They are dying on our right hand and on our left.

We live in the midst of death.

Isaac Heston wrote this letter to his brother on September 19th, 1793.

Ten days later, he was dead.

Heston lived in Philadelphia, which was the capital and heart of the United States.

Only about a decade after the American Revolution.

A mysterious disease paralyzed the capital with sickness, fear, and death, threatening the stability of a still developing nation.

And just when it seemed like we might lose Philadelphia for good, an unexpected, community, Mistrusted and maligned, stepped up to save the city.

I'm Harini Bhat, and this is in the margins.

In the 1790s, Philadelphia was the place to be.

Culture, politics, and commerce all intersected to create a budding city of 50,000, nicknamed the "Athens of America".

By 1790, 2000, free African Americans were laying the groundwork for what would become a Black Metropolis.

Pennsylvania had begun the gradual abolition of slavery in 1780, prohibiting the importation of enslaved people and establishing a timeline for freedom for all children born in the state.

It was late July in 1793 when the first cases appeared.

Families were shocked as their previously healthy relatives succumbed to sudden illness in a matter of days.

These mysterious deaths weren't connected until Dr. Benjamin Rush entered the scene.

He visited the home of his colleague, Doctor Hugh Hodge, because his daughter wasn't feeling well.

Appearing unnaturally yellow, feverish and vomiting blood.

Later that day, she died.

As Dr.

Rush saw more patients with the same symptoms.

He quickly realized that yellow fever was spreading throughout the city, but identifying the disease was different than knowing how to treat it.

We now know that yellow fever is caused by bites from infected mosquitoes, But this was not discovered until 1900.

The transatlantic slave trade brought yellow fever from Africa to the tropical regions of the New World, where it took root.

It popped up in various locales, occasionally striking port cities farther north, like Philadelphia.

Summer conditions in Philadelphia, extremely hot weather, areas of standing water, made it easy for virus infected mosquitoes to breed.

Combined with the crowded streets and courtyards of a bustling city an epidemic was in the making.

Panic rippled through the city as newspapers published reports about the disease.

Secretary of the Treasury Alexander Hamilton and other Federalists thought yellow fever was brought in by immigrants, specifically the French refugees fleeing the Haitian Revolution, and wanted to close the ports as a result.

But Doctor Rush, a Republican, blamed miasma or impure air and advocated cleaning up the city.

Hamilton believed in rest, quinine and wine, a remedy known as the West Indian cure or the French treatment, and rushed the bloodletting and doses of mercury would do the trick.

Both sides claimed favorable results for their treatments while attacking their opponents of remedies as ineffective or dangerous.

In reality, none of these treatments were effective.

To this day, there is no actual cure for yellow fever.

While everyone searched for answers, one theory began to gain traction.

Whispers spread that black people were immune to this disease.

Prior to the catastrophe in Philadelphia, a doctor by the name of John Lining wrote down his observations about yellow fever in 1748.

In Charleston, South Carolina.

In this document, he noted that Black people were frequently exposed to the illness, but almost never got sick.

His observations were likely influenced by the fact that enslaved people who had survived yellow fever at home in West Africa gained immunity to the illness.

There is no racial immunity to yellow fever, but Lining's observations influenced other people, those with power and their understanding of yellow fever's impact on black people.

This included Dr. Benjamin Rush.

By 1790, the United States was home to almost 700,000 enslaved people.

Some newly freed people from other parts of the country made their way to Philadelphia seeking a freer life, as did refugees and fugitive slaves.

When Richard Allen and Absalom Jones created the Free African Society to improve the conditions of the city's Black community, a promise of a better life seemed to be on the horizon.

The organization taught trades for Employment Advancement provided mutual aid for free Black people and promoted general solidarity with those still enslaved.

Jones and Allen championed Black people's right to participate equally in American society.

The Free African society would play a vital role in maintaining the last remnants of stability in Philadelphia.

Rush begged every Philadelphian who could to flee the city.

40% of the entire city's population.

So about 20,000 people abandoned the rapidly deteriorating city.

The majority of Black and working class families had no access to country homes for quarantine.

This left just a handful of civic leaders, people without a place to flee to, and free black people to pick up the pieces.

Despite his advice to evacuate, Rush chose to stay behind to tend to the many who were sick and desperate.

"Parents desert their children as soon as they are infected," Rush lamented.

"And in every room you enter, you see no person but a solitary black man or woman near the sick," unquote.

From municipalities to the state, all the way up to the federal government.

Philadelphia broke down.

Other cities, quarantined Philadelphians to help quell the spread.

