The Account of Matthew Carey

Seen from above, Philadelphia in November 1793 was still a city holding its breath: the fever was not yet over, and in the yards behind Christ Church and the burying ground where the Free African Society interred its dead, men were still carrying bodies to trenches they had dug themselves, working in the cold that had finally come to break the epidemic’s hold on the city. Down in the print shop, the press was still running. Sheets came off damp, ink darkening as they dried, and the compositor set the next forme with hands that did not pause.

Matthew Carey’s pamphlet was forty-eight pages, stitched cheaply between paper covers, and titled A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia. It bore the date November 1793. Two scenes in the same week of November: one man composing a narrative for sale, others interring the dead for no pay. The contrast was not lost on the people who lived it, though Carey’s pages would make it difficult to see.

The pamphlet spread fast. Within days of its appearance, copies sat on the tables of Philadelphia booksellers. Within weeks, the pamphlet reached New York, Baltimore, and Boston. People who had fled the city and were trickling back through the frosty roads found it waiting for them. They wanted to know what had happened. Carey gave them an answer.

He was a merchant, a publisher, and a political economist who had emigrated from Ireland a decade earlier. He had stayed in Philadelphia through the worst weeks of the epidemic, and he had watched the city empty. Now he set down what he had seen, or what he believed he had seen, in plain language aimed at the widest possible audience. The pamphlet was hasty. Carey assembled it from newspaper reports, from letters, from his own observations, and from conversations with men who had served on the Mayor’s Committee or at Bush Hill. He did not pretend to completeness. He wanted to be first. Indeed, as an eyewitness, Carey wrote in his Short Account that the “consternation of the people was carried beyond all bounds. Dismay and affright were in the countenance of almost every person.”

The result was a document that would shape every subsequent telling of the epidemic. Carey provided a chronology, tracing the fever from its origins near the wharves in August through the weeks of mounting terror to the frost that broke it in late October. He estimated the dead. He named the heroes. He named the villains. And in doing so, he performed the first major act of narrative triage the disaster would see: sorting the chaos of a catastrophe into a story with clear causes, clear lessons, and a clear moral hierarchy.

The pamphlet opened with the atmosphere of panic. Writing of the Philadelphia epidemic of 1793, Carey said in his Short Account that the “consternation of the people was carried beyond all bounds. Dismay and affright were in the countenance of almost every person.” Flight from the city was sought by many, including some of the representatives of the Federal government, while “of those who remained many shut themselves in their houses and were afraid to walk the streets.” The passage set the tone for everything that followed. Carey wanted his readers to feel what he had felt, and he wanted them to understand that the disaster had been, above all, a failure of nerve and order.

He was not wrong about the terror. People had fled by the thousands. The federal government had decamped, with George Washington and his cabinet riding out to Germantown and then further. The state legislature had adjourned. The banks had closed. The post office had stopped delivering. Philadelphia, the capital of a republic barely four years old, had become a place where the living envied the dead and the dead went unburied. Carey’s chronology captured this collapse with a clarity that no other contemporary account matched.

But clarity is not the same as accuracy. Carey’s death estimate, while roughly correct in aggregate, smoothed over the patterns of mortality that mattered most. He reported that more than four thousand had perished, a figure later revised upward toward five thousand based on burial counts. The number was staggering for a city of roughly fifty thousand. Yet Carey presented it as a single great wave, not as a catastrophe that had fallen disproportionately on the poor, on immigrants, on the people who could not afford to leave. The distinction mattered. It mattered because Carey’s narrative was already, even before the last graves were filled, assigning credit and blame in ways that would determine who was remembered and who was forgotten.

He praised Stephen Girard. The French-born merchant had taken charge of Bush Hill, the fever hospital on the city’s outskirts, when no one else would go near it. Girard had walked the wards, changed the sheets of dying men, and managed the institution with a competence that shamed those who had fled. Carey also praised Jean Devèze, the French physician who had overseen medical care at Bush Hill and whose methods, gentler than Benjamin Rush’s bleeding and purging, had produced better results. These were deserved laurels. Girard and Devèze had risked their lives. Carey made sure the record showed it.

Then he turned to the Black nurses.

