A Physician's Duty: Serving in Pestilence and in War
Today's blog post is by College Librarian Beth Lander, MLS
“To the memory of Fellows of The College who have fallen whilst in performance of duty during pestilence or war” begins a plaque hanging near our Historical Medical Library. The memorial not only offers a gentle reminder of the sacrifices made by physicians in the care of their patients, but also is a reminder of how closely mortality hovered prior to the age of vaccines.
The summer of 1793 was unusually hot and dry. Wells and creeks were low, and the people of Philadelphia were plagued by flies and other pests. By mid-August, people in Philadelphia fell ill with symptoms similar to an outbreak of fever that Benjamin Rush, a founder of The College of Physicians of Philadelphia, had witnessed in 1762: “These patients were generally seized with rigors, which were succeeded with a violent fever and pains in the head and back. The pulse was full, and sometimes irregular. The eyes were inflamed, and had a yellow cast, and vomiting almost always attended. The third, fifth, and seventh days were mostly critical, and the disease generally terminated in one of them, in life or death. An eruption on the third or seventh day over the body, proved salutary. An excessive heat, and burning about the region of the liver, with cold extremities, portended death to be at hand” (Schultz, 2014).
James Hutchinson, port physician and Fellow of The College of Physicians, was told to seek the source of the disease that, by the end of August, had taken 325 lives (Bell, 1987, p. 27). Some physicians assumed the outbreak was caused by rotting cargo left on the docks near the Delaware River; others believed that the disease was caused by miasmas, or unhealthy vapors, that resulted from the filth that clotted city streets and gutters. All believed the disease to be highly contagious (Bell, 1987, p. 26).
Hutchinson was no stranger to large outbreaks of disease. Born in 1752, Hutchinson was the son of a Quaker farmer and stonemason. He began his medical training through an apprenticeship at the age of 15 with druggists Moses and Isaac Bartram. Hutchinson received his MD in 1774 from the Medical Department of the College of Philadelphia, the precursor to the University of Pennsylvania, and rose to prominence there as Professor of Materia Medica (1789-1791) and Professor of Chemistry (1791-1793). Hutchinson also served as Surgeon General of Pennsylvania from 1778-1784 ("James Hutchinson (1752-1793)," 2013).
Medical service was not limited to Hutchinson’s official posts and teaching duties. He volunteered to serve during the American Revolution, and helped inoculate 3,000 soldiers encamped at Valley Forge against smallpox ("James Hutchinson (1752-1793)," 2013). The willingness to meet disease head-on is emblematic of the physician’s oath, and Hutchinson did not fail in his duties during the outbreak of yellow fever in August of 1793. He fell ill sometime at the end of August, and died of yellow fever on September 6, 1793 at the age of 42 ("James Hutchinson (1752-1793)," 2013).
Other fellows of The College of Physicians aided the citizens of Philadelphia that summer. Rush tended patients and fell ill, but survived. John Morris, another founder of The College of Physicians, was not so lucky. Morris was born in 1759, and received his MD from the University of Pennsylvania in 1783. He began his medical practice in the office of his uncle, Dr. Charles Moore, in Montgomery County, Pennsylvania. Morris established his solo practice in Burlington, New Jersey prior to moving his practice to Philadelphia in 1785. His first office was at 27 Chestnut Street, where he worked until 1791, at which point Morris moved his practice to 11 Pear Street (Jordan, 1978, p. 45).
Morris was said to have been devoted to his patients. He, too, fell ill with yellow fever at the very end of August. Morris died in his mother’s arms on September 8, 1793. His wife, Abigail, died eight days later (Jordan, 1978, p. 46). Hutchinson and Morris were just two of the 1,442 people who died of yellow fever during the month of September 1793.
It is estimated that 11% of the residents of the city died during the 1793 outbreak, nearly 5,000 of the 45,000 people who called Philadelphia home ("Contagion: Historical Views of Diseases," 2014). Those who could leave the city did. John Dyer, a miller just outside Doylestown, Pennsylvania, noted in his diary on August 27, 1793, that “…the yallow fevour Rages Dreadfully in the City, our accounts are that upward of forty thousands of the Inhabitants Left the City” (Dyer, n.d). While Dyer exaggerated the number of people who fled Philadelphia in panic, his diary provides a glimpse of what it was like for the residents outside of the city, who were faced with the fear of contagion. On September 2, Dyer writes that an acquaintance told him that a quarter of the population of Philadelphia had left the city, an estimate close to the one made by Mathew Carey in A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia…. published in 1794.
