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May 20, 2020 by Hannah Leave a Comment

Quarantea: Yellow Fever 1793

In the third installment of our limited series, we discuss the outbreak of Yellow Fever, which ravaged Philadelphia in the year 1793, along with the various treatments for this particularly terrible plague. We also discuss the manner in which the very new American Government handled the situation, how mercury and Vicks vapour rub got involved, along with a smattering of Hamilton references.

Listen on Buzzsprout here!

Philadelphia in 1793.

In 1793, Philadelphia held a special place in the newly formed United States. Only 10 years past the Revolutionary War, the city was acting as a temporary center of the government during the construction of the new capital building in Washington. Adding to its importance was the port, surrounded by seven blocks where most of the occupied homes were located.

Guns and ships.

In late spring, merchant ships came into port, fleeing a slave uprising in northern Saint Dominique (now known as Haiti). Donated by a wealthy Philadelphian named Steven Girard to assist in relocation, they carried 1400 French refugees and 600 enslaved persons. Reports indicate that passengers began showing symptoms of illness en route, and their arrival in the densely-packed housing districts only spread the contagion.

Yellow Fever is a virus that is thought to have originated in West Africa. It spread to the Caribbean and North America via the slave trade on ships owned by Dutch and American companies. Mosquitos, the vectors of the disease, were able to cross the ocean on these ships and were causing outbreaks in Barbados and Guadalupe by the mid-1600s. Certainly by 1793, symptoms were familiar enough to be recognized by those who had encountered it before.

Once the mosquitos aboard Girard’s ships came ashore, they were able to breed quickly in the standing water in the streets, as well as outhouses built close to wells. Because mosquitos travel only about a quarter of a mile during their lifetimes, the initial spread of the disease took time, with each generation of the bugs expanding their territory a little further during their two-weeks on earth.

Oregon Trail, Aedes aegypti edition.

In both 1793 and modern outbreaks, Yellow Fever is characterized by rapid development of a high fever, flushed face, nausea, joint and muscle pain, fatigue, and an infection of the upper eyelid. After initial onset, the fever will relent, only to return a few days later with yellowing of the skin known as jaundice (caused by damage to the liver) that gives the virus its name. As tissue damage continues, the gums and gastrointestinal tract will bleed, leading to vomiting of black blood, shock, and death. In modern cases where patients develop jaundice, the death rate is between 20 and 50%.

Stages of Yellow Fever.

As the death count rose, Stephen Girard felt responsibility for the outbreak, as he had provided the ships that carried the contagion. He threw himself into efforts to care for the sick, establishing a care center at Bush Hill and personally performing the duties of a nurse at the peak of the epidemic.

Illustration of Stephen Girard assisting a patient.

Other city leaders and doctors had more creative approaches to stopping the spread. Suggestions ranged from avoiding night air (probably effective as mosquitos are nocturnal) to exploding caches of gunpowder in the streets to improve the air quality (less effective but more entertaining). See our episode for a lively and full discussion of various remedies, as well as which 18th century cures we would opt for! Spoiler: early heroic medicine was given a hard pass by each of your hosts.

And when we say “early heroic medicine”, we are looking at Benjamin Rush.

Three months after it began, the disease relented as the chilly fall air killed off the mosquitos. The city slowly relaxed, and government officials began to trickle back into the city. Alexander Hamilton had never left, and contracted and survived the fever. George Washington, who had avoided the disease by leaving town, refused to return until the first good hard frost.

Yellow Fever would return to Philadelphia in the coming years, but never with the terrible impact of its 1793 rampage. It would take 145 years until a vaccine would be available, but since its debut in 1938, only 12 post-vaccination cases have been identified. The vaccine appears to provide lifelong immunity, so the WHO recommends vaccinating infants between 9 and 12 months in areas where the fever occurs frequently (mainly the tropics). Though Yellow Fever continues to take lives each year, it is no longer an unstoppable force.

The Yellow Fever vaccine today.

Filed Under: Show Notes Tagged With: american history, early american history, Philadelphia, quarantea, quarantine, Yellow Fever

April 29, 2020 by Allison Drtina Swanson Leave a Comment

Tea with us: Patreon Announcement

First of all: Thank you!

Thank you all so much for listening, sharing, and enjoying our little adventure. It’s been a rough 2020 so far, but we are so glad to share these stories with each other and with all of you. Thanks to your requests we have started a Patreon! It’s just getting started now, so please keep an eye out for updated Patreon tiers and rewards. What would you like to see from us?

Once again, thank you all!

Filed Under: Announcements, Patreon

April 21, 2020 by Hannah Leave a Comment

Quarantea: The Black Death

In the second episode of our limited Series “Quarantea”, we learn about the fabled Black Death. We hear even more dramatic reading from Allison, her death plushies make yet another appearance, and Hannah describes in vivid detail how this horrible disease took hold, all while we debate whether fleas can cough.

