The Narrow Court of Public Opinion

The Narrow Court of Public Opinion

Philadelphia’s print culture in the late autumn of 1794 occupied a tight grid of streets near the State House. Along High Street and Chestnut, the city’s printers and booksellers operated from narrow, deep rooms fronted by wooden counters. Dunlap ran his broadside operation near Market Street. Dobson published from a shop on Second. Young and M’Culloch, Campbell, and a half-dozen others kept handpresses clattering through working hours, turning out newspapers, almanacs, sermons, and political pamphlets on rag paper sorted by the wagonload. The shops smelled of ink, damp paper, and the lamp oil that lit the compositors’ stands after dark.

Into this atmosphere, in November 1794, a new unbound pamphlet arrived: Benjamin Rush’s ‘An Account of the Bilious Remitting Yellow Fever as it Appeared in Philadelphia, in the Year 1793’, published by Thomas Dobson. A fresh copy, its signatures still untrimmed, would have been placed on a counter or handed across a shop board like any other publication. This one carried more than a medical argument. It was a forceful, often defensive restatement of a therapeutic regimen and a theory of origins, and it reignited a war that the College of Physicians’ formal inquiry had only briefly paused.

Rush had been building toward this publication for months. His letters through the spring and summer of 1794 had rehearsed the arguments. He had watched the College’s proceedings with impatience, then with something closer to alarm.

The testimony of Jean Devèze, the French physician who had managed the hospital at Bush Hill, had been received respectfully by the College. Devèze had questioned the use of mercury and the severity of bleeding. He had described, in his measured, accented way, a gentler regimen of rest, cooling drinks, and bark. Rush had heard this testimony or learned its contents through the channels of professional gossip and correspondence that connected the city’s medical men.

He understood its implication. If Devèze’s methods were credited, if the mortality at Bush Hill was attributed not to the disease’s severity but to the treatment, then Rush’s own approach—the aggressive bleeding and purging that he had prescribed to hundreds—was not medicine but murder. Rush wrote his account to prevent that conclusion from taking hold.

The pamphlet was organized as a narrative of the epidemic’s progress, but its structure served a polemical purpose. Rush described the fever’s appearance in August, its spread from the wharves, the panic and flight. He detailed his own initial uncertainty, his consultations, his eventual commitment to the use of mercury and the lancet. Case after case followed, naming patients and outcomes, building a wall of evidence for his methods.

He argued that the disease originated in the putrefaction of vegetable and animal matter along the waterfront, a miasmatic theory that placed the blame on local conditions rather than on imported infection. The scientific claim carried a political one.

If the fever was imported, then the port should have been quarantined, and the merchants who opposed quarantine—the same merchants who sat on the City Committee—bore responsibility. If it was local, then the city itself was to blame, and the merchants were exonerated. Rush chose local origin.

The City Committee, for its part, was producing its own record. In March 1794, the Mayor’s Committee published its minutes. The document was a ledger of effort and expenditure: provisions purchased, nurses hired, carts paid for the removal of the dead, the cost of the hospital at Bush Hill, the salaries paid to those who had stayed. The accounting was detailed and dry. It listed what had been spent and, implicitly, what had been saved. The medical debate went unengaged. The relative merits of Rush’s bleeding or Devèze’s cooling regimen went unassessed. The Free African Society was not mentioned by name in its early pages, though the society’s nurses had been paid from the committee’s funds. The committee’s report treated the epidemic as a logistical problem that had been managed, at great cost, by responsible men. It was a document of governance, not of science.

The contrast between these two publications was stark. Rush’s pamphlet was a passionate defense of a theory and a practice. The committee’s minutes were a cold accounting of sums and services. Rush sought vindication. The committee sought credit. Neither document could settle the question that most troubled the city: whether the right things had been done, whether the dead had been well served, whether the living had behaved as citizens should. The formal institutional verdicts—the College’s report and the committee’s minutes—proved insufficient to settle the city’s profound need for moral and scientific closure. What followed was a fractious contest played out in print and pamphleteering, a war of words that would last through the winter and into the spring of 1795.

Rush’s account was excerpted in the newspapers within weeks of its publication. The Aurora, Dunlap’s American Daily Advertiser, and other papers carried selections. Readers who could not afford the pamphlet read the case histories in the morning papers over their coffee. The excerpts were chosen for drama: the physician rushing to a bedside, the patient’s black vomit, the ten ounces of blood drawn from a vein, the recovery or the death. Rush wrote with a clarity that made the medical details vivid to a lay reader. He also wrote with a defensiveness that was visible between the lines. He named his critics, sometimes directly, sometimes by allusion. He referred to a French physician whose methods had been misrepresented to the public. He described the opposition to his treatment as a combination of ignorance and self-interest.