While not as well documented as the 1793 outbreak of yellow fever, other periods of pestilence claimed the lives of fellows of The College of Physicians. Seventy-two years after the outbreak in 1793, yellow fever continued to claim the lives of Philadelphia residents, including one Dr. Joseph Hopkinson. Hopkinson was born in 1816. He was a surgeon during the Civil War, and the Chief Surgeon at Mower General Hospital in Chestnut Hill, now part of the city of Philadelphia ("Dr. Joseph Hopkinson," 2004). Hopkinson died in July 1865 shortly after the end of the war.
Isaac Parrish, a Quaker physician born in 1811, also is memorialized on our plaque. He received his MD in 1832 from the University of Pennsylvania and had an active family practice. Parrish died in 1852, of “perhaps cholera,” although the cause of his death isn’t certain (Brinton, 1964, p. 43). During 1852, 427 people died from smallpox; 433 died of scarlet fever; 558 from dysentery; and 1,204 from tuberculosis (Weigley, Wainwright, & Wolf, 1982, p. 318). Cholera was present in Philadelphia between 1849 and 1854, but was not noted as being as virulent as in years past (Bell, 1987, pp. 96-97).
College Fellow Dr. Robert P. Thomas, born in 1821, began working at 16, but not in medicine. He first started working for Walter & Souder, who were shipping merchants. Thomas eventually pursued the study of medicine under Dr. George Fox, and graduated from the University of Pennsylvania in 1847. Thomas was elected professor of Materia Medica at the Philadelphia College of Pharmacy in 1850. One evening in February 1864, he gave a lecture, at which he was said to have been in good spirits. The next morning, Thomas fell ill, and within 36 hours, died of typhus ("Association, American Pharmaceutical," 2013, p. 25).
Foreign wars exposed servicemen and physicians to diseases which were often more fatal than combat. The Spanish-American War (1898) saw the loss of less than 400 American troops to combat, but over 2,000 troops were sickened by yellow fever ("The Great Fever," 2006). Even more devastating was an outbreak of typhoid fever in recruitment camps in the U.S.: “In all, 20,738 recruits contracted the disease, (82 percent of all sick soldiers), and 1,590 died, yielding a mortality rate of 7.7 percent” (Cirillo, 2000, p. 363). A young Fellow of The College, Major Lawrence S. Smith, lost his life to typhoid fever during the war. Smith received his MD from the University of Pennsylvania in 1888, and succumbed to his illness while serving as a surgeon at the US Reserve Hospital. He died at the age of 31 on the hospital ship “Relief” (Graham, 2007).
In addition to the aforementioned physicians, College Fellows Charles Pendleton Tutt (d. 1866) and Albert Owen Stille (d. 1862) are memorialized on the plaque described here.
Association, American Pharmaceutical. (2013). In Proceedings of the Annual Meeting, 1864 (pp. 24-25). London: Forgotten Books. (Original work published 1864)
Bell, W. J., Jr. (1987). The College of Physicians of Philadelphia: a bicentennial history. Canton, MA: Science of History Publications.
Brinton, A. C. (1964). Quaker profiles: Pictorial & biographical 1750-1850. Lebanon, PA: Pendle Hill.
Cirillo, V. J. (2000). Fever and reform: The typhoid epidemic in the Spanish-American War. Journal of the History of Medicine and Allied Sciences, 55(4), 363-397.
Contagion: Historical views of diseases and epidemics. (2014).
Dr. Joseph Hopkinson. (2004). Retrieved July 2, 2014, from Find a Grave website: http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GRid=9428746
Dyer, J. (n.d.). Diary. Unpublished manuscript, Spruance Library (BM-A 483). Bucks County Historical Society, Doylestown, PA.
Graham, A. D. (2007). A brief history of global engagement at the University of Pennsylvania, international crises: Spanish-American War.
The great fever. (2006, September 29). Retrieved July 3, 2014, from http://www.pbs.org/wgbh/amex/fever/peopleevents/e_cuba.html
James Hutchinson (1752-1793). (2013).
Jordan, J. W. (1978). Colonial and revolutionary families of Pennsylvania: Genealogical and personal memoirs. Baltimore: Genealogical Pub. Co.
Mower U.S.A. General Hospital, Chestnut Hill, Philadelphia. (2013). Retrieved July 2, 2014, from http://www.wdl.org/en/item/9534/
Schultz, S. M. (2014). Epidemics in colonial Philadelphia from 1699-1799 and the risk of dying.
Thacher, J. (1828). American medical biography (Vol. 1). Boston, MA: Richardson & Lord.
Weigley, R. F., Wainwright, N. B., & Wolf, E. (1982). Philadelphia: A 300 year history. New York: W.W. Norton