With the Federal Government Gone

The city that remained belonged to those who had no other city. On a lane off Dock Street, in the second week of September 1793, a woman opened a shutter and called down to a passerby. She needed a nurse. Her husband lay dead on the second floor. Her children were burning with fever. The passerby walked on. He was searching for a cart to carry his own brother’s body. There was no cart. There was no nurse. The woman closed the shutter. This was Philadelphia now: a capital stripped of its government, a city whose white leadership had joined the exodus north and east, whose streets carried none of the ordinary commerce that had made them loud. What remained were the people who had nowhere to go and the people who were already sick.

The federal layer of the civic body had fully evaporated. President Washington had departed. Secretary of State Jefferson was gone. Secretary of the Treasury Hamilton was gone, soon to be carried out of the city himself, stricken. The offices of government stood shuttered. Congress was not due to return until December, and whether it would return at all to a plague-stricken capital was an open question. The federal employees who remained were clerks, porters, messengers—people without the means to relocate their families or the connections to secure lodging elsewhere. They stayed not out of duty but out of necessity. The government of the United States had not paused. It had simply left.

What remained of municipal authority was vestigial. Mayor Matthew Clarkson still held his office, but the city’s institutional infrastructure had hollowed around him. The voluntary hospitals were overwhelmed or closed. The overseers of the poor, the city’s traditional relief mechanism, were depleted and understaffed. The almshouse had stopped accepting fever patients. What had been a functioning civic order ten days earlier was now a skeleton: a mayor, a handful of officials, and whatever volunteers could be pressed into service. The city’s benevolent societies, the charitable associations that normally handled paupers and orphans, had seen their membership lists gutted by flight. Those who remained were trying to govern a catastrophe with the remnants of a peacetime apparatus.

The need was not abstract. In the alleys and rooming houses of the old city, between the Delaware waterfront and Fifth Street, families lay in rooms they could not leave. The fever took a household the way fire took a block: one person, then the next, then everyone. A carpenter’s wife on Third Street had been nursing her husband for two days when she collapsed. Their children, aged four and six, were found by a neighbor wandering the hallway, weak and crying. The neighbor took them in. By the next morning, the neighbor was sick.

There was no system for this. There was no agency that could absorb the orphans, nurse the stricken, or carry away the dead at the pace the disease demanded. The city’s capacity to respond had been built for individual crisis, for the occasional pauper family or isolated death. It was now confronting mass casualty in the neighborhoods least equipped to survive it.

The physicians who had stayed were few. Benjamin Rush remained, moving from house to house, seeing fifty or more patients a day, his carriage one of the few vehicles on the streets. He was writing letters, issuing instructions, and bleeding patients with a conviction that bordered on fury. Other doctors had fled or died. Some who remained disagreed with Rush’s methods but lacked the standing or the numbers to challenge him. The French physicians in the city, men who had seen yellow fever in the West Indies, watched his purging and bleeding with something close to horror. They believed in cooling regimens, rest, and mild stimulants. Rush believed in depletion. The medical dispute was not academic. It was being settled in real time, on real bodies, in rooms where the patient’s family had already fled or already fallen.

Rush’s ideas on yellow fever treatments differed from those of many experienced French doctors, who came from the West Indies where yellow fever outbreaks occurred every year and who had developed medicinal techniques that often were ineffective and actually brought many patients closer to their deathbeds. The disagreement between Rush and the French physicians was a dispute conducted at the bedside, with patients dying regardless of which method was applied. Both schools of treatment rested on assumptions about the disease that were fundamentally incomplete. Neither understood that yellow fever was transmitted by mosquitoes. Neither knew the vector. Neither knew the cause. What each possessed was a theory of intervention, a conviction that doing something was better than doing nothing, and a willingness to apply that theory to the bodies of the poor, the abandoned, and the desperate.

The question for the city’s remaining authorities was not whether to accept help. It was where to find any. The white physicians were overextended. The white nurses—largely women who had served families in better times—had fled or died or refused to enter houses where the fever was known to be. The price of nursing had risen to levels no working family could pay, and even at those prices, no one could be found. The city’s poor were sick and could not pay. The city’s institutions were broken. The only population that remained organized, present, and available was the free Black community of Philadelphia.