The reception was divided. Some readers found in Rush’s account the voice of authority they craved. The epidemic had stripped the city of certainty. People wanted to believe that someone had understood the disease, that the deaths had not been random, that a competent physician had been at work. Rush’s confident tone, his detailed cases, his willingness to name names and state positions, all served this need. His supporters wrote letters to the newspapers praising his courage and his skill. They pointed to the patients who had recovered under his care. They argued that the critics were foreign interlopers who did not understand the American constitution or the American body.

Others read the account with a colder eye. They noted what Rush did not say. The patients who had died after his bleeding went unmentioned. His mortality rate was never compared with Devèze’s. The nurses at Bush Hill, working under Devèze’s directions, had reported a recovery rate that seemed, to some observers, higher than the rate among Rush’s patients. These readers saw in Rush’s unyielding stance a refusal to learn from the epidemic’s evidence. They saw a man who had committed to a theory and could not retreat from it without admitting that his treatment had killed people. Their letters to the newspapers were more cautious in tone but pointed in their criticism. They asked whether the lancet had been a cure or a weapon.

The pamphlet wars expanded. Among the clerical responses, the Lutheran minister J. Henry C. Helmuth produced one of the most notable. His account, published as a sermon and narrative, offered a theological reading of the epidemic. Helmuth had stayed in the city through the worst weeks. He had ministered to the dying, buried the dead, and kept a journal of what he had seen. His publication framed the fever as a divine visitation, a punishment for the city’s sins, and a test of its faith. The medical debate went unengaged directly. Rush’s bleeding and Devèze’s cooling methods were not assessed.

But the framing of the epidemic as a moral event, a judgment on the city’s character, implicitly challenged the physicians’ claim that the epidemic was a medical event to be understood in scientific terms. Helmuth’s account was widely read. It went through multiple editions. It spoke to a population that wanted meaning, not data.

The Free African Society’s response had already been in print for nearly a year. Absalom Jones and Richard Allen had published their pamphlet, ‘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’, in 1794. The pamphlet was a direct response to Mathew Carey’s short account, which had accused black nurses of extortion and neglect.

Jones and Allen confronted these accounts directly, noting that some blacks had worked for free, that they had died at the same rate as whites from the epidemic, and that some whites had also overcharged for their services. Their pamphlet detailed the work that black Philadelphians had done: the nursing, the burying, the care of the abandoned sick. It listed names and dates. It described the conditions under which the nurses had worked, the dangers they had faced, the deaths among their own number.

The document carried a moral weight that the physicians’ pamphlets could not match. The black nurses had not chosen between theories of the disease. They had chosen to stay.

The rapid succession of other yellow fever epidemics in the years that followed kept the Philadelphia debate alive. When the fever appeared in New York in 1795, the competing Philadelphia accounts were reprinted and cited. Rush’s methods were tried, questioned, and tried again. Devèze’s approach was discussed in medical societies. The Philadelphia epidemic had become a case study, a reference point, and a weapon. Every new outbreak reignited the argument about what had been done right and what had been done wrong.

Rush himself was aware of the stakes. His correspondence in the months after the account’s publication shows a man monitoring his reputation with anxious attention. He wrote to colleagues in other cities, sending copies of his pamphlet, requesting their opinion, and reporting their favorable responses. He collected testimonials from patients who had recovered under his care. He forwarded these to newspapers and to the College of Physicians. He was building a record, constructing an archive of vindication. He understood that the court of public opinion would deliver its verdict before any institution could, and he intended to shape that verdict.

The City Committee’s minutes, by contrast, were received in near silence. They were read, acknowledged, and filed. The committee members—the merchants and civic leaders who had organized the emergency response—did not need to defend their actions in print. Their work was self-evident, they believed. They had stayed. They had spent. They had managed. The minutes were their defense, and the minutes were dull. The public did not read them with the same urgency they brought to Rush’s account or Helmuth’s sermon. The committee’s report did not answer the questions that most troubled the city. It said what had been done but not whether it had been right.

This was the gap that the pamphlet wars filled. The formal institutions had spoken. The College of Physicians had heard testimony and would issue its report. The City Committee had published its minutes.

