Churches in Philadelphia never closed during the epidemic. Given the nature of the disease, it wouldn’t have made a difference either way. If government officials had ordered them closed, there’s good reason to believe that devout Philadelphians would have defied or resisted such orders.

Do not read this book before eating, or in the midst of a sleepless night. For it is a revolting book, filled with the disgusting details of a loathsome disease.

Sounds like the opening paragraph of a one-star review by a merciless critic, but it’s not. It’s from the 1949 preface to a book by the book’s author himself, J. H. Powell. Titled Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793, it is “the story of a foul and fantastic pestilence, striking without warning in all classes of society,” a true account of “people sick in body and heart, astonished and fearful, paralyzed by the mysterious obscenity about them.”

I thoroughly enjoyed it—the book, that is.

Powell brings to life the people and events of the worst epidemic in American history—yes, worse than the Wuhan coronavirus of 2019-2020 and the Spanish Flu of 1918. Though it was localized in Philadelphia, it killed nearly ten percent of the city of 51,000 people between August 1 and November 9, 1793. That’s about ten times the death rate in the U.S. from today’s pandemic. More than 40 percent of Philadelphians fled into the countryside to escape a disease whose origin (a virus spread by the bite of a mosquito) no one would know for another hundred years.

New interest in historic health disasters is drawing attention to Powell’s book, as well as another good one from 2003, An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793 by Jim Murphy. For this essay, I draw passages from both volumes.

Philadelphia was America’s national capital and headquarters of the federal government in 1793. By act of Congress, the capital wouldn’t move to what is now Washington, D.C. for another seven years. President George Washington had commenced his second term in March. Five months later, in the midst of a hot, wet summer, Philadelphians suddenly took sick in huge numbers, leading quickly to scores of deaths each day. What did the Washington administration do in response?

Nothing. That’s all it could do. It possessed no constitutional duty in the matter and even less experience and expertise. No one argued there were epidemiological exceptions to the First Amendment or, for that matter, to any other provisions in the document ratified just four years earlier. So the federal government never got involved.

Even if the federal government possessed the power to jump into the crisis, it’s hard to conceive of any action it might have taken that would have better met the challenge than what Philadelphians did, crude though it seems by today’s standards. The feds were there, on the scene, but possessed no special knowledge the locals did not also have. Yellow fever is not contagious from one person to another. The disease requires a mosquito in between and nobody knew that then. Lockdowns would likely have made little difference.

The one big issue the Washington administration had to decide—whether to convene Congress in the fall at its Philadelphia location or somewhere else—prompted sharp views on both sides. Thomas Jefferson and James Madison (both of an Anti-Federalist bent) told the President he had no authority to move the site where Congress met, so it would have to be Philadelphia, in spite of the crisis. Alexander Hamilton argued that if a foreign enemy occupied the capital or if any other kind of disaster in the city prevented Congress from assembling, then of course the President could bring it together elsewhere. Just weeks into the epidemic, Washington and his Cabinet members themselves skedaddled to Germantown, ten miles to the north, and they hoped Congress would follow.

Jefferson and Madison won that one but, in the end, the question was moot. The first frost in early November killed the mosquitoes and the disease with it. Congress met in Philadelphia in December but one of its first acts was to pass a law authorizing the President to convene it outside the national capital in the future, should conditions require it.

Pennsylvania state government was also domiciled in Philadelphia at the time. The capital wouldn’t be moved to Harrisburg until 1812. In 1793, Governor Thomas Mifflin and the legislature provided some money to Philadelphia to help handle the crisis, then they left town for the duration. So it all came down to Philadelphians. Fortunately, they were blessed with both public and private leadership talent in the persons of Mayor Matthew Clarkson, Dr. Benjamin Rush, and others. Rush was a signer of the Declaration of Independence and had served as Surgeon General of the Continental Army during the War for Independence.

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