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1.5: “The disorder, I fear, increases-” Yellow Fever in Philadelphia, 1803

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  • By Elizabeth Sandwith Drinker


    Elizabeth Sandwith Drinker (c. 1735 – 1807) was a Quaker woman in Philadelphia who kept a diary from 1758 to 1807. Her husband, Henry, worked for an import business. Her diaries documented the changing medical practices in 18th century America. Yellow fever, also known as “American Plague,” is a tropical disease and likely came to the United States aboard ships from Africa and the Caribbean that brought infected mosquitoes. These disease vectors thrived in the standing water and hot, humid summers in the Philadelphia area. The medical community did not understand the cause of the disease or how it was transmitted.

    Symptoms of the disease include fever, chills, loss of appetite, nausea, muscle pains particularly in the back, and headaches. Some people develop jaundice due to liver damage, bleeding in the mouth, nose, the eyes, vomiting, kidney failure, and delirium. Those who develop more severe symptoms have a 50% fatality rate. There is no treatment for yellow fever. It can now be prevented with a vaccine and the eradication of the infected mosquito population.

    Aug. 12. Our little dog Tartar barked last night from between 11 and 12 o'clock till near one, with very little abatement. I arose and went to ye window , but could not see ye cause . Something there was to set him agoing , as he is too fat and lazy to exert himself for nothing. 'Tis very rarely he barks.

    . . . .

    September 21. Our neighbor Campbell called to say farewell. They leave the city to morrow, during the fever. Dr Wistar has said that the town is in better state at present, than for 10 days past.

    Sept. 22. Ye Library is shut up for the present, and our evening paper is not sent, as ye printer is moving. We do not hear of many new cases of fever.

    Illustration of a large sailing vessel docked and people loading and unloading cargo.
    In 1803, Philadelphia was a busy port city.

    "Arch Street Ferry in Philadelphia." by William Birch is in the Public Domain

    A girl of ye name of Hannah Stringer, an intimate of our S. Dawson's, and a maid of neighbor Campbell's, has come, by Sall's invitation, to lodge here tonight. Girls who are running about the city at this time, without fear or care, are not desirable inmates. I did not like to refuse her, but shall not like a long continuance of her company.

    Sept. 25. First day. One more of the few remaining old friends and acquaintances is departed! James Logan died this morning, I expect rather suddenly. I have not heard any particulars. About 2 or 3 weeks ago, I sent him some plums. He told Peter he was better than he had been, and was coming soon to visit us.

    Sept 26. H. D. went in our waggon to the funeral of our friend J. Logan, this afternoon, at 4 o'clock. A short procession — no women there.

    Sept. 28. This morning Sally Dawson was going to market, but complained of a pain in her head, and sick stomach. Sister told her she had better lay down, and not think of going out. Soon after, she vomited frequently. I sent for Dr Kuhn, knowing how imprudent Sally had been running out of nights &c. The Doctor said he hoped it was not ye yellow fever, but might turn out [to be] an intermittent fever. He ordered a puke of antimonial wine, and if her headache and fever continued, to have 8 ounces blood taken in ye evening. This evening she is, we hope, no worse, and fearing her arm might bleed in ye night , we have put off ye bleeding till morning. Judah tends her at night. She is very careful — I am not well enough to stay with her all night. I am very uneasy indeed on S. D's, and on our own account.

    Sept, 29. Sally continued very ill, but not so much so as to alarm me much. Dr Kuhn came rather sooner than is common for him. He went up with me, and examined her eyes, which were red. On coming out of ye room he told me she had the yellow fever, and ordered 12 ounces of blood to be taken, and wrote a recipe to send to ye apothecary for pills of calomel &c. My husband and ye Doctor talked of sending her to ye Hospital . He said she would be taken as much care of there as she could be here, unless her mistress could attend constantly upon her, which I am not qualified to do. Were I in good health, and the rest of my family absent, I think I could undertake it, but that would not be allowed of . Ye Doctor wrote a note to ye Board of Health, and a carriage was sent about 3 o'clock p.m., in which she was taken. She shifted herself, and was dressed rather smartly ; stood at ye kitchen door while her bed and bedclothes were put into the carriage. I wrote her a little letter to keep up her spirits. My husband wrote another to Dr Dorsey the attending physician, desiring his particular care of her. Poor child! as she is in the first stage of ye disorder, may it please kind Providence to restore her — but this we must leave. We have all felt weak and low since her absence. I am going to bed but not with much expectation of sleeping.