But the city was not satisfied. The epidemic had killed roughly five thousand people between August 1 and November 9. The dead were in the churchyards, in the common pits, in the registers of burial that the committee had ordered kept. Their survivors were scattered across the city and the surrounding country.

Some had returned to Philadelphia. Some had not. The survivors wanted to know why the dead had died, and they wanted someone to be responsible. The physicians argued about mercury and bleeding. The committee argued about costs. The ministers argued about sin. The black community argued about credit and blame. None of these arguments could be settled by a verdict from a college or a report from a committee.

The sovereignty of care—the contested authority to define who had preserved life and who had failed to—was being adjudicated in the newspapers and pamphlets. Rush claimed it through his theory and his practice. Devèze claimed it through his results at Bush Hill. The City Committee claimed it through its expenditures and its logistics. The Free African Society claimed it through its labor and its witness. Each claim was made in print, and each was challenged in print. The court of public opinion was conducting its own triage, sorting the heroes from the failures, the credit from the blame, the remembered from the forgotten.

The winter of 1794 and 1795 was a season of sorting. The newspapers carried letters and essays under pseudonyms. A Friend to Truth wrote that Rush’s methods had saved hundreds. A Looker-On replied that the dead could not speak for themselves. A correspondent signing Humanitas asked whether the city had learned anything from the epidemic or was simply waiting for the next one. The pamphlet shops on High Street stocked the competing accounts. Carey’s short account, now in its fourth edition, still sold. Jones and Allen’s narrative continued to circulate. Helmuth’s sermon was reprinted. Rush’s account was debated in letters between physicians in Philadelphia, New York, and Boston. The city’s print culture was processing the epidemic, turning it from an experience into a text, from a catastrophe into an argument.

Rush monitored all of this. His letters reveal the strain. He wrote to a friend that the opposition to his methods was the effect of prejudice and that his critics were ignorant of the disease. He collected reports of recoveries attributed to his treatment. He sent them to colleagues and to newspapers. He was relentless in his self-defense. He believed he was right. He believed that his treatment had saved lives and that the opposition to it was killing people.

He could not retreat. To retreat was to admit that the bleeding and purging had been wrong, that the patients who had died under his care had been killed by the treatment, not by the disease. That admission he could not make. It would destroy him as a physician and as a man. So he doubled down. He published more cases. He cited more recoveries. He attacked his critics more sharply.

Devèze, by contrast, said little in print. His testimony before the College had been his statement. No pamphlet appeared under his name. No letters went to newspapers. He returned to his practice and his community. His silence was itself a position. It suggested that the evidence spoke for itself, that the recovery rate at Bush Hill was its own argument, that the gentleness of his methods was its own defense. But silence was also a vulnerability. In the court of public opinion, the man who speaks most makes the case. Rush spoke most. Devèze spoke least. The public record was shaped by this asymmetry.

The City Committee’s members also spoke little. Their minutes had been published. Their expenditures were accounted for. The carts, the nurses, the provisions were listed. They had done what citizens do. They returned to their businesses, their counting houses, their wharves. The pamphlet wars did not engage them. Their decisions were not defended in the newspapers. They believed their work was its own defense. But the questions that the public wanted answered were not about logistics. They were about judgment. Had the committee acted quickly enough? Had Bush Hill been managed well? Had the nurses been treated fairly? Had the dead been buried with respect? These were questions of moral authority, not of accounting. The committee’s minutes could not answer them.

The Free African Society’s pamphlet had answered some of these questions. Jones and Allen had described the work. The nurses were named. The dead were listed. The charges of extortion and neglect were refuted. Their pamphlet was a document of moral authority. The medical debate went unengaged. Theories of origin and methods of treatment were not assessed. It simply said: we were there. We did the work. We did not abandon the city. The pamphlet’s power lay in its specificity. It listed what had been done, by whom, and at what cost. It was a counter-narrative to the accounts that had erased or slandered the black community’s contribution. It was also a claim. The black nurses had earned credit, and credit meant recognition, and recognition meant rights. The pamphlet was a political act.

The pamphlet wars of 1794 and 1795 were the city’s attempt to process the epidemic through the only medium it had: print. The formal institutions had delivered their verdicts, but the verdicts were narrow. The College of Physicians could assess theories and treatments. The City Committee could account for expenditures. Neither could address the moral questions the epidemic had raised. Who had acted well? Who had acted badly? Who had abandoned the city? Who had stayed? Who had profited? Who had served? These questions belonged to the court of public opinion, and the court was narrow, fractious, and unresolved.