The Free African Society had answered Benjamin Rush’s call in September. Richard Allen and Absalom Jones had rallied Black Philadelphians to serve as nurses and gravediggers when the white population had fled or fallen ill. The work was brutal. They entered houses where the stench of fever and death was unbearable. They carried the sick to Bush Hill and the dead to the burying grounds. Through the worst weeks of September and October, some of them sickened and died. The Society’s members had taken on the labor that the city’s collapse had left undone.

Carey acknowledged this. Then he undercut it. In his pamphlet, he accused Black nurses of charging exorbitant fees, of exploiting the sick, of demanding payment from families already ruined by the epidemic. He suggested that some had stolen from the dying. The accusations were sweeping. They were also, in several cases, simply wrong. Allen and Jones would later document that some nurses had worked without pay, that others had accepted modest wages for work no one else would do, and that the accusations of theft and extortion were either unproven or fabricated. But Carey’s pamphlet came first. By the time Allen and Jones published their rebuttal, Carey had already issued four editions.

This was the mechanism of the thing. The pamphlet worked because it arrived at the right moment. People returning to Philadelphia in November needed an explanation. They needed to know who to thank and who to blame. They needed, above all, a story that restored the social order that the epidemic had shattered. Carey gave them one. The heroes were white merchants and physicians. The villains were Black nurses and, to a lesser extent, the city’s political leadership, which Carey criticized for its slow response. The hierarchy was restored. The civic evaporation that had emptied Philadelphia of its government, its commerce, and its respectable population was recast as a story in which the respectable classes had behaved heroically and the lower orders had behaved badly.

The consequences moved quickly. For Carey, the pamphlet brought profit and authority. Four editions in a matter of months. His name became permanently associated with the epidemic. When people spoke of 1793, they spoke of Carey’s account. He was the witness, the chronicler, the authority. For white citizens returning to the city, the pamphlet offered reassurance. The disaster had a shape. The heroes were recognizable. The social world was intact. For the Black volunteers of the Free African Society, the pamphlet stole their credit and seeded a lasting grievance. They had nursed the sick and buried the dead while the city’s white elite was in Germantown or on the road to New York. Now they read that they had been thieves and extortionists.

The irony was sharp. Carey had stayed in Philadelphia. He had seen the work of the Black nurses. He knew, or should have known, that the accusations were thin. But the pamphlet was not an exercise in neutral reporting. It was a political document, born of the moment, designed to assign narrative order to chaos. The social hierarchy that the epidemic had threatened, with its inversion of who served and who fled, needed to be restored before the city could return to normal. Carey’s pamphlet performed that restoration. It was triage of a particular kind: not of bodies but of reputation.

The timing made it worse. Carey published before the epidemic was officially over. The last victims were still dying. The last nurses were still working. The Free African Society was still burying the dead. And while they did, the pamphlet was already circulating, already shaping the public memory of what had happened. Allen and Jones moved to respond. They gathered testimony. They compiled records. They wrote their own account, which they would title A Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia in the Year 1793 and a Refutation of Some Censures, Thrown upon them in some late Publications. It would appear in 1794. But by then, Carey’s version had already become the standard account. Four editions had saturated the market. The story was told. The refutation arrived into a conversation already settled.

What Carey’s pamphlet revealed was not simply one man’s prejudice. It revealed the structural pressure of a society that could not afford to remember what the epidemic had shown. The civic evaporation had exposed something intolerable: that the city’s survival had depended on the people it held at the bottom. Black Philadelphians, free and organized, had kept the city functioning when its white elite had fled. They had done the work that defined citizenship, the work of care and sacrifice and risk. If that fact were allowed to stand, it would unsettle everything. The slave society of the American republic, already under strain from the contradictions of liberty and bondage, could not absorb the image of Black citizens carrying the city through its worst crisis while the white leadership ran.

So the narrative had to be managed. Carey’s pamphlet was not unique in this. Benjamin Rush, too, had published his own account, framing the epidemic through his medical theories and his conviction that bleeding and purging had saved lives. The newspapers had carried reports throughout the crisis, some accurate and some not. But Carey’s pamphlet was the most widely read and the most consequential. It was the one people cited. It was the one that reached other cities. It was the one that fixed the story.