This was not a large population. Philadelphia’s free Black community numbered perhaps two thousand, a fraction of the city’s pre-epidemic fifty thousand. But it was organized.

The Free African Society, founded by Absalom Jones and Richard Allen in 1787, was a mutual aid society that had been built for exactly this kind of crisis—not yellow fever specifically, but the communal disasters that came to people who could not rely on the broader civic order. The Society had been formed after a walkout. Jones and Allen had been members of St. George’s Methodist Episcopal Church, where Black congregants were increasingly segregated, first made to sit against the wall and then ordered to the gallery.

During a service, Jones and others had been pulled from their knees while praying and told to move. They stood and walked out. From that act of refusal came the Free African Society: a non-denominational organization that assisted fugitive enslaved people arriving from the Southern United States and new migrants coming into the city. It functioned as a burial society, a relief fund, and a community anchor for people who had built their own institutions because the existing ones would not have them.

Jones was a lay minister, born in 1746, who had become prominent in Philadelphia through his preaching and his organizing. Allen was a former slave who had purchased his own freedom and had begun preaching to Black congregations in the city, holding early-morning services that attracted growing numbers of worshippers. Both men lived in the same physical city as the white Philadelphians who had fled: the same streets, the same markets, the same river.

But their social position was fundamentally different. They could not leave so easily. Their resources were thinner. Their networks outside Philadelphia were weaker. And their community’s survival depended on mutual aid, not on the assumption that the broader society would provide. When the fever struck and the white population fled, the Free African Society did not dissolve. It remained because its members had nowhere else to go and because its purpose was to serve exactly this kind of need.

The decision to approach the Black community was made by the city’s remaining authorities. The precise chain of the request runs through the Mayor’s office and the benevolent societies, the vestigial apparatus of a city trying to govern a catastrophe. Benjamin Rush, the most prominent physician still active in the city, was part of this appeal. He had treated Black patients. He knew the Free African Society existed. And he held, as did most of his contemporaries in medicine, a belief that would shape the epidemic’s most consequential decision: that Black people were less susceptible to yellow fever than white people.

This belief was not Rush’s alone. It was a common medical assumption of the period, rooted in observations of yellow fever in the West Indies and the American South, where enslaved populations had often survived epidemics that decimated white populations. The reasoning was flawed. What physicians were observing was likely the result of prior exposure. Yellow fever, transmitted by mosquitoes, often confers immunity on those who have survived a childhood case. In populations where the disease was endemic, many adults had already been exposed. In Philadelphia, where the disease was not endemic, no one had prior immunity—not white residents, not free Black residents, not enslaved people brought north. The distinction was not racial. It was epidemiological. But the medical theory of the time did not make that distinction. It read immunity as racial, and it acted accordingly.

The belief in Black immunity to yellow fever was, in other words, a misreading of a real pattern. Physicians in the Caribbean and the American South had seen yellow fever sweep through white populations while Black populations appeared to suffer less. They attributed the difference to race. They did not know that the difference was one of exposure history. In the plantation societies where yellow fever was established, Black adults who had grown up in endemic regions had likely survived childhood infections and carried immunity. White colonists arriving from Europe or the northern colonies had no such exposure. When the disease struck, it struck them. The physicians saw who lived and who died and drew a conclusion that fit the racial categories of their world. The conclusion traveled north. It reached Philadelphia. It reached Rush. And it would shape the most consequential decision of the epidemic.

Rush appealed to Jones and Allen. The request was formal: would the Free African Society organize its members to serve as nurses and corpse-bearers during the epidemic? The terms were framed by the moment. The city needed people willing to enter sick houses, to sit with the dying, to carry the dead. The white population that might have performed these tasks was gone. The Black community was present, organized, and believed to be resistant. The appeal carried an implicit promise: this work, though dangerous, would not kill you. Your race will protect you.

