\u27We live in the midst of death\u27: Medical Theory, Public Health, and the 1793 Yellow Fever Epidemic

Much has been written on the history of disease in early America, especially surrounding the 1793 yellow fever epidemic that ravaged Philadelphia. The stories of the men and women who lived through and were affected by it, including the physicians who treated the victims, have been thoroughly covered by historians. What has yet to be discussed is the medical context in which this epidemic existed. Medical education, scientific thought, and particularly past experiences came together during this outbreak to influence both the medical establishment and governments’ decisions regarding their appropriate response. Doctors’ medical education predisposed them to beliefs and preferred treatments, including the understanding of disease. But it was a doctor’s prior experience with tropical diseases that influenced how they reacted during this epidemic. Those like Philadelphian Benjamin Rush, who practiced in a single town, were unlikely to come into contact with yellow fever and were less likely to accept new theories concerning it. Physicians such as Frenchman Jean Devèze, a physician in Haiti with the French army, not only had more clinical knowledge overall but were also open to different methods based on their prior experiences. Devèze’s use of autopsy and empirical medicine came as a result of his background and was something Rush did not have exposure to. Using the 1793 epidemic and these two prominent doctors, I will demonstrate that physicians’ formal education in fact formed a small role in how they treated yellow fever, while their prior experience throughout the Atlantic played a significant role in medical personnel’s response to the epidemic than is currently addressed. In doing so this thesis will expand the history written on the 1793 epidemic beyond the standard social history and place the event within the larger context of medical history, as well as contribute to the medical and public health history of America