The epidemic had exposed how thin the new republic’s capital was in its institutions and resources. The federal government had fled. The municipal government had collapsed. The city had been governed by an improvised committee of merchants and volunteers. The sick had been cared for by an improvised corps of black nurses and volunteer physicians. The dead had been buried by an improvised crew of carters and grave-diggers. The institutions of the republic had not held. The authority to care for the sick had been contested, not conferred. The physicians argued about who had the right theory. The committee argued about who had the right to govern. The black community argued about who had the right to claim credit. The public argued about all of it.

The newspapers carried the arguments through the winter. The pamphlet shops stocked the competing accounts. The readers read, and judged, and wrote, and argued. The epidemic was being processed, turned into text, made into a story with heroes and villains and victims. The story was contested. Rush’s account told one story. Devèze’s silence told another. The committee’s minutes told a third. Jones and Allen’s pamphlet told a fourth. Helmuth’s sermon told a fifth. Carey’s short account told a sixth. The stories contradicted each other. They could not all be true. The public had to choose, and the choosing was the work of the court of public opinion.

The court was narrow because the public was narrow. The readers of newspapers and purchasers of pamphlets were the educated, the literate, the propertied. The black nurses who had done the work did not write letters to newspapers. The carters who had driven the dead did not publish pamphlets. The patients who had recovered or suffered under Rush’s care did not, for the most part, tell their own stories in print. The court of public opinion was a court of the articulate, the educated, and the connected. Its verdicts were shaped by who could speak and who could not.

Rush understood this. He was articulate, educated, and connected. He had access to the presses. He had the standing to be published. He used these advantages relentlessly. His account was the most comprehensive, the most detailed, and the most forceful statement of any participant’s position. It dominated the pamphlet wars. It was cited, excerpted, and debated more than any other document. Rush’s narrative of the epidemic became, for many readers, the narrative of the epidemic. His theory of local origin was accepted by many. His defense of bleeding and purging was accepted by some. His account of his own courage and dedication was accepted by most. The court of public opinion was delivering its verdict, and Rush was shaping it.

But the verdict was not unanimous. The critics persisted. Devèze’s methods were discussed in private correspondence among physicians. The mortality at Bush Hill was compared, quietly, with the mortality among Rush’s patients. The question of whether the bleeding had helped or harmed would not go away. Rush’s defenders could not silence it. They could only shout over it. And the shouting—the pamphlets and letters and newspaper essays—was itself a form of evidence. It showed that the city was not settled. It showed that the epidemic’s meaning was still being contested. It showed that the formal verdicts had not closed the case.

The spring of 1795 brought no resolution. The newspapers continued to carry letters and essays about the epidemic. The pamphlet shops continued to stock the competing accounts. Rush continued to monitor his reputation. The City Committee’s members continued to attend to their businesses. The Free African Society continued to seek recognition and compensation for its members’ work. The dead remained dead. The survivors continued to argue about who was to blame.

The pamphlet wars did not settle the questions the epidemic had raised. They entrenched them. Rush’s account fixed his position in the public record. The committee’s minutes fixed theirs. Jones and Allen’s pamphlet fixed theirs. The competing narratives hardened into competing orthodoxies. The city’s readers chose their authorities and defended them. The epidemic became a set of arguments, and the arguments became fixed positions, and the fixed positions became the memory of the epidemic.

The moral rancor of the pamphlet wars was unresolved. The physicians’ dispute was unresolved. The question of credit and blame was unresolved. The question of who had served and who had abandoned was unresolved. The formal verdicts had not closed the case. The public verdicts had not closed the case. The case was open. And the open case was about more than reputation or theory. It was about debt. The Free African Society had served. The nurses had worked. The carters had driven the dead. The city owed them. The debt was tangible. It was financial. It was waiting.

The first cart of provisions from Germantown had arrived in a silent, stripped Philadelphia after the killing frost. The city had been empty. The shelves had been bare. The dead had been in the streets. The living had been hiding. The cart had come from outside, from the country, from the people who had fled. The provisions had been a gift. But the labor of the epidemic—the nursing and the burying and the caring—had not been a gift. It had been work. It had been done by people who had been promised pay. Some had been paid. Some had not. The debt was real. It was waiting for a reckoning.