After the city's massive exodus volunteers were needed to transport and tend to the sick, assist the grieving, and dispose of the growing piles of dead bodies.

Prominent voices like Dr.

Rush and Mayor Matthew Clarkson pleaded with the Black population to stay behind and help care for victims of yellow fever.

Based on the contemporary theory of Black "immunity".

Absalom Jones, Richard Allen and the members of the Free African Society accepted the challenge.

Any assistance these newly trained black nurses could provide, they did.

Rush relied heavily on Jones and Allen to give postmortem reports on patients who died.

The pair arranged burials, and another member, William Gray, was instrumental in recruiting Black nurses.

Member Sarah Bass was a widow who went from sickbed to sickbed to offer any services that she could, and refused any compensation for her bravery.

Thousands of Philadelphians relied on Dr.

Rush, and Dr.

Rush relied on a former slave named Marcus Marsh, an invaluable teammate.

During Rush's own bout with yellow fever, Marcus' skills were essential to get Rush back to his patients.

In another letter to his wife, Julia, rush wrote, quote, "I cannot tell you how much we all owe to Marcus," unquote.

As the death toll rose, houses were boarded up or abandoned.

The streets were littered with dead bodies for days after a person passed since there was a deep unease of catching the illness from what they believed was impure air.

The need for help was so dire that even those who were in jail were granted a release in exchange for being volunteers.

Isolation became the new normal.

Do you think volunteer nurses like Marcus were ever thanked for their help saving the capital?

Well, let's take a look.

Matthew Carey, a prominent publisher, wrote an instant history of the epidemic in which he accused black volunteers of profiting from the yellow fever crisis.

Even though Carey himself initially fled the city, Carey cited Doctor Linus interpretations about why it seemed that descending of enslaved Africans were, in his words, quote, not liable to this fever, unquote.

This commonly held belief fueled Carey's jealous tirade against the Black volunteers and Dr.

Rush's insistence that the Free African Society was key to saving Philadelphia.

It's estimated that a few hundred black people were taken by this disease.

In his account of the crisis, Carey did praise Jones, Allen and the Black volunteers in perfunctory terms, but then proceeded to lay out unsubstantiated allegations of price gouging and theft.

Within two months, Carey published four editions of his account and sold about 10,000 copies.

The widespread circulation of Carey's account drove Jones and Allen to respond in print less than two months later.

In it, they refuted Carey's allegations and insisted that if it hadn't been for the Black community that stepped forward while others fled, there would have been more suffering and more deaths.

They said, quote, "We have buried several hundreds of poor persons and strangers for which service we have never received, nor never asked any compensation."

"It is unpleasant for us to make these remarks, but justice to our color demands it."

As soon as the temperatures cooled down and the mosquito populations shrunk, the fever began to retreat and the city returned to normalcy.

Around 5000 people are estimated to have perished from a population of 50,000.

Philadelphia's Black community survived.

Free Black Americans found work as sailors, dock workers, day laborers, and domestic servants.

Some turned lifelong skills exploited for others into business built to serve the growing free black population around the city.

Along with yellow fever, other illnesses would ravage the United States, including cholera, bubonic plague, and smallpox.

While each disease is distinct, Most are characterized by persistent health inequalities, high death tolls, and the blame directed at ethnic minorities.

When San Francisco faced the bubonic plague, Chinese immigrants were falsely blamed and persecuted.

Cholera was blamed on Irish immigrants, and Asian communities faced racist attacks during Covid 19.

At the same time, according to a 2024 report from the National Academies of Sciences, Engineering and Medicine.

Racial and ethnic inequities contribute to millions of premature deaths, resulting in loss of years of life and economic productivity, The experience of Covid 19 reminded us not only of the importance of the medical community, but also of how much we rely on a much larger and less publicly visible network of caregivers and service providers.

Not unlike the black volunteers of 1793.

Philadelphia's brush with disaster and its unappreciated saviors is a reminder that there is tremendous strength within our own communities.

Banding together in difficult times is the first step towards an America where we all get to live a long, healthy life.

Thank you so much for watching this episode of In the Margins.

In times of Crisis, who do you all turn to?

Oh.

Oh!

Oh.

Oh.

They are dying on her right hand and on her left.

To see the hearse go by is now so common that we hardly take notice of it.

We live in the midst of death.

Isaac Heston wrote this letter to his brother on September 19th, 1793.

Ten days later, he was dead.

Okay, let's do that a few times.

I'm just gonna.

The.

You might hear the sofa make a few noises because of the leather.