When the Yellow Fever Outbreak of 1793 Sent the Wealthy Fleeing Philadelphia

The Capital in Crisis: Philadelphia, 1793

In the summer of 1793, Philadelphia was the largest city in the United States and the seat of the federal government. It was also about to become the site of the worst urban epidemic in the young republic’s history. Thousands of residents fell ill with fevers and chills, jaundiced skin, stomach pains, and vomit tinged black with blood. By late August, as the death toll climbed, wealthy Philadelphians fled in droves — including Secretary of State Thomas Jefferson, who wrote that September that the sickness “is called a yellow fever, but is like nothing known or read of by the Physicians.”

What makes 1793 historically significant is not only the disease, but who stayed. Philadelphia’s free African American community largely remained in the city and was enlisted to nurse the sick, bury the dead, and sustain the city’s essential labor. Their story — told in detail by ministers Richard Allen and Absalom Jones — is one of the earliest documented acts of organized Black civic leadership, mutual aid, and written protest against racial slander in the United States. It is a founding chapter in the history of traditional and community-based healing in North America, and it belongs alongside the broader chronicle of American Revolution-era upheaval, in which Native nations to the west were simultaneously defending their own lands and sovereignties while the Atlantic seaboard convulsed with war and disease.

The Nature of Yellow Fever and Contested Origins

A Disease Nobody Understood

At the time, no one knew what caused yellow fever or how it spread. One theory held that the disease arrived aboard a ship carrying French refugees fleeing the slave rebellion in Santo Domingo (modern Haiti), where the epidemic was raging. Another theory — championed by Dr. Benjamin Rush, the city’s leading physician and a signer of the Declaration of Independence — held that the illness arose from Philadelphia’s poor sanitation and corrupted air, the miasma produced by rotting matter along the waterfront.

In the absence of reliable knowledge, Philadelphians improvised protective rituals: keeping their distance from one another, avoiding handshakes, covering their faces with handkerchiefs dipped in vinegar, or smoking tobacco in the belief that it would prevent them from breathing contaminated air. Cases clustered near the Arch Street Wharf, where some of the first infections were identified.

The Great Exodus: Washington, Hamilton, and the Wealthy Depart

Those with the means to leave did so. Thomas Jefferson left the city. President George Washington returned to Mount Vernon, attributing his departure to the concerns of his wife, Martha. Alexander Hamilton contracted yellow fever early in the epidemic and removed his family to their summer home a few miles outside the city; his wife Eliza soon fell ill as well, and their children were evacuated to her parents’ home in Albany, New York. Both recovered under the care of Dr. Edward Stevens, a boyhood friend of Hamilton’s from St. Croix whom he had re-encountered in Philadelphia.

Roughly 20,000 Philadelphians — nearly half the city’s population — eventually left, and among the emigrants were many of the city’s doctors, who feared for their own lives. Rush remained, treating rich and poor alike, losing his sister to the disease and falling ill himself before recovering. Yet his understanding of yellow fever was no sounder than anyone else’s: his harsh regimen of bloodletting, “Mercurial Sweating Powder,” and forced vomiting did not curb transmission, and critics charged that it intensified patients’ suffering. Hamilton himself took up his pen to promote the gentler methods prescribed by his own physician — cold baths, Madeira wine, hot brandy, and large doses of quinine, then called “Peruvian bark.” Stevens’ homeopathic approach proved no more effective than Rush’s traditional one. By the time the epidemic subsided in November 1793, it had killed roughly 5,000 people, about one-tenth of Philadelphia’s population, and infected many thousands more.

Who Cared for the Sick: Race, Medicine, and Misconception

Rush’s letter to his wife Julia, who had taken the couple’s children to Princeton, New Jersey, captured the social collapse of the crisis: “Parents desert their children as soon as they are infected, and in every room you enter you see no person but a solitary black man or woman near the sick. Many people thrust their parents into the street as soon as they complain of a headache.”

As that letter suggests, Rush enlisted members of Philadelphia’s free African American community to nurse the fever’s victims and perform the essential labor that kept the city running. He and other white physicians initially — and wrongly — believed that African Americans were immune to yellow fever, an assumption grounded in the era’s supposed biological hierarchies of race rather than in evidence. That false premise became a lethal burden: Black nurses and gravediggers were sent into the most infectious households in the city, and many died as a result.

Rush himself was an ardent abolitionist who had supported the efforts of the city’s Black community to form their own congregations in protest against segregation in white-led churches. The labor of the epidemic’s Black volunteers was organized largely under the leadership of Richard Allen, co-founder of the African Methodist Episcopal Church, and his fellow minister Absalom Jones. Their work stands within a long tradition of community stewardship and caregiving that also connects to the wider history of leadership and governance roles held by women and community leaders across Indigenous and African American societies in early America.

The Carey Accusation and the First Black Copyrighted Pamphlet

An Attack on Black Reputation

When the publisher Mathew Carey, who served on the city’s health committee, issued his account of the epidemic beginning in October 1793, he accused members of Philadelphia’s free Black community of profiting from the epidemic and even of stealing from the houses of fever victims.

