October 2, 2012 12:23:24 PM
It used to be that southern communities would expect attacks of yellow fever every summer; it was as natural as the rise in the temperatures. The fever would come, linger through the hot months, and go. Some people would die from it, and then it would be over. The attack of yellow fever that hit Memphis in 1878 was extreme in its numbers, killing around a tenth of the 50,000 citizens, with the number that low because most of the others had fled the city. We have new plagues, and we don't worry much in this country anymore about yellow fever, but the story of the Memphis attack makes for macabre and fascinating reading in Fever Season: The Story of a Terrifying Epidemic and the People Who Saved a City (Bloomsbury Press) by historian Jeanette Keith. This is a classic plague tale, with participants unpredictably turning into heroes or cowards. The devastation fascinated newspaper readers across the nation at the time, but Keith might also be writing about readers of this very book: "The people who read of the plague summer in the daily papers were as fascinated by the vagaries of character as the firsthand observers in Memphis. It is almost comical how surprised they were - how surprised we all are - when the same things happened in Thucydides's Athens, Boccaccio's Florence, Defoe's London, and in every major epidemic, over and over again."
This is a study of yellow fever's effects on Memphis for one disastrous season. Keith emphasizes that it is not a scientific romance leading to understanding of the illness and victory over it. Walter Reed and his team of doctors only in 1901 discovered that mosquitoes spread the fever, but that understanding was not available at the time of the book's events. People in Memphis blamed bad sanitation, and they had good reasons to do so. The city was loosely organized, with most people relying on simple pit toilets and no civic funds to clean the horse- and mule-ridden streets or to pick up garbage. Crusading was in vain to correct such things before the plague year. Memphis's biggest failure leading to yellow fever was its water system. Few people paid to have water piped in privately, with others relying on thousands of cisterns and wells. That sort of still water was just the place that the mosquito Aedes aegypti would use to lay its eggs; it was even known as the common gray cistern mosquito. Any house with a cistern had the mosquitoes, which tended to feed by day. Doctors by 1878 had generally discounted the idea that the fever came with bad air or miasmas. (In Memphis during the plague, however, there were still those who organized periodic explosions of gunpowder in order to clear the air.) They also knew that people could breathe in the air of a sickroom or clean up the black vomit that is characteristic of the disease without catching it themselves, so it was not spread like measles or smallpox. Somehow, however, the disease moved, seeming to travel upriver from New Orleans by steamboat. The virus traveled not by mosquitoes, which do not roam far, but in the blood of people, with an infected person in a new area being bit by a mosquito which then spreads the illness around the neighborhood. When train travel became common, yellow fever traveled the rails, and the disease could spread faster; this was a foretaste of the international spread of diseases via airplane that we all confront now.
Scientific explanations were incomplete, but people took the standard comfort that bad things must have a religious cause. The fever was retribution for the city's role in the slave trade, for instance. God was using it as a scourge, others said, against the citizens' drunkenness or debauchery. Others were sure that it was because Memphis had committed the sin of celebrating Mardi Gras. Keith mentions that "The Great Agnostic," Robert Ingersoll, wondered how anyone could worship a being that thought such a pestilence was a just punishment.
Yellow fever in most who got it caused a three day mild infection with fever, headache, nausea, and vomiting. In about 15% of cases, the patients go to a toxic phase of the disease causing liver damage, jaundice (producing the yellow coloration that gives the illness its name), and gastrointestinal bleeding producing the characteristic black vomit. A fifth to a half of those who get the toxic version die. There was no cure then, and there is none now. These dire characteristics were well known, and in 1878, citizens of Memphis knew the disease was coming up from New Orleans, and they fled. In three days of mid-August, 20,000 people left the city; no one had ever seen such flight, even from cities threatened by approaching armies. The flight was full of panic, but doctors agreed that the emptier the city was, the less human fuel the disease would have. Those who did not flee didn't have money to leave or anywhere else to go, or they wanted to keep up their property, or they had ill members of the family and could not leave them. And then there were others who stayed because they felt a sense of faith or duty to help the others who stayed on.
It was grim staying in the city. What little city government Memphis had was further reduced by the evacuation. A crime spree started in the empty city, with thieves pillaging empty houses. (When the plague was over, householders returned and often found decayed corpses of housebreakers who had died after enjoying the house's food and drink.) Much of what we know about life and death in the city comes from John McLeod Keating, a newspaper editor who became the voice of Memphis to the outside world, and who is quoted here often. "The business of the hour," he wrote, "is the succor of the sick, the burial of the dead and the care of the needy living. The last words of those who are well, are at night farewells to the dead, and the first in the morning 'Who lives, and who has died?' All day, and every hour of the day, this question is repeated, and the heart sickens at the reports, and the soul goes weary over the repetition. And yet there is no relief nor any release... Hope have we none." Keating was a typical partisan southerner, and had long opposed racial equality, but he acknowledged and praised the black citizens of Memphis as crucial to the city's survival. Essential were the black militia and the black policemen, and citizens who were there knew how important they were; in an epilogue, Keith demonstrates that this was not to be a legacy of the disaster. Historians were to write out the efforts of blacks; while black and white relief workers, for instance, ate at the same tables at the canteen, Jim Crow became the law after the danger had all gone away. Similarly, histories tended to play up the fully commendable roles of the volunteers and the mostly Catholic sisters and priests who stayed in the city to provide comfort. That there were Protestant ministers who fled, or fathers who fled and refused to help their families, were true stories that didn't bear retelling.
Among the stories of feckless fathers and thieves surrounded by stacks and stacks of coffins are some stories that are inspirational. A heroine here is Annie Cook, a madam to one of many Memphis brothels. In her house, the carpets and velvet sofas were removed and army cots took their place, with Annie becoming an acting nurse, trying to coax patients to take nourishment, sponging their fevers, and cleaning up the black vomit. She did this until she herself became ill. Keating announced the death of "the woman who, after a long life of shame, ventured all she had of life and property for the sick." Her body joined thousands of others in the Elmwood Cemetery. Her death attracted public attention at the time, but it was not until the 1970s that someone thought to mark her resting place with a stone and the epitaph, "A Nineteenth Century Mary Magdalene who gave her life trying to save the lives of others."
The plague disappeared as the weather cooled and the mosquitoes withdrew. Yellow fever came back, but never with such virulence; quarantine, the immunity of those who had recovered from the illness, and just good fortune meant that Memphis was never stricken in such a way again. We understand the illness now, and we have vaccination and mosquito control. Keith's fine history is a reminder, though, that we will have other plagues, and they will not be merely city-wide, and we will find them as incomprehensible and frightening as Memphis did, and we will again be surprised at who turns hero and who turns coward.
5. A Stone's Throw: The veil COLUMNS