Introduction
You face the challenge of surviving a sudden and devastating public health crisis that strips away social order. Laurie Halse Anderson explores this struggle in Fever 1793.
A young girl navigates the devastating yellow fever epidemic in Philadelphia, fighting for survival and rebuilding her life.
You learn how a bustling city descends into chaos as a mysterious illness overwhelms residents and medical systems. The book examines the collapse of commerce, the flight of the wealthy, and the heavy burdens placed on those who remain behind. You explore the historical events through five distinct phases of the crisis.
- How did the epidemic begin at the Cook Coffeehouse?
- What methods did doctors use to treat the fever?
- How did Bush Hill transform into a functioning hospital?
- What hardships did survivors face upon returning home?
- How did the community finally recover when the frost arrived?
1. Historical Context and Setting
The Cook Coffeehouse operates as a bustling community hub in Philadelphia until initial rumors of yellow fever spark panic and denial across the city.
The Coffeehouse Business
You enter the Cook Coffeehouse off High Street, where gentlemen, merchants, and politicians gather to discuss politics and gossip. The house and business were built in 1783, the year the War for Independence ended. Matilda was four years old when her father built the home and business.
A widow and her father-in-law run the establishment after the death of the founding carpenter. Eliza manages the kitchen preparations, providing the culinary success that keeps the family afloat. The business serves coffee and food while allowing limited card games, but it refuses alcohol. Mr. Carris, Grandfather, and government officials gather in the coffeehouse to discuss politics, gossip, and the initial rumors of the fever.
Outset and Rumors
Initial outbreaks of yellow fever in Philadelphia are dismissed as minor illnesses or attributed to poor smells and divine punishment, leading to societal denial. Thirty years had passed since the last yellow fever outbreak in Philadelphia prior to 1793. Doctors and citizens debate whether the deaths stem from rotting coffee beans, waterfront miasma, or refugees from Santo Domingo. Many wealthy families flee to the country while others deny the existence of a severe epidemic.
Mr. Carris blames the foul stench of rotting coffee beans on Ball's Wharf, while Mrs. Epler claims the fever is a sign of God punishing sinners who do not visit the church. Sixty-four people had died a week after Polly's death.
2. Medical Responses and Orders
City authorities issue official broadsheet guidelines to manage the epidemic, while physicians clash over aggressive bloodletting and alternative French medical practices.
City Orders
Philadelphia holds a population of forty-thousand people. The city authorities issue official broadsheet guidelines to manage the epidemic and halt public panic. Mr. Carris and Andrew Brown read the mayor's new orders printed in the print shop.
You must follow specific instructions when the infection spreads through the streets:
- Avoid those that are infected
- Mark the homes of the sick
- Place sick people in the center of large airy rooms without curtains and keep them clean
- Supply a hospital for the poor
- Cease all bell tolling immediately
- Bury the dead privately
- Keep the streets and wharves clean
- Avoid fatigue of the body and mind
- Avoid being in the sun, drafts, and evening air
- Dress appropriately for the weather
- Consume alcohol in moderation
Medical Treatments
Physicians disagree on treatment methods for the fever. Practitioners utilize aggressive bloodletting and purges, while others apply alternative French medical practices. You will see doctors rely on specific remedies to drain the pestilence.
Dr. Kerr performs a ten-ounce bloodletting on Matilda's mother to purge the pestilence from her blood. Dr. Rush and Dr. Kerr advocate for bleeding patients with a lancet and administering heavy doses of jalap and calomel.
You encounter these standard medical steps during the outbreak:
- Bathe the patient every four hours to keep them clean and cool
- Bleed the patient to drain the pestilence from the blood
- Administer ten grains of jalap and ten grains of calomel to purge the system
3. Quarantine and Hospital Transformation
Surrounding towns enforce strict quarantine measures while Bush Hill is successfully reformed into a functional hospital for fever victims.
Flight and Quarantine
Towns set up armed patrols to inspect travelers. You see them demand health checks and force anyone suspected of carrying the sickness to turn back regardless of their condition. Armed guards in Pembroke stop the wagon carrying Matilda and Grandfather. When Grandfather coughs, the doctor forces them out into the dust.
You find yourself stranded ten miles out of the city.
Bush Hill Hospital
Bush Hill is transformed from a lawless pest house into a functional hospital through the intervention of merchant Stephen Girard and French physicians. After clearing out thieving scoundrels, repairing water pumps, and securing supplies, the administration employs French medical practices and structured nursing care to successfully treat recovering fever victims. Mrs. Flagg nurses Matilda back to health at Bush Hill while Dr. Deveze oversees the patients and notes Matilda's recovery.