Listen on Buzzsprout here!

The story of the Black Death is a complicated one that likely began somewhere in China with the bite of a flea on an infected rat. By the mid-1340s, rumors were circulating of a pestilence blazing through India, Persia, Syria, and Egypt, leaving death in its wake. And it was on its way to Europe.

Theodor Kittelson, “Pesta Comes”, 1900

The plague arrived in Europe in October 1347, when 12 ships from the Black Sea docked at the Sicilian port of Messina. Most of the sailors were dead and the ones who were alive were succumbing to a terrifying disease. They were quickly forced by the authorities to leave, but it wasn’t soon enough.

From that port in Messina, the plague made its way through the continent. Just like today, it arrived first in port towns like Marseilles in France and Tunis in North Africa. It wreaked a special kind of havoc in Florence and Rome, the densely-populated hubs of massive trade routes. They were seeing lots of traffic due to recent developments (Marco Polo had completed his legendary journeys just over 50 years prior). By the middle of 1348, plague had reached Paris, Bordeaux, and London. 

Like the world’s most unwelcome DoorDash.

As the disease raged, Welsh poet Ieuan Gethin described the black sores (referred to as “buboes”), which he saw first-hand in 1349:

“We see death coming into our midst like black smoke, a plague which cuts off the young, a rootless phantom which has no mercy for fair countenance[…] It is of the form of an apple, like the head of an onion, a small boil that spares no-one. Great is its seething, like a burning cinder, a grievous thing of ashy color…They are similar to the seeds of the black peas, broken fragments of brittle sea-coal…cinders of the peelings of the cockle weed, a mixed multitude, a black plague like half pence, like berries[…]“

In England, Henry Knighton referenced the plague’s speed and steady march from East to West:

 “Few kept their beds more than two or three days, or even half a day. Then this cruel death spread everywhere around, following the course of the sun.”

Plague doctor ensemble. A slight correction to our statements in the episode: it appears this particular look was in vogue during outbreaks of the plague in the 1600s, not the initial wave in the 1300s.

The plague was merciless, leaving physicians of the time unable to offer any effective remedy. Death tolls varied by location, but estimates place it at about 1/3 of the world’s population. In some communities, fatality was 100%, the villages left to be reclaimed by nature. In Florence, the death toll was so great that the burial process had to be adapted:

“At every church they dug deep pits down to the water level; and thus those who were poor who died during the night were bundled up quickly and thrown into the pit; they then took some earth and shoveled it down on top of them; and later others were placed on top of them and then another layer of earth, just as one makes lasagna with layers of pasta and cheese.” (Marchione di Coppo Stefani, eyewitness of the plague in 1348)

Survivors, and those who hadn’t yet fallen sick, were left to respond to the trauma as they would. Some blamed minorities for the disease, others moved into the homes of wealthy victims of the plague and tried to live as much of the high life as they could. Others, known as the flagellants, could only believe this was a judgement from God and roamed from town to town, whipping themselves in an attempt to take the punishment upon themselves.

While this wave of the disease eventually burned itself out around 1351, Europe would suffer further outbreaks well into the 1600s. It wasn’t until an outbreak in Hong Kong in 1894 that a doctor named Alexandre Yersin would finally identify the bacteria responsible for the bubonic plague. It was dubbed Yersinia pestis in his honor.

Electron microscope image of Yersinia pestis bacterium. Why, pestis?

Despite many matches between descriptions in historic records and modern outbreaks, as well as evidence of ancient Y. pestis DNA in many plague graves, some researchers express doubts as to whether bubonic plague was the only or even primary cause of the 1347-51 epidemic. One key discrepancy is transmission rate: it is typically spread by fleas, which feed upon infected rats and then cough the bacteria back into the bloodstream of the next human they bite. Some hold that this process could not have carried the plague fast enough to be the culprit. Other discrepancies include a climate that was too cold for the black rat and the absence of the evidence of the massive rodent die-off that typically precedes modern plague outbreaks.

However, other researchers point out that Y. pestis causes not only bubonic plague, but also septicemic and pneumonic plague. Septicemic plague happens when the bacteria poisons the blood, and can be spread by contact with bodily fluids. Pneumonic plague results when Y. pestis infiltrates the lungs. It can be spread by coughing, sneezing, and even breathing. The combined transmission of the same bacteria by fleas, contact with fluids, and airborne particles would account for a much faster spread of the disease.

This image has an empty alt attribute; its file name is P0-1024x1024.jpeg
Maybe it wasn’t just the rats after all.

We often think of individuals living in medieval times as having a kind of emotional immunity to death because they were, for lack of a better term, “used to it”. And it can’t be denied that due to things like disease, infant mortality, and childbirth, they did experience it much more frequently than we do today. But accounts of the Black Death show a response to loss that rings achingly familiar across nearly 700 years.

