Too Short for a Blog Post, Too Long for a Tweet 227 (1 of 2)

I am only two-thirds through Ron Chernow's "Alexander Hamilton," but wanted to post one extended excerpt for your reading pleasure, and much later I will be done with the book and will share other passages.  This portion is presented with commentary, in true "TSFABPTLFAT" fashion, although I can't resist repeating the old saw that "history may not repeat itself but it often rhymes."  Enjoy.

While Washington meditated the fate of Citizen Genêt that August, Philadelphia was beset by a threat far more fearsome than the French minister appealing to the American people. Some residents who lived near the wharves began to sicken and die from a ghastly disease that shook the body with chills and severe muscular pain. The red-eyed victims belched up black vomit from bleeding stomachs, and their skins turned a hideous jaundiced color. The onset of the yellow-fever epidemic, the worst to have befallen the young country thus far, has been traced to many sources. The disease had ravaged the West Indies that year, and an influx of refugees after the slave revolt in Santo Domingo may have introduced it to Philadelphia. A wet spring giving way to an uncommonly hot, dry summer may have helped to spread the disease. Sanitary conditions were atrocious in many parts of town, with residents dumping refuse into clogged, filthy gutters and drinking water from wells contaminated by outhouses. 

 

 

By late August, twenty people per day were expiring from the epidemic, which was to claim more than four thousand lives, bringing government and commerce to a standstill. Coffin makers cried their wares in front of City Hall. People didn’t understand that the disease was transmitted by mosquitoes but knew it could be communicated by contact with victims. People stopped shaking hands and stuck to the middle of the street to avoid other pedestrians. Some people covered their noses with vinegar-dipped handkerchiefs while others chewed garlic, releasing malodorous clouds that could be smelled several feet away. The safest course was to flee the city, and twenty thousand people did just that, thinning the ranks of government employees. By early September, six clerks in Hamilton’s Treasury Department and seven in the Customs Service had the disease, as did three Post Office employees. 

 

The city’s preeminent physician was the indomitable Dr. Benjamin Rush—“a sprightly, pretty fellow,” as John Adams described him—who scarcely slept during the pestilence, flitting bravely from house to house, treating rich and poor alike. This required intestinal fortitude as carts rumbled across the cobblestones, carrying piles of cadavers, and residents were loudly exhorted, “Bring out your dead.” Rush had warning signs posted outside affected houses. In treating yellow fever, Rush adopted an approach that now sounds barbaric: he bled and purged the victim, a process frightful to behold. He emptied the patient’s bowels four or five times, using a gruesome mixture of potions and enemas, before draining off ten to twelve ounces of blood to lower the pulse. For good measure, he induced mild vomiting. This regimen was repeated two or three times daily. Rush was a man of exemplary courage, but it is questionable whether he saved lives or only hastened deaths by weakening the body’s natural defenses. 

 

On September 5, 1793, Hamilton contracted a violent case of yellow fever. He and Eliza repaired to their summer residence, a mansion called Fair Hill that lay two and a half miles from town and was owned by Philadelphia merchant Joseph P. Norris. Their children were sequestered at an adjoining house. To calm them, Eliza would appear at a window and wave to them. Pretty soon, Eliza had the illness, and the children were evacuated to the Schuylers in Albany. In an astonishing storybook coincidence, Hamilton’s boyhood friend from St. Croix, Edward Stevens, had turned up in Philadelphia and now attended to the couple. A prosperous, distinguished physician, Stevens had practiced in St. Croix for ten years until his wife, Eleonora, had died the previous year. He then married a rich widow named Hester Amory and moved to Philadelphia. 

 

Having treated yellow-fever victims in the islands, Stevens dissented from the American dogma of bloodletting and bowel purges, which he thought only debilitated patients. He argued for remedies that were “cordial, stimulating, and tonic.” To strengthen patients, Stevens administered stiff doses of quinine called “Peruvian bark” as well as aged Madeira. He also submerged them in cold baths before giving them glasses of brandy topped with burned cinnamon. He sedated patients nightly with a tincture of opium (laudanum). To stop vomiting, patients quaffed an aromatic blend of camomile flowers, oil of peppermint, and lavender spirits. 