The pamphlet’s design was simple. It moved chronologically. It offered a clear chain of events. It identified causes, both medical and moral. It assigned roles. And it closed with an appeal to the wealthy to contribute to the relief of those who had suffered. Carey was a political economist by inclination, and he understood that a disaster was also an opportunity to make an argument about how society should be organized. The pamphlet was, among other things, a brief for charitable giving, for the paternalistic order in which the wealthy rescued the deserving poor. In that framework, the Black nurses who had done the saving were inconvenient. They did not fit the story Carey wanted to tell.

The consequences for each party were concrete. Carey became the city’s chronicler. His pamphlet went through edition after edition. When he revised it, he softened some of the accusations against Black nurses, but he did not retract them. The damage was done. The first edition had said what it said, and the first edition was what people remembered. For white citizens, the pamphlet provided a story they could live with. The heroes were men like themselves. The city had been saved by Girard and Devèze and the Committee of Twenty, not by Black volunteers who had worked for wages that were, by any measure, fair compensation for risking one’s life. The social order was intact. The republic had survived. The lesson was that philanthropy and civic organization had carried the day.

For the Free African Society, the consequences were devastating. Allen and Jones had organized the response. Nurses and gravediggers had been recruited from among their members. Records had been kept. Members had sickened and died. And now they read that they had been extortionists. The accusation was not merely insulting. It was dangerous. In a society where Black freedom was contingent and contested, where free Black Philadelphians lived under the constant threat of being associated with the enslaved, the charge of dishonesty and theft was a political weapon. It undermined the case for Black citizenship that Allen and Jones were trying to build. It suggested that Black people, even when performing the most essential civic labor, could not be trusted.

The epidemic had tested every institution the young republic had built. The flight of the federal government had left a vacuum. Into that vacuum had stepped the Committee of Twenty, the volunteers at Bush Hill, and the Black nurses of the Free African Society. The city had survived because of them. But survival was not the same as recognition. The people who had stayed, who had done the work, were not the people who got to tell the story. Carey’s pamphlet was the proof. The first major public history of the disaster came from a man who had stayed but who shared the assumptions of the class that had fled.

The pamphlet was, in its way, a performance of the same civic evaporation that had emptied the city. The people who had filled the vacuum were written out of it. The people who had fled were written back in as heroes. The social hierarchy that the epidemic had briefly inverted was reinverted on the page. And the public, hungry for explanation, accepted the story because it was the story they wanted.

The epidemic’s medical dimensions were real enough. The era’s ignorance of disease transmission, the failure of heroic medicine, the absence of any effective treatment for yellow fever, all contributed to the catastrophe. Carey did not dwell on these things. He was not a physician and did not pretend to be. But by framing the disaster as a moral story rather than a medical one, he shifted the ground from scientific failure to human failure. The doctors had done their best. The nurses had not. The merchants had been heroic. The Black poor had been grasping. The narrative was clean. It was also, in the places that mattered most, false.

Carey’s account did not invent the accusation against Black nurses from nothing. Rumors had circulated during the worst weeks, carried by frightened people who had seen, or claimed to have seen, nurses demanding high wages. Some nurses had indeed asked for pay. The work was dangerous, and the families who needed help were often desperate. But Carey took scattered complaints and made them general. He turned individual instances, some of them unverifiable, into a collective judgment. The Black nurses, as a class, were accused. The distinction between a few individuals and an entire community was erased. That erasure was the pamphlet’s most consequential act.

The Free African Society had organized the nursing effort under Allen and Jones. The two men had appealed to their members, and volunteers had come forward. Some had served for weeks without compensation. Others had been paid, at rates that reflected the danger of the work and the scarcity of anyone willing to do it. A few, perhaps, had taken advantage of the situation. But the same could be said of white physicians, white merchants, white landlords. Carey did not generalize from those individuals to their race. He reserved that treatment for Black nurses alone.

The pamphlet’s fourth edition appeared before Allen and Jones could respond. Each edition sold. Each printing fixed the accusations more firmly in the public mind. By the time the rebuttal appeared, the story had hardened. People had already decided what had happened. They had read it in Carey.

The frost had come. The fever was abating. The dead were being counted. And while the last nurses of the Free African Society laid down their work and looked for the recognition they had earned, the first edition of Carey’s pamphlet was already on the shelves, its ink dry, its accusations fixed, its version of events becoming the version that people believed. One document sat stacked in a bookseller’s window near the corner of Second and Market, its fourth edition already wearing the handling of dozens of readers.

In the church on South Fifth Street, Absalom Jones sat down to write.