Editing Yellow Fever Epidemic of 1793 (section)

== Origins and Spread ==

The epidemic began in late July 1793 when refugees from the slave revolt in Saint-Domingue (Haiti) arrived in Philadelphia, bringing with them the Aedes aegypti mosquito that carries yellow fever—though this connection was not understood at the time. The disease appeared first in the waterfront district near Water Street and spread rapidly through the city during the hot, humid summer months. Dr. Benjamin Rush, the most prominent physician in Philadelphia, recognized the disease in mid-August and sounded the alarm, but by then the epidemic was already out of control. Within weeks, the normal rhythms of city life had collapsed as shops closed, businesses shuttered, and families fled to the countryside.<ref name="estes">{{cite book |last=Estes |first=J. Worth |last2=Smith |first2=Billy G. |title=A Melancholy Scene of Devastation: The Public Response to the 1793 Philadelphia Yellow Fever Epidemic |year=1997 |publisher=Science History Publications |location=Canton, MA}}</ref>

The disease struck with terrifying swiftness. Victims developed fever, headache, and muscle pain, followed by jaundice (the yellowing of skin that gave the disease its name), hemorrhaging, and often death within days. Physicians debated whether the disease was contagious or arose from local environmental conditions—"miasmas" or bad air from rotting matter in the streets and wharves. Dr. Rush advocated aggressive treatment including bloodletting and purging, while other physicians recommended gentler approaches. Neither proved effective; modern estimates suggest the case fatality rate exceeded 50% for those who developed full-blown symptoms. The terror of the disease was compounded by its unpredictability: some families were entirely destroyed while neighbors escaped untouched.<ref name="powell"/>