Americans in the revolutionary and early national period were frequently exposed to disease and suffered from several epidemics. As a result, their lives were shorter and often were marred by physical debilitation and personal trial. Many of the diseases remain unnamed and resulted from poor sanitation, unhealthy drinking water, as well as unidentified microbes. The two most common diseases were malaria and tuberculosis, but the two most devastating diseases were smallpox and yellow fever.
Malaria, often called “intermittent fever,” was endemic in much of the South wherever the anopheles mosquito could breed year round. Creating recurrent bouts of fever, chills, weakness, and the shakes in its victim, malaria did not necessarily kill, but it left an individual susceptible to other illnesses. Most people with malaria struggled with the disease, attempting to maintain their work routine as best as possible. When there was no fever, they might function normally enough. If their hands started shaking or they had an “ague fit,” they had to persevere and move on. Because many African Americans had a hereditary sickle cell trait in their blood, they were less susceptible to malaria.
Tuberculosis or, as it was called at the time, “consumption” was transferred by close contact when a sick person coughed or sneezed. The disease was prevalent in cities with compact housing and crowded workplaces. Consumption acted slowly, destroying its victim’s lungs over the course of years. Although in the 19th the century consumption became romanticized as a disease that struck young women, supposedly making them pallidly beautiful even as it stole their lives, the reality was often harsh. Tuberculosis had a devastating impact on poor families, removing breadwinners from gainful employment, while one person after another caught the disease and slowly died.
If malaria and tuberculosis were persistent and worked their harm over time, smallpox and yellow fever were episodic and virulent. Smallpox as a disease was on the decline by the end of the 18th century because of the practice of variolation—inoculation by purposefully exposing the blood of an individual to infected matter. A mild form of the disease followed with a much lower mortality rate than if the person had caught the disease naturally. There was some popular opposition to this method since it favored the affluent over the poor. Someone with extra money could afford both the medical expense and the time away from work to effect the treatment. Moreover, common folk feared that a person who was inoculated became a carrier of the disease to the rest of the community. By the end of the Revolutionary War (1775-83), with many men in the Continental army inoculated, objections decreased. In 1796 English physician Edward Jenner found a safer vaccination based on cowpox. Within a decade, this form of inoculation had become widespread in the United States leading to a further decline in smallpox.
Yellow fever, which had appeared occasionally in the colonial period, replaced smallpox as the disease most dreaded in the early national era. Like malaria, yellow fever was transmitted by a mosquito. But it was not endemic. Instead, the disease and the mosquito had to travel from hotter climates—usually the West Indies. In the 1790s yellow fever appeared in several port cities in the United States with dramatic results. Philadelphia in 1793, the worst year for the epidemic, lost almost 10 percent of its population. The onset of the disease was sudden, a person would feel ill, run a fever, vomit black material, and turn a telltale jaundice yellow. Mortality was high. Within days, sometimes hours, the victim was dead. No one connected the disease with a mosquito, but everyone knew that it struck only in the summer time and lasted until the first frost. Each June and July urban denizens began to watch for reports of yellow fever. At the first sign of trouble, masses of people exited the city. The poor, who often lived close to the waterfront, were left to suffer. Not every year brought yellow fever, but the experience became seared into popular memory. For decades after the outbreak of 1793 the people of Philadelphia would remember the call “bring out your dead” and the procession of coffins in the street.
See also medicine.
Further reading: Jack Larkin, The Reshaping of Everyday Life, 1790-1840 (New York: Harper & Row, 1988); J. H. Powell, Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793, Philadelphia: University of Pennsylvania Press, 1949).
World History
