This post is part of an exchange between “Books, Health, and History” at the New York Academy of Medicine and The Public’s Health, a blog of the Philadelphia Inquirer.
By David Barnes, Associate Professor of History and Sociology of Science at the University of Pennsylvania
The illness itself is scary: first the sudden aches, then the spikes of fever and chills, before the massive internal bleeding and copious vomiting and diarrhea. Death comes amid delirium and hemorrhaging from the nose, mouth, and other mucous membranes. A handful of isolated cases in the United States have been enough to spark a nationwide frenzy of fear and recrimination. Imagine what would happen if the nation’s capital lost a tenth of its population to the disease in the space of two months, and another half to panicked flight. And imagine if it happened again in the same city a few years later, then again, and again—four times in seven years.
The time was the 1790s, and the place was Philadelphia Vice President Thomas Jefferson even called for the city to be abandoned. The disease wasn’t Ebola, but yellow fever, another of the viral hemorrhagic fevers that wreak such terrifying havoc on the body’s internal organs. Yellow fever was also known colloquially by its most distinctive symptom: “black vomit,” which occurred when large quantities of blood accumulated in the stomach. Its ravages in Philadelphia and other seaport cities in the nation’s formative years constituted a serious national crisis.
The public discourse surrounding the ongoing Ebola epidemic has been singularly unedifying. In the United States, news media outlets have eagerly stoked groundless fears, which public officials have rushed to appease with policy responses that will do nothing to stop the disease’s spread. Meanwhile, help has been slow to arrive where it is desperately needed, in Guinea, Sierra Leone, and Liberia. Rural health centers there turn away patients for lack of staff and equipment, while well-funded American hospitals prepare for an influx of patients that may never come.