    Sept. 30. Dr Kuhn kindly called this morning. The sending S. D. to the Hospital I believe was quite right; my mind is more at ease, tho' we have not yet heard how she is. Dr Kuhn says we may know by sending after dinner to Dr Duffield. I wrote a few lines to my daughter Nancy by ye stage, desiring her not to return in ye stage to town, but to stay till we send for her. The disorder, I fear, increases.

    John Alsop called about dinnertime. He asked if we had heard from our girl. No, not yet. He had been to the Hospital this forenoon , where a servant girl of his was taken yesterday, just after ours. She was taken ill, and they sent for a Doctor, who said he could not say it was the yellow fever, but if she continued in the city it might become such, and advised them to send her to ye Hospital . He said he would go again tomorrow and let us know how Sally is.

    Now if I had strength of body and firmness of mind to have undertaken ye care of our S. D., my family would not have suffered it, tho' I think, with Dr Kuhn's help, I might have brought her through. But I believe we have acted for the best; the symptoms with Sally were decided, I think — ye puke she took, ye copious bleeding of yesterday morning, and the mercurial pills she had taken before she left us, might have contributed to her amendment; but it is a deceitful disorder, and we must not flatter ourselves that she is out of danger, tho' seemingly better. People avoid our house, as we perhaps, should do ourselves. Sally's room has been cleaned, and her clothes washed — I believe there is no more infection in it now than there was a month ago. If I am clear, who was 3 or 4 times in her room the day she was taken, and twice the day after, when she was going away, to encourage and comfort her, and to keep her spirits up, which advice she did not appear to stand in much need of. My husband stood in almost, if not quite contact with the men who came for her. He took a paper from one of them and read it. We may, nevertheless, be preserved.

    Oil painting of a young woman in a long skirt and apron sitting on a chair spinning wool.
    "A kitchen maid" by Hugues Taraval is in the Public Domain

    October 1. John Alsop borrowed W. D's horse to go again to the Hospital. He brought a different account from yesterday. His girl continues better, but our poor Sally is very bad, and is delirious. She was blistered yesterday, which is no sign that she was much, if any better. John intends going again tomorrow.

    We received an invitation to the passing of meeting of Charles Townsend and Prissy Kirk at Darby, next fifth day.

    Our neighbor Christian Hahn, chocolate maker or grinder, shut up his house this morning, and went into ye country with his family. When they had arrived at ye destined place, Wm Hyatt got off his seat, holding ye reins in his hand, to assist in taking the baggage out. One of the horses was somehow frightened, or as they say, stung by a hornet. He became violent. William endeavored to hold him in, but he made a turn and overset the carriage, and broke it irreparably. It belongs to Molly Oliver, and will be a great loss to her — but that is not the worst of the business; a sister of C. Hahn had her arm broken, and her head badly bruised. I don't find that Wm Hyatt was anyways to blame; where there are two horses there should always be some one behind the carriage to open gates, let down ye steps, knock at doors &c.; but with Hacks, that cannot be expected.

    My husband, sister, William and self were sitting this evening reading, apparently at our ease, while our poor Sally may be vomiting her life away, or be in the agony of death! Yet that may not be the case — she may be restored.

    Oct. 3. John Alsop came in the forenoon. He had not been to the Hospital, but heard, upon enquiring that our Sally Dawson was gone. My husband brought a letter home from Dr Dorsey, wherein he informs us, "that the first indication he received of the malignancy of her case, was a considerable bleeding from the arm, which commenced before she arrived here," and which he found it for sometime difficult to check. Her symptoms abated the day after her arrival, but on ye next day, seventh day, she was seized with black vomiting which recurred seven times in the course of first day — and she expired this morning at a quarter before six o'clock, without having suffered, as she often told him, any pain, but weakness and a sick stomach. He thinks he has seen but few cases of more malignant disease than hers, and that Drs, Caldwell and Duffield coincide in this opinion. He finishes with saying — "I trust you will do me the justice to believe that I made every exertion in my power to prevent this unfortunate termination of her malady."