Jones and Allen heard the request. The meeting itself has left no detailed record—no minutes, no transcript, no surviving letter that captures the exact words exchanged. What survives is the decision. The Free African Society agreed. Its members would serve as nurses. They would carry the dead. They would enter the houses that white Philadelphians had fled and would not re-enter. The agreement was made on the basis of a medical claim that was false. But the agreement was also made in a context that was real: a city in crisis, a community with its own traditions of mutual aid, and a population that had been asked to serve because no one else would.

The logic was inexorable. Why did the city need Black nurses? Because the white nurses had fled. Why had they fled? Because they could, and because they feared the fever. Why did the authorities believe Black nurses would not flee? Because they believed Black people were immune. Why did they believe that? Because the medical theory of the time racialized immunity. Why did Jones and Allen accept? Because their community was organized for service, because they were asked by people they respected, and because the medical authority of Rush and others told them the risk was low.

Each answer in the chain was reasonable on its face. Each answer was shaped by the power imbalance between the white authorities making the request and the Black community receiving it. The Free African Society could refuse. But the cost of refusal, in a city where Black Philadelphians depended on white institutions for legal protection, economic opportunity, and basic civic standing, was not zero.

The result was a racialized division of labor at the heart of the catastrophe. Black men and women would do the work that the disease made most dangerous: nursing the sick, handling the dying, carrying the dead. They would do it under a false promise of safety. And they would do it in a city that had, in every other respect, excluded them from full civic participation. The same community that could not sit in the pews of St. George’s Church without being pulled from its knees would now enter the bedrooms of white Philadelphians and hold their hands as they died.

The irony was structural. It was not the product of individual malice. Mayor Clarkson, Rush, the benevolent society leaders—they were not acting out of cruelty. They were acting out of desperation, guided by the best medical theory available to them. But the structure of the decision—white authorities appealing to a Black community, using a false theory of racial immunity to justify the assignment of lethal labor—embedded exploitation in the response. The Free African Society’s members would serve, and some of them would die, because the city’s institutions had failed and because the medical theory of the time provided a convenient justification for asking the most vulnerable organized population to absorb the highest risk.

The work itself was visceral. Nurses entered houses where the air was thick with the smell of vomit and decay. They sat with patients whose skin had turned yellow, whose eyes bled, whose vomit was black. They changed soiled linens, offered water, and watched people die. They carried bodies down stairs, loaded them onto carts, and rode with the dead to the burial grounds. The work was relentless. The number of sick was growing. The number of dead was growing. And the nurses and corpse-bearers were moving through all of it, house to house, street to street, in a city that had gone silent except for the sound of carts and the cries of the dying.

The decision to assign this work to Black Philadelphians was not made in a single dramatic moment. It was made through a series of smaller choices, each of which followed logically from the one before.

The federal government left because its members could leave. The white elite left because they could leave. The white nurses left or refused because they could refuse. The city turned to the Free African Society because it was the only organized body of people still present and still willing. And the Free African Society accepted because its leaders were told, by the highest medical authority in the city, that the danger was manageable. Each step was rational. Each step narrowed the options. The cumulative effect was a system in which the most dangerous work in the epidemic was performed, almost exclusively, by the segment of the population that had been excluded from every other civic institution.

This was the civic cost of the exodus. The flight of the federal government and the white elite did not merely leave Philadelphia without leadership. It left the city with a leadership vacuum that was filled, improvisationally, by the people who remained. Mayor Clarkson and his committee would eventually formalize the city’s response. Rush would continue his medical campaign. Stephen Girard would later take charge of the hospital at Bush Hill. But in the second week of September, before those structures were fully in place, the city’s response to the epidemic ran through the Free African Society. The Black community was, for a critical period, the only resort.

The Free African Society had agreed to provide nurses and corpse-bearers, setting its members on a path into the epidemic’s epicenter under a false belief in immunity. The agreement transformed the social geography of the crisis. What had been a city of the sick and the fled was now, also, a city of the Black nurse and the Black corpse-bearer, moving through rooms that white Philadelphians had abandoned, performing the work that the disease made most lethal, under a promise that would prove false. The first of them were already in the houses by mid-September. They were already sitting with the dying. They were already carrying the dead. And they were already beginning to sicken.