franklin's grandson. He described his cure meticulously. (An article timed to elucidate political divides during the Covid pandemic  summarized Stevens' three long paragraphs of remedies as "staying clean, hydrated, and inhaling herbs." The author forgot to mention the teaspoon full of Laudanum, an opiate, and "Flannel clothes wrung out of spirits or Wine impregnated with spices may be applied to the pit of the stomach and changed frequently.")

Stevens specifically criticized violent purges as going against medical theory which they did. Rush well understood that, and heard similar complaints from other doctors. 

How much Hamilton's endorsement added to the popularity of the West Indian remedy is hard to gauge but it certainly enraged Rush. Pernick admits that there really was no Republican cure and no Federalist cure, but he can't resist characterizing Rush's response to Hamilton's perceived attack as creating Republican dogma. Rush attempted to "rally the Republican leadership behind his 'egalitarian' medicine." Rush promoted the idea that with calomel pills and a lancet, anyone could treat disease.

However, Rush did not write to either Jefferson, Madison or local Republican leaders during the epidemic. As evidence for the attempt to "rally" the party, Pernick quotes a sentence from a letter Rush wrote to Elias Boudinot on October 3: "Colonel Hamilton's remedies are now as unpopular in our city as his funding system is in Virginia and North Caroline."

Rush was addicted to using analogies, still that was likely an accurate observation. But it didn't reflect a rallying of Republican leaders around Rush's cure. The two most active organizers of the Democratic Society, Hutchinson and lawyer Jonathan Sergeant stayed in the city. Before he died in early September, Hutchinson refused Rush's remedies. So did Sergeant when he died in early October.

Boudinot was a member of congress from New Jersey, and a stalwart non-partisan who idolized George Washington and supported his administration, which is to say he was decidedly not a Republican. He was Rush's wife's uncle. Like Rush, he was a devout alumni of the Presbyterian College of New Jersey (which became Princeton,) Religious scruples accounted for Rush's opposition to Hamilton's financial schemes and he likely knew that Boudinot shared them. 

Rush offered his quip about the competing cure at the end of a long letter cataloguing the suffering of the city, including the death of Rush's sister. Boudinot had written offering financial help to the city and Rush advised him to send money to the "Mayor or setting committee of the city."

Despite Pernick's tables tracing the political divide, Rush did not distinguish between the Federalists mayor and the committee with its Republican majority. Nobody else did either. As far as is known, there was never any differences between the mayor and committee. In one of its first acts, it turned its back on what Pernick suggests had become the Republican take on the epidemic. It resolved to build a hospital just for fever patients and also build a hospital for sick emigrants: "that as the increased trade and population subjects the citizens to constant danger from the numbers that are daily arriving from foreign parts, where infectious disorders are frequently prevalent; that this subject be laid before the citizens at their next meeting, in order that some steps may be taken to bring the subject before the Legislature, that the evils now experienced may be avoided in future, by suitable and comfortable provision for those who may suffer a similar affliction."

The French refugees were not singled out. A ship filled with Irish emigrants had just arrived.

The point Pernick made in Table 4 remains: at least some Federalist leaders fled and at least some Republican leaders stayed. But Republican doctors didn't advise that at the beginning of the epidemic. Both Hutchinson and Rush told people to flee. The Pennsylvania legislature convened in late August. The Federalist leader of the state senate, Samuel Powel III asked Rush whether senators should continue doing business. Rush advised flight.

Once he discovered the efficacy of calomel, Rush advised everyone that it was safe to stay. Once Stevens cured Hamilton, both of those gentlemen advised that flight was not necessary. At least, two Federalist leaders, Powel and Timothy Pickering stayed in the city so they could get  medical advice from Rush. (Pernick notes Pickering's defection but excuses it because he and Rush were friends.) Powel died and Pickering lost a son.

Republicans who stayed were not necessarily there because of any supposed imperatives of the Republican Party. When they organized the Democratic Society, Hutchinson and Sergeant made Charles Biddle its secretary, much to the embarrassment of Biddle who knew nothing about it and had many Federalist friends. Just before he died, Hutchinson warned Biddle to leave the city, said he must stay to do his duty as a doctor, and thought they would never see each other again. Sergeant had wealth and family, Biddle credited other doomed lawyers for staying in the city to collect fees for writing wills. He  explained Sargeant's staying in the city as arising from "motives of benevolence."

Pernick imposes politics on men who can best be described as acting in a non-partisan manner. Nothing precluded the Democratic Society of Philadelphia from organizing a relief effort. Indeed, another society whose members were shut out of political life did just that. The African Society offered their services under the auspices of the mayor to collect the dead, cart the sick to the hospital and follow Rush's directions for treating the sick.

Religion or one's moral compass has a good deal more to do with one's reaction to a deadly epidemic than politics. At least in 1793, when the sick and vulnerable were threatened with being abandoned, citizens didn't look forward to the November election. Not a few thought that they were in Biblical times and that they could not escape God's rod and they survived by His grace. However, Pernick examines the sermons thundered from pulpits after the epidemic and finds a political divide.