 

When they learned of Hamilton’s illness, George and Martha Washington sent sympathy notes and six bottles of vintage wine. “With extreme concern, I receive the expression of your apprehensions that you are in the first stages of the prevailing fever,” the president wrote to Hamilton. Quite different was the response of Thomas Jefferson, who wrote a misguided letter to Madison that accused Hamilton of cowardice, hypochondria, and fakery: “His family think him in danger and he puts himself so by his excessive alarm. He had been miserable several days before from a firm persuasion he should catch it. A man as timid as he is on the water, as timid on horseback, as timid in sickness, would be a phenomenon if his courage, of which he has the reputation in military occasions, were genuine. His friends, who have not seen him, suspect it is only an autumnal fever he has.” At one stroke, Jefferson heaped heartless abuse on a sick man and inverted reality. Not only did Hamilton have yellow fever, but he had shown outstanding valor during the Revolution while Jefferson, as Virginia governor, had cravenly fled into the woods before the advancing British troops. 

 

Edward Stevens achieved spectacular results with Alexander and Elizabeth Hamilton, curing them within five days. Trusting a man who may have been Alexander’s biological brother, the Hamiltons were saved while countless others perished. Ever since King’s College, Hamilton had been interested in medicine; he had had his children inoculated against smallpox. He was not content to be a passive patient. No sooner had Stevens cured him than Hamilton wanted to proselytize for his approach. With Eliza responding well to treatment, he published an open letter to the College of Physicians, hoping to stop “that undue panic which is fast depopulating the city and suspending business both public and private.” Praising Stevens, he said his friend would gladly relate his methods to the medical faculty. 

 

Hamilton’s letter created a sensation. Even in illness, he was shadowed by controversy, since he had implicitly rebuked Benjamin Rush. Rush gave Stevens’s methods a fair chance for several days, tossing buckets of cold water on patients and injecting quinine into their bowels, but he could not reproduce Stevens’s results and reverted to the rigors of bleed-and-purge. Unfortunately, this legitimate clash of medical viewpoints took on political overtones. Rush was an abolitionist and a passionate, outspoken reformer who later published a groundbreaking treatise on mental illness. He was also a convinced partisan of Jefferson. So when Hamilton lauded Stevens’s yellow-fever treatment as superior to the “standard” method, Rush was perhaps predisposed to take offense. 

 

An unfortunate medical dispute erupted between the “Republican” method of Rush and the “Federalist” alternative of Stevens. Rush was not averse to casting the controversy in political terms. “Colonel Hamilton’s remedies are now as unpopular in our city as his funding system is in Virginia and North Carolina,” he declared. He was persuaded that Hamilton’s open letter betrayed political bias against him: “I think it probable that if the new remedies had been introduced by any other person than a decided democrat and a friend of Madison and Jefferson, they would have met with less opposition from Colonel Hamilton.” Rush, like Jefferson, refused to believe that Hamilton had had yellow fever and pooh-poohed it as an overblown cold. “Colonel Hamilton’s letter has cost our city several hundred inhabitants,” he told Elias Boudinot, asserting that the Hamiltons had suffered “nothing but common remitting fevers from cold instead of the malignant contagion.” Though Benjamin Rush blamed Alexander Hamilton for yellow-fever deaths, the public ended up blaming Rush. After a second yellow-fever epidemic in 1797 and more copious bloodletting, Rush lost so many patients that President Adams rescued him by appointing him treasurer of the U.S. Mint. 

 

Alexander and Eliza eagerly awaited a reunion with their children in Albany. To make sure they were fully recovered, they relaxed and took carriage rides for two or three days before leaving Philadelphia on September 15. They set aside any garments that might have been infected and packed only fresh clothing. It was a long, wearisome trip. On the first leg, they stopped at a tavern packed with terrified refugees from Philadelphia, who refused to allow the Hamiltons to enter until the landlord insisted upon it. At town after town, they had to contend with barriers erected to keep out potentially contagious Philadelphians. Even New York posted guards at entrances to the city to deter fugitives from the plague-ridden capital.