The American Plague - Molly Caldwell Crosby [17]
Yellow fever answered to many different names, including yellow jack, coup de barre (blow of the rod), vomito negro (black vomit), the saffron scourge and the American plague. Regardless of what it was called, yellow fever, elusive and terrifying, remained a mystery to medical minds during the nineteenth century. Disease in general was an enigma, medicine still in its infancy. By the 1870s many doctors received no formal medical education, instead receiving their knowledge through a type of medical apprenticeship with local physicians or during the Civil War. The medical programs that did exist at places like Harvard and Yale had no admissions program, performed few autopsies, did not even own microscopes. While Europe excelled in its medical research, American institutions placed almost no value on evidence-based medicine. To them, the body was a balanced system, and their work focused on treating the occasional imbalancewith lancet bleeding, leeches, castor oil and even arsenic at times.
To make matters worse, a thin line existed between medicine and religion. Newspapers smacked of advertisements for medications like Tutt’s pills, which could cure everything from wind colic to low spirits, and were “Recommended by physicians. Indorsed by Clergy.” The physical body was the realm of the Almighty, so knowledge of its inner workings through autopsy or examination was like trespassing. From the pulpits people were often told that epidemics, plagues, resulted from wicked ways and intoxication. And, in reality, there might have been some common sense to it considering venereal disease was one of the largest health concerns of the day; a number of doctors even specialized in these private or secret diseases. Very little connection had been made between filth and disease, so amid this near witch-doctor approach to medicine, cities remained baffled by cholera epidemics as they drank from the same sources in which they dumped sewage. The germ theory would soon change all of that, but in Memphis in 1878, sanitation, like immoral behavior, was still just one in a number of guesses as to what caused and spread disease.
Doctors relied on two prevailing theories about yellow fever: One camp believed it was mysteriously spread by filthy conditions much like cholera and dysentery. Terms like fomites, effuvia, and noxious gases peppered medical literature in an attempt to explain what substance—whether animal matter, fungal or gaseous— spread the disease. The other side held that the fever was imported each summer into the city by railroads and river traffic. Not sure which would prove to be more effective, Memphis health officials decided to tackle both problems.
In the summer of 1878, the Board of Health secured $8,000 in city funds to clean up the foul city, investigating cisterns and outhouses.Wayward goats and hogs were impounded. Regulations for the disposal of animal carcasses were strictly enforced. Regardless of their efforts, over 70 percent of the city’s dwellings were wooden and prone to rotting. When it rained, basements flooded, holding several inches of water, while the walls wept polluted mud. The Nicholson paving continued to decay, and the city’s water, though routed through the pumping station, came from the Wolf River. Even milk, under no inspection, was diluted with river water, and it was reported that one person found a minnow in his milk jug. The biggest problem was that of raw sewage and privies. Like all other densely populated cities, there was no effective way to remove waste. Citizens in downtown Memphis carted and dumped their privies into the river, and over half of the city’s privies were located fifty feet or less from drinking wells. One authority would call privies the “most annoying problem connected with urbanization.”
Nonetheless, as yellow fever season loomed, one newspaper column read, “Memphis is about the healthiest