Religious leaders that Pernick identifies as Federalists not surprisingly harped on the infidelity of the French revolution as reason enough to God to visit pestilence on a country that harbored pro-French vipers. It was more difficult to find anyone blaming Britain for the visitation but Pernick did. He found a newspaper article that blamed the epidemic on building a new theatre, and "the actors and retainers of the stage, who actually arrived here at the time when the fever raged with the utmost violence," were English.

Pernick has to scramble to sort out such an attack as Republican. The best he can do is associate it with a Quaker petition to the State legislature demanding that theatrical entertainments be banned. At the beginning of the Revolution the city did that and theatres were banned until 1789. Without evidence, Pernick suggests that Republicans in the legislature were sympathetic because they were building alliances with Quakers. Actually, leaders of all religious denominations supported the Quaker petition. Theocracy was an ill fit with Republican rhetoric. The legislature seems to have killed the petition in committee, the time honored way of saving both parties from taking sides.

More to the point of his monograph, once the debate about closing the theatre filled the newspapers, the dispute over the cause of the epidemic took a back seat. Not that it began with any political overtones. The first to mount a well documented attack on Rush's position was Matthew Carey, a fellow Republican.  Doctors divided with Rush eventually leading a rump of followers out of the College of Physicians. The Republican governor, Thomas Mifflin, decided to address both possible causes: stiffen quarantines and keep the port cleaner. It didn't become a raging political issue.

Once again a letter Rush wrote provided fodder for Pernick to line up on the Republican side of the religious debate over causes: "And Benjamin Rush, the Enlightenment man of science, commented in retrospect, 'I agree with you in deriving our physical calamities from moral causes.... We ascribe all the attributes if the Diety to the name of General Washington. It is considered by our citizens as the bulwark of our nation. God would cease to be what He is, if he did not visit us for these things.'"

Washington-worship caused the epidemic!

To begin with, as well as being a "man of science," Rush was a Millenarian who believed that the Second Coming was coming soon and it behooved man to pursue Truth and practice Righteousness. In 1792, he attended a Jewish wedding and had a chat with Dr. Nassy, a French Jew. Nassy explained that circumcision limits venereal disease. Rush asked Nassy if the unsettled state of affairs in Europe suggested the imminent return of the Messiah. (Corner, page 223)

Pernick was wrong to suggest that Rush was writing retrospectively about the 1793 epidemic. He wrote the letter during the 1798 yellow fever epidemic. Pernick cuts out Rush's main point which was that party spirit on both sides is to blame for God's disfavor: "Antifederal infidelity and Federal hypocrisy, with all the vices that flow from both, pervade every part of the United States. A bitter and unchristian spirit has likewise divided our citizens. We have not, it is true, erected a guillotine in our country, but enjoy similar spectacles of cruelty in the destruction of public and private character in our newspapers. We have not instituted divine honors to certain virtues in imitation of the inhabitants of Paris, but we ascribe all the attributes of the Deity to the name of George Washington."

If Pernick read the next paragraph in Rush's, he would have found evidence of Rush himself modifying the supposed dogmatic republican strictures of 1793: "Our fever increases. It is much more malignant than in 1793 and 1797, and requires in many instances a different treatment from the fever of those years. In many cases it will bear but small bleedings, and in some none at all. Those cases which bear plentiful bleeding generally end favorably." Rush also noted that he had slept "two miles from the city" and then went to visit patients in the city and worked at the fever hospital which was on the outskirts of the city. He also implied that there was no rancor that Pernick ascribed to partisan politics during the 1798 epidemic. He wrote in a P.S. "No part of this letter must be made public. Persecution at present sleeps against me."

During a smaller yellow fever in epidemic in 1797, the editor of Porcupine's Gazette began unmercifully attacking Rush for replicating the French Revolution with his bloody remedies. William Cobbett, an Englishman, was arguably the best newspaper writer in the city and had a wide following. Others, including Dr. Currie, attacked Rush leading to duels and lawsuits. It didn't completely divide Republicans and Federalists. Rush's old friend President John Adams appointed him to a government sinecure, treasurer of the Mint.

Still, one could give Pernick's thesis a better run through the 1797 epidemic then it had during the 1793 epidemic. Then in 1798, when party animosity reached its peak in Philadelphia, yellow fever demolished Pernick's thesis.

The city had a health committee chaired by a Republican. On September 1, it instructed everyone to leave the city. Cobbett decreed that bickering about the cause of the epidemic could wait until it was over. He left the city. Two partisan editors stayed, tried to raise the political stakes, and both died of the fever. The radical Republican Bache ignored Rush's cure and took cold baths in vain.

There was a possible political divide over providing for the poor in the city who had no place to go. One camp was private, the other public. When the city reopened, leaders of both political parties endorsed inspections of suspect houses and all outhouses, where, come to think of it, "Politics, Parties and Pestilence" belongs.

Exploring the uses of political rhetoric is something political scientists do but taking discourse out of context to create a dynamic that didn't exist does not help us understand the 1793 epidemic. Forget Pernick. In their 925 page history The Age of Federalism: The Early American Republic, 1788 - 1800, Stanley Elkins and Eric McKitrick, state the obvious in the paragraph they devote to the epidemic: "The epidemic of yellow fever in Philadelphia which took some four thousand lives during the months of September and October had as one of its effects that of bringing politics to a temporary standstill...." Their point is that Philadelphia newspaper who were then the fount of most political news were otherwise occupied or ceased publication.

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