    Thus it is — a pretty girl, in the bloom of youth, with an high and independent spirit, is taken off the stage of life in no more than 5 days illness . A lesson for both the young and old.

    Oct. 6. A letter from Jacob Downing; he is in town, but is, I expect, under some apprehensions of coming here. I don't wonder at it, though there is no danger; we have been very careful to have Sally's room, which is over the kitchen, thoroughly cleaned. He tells us in his letter that a waggon from Downingtown is now here, and we could go with him tomorrow. I asked my husband what he thought of Jacob's proposal; he said — nothing at all . So that there is no probability of our leaving ye city.

    Oct. 16. It is two weeks tomorrow since Sally's death. I wish to know how she seemed in her mind during her illness. When ye fever is over, and the City Hospital closed, I shall endeavor, if I live, to see Dr Dorsey, who attended her while there.

    Oct. 19. A young man over the way, next door to the barber's, died last night. Peter saw a horse and some sort of carriage at ye door when he went to bed, and this morning Sister and Paul saw a bed sent away from ye house in a cart. The man who put it in the cart stood by Campbell's wall and puked. We know nothing of this illness. He has left a young wife, who is daughter to ye man of the house. I know not their names — they have been married but 6 months. Their windows have been opened

    all day, and the room whitewashed. There can be no doubt of the disorder; many keep it private.

    . . . .

    Oct. 30. First day. The sun arose, I believe clear, as I saw it shine on Pratt's buttonwood tree. Nancy Dawson called before meeting. She had not heard of her sister Sally's death till this morning. She has not heard anything of her sister Betsy, who said she was going to New-York sometime last year. 'Tis not unlikely she may be dead, if so, I told Nancy, she would be entitled to all poor Sally left; that we had not yet opened her trunk, not knowing but that something she had worn while sick was in it. When frosty weather came, we would bring it into the yard, and air the clothes, and take a list of all she had, which should be kept for her until she was free, unless we should hear from Betsy, who, if living, is entitled to one half. Nancy is between 15 and 16 years of age.

    November 8. Judah and Peter went this afternoon to ye negro meeting. Many will not call ye black people negroes. 'Tis thought by some rather a harsh appellation , but as it is a common name for them, and Niger is, I believe, the Latin term for them, or for black, I think there is no impropriety in it. Have they not always been so called? Africans and Ethiopians indeed! Those here are neither.

    Nov, 15. The old story of cold in my head and cough, which is an affliction that I am often troubled with.

    Nov. 16. W, D. called on Dr Kuhn, who came here between 11 and 12 o'clock. He advised the loss of 10 ounces of blood, which was taken from my right arm before 12 o'clock, by John Hailer. My cough continues very hard.

    Nov. 17. My husband weighed the Bowl with the blood yesterday, 22½ oz. He weighed ye bowl today, 9½ oz; so that instead of 10 ounces, I lost thirteen.

    Non. 18, Dr Kuhn came this morning. He advised me to stay a few days in my chamber, but as I feel rather better this evening, I believe I shall not, as it is disagreeable to me to be confined up stairs when I can do otherwise.

    Nov. 19. The Dr called and said he wished I would stay in my chamber — the frequent passing thro' ye entry, and coming up and down stairs, renewed my cold; if the cough were not better in a day or two, I must lose more blood. He ordered a medicine to cut the phlegm. I am now up stairs, and how long I shall remain so, I cannot judge.

    December 8. James Pemberton informed H.D. of the death of Joseph Galloway — who died in August last, in what part of old England, I did not hear.

    Dec. 12, W.D. went to Dr Duffields', and gave ye Docr a list of what Sally Dawson took to ye Hospital. He said he would enquire after them, and further said, which I most desired to know, that Sally when in the Hospital made little complaint or moaning — as many others did. That she was very much debilitated, and her blood dissolved; that she had the disorder in a very malignant degree; that it generally proved fatal to Girls; that she lived but 3 days after her coming there.