Allen and Jones Answer With Evidence

In response, Allen and Jones published their own pamphlet in early 1794, refuting Carey’s accusations point by point. They included eyewitness testimony of the work Black Philadelphians performed in treating patients, along with documentation of payments and expenses. The weight of that documentation forced Carey to revise his chronicle in later editions. Their work was the first copyrighted pamphlet written by Black authors in the nation’s history: A Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, in the Year 1793. It documented the racism and poor treatment free African Americans endured even as they played a decisive role in fighting the most serious epidemic in the history of the still-young republic.

The Scientific Reckoning: 1900 and the Mosquito

Despite decades of research following the 1793 outbreak, it would take more than a century — and a devastating outbreak among troops during the Spanish-American War — before Dr. Walter Reed demonstrated in 1900 that mosquitoes carried yellow fever. The confirmation overturned both the miasma theory and the importation theory as sole explanations, and validated the vector hypothesis long promoted by Cuban physician Dr. Carlos Finlay. It also retroactively explained why the Black nurses of 1793 were placed in such extraordinary danger by a myth of racial immunity.

The 1793 epidemic belongs to the same revolutionary era that reshaped the continent’s political landscape — an era in which the new United States was also expanding westward into Native homelands and renegotiating the diplomatic balance with sovereign tribal nations. The decade produced the Battle of Fallen Timbers in 1794 and the Treaty of Greenville that reshaped the Ohio Country, events that were unfolding concurrently with the Philadelphia crisis and that reveal how intimately public health, national expansion, and Indigenous sovereignty were interwoven in the founding decade.

Historical Context & Key Cultural Takeaways

• The epidemic reshaped governance. With Washington, Jefferson, Hamilton, and much of the federal apparatus absent, Philadelphia’s survival depended on local institutions, volunteer networks, and the free Black community that stayed.
• Race was weaponized as medical theory. The false belief that African Americans were immune to yellow fever channeled Black laborers into the highest-risk work of the epidemic, with fatal consequences.
• The Allen–Jones pamphlet is a landmark American document. Written and published in 1794, it was the first copyrighted pamphlet authored by African Americans in the United States, and it fused advocacy with meticulous record-keeping.
• Rush’s reputation is historically complex. He was a committed abolitionist and a steadfast caregiver who remained in the city — and simultaneously a practitioner whose depletive treatments are judged ineffective and harmful by modern standards.
• The scientific truth arrived late. Walter Reed’s 1900 confirmation that mosquitoes transmitted yellow fever closed a 107-year gap between the Philadelphia outbreak and a correct understanding of its cause.
• Native and African American histories often share a colonial context. Both communities were subjected to racialized assumptions about their bodies, both resisted through organized institutions and published testimony, and both preserved community memory in written and oral form after epidemics and removal.

Frequently Asked Questions

What caused the 1793 Philadelphia yellow fever epidemic? Contemporaries did not know. Two rival explanations dominated: importation aboard a ship carrying refugees from Santo Domingo, and local “miasma” generated by unsanitary conditions. Neither was correct in full. In 1900, Dr. Walter Reed demonstrated that yellow fever is transmitted by mosquitoes, validating the vector hypothesis first advanced by Dr. Carlos Finlay of Cuba.

Who were Richard Allen and Absalom Jones? Richard Allen was co-founder of the African Methodist Episcopal Church; Absalom Jones was a fellow minister and community leader in Philadelphia. Together they organized Black volunteers during the 1793 epidemic and, in 1794, published A Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, in the Year 1793.

Why is the Allen–Jones pamphlet historically important? It was the first copyrighted pamphlet written by Black authors in United States history. It combined eyewitness testimony with documented payments and expenses to rebut publisher Mathew Carey’s charge that Black Philadelphians had profited from the epidemic. The evidence forced Carey to revise his account in later editions.

Did Benjamin Rush really believe African Americans were immune? Yes. Rush and other white physicians of the period wrongly assumed that African Americans could not contract yellow fever. Acting on that false premise, they assigned Black volunteers to the most dangerous nursing and burial work, and many of those volunteers died.

How many people died in the 1793 outbreak? Approximately 5,000 people died, roughly one-tenth of Philadelphia’s population at the time. Around 20,000 residents — nearly half the city — fled, and thousands more were infected without dying.

Cultural Legacy and Modern Preservation

The 1793 epidemic is remembered today less for its medical facts than for the moral record it left behind. Richard Allen and Absalom Jones transformed lived experience into documented history — a counter-archive against slander. Their pamphlet, the Mother Bethel African Methodist Episcopal Church that Allen founded in Philadelphia, and the ongoing scholarship of the College of Physicians of Philadelphia’s Mütter Museum preserve a record of an epidemic that shaped the young nation’s understanding of public health, race, and civic duty. That tradition of documented community care echoed across the longer history of American cultures defending their institutions against erasure, from the founding decade through today.