After a few weeks, Rush became convinced that the bleeding and purging simply hadn’t been aggressive enough. He began administering large amounts of mercury as a purgative—doses criticized by some of his colleagues as “murderous” and fit only for a horse. If the other doctors had also known that mercury was toxic even at lower doses, no doubt the criticism would have been even more severe. Rush also advocated drawing four-fifths of a patient’s blood. Because, like other doctors, Rush believed that the human body contained more than twice as much blood as it actually does, that amounted to far more blood than his already-weakened patients had in the first place. Many of his patients died, and some blamed Rush’s “cure.” But it wasn’t clear that other approaches were working any better, and somehow, enough people managed to recover to give Rush and many others confidence in his methods.
Given the ineffectiveness—or downright harmfulness—of most 18th-century medicine, that people turned to folk remedies is understandable. In an attempt to purify the supposedly noxious air, residents lit bonfires and shot off guns—a clear danger in a hot and crowded city, and discouraged by doctors. But the governor of Pennsylvania himself took things a step further, ordering a small cannon to be hauled through the streets, stopping every few yards to fire.
While today people in hot spots like New York City try to defy mandates to “shelter in place,” the “bad air” theory of disease led Philadelphia doctors to advise fleeing the area. Everyone who could afford to escape tried to do so, clogging roads and overburdening the modest inns that were often travelers’ only options. Before the end of the fever, nearly 20,000 had left. The many abandoned houses led to a problem we don’t see today, at least not yet: looting. On the other hand, the economic effects were similar. One resident who stayed in the city reported in September that “business of every kind is stopped, and provisions double price.”
People also started to fear Philadelphians. Major Christian Piercy, a Philadelphia potter, fell ill in a stagecoach in New Jersey. The other passengers forced him out, and a local landowner would allow him only an empty log cabin—where Piercy died alone, almost immediately. As far away as Massachusetts, Governor John Hancock issued a travel ban, directing each town to examine “all Persons, with the Baggage, and other Effects, by Land or Water, coming from Philadelphia, or any other infected Place.” Postmasters used tongs to dip letters from Philadelphia into vinegar before opening them—the 18th-century equivalent of hand sanitizer. In the case of yellow fever, of course, these precautions were unnecessary. In places with no mosquitoes, there was no real danger of contagion.
Some myths are common to both the current pandemic and the epidemic of 1793—like the idea that African Americans are immune or less susceptible to the disease. Acting on that belief, Rush employed black people as nurses and gravediggers for yellow-fever victims. In the end, African American and white Philadelphians died in similar proportions. A less pernicious but equally persistent misconception is that garlic has protective powers. Rush reported that people in Philadelphia “chewed garlic constantly.” During the current pandemic, one woman in China needed hospital treatment for a severe sore throat after consuming one and a half kilograms of raw garlic.