In 1348, Edward III of England sent his daughter on a journey to Castile, where she was to marry the heir to the throne. In France, her retinue was stricken with the plague and Joan died at the age of 14. In his letter informing the king of Castile, Edward writes of the experience:

“No fellow human being could be surprised if we were inwardly desolated by the sting of this bitter grief, for we are humans too.” 

Statue said to depict Joan of England.

Filed Under: Show Notes Tagged With: Black Death, British History, European History, Medieval History, quarantea, quarantine

April 17, 2020 by Hannah Leave a Comment

Quarantea: The Plague of Athens

In the first episode of our limited series on the plagues of the past, we dive into the plague of Athens. In a lively discussion led by Allison, we talk about how the Athenians and their neighboring city-states handled the epidemic, some unique funeral practices, as well as Allison’s collection of death plushies. We also talk about DNA and, of course, our beloved troll person Andrew Lloyd Webber. 

Listen on Buzzsprout here!

In order to learn about the plague of Athens, we turn to someone who had first-hand experience with the events: Thucydides. In addition to being a great sculpture model, he also not only lived through and chronicledthe plague of Athens, but contracted and SURVIVED it. He also had a longstanding rivalry with fellow historian Herodotus (click here for the full story courtesy of Kate Beaton!)

Looking fly, Thucydides.
Herodotus scoffs at your “impartial history” and raises you one giant ant.

Our story begins about 2,400 years ago in the Greek Isles. After the Persian empire had left the area, Sparta and Athens were left in a fight for dominance. Sparta took the land war approach, trying to blockade Athens and starve them out.

Athens is inside the black circle. Also, we might have added an extra note to this map.

In response, Athens built an encompassing wall about 3 3/4 miles long to provide a safe connection to their port city even under siege. The rural population also moved inside the walls for safety, which is said to have tripled the combined population of the two cities.

Athens, cotton swab of the Aegean.

Into this dangerous combination of a port city with crowded conditions came the plague. Seemingly healthy individuals would be stricken with coughing fits and other respiratory symptoms, inability to sleep, dry heaving, skin breakouts similar to pimples or ulcers, and a strange feeling of heat of the inner body (though patients were noted to feel cool to the touch). This inflammation would extend to the eyes, throat, and tongue, to the point that sufferers “could not bear […] to be otherwise than stark naked.” Thucydides painted a dark picture:

“The bodies of dying men lay one upon another, and half-dead creatures reeled about the streets and gathered round all the fountains in their longing for water. The sacred places also which they had quartered themselves were full of corpses of persons that had died there, just as they were; for the disaster passed all bounds, men, not knowing what was to become of them, because utterly careless of everything, whether sacred or profane”.

Current mood: second figure from the left.

By the time the disease finally burned out, an estimated 77,000 to 100,000 people had perished. Survivors were often left with missing fingers and toes, as well as loss of sight due to the disease.

In addition to taking the lives and health of many Athenians, the plague also took a a social and political toll. Many of the upper class died, leaving their money to the hands of the lower class. There was also a drop in citizens able to fight in the wars, leading to the decline of Athens as a superpower of the ancient world.

Theories range as to the cause of this ancient epidemic, especially since its ancient context makes it difficult to retrieve forensic evidence. Popular contenders are bubonic plague, typhus, measles, smallpox, and even hemorrhagic fevers such as Ebola (it was known to have originated in African ports). In 1999, the University of Maryland hosted a medical conference in which it was agreed that the most likely culprit was typhoid, based on current knowledge and contemporary accounts. A 2005 analysis of remains from an Athenian plague pit revealed the bacteria Salmonella enterica, which causes typhoid. However, the pit had also been contaminated by hogs (known carriers of salmonella) around the same time period.

Of all the epidemics covered in this series, the Plague of Athens is the farthest-removed from us by time, scientific advancements and, for some of us, even geography. But the lives it took and its impact on society is no less important for its distance.

In the 1990s, excavations of a plague pit revealed skeletal remains of an 11-year-old girl lost to the disease. Scientists recreated her facial features and gave her the name Myrtis. In 2010, she was named a Friend of the United Nations, and “wrote” a letter as part of their world campaign to end poverty:

“My death was inevitable. In the 5th century BC we had neither the knowledge nor the means to fight deadly illnesses. However, you, the people of the 21st century, have no excuse. You possess all the necessary means and resources to save the lives of millions of people. To save the lives of millions of children like me who are dying of preventable and curable diseases [….] Listen to me. I know what I’m saying. Never forget that I’m much older and therefore much wiser than you.”

Myrtis.

Filed Under: Show Notes Tagged With: ancient greece, ancient history, plague of athens, plauges, quarantea, quarantine

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