    William asked him if he thought she would have lived could she have had the best of nursing at home. He answered, No, she could not. All this is rather satisfactory than otherwise.

    Dec. 14. The old man back of our stable has commenced a suit against Henry Pratt, Henry Drinker, and Isaac Knight. His premises, he said, were injured by the liquid from some of the dungheaps , running on his ground. The matter is to settle from whose dungheap it proceeds. The old man died last spring, and his widow is lately married to Wm Hyatt.


    • “&c” - archaic form of etc., meaning “and other things.”
    • abatement - a lessening, diminution, or reduction; a moderation; removal or putting an end to; the suppression of.
    • affliction - a disease; a state of pain and suffering.
    • amendment - the change for the better; healing.
    • apothecary - a person who makes and provides/sells drugs and/or medicines.
    • appellation - a name, title or designation.
    • “by ye stage” - short for stagecoach, the carriages that would transport people and small packages.
    • “commenced a suit” - began to sue or otherwise bring to court on legal grounds.
    • continuance - the action of continuing or prolonging.
    • copious - having an abundant supply.
    • debilitated - weakened; damaged.
    • “fifth day” - Thursday, usually used in Quaker society. (Quakers rejected the use of the names of days of the week that were derived from the names of pagan gods.)
    • “first day” - Sunday
    • forenoon - the part of the day between sunrise and noon; morning.
    • impropriety - having a quality of improperness; being rude.
    • imprudent - not prudent; lacking discretion; not attentive to consequence; improper.
    • “inflammatory rheumatism” - a disease causing pain and stiffness in joints.
    • inmates - a person who shares a residence, such as a lodger.
    • intimate - a very close friend.
    • malady - a disease or illness.
    • malignancy - the state of being malignant or harmful; the state of being deadly.
    • “mercurial pills” - pills of mercury used to induce urination and bowel movements.
    • minute - a short moment of time; a part of a meeting.
    • overset - to turn over or capsize.
    • “passing of meeting” - Quaker marriages required that the couple bring their request to be married to their congregation for their approval. If their marriage is approved, the couple is said to have “passed meeting.” (Bernard, Ella Kent. Dorothy Payne, Quakeress: A Side-light Upon the Career of "Dolley" Madison . Philadelphia: Ferris & Leech, 1909.)
    • “pills of calomel” - pills containing a mineral composed of mercury and chloride, used as both a sedative and laxative.
    • Providence - divine care or direction, the will of God; fate.
    • “puke of antimonial wine” - wine containing antimony that was designed to make a person throw up, an emetic.
    • Rising Sun - East.
    • Sall’s - a nickname for Sally Dawson.
    • simple - dim-witted; foolish; lacking intelligence; often used for those with learning or intellectual disabilities.
    • whitewashed - painted over with a lime and water mixture to both brighten and sanitize walls or fences.
    • Wm - shorthand for “William.”


    1. Quarantined families have to decide whether family members should associate with others outside of the household since any contact one person has with others has the potential to bring infection into the household. Is this a problem you have encountered? If so, how did your family handle it?
    2. How does yellow fever spread? How did the people in Philadelphia in 1803 think it spread? Did social distancing and stay-at-home help slow the spread of the virus?
    3. Mention is made numerous times about people having blood removed. Why do you think doctors used bleeding as a remedy for illnesses like Yellow Fever?


    Drinker, Elizabeth. Extracts from the Journal of Elizabeth Drinker: from 1759 to 1807, A.D. Edited by Henry D. Biddle, Lippincott, 1889, Internet Archive ,

    “Elizabeth Sandwith Drinker.” Wikipedia, Wikimedia Foundation, 6 Apr. 2020,

    “Yellow Fever.” Wikipedia, Wikimedia Foundation, 28 Apr. 2020,

    Public Domain Mark

    This work ( Extracts from the Journal of Elizabeth Drinker: From 1759 to 1807, A.D., by Elizabeth Sandwith Drinker ), identified by Internet Archive , is free of known copyright restrictions.