With the Yellow Fever raging over Rocca Sorrentina past week, i think its useful to publish the facts that are known now adays about this disease. I know this will be a boring article, but believe me, an outbreak isn't boring at all. On the contrary. Recently we are withnessing an outbreak of Ebola in Western Africa. I guess its about the same.

General description:

What is Yellow fever, known historically as yellow jack or yellow plague? Its an acute viral disease. caused by the yellow fever virus and is spread by the bite of the female mosquito.
A mosquito bites an infected person, and the virus is absorbed, along with the persons blood. Then the mosquitoe bites a healthy person, and transfers the virus. It only infects humans, other primates and several species of mosquito.

The disease originated in Africa, where it spread to South America through the slave trade in the 17th century. Since then, several major outbreaks of the disease have occurred in the Americas, Africa, and Europe. In the 18th and 19th century, yellow fever was seen as one of the most dangerous infectious diseases, causing massive deaths and misery.

Now adays, a safe and effective vaccine against yellow fever exists, but in the early days no one had any idea what was the cause. Some countries require vaccinations for travelers.

Once infected, management is symptomatic with no specific measures effective against the virus. In other words, there is still no cure, even not today in the 21sth century. In those with severe disease, death occurs in about half of people without treatment. That means massive numbers of people died in the past when an epidemy struck. In our time yellow fever causes about 200,000 infections and 30,000 deaths every year. Nearly 90% of these occur in Africa.

Not everyone gets the disease with the same strenght or intensity. Yellow fever begins after an incubation period of three to six days. Most cases only cause a mild infection. The afflicted initially experienced pains in the head, back and limbs accompanied by a high fever. Other symptoms are: headache, chills, back pain, loss of appetite, nausea, and vomiting.
In these cases the infection lasts only three to four days. These symptoms would often disappear, leaving a false sense of security.
In fifteen percent of cases, however, the disease would announce its return with an even more severe fever, and turn the victim's skin a ghastly yellow, while he vomits black clots of blood. The yellow colored skin (jaundice) is the result of liver damage, Bleeding in the mouth, the eyes, and the gastrointestinal tract will cause vomit containing blood, hence the Spanish name for yellow fever, vomito negro ("black vomit"). I can assure you, that is not a pleasant sight. Death soon followed as the victim slipped into a helpless stupor.

The toxic phase is fatal in approximately 20% of cases. In severe epidemics, the mortality may exceed 50%. Luckily, surviving the infection provides lifelong immunity, and normally there is no permanent organ damage.

Now adays we know there is no cure. We have to treath the patients symptomatically.
In the 18th century on the other hand the most commonly used treatments were bloodletting and purging.
An widely used remedy was calomel or Mercury chloride. Mercury became a popular remedy for a variety of physical and mental ailments during the age of "heroic medicine." It was used by doctors in America throughout the 18th century, and during the revolution, to make patients regurgitate and release their body from "impurities". Dr. Benjamin Rush used calomel to treat sufferers of yellow fever during its outbreak in Philadelphia in 1793.
Calomel was given to patients as a purgative or cathartic until they began to salivate and was often administered to patients in such great quantities that their hair and teeth fell out.
A war of words erupted in the press concerning the best treatment for yellow fever; bleeding or calomel. Anecdotal evidence indicates calomel was more effective than bleeding.
These days we know that Mercury is highly toxic (no offense to you Mr. Gandt).

History of the 'Yellow Plague':

The first accurate description of yellow fever seems to be the one written in the year 1495, after the battle known as Vega Real or Santo Cerro, fought by Columbus in Hispaniola against the Indians.

Yellow fever did not originate in Europe. Hippocrates does not mention it. There are no descriptions of this striking disease entity by any European writer of the Pre-Columbian period. Nothing about yellow fever appeared on paper until the discovery of America.

Santo Domingo, the Island of Guadeloupe, The Island of Cuba, Barbados, Santa Lucia, Martinique, all were scourged in the 17th century.
It appeared in New York in 1668, in Boston in 1691, in Philadelphia in 1669 and in Charleston in 1699.
However, from the 18th century on, because of the great military expeditions and the facilities in the passenger routes, intensive yellow fever epidemics broke out. Spain paid a high price for its trading monopoly. Malaga suffered five epidemics, causing the death of more than 3,000 human beings in 1741. Cadiz was scourged several times, and the Canary Islands suffered their first severe attack in 1771.

New York underwent no less than seven important epidemics from 1702 to 1800. Philadelphia was scourged on eleven occasions and we all know about the 1793 epidemic, so well described by Mathew Carey in his excellent exposition of the horrors suffered by the inhabitants of that city.
Indeed, during the Yellow Fever Epidemic of 1793 in Philadelphia, Pennsylvania, 5000 or more people were listed in the official register of deaths between August 1 and November 9. The vast majority of them died of yellow fever, making the epidemic in the city of 50,000 people one of the most severe in United States' history.

The 19th century had major outbreaks in The America's as in Afrika and Europe.
We find Madrid shaken in 1878, and the epidemics recorded in that century in the cities of Cadiz, Cartagena, Jerez de la Frontera, Malaga and Barcelona were indeed horrible,

This brief historic outline of yellow fever epidemics brings us to the year 1878, when the disease invaded more than 100 cities and villages in the United States, mainly in the States of Louisiana, Mississippi and Tennessee. The number of cases reached the figure of 120,000 out of which 20,000 were lost.


The Congress of the United States passed a law in March 1879, setting up the National Board of Sanitation. The first resolution passed by the Board was to organize a Commission to visit the West Indies, with the object of studying Black Vomit in the supposed source areas of the disease.
Finally the cause was identified: transmission my Mosquitoes. Sir William Reed has to take the most credits in unraffling this widespread plague.

End of lecture. (I hope you found this a bit interesting).

Panacek, Retired War Surgeon

updated by @docteur-panacek: 06 Oct 2016 06:30:18AM

((This is a wonderful article. Thank you!

Many historians believe that heavy British losses from Yellow Fever (and malaria) during the summer of 1780 in Georgia, Carolina, Florida led to the British defeat at Yorktown. Both sides suffered heavy losses, but the British were hit hardest.

My grandmother still has a few letters (mostly copies) from 18th and 19th century family members describing outbreaks in Louisiana and in Charleston that claimed the lives of numerous "kin" and when I read them I realize how very blessed we are--as well as how much our circumstances could change without warning, e. g. ebola.))

Lorsagne's amanuensis

Thanks for these very interesting background informations:)

Thank you for sharing, Pekel

The information and the virtual quarantine experience in Rocca (which I was actually sorry to miss while I was traveling in RL) are really helpful in understanding18th century life. Thank you!