You wake up in the hospital after five days have passed since you and your grandfather left home.
4. Survival and Hardship in the City
More than half of Philadelphia's population emigrated to escape the crisis. More than three thousand people died during the fever. You return to the city to find desolation and ruin.
Survivors return to ransacked homes, facing severe starvation, violent looters, and mass burials without proper ceremony.
Home Looting
Returning to a home ransacked by thieves forces survivors to rely on meager garden scraps and strict domestic routines. Mattie returns to find her kitchen robbed of food and the garden infested with bugs and weeds, leaving only a few green beans and stunted squash to sustain her and her recovering grandfather. Thieves also search for hidden silver and strongboxes.
Mattie meticulously divides meager garden harvest into two portions, one for herself and one for Grandfather, while enforcing strict rules about feeding their cat Silas on the floor. Intruders break into the coffeehouse, leading to a violent confrontation where Grandfather is fatally struck defending Mattie. When two thieves discover Mattie hiding, Grandfather confronts them with a rifle, but during the ensuing scuffle, he is mortally injured and dies soon after.
Mass Burials
The staggering death toll forces mass burials without proper ceremony, requiring survivors to demand dignity for their loved ones. The death cart arrives with the cry of Bring out your dead. Thirty, maybe forty men work methodically as grave diggers in the burial square.
Overwhelmed grave diggers toss bodies into mass graves without prayers, but Mattie fiercely insists on a proper burial with readings from the Psalms for Captain William Farnsworth Cook. Mattie seizes a worn copy of the Psalms from a cart driver and reads aloud over Grandfather's shroud until the surrounding grave diggers uncover their heads in respect.
5. Community Heroes and Recovery
The Free African Society provides vital relief, community compassion shelters orphans, and the first frost ultimately ends the epidemic.
Free African Society
Volunteers from the Free African Society step forward to care for thousands of victims. Initial medical misconceptions about racial immunity are proven entirely false. Eliza visits homes across the city to deliver food and medicine, demonstrating that black people are just as susceptible to the yellow fever as anyone else.
Finding a traumatized toddler named Nell whose mother has died of the fever, you attempt to place her in an overflowing orphan house. An overwhelmed worker at the orphan house admits they have no room for more children. Mattie chooses to keep Nell and integrate her into their care alongside Eliza.
End of the Epidemic
A severe frost covers the city in ice crystals, instantly eliminating the insect vectors. The cold lowers food prices as farmers return to the markets, and survivors air out furniture to destroy lingering pestilence. Ten percent of the city's population is killed by the outbreak.
You must follow specific recovery steps when the weather finally shifts:
- Get all the furniture outside and expose it to the cold to destroy the pestilence.
Mattie wakes to find frost covering the garden, and she and Eliza celebrate as the town quickly fills with returning residents and open markets. Refusing advice to sell the coffeehouse, Mattie partners with Eliza to reopen the establishment. Mattie formally invites Eliza to become her business partner, and they successfully reopen Cook's Coffeehouse to bustling crowds just as President Washington returns. Nathaniel will need three years, maybe four, to support himself fully through painting before they can plan their future together.
10 Key Ideas
- Initial outbreaks of yellow fever in Philadelphia are dismissed as minor illnesses or attributed to poor smells and divine punishment, leading to societal denial.
- The Cook Coffeehouse operates as a bustling community hub until initial rumors of yellow fever spark panic and denial across the city.
- City authorities issue official broadsheet guidelines to manage the epidemic and halt public panic.
- Physicians disagree on treatment methods for the fever, relying on aggressive bloodletting and purges alongside alternative French medical practices.
- Surrounding towns enforce strict quarantine measures that force travelers to turn back regardless of their condition.
- Bush Hill is successfully reformed from a lawless pest house into a functional hospital for fever victims through the intervention of merchant Stephen Girard and French physicians.
- Survivors return to ransacked homes, facing severe starvation, violent looters, and mass burials without proper ceremony.
- The staggering death toll forces mass burials without proper ceremony, requiring survivors to demand dignity for their loved ones.
- Volunteers from the Free African Society step forward to care for thousands of victims, while community compassion shelters orphans like Nell.
- A severe frost covers the city in ice crystals to end the epidemic, allowing Mattie and Eliza to successfully reopen Cook's Coffeehouse to bustling crowds.