1. Early in August, 1793, the first cases of a mysterious fever had appeared in Water Street, Philadelphia, killing a number of inhabitants. The disease quickly spread to other parts of the city, and on August 19, 1793, Dr. Benjamin Rush, Philadelphia’s leading physician, identified the fever as a “billious remitting yellow fever,” the same disease which had been sweeping through the West Indies for much of the year. Numerous theories on the cause of the disease were advanced: the extreme heat and dryness of the summer of 1793, the presence of large numbers of refugees from Santo Domingo who were suspected of having brought the fever with them, and the unsanitary conditions prevailing in the city. Some physicians believed it was spread by contagion, others that it was the result of a miasma arising from marshes and stagnant water. By mid-August Philadelphia was in the throes of a major epidemic.

Although statistics vary as to the number of Philadelphians who died before the epidemic had run its course in November, the number was certainly in excess of five thousand. The best modern account of the epidemic may be found in J. H. Powell, Bring Out Your Dead description begins J. H. Powell, Bring Out Your Dead (Philadelphia, 1948). description ends (Philadelphia, 1949). For a contemporary account, including necrology lists, see Mathew Carey, A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia: With a Statement of the Proceedings That Took Place on the Subject, in Different Parts of the United States (Philadelphia, 3d. ed., 1794).

Both H and his wife contracted the disease. As with almost every other phase of H’s life, his illness became involved in politics. The Hamiltons were treated by Dr. Edward Stevens, a physician educated in Edinburgh who had been H’s friend since their boyhood in the West Indies. Stevens, who practiced the “West Indies treatment” of cold baths, publicly opposed the depleting therapy practiced by Dr. Benjamin Rush, Thomas Jefferson’s friend and political ally. Almost every issue of the Philadelphia newspapers for this period contains remedies and cures for the fever suggested by physicians and laymen alike, and following his recovery H published a letter praising Stevens’s treatment (H to the College of Physicians, September 11, 1793). As a result many Philadelphians seemed to feel that there was a Federalist method (Stevens’s) and a Republican method (Rush’s) for treating the malady. The political temper is further indicated by observations in a letter of September 8, 1793, which Jefferson wrote to James Madison: “Hamilton is ill of the fever, as is said. He had two physicians out at his house the night before last. His family think him in danger, & he puts himself so by his excessive alarm. He had been miserable several days before from a firm persuasion he should catch it. A man as timid as he is on the water, as timid on horseback, as timid in sickness, would be a phænomenon if his courage of which he has the reputation in military occasions were genuine. His friends, who have not seen him, suspect it is only an autumnal fever he has” (Ford, Writings of Jefferson description begins Paul Leicester Ford, ed., The Writings of Thomas Jefferson (New York, 1892–1899). description ends , VI, 419).