A fever for knowledge

Noah Webster inaugurates the field of public-health research

Tuesday, April 12, 2011

  • Image
In 1795, just as summer turned to fall, Noah Webster Jr., then the editor of American Minerva, New York City’s first daily newspaper, began to fear for his life. The yellow fever, so called because its victims looked “as yellow as gold,” had come to his doorstep. Dozens of New Yorkers were dying every day, and Webster, like everyone else in Manhattan, could think of little else. 


When not confused with his distant cousin Daniel, the eloquent Massachusetts senator, Noah Webster is synonymous today with his “American Dictionary,” first published in 1828. But the Hartford, Conn., native and 1778 Yale grad was more than just America’s best-known lexicographer. During his stint as a New York journalist in the mid-1790s, the word-obsessed Webster also turned his attention to gathering and organizing scientific information; the yellow fever, which then posed a threat to all Americans, would motivate this brilliant polymath to inaugurate the field of public-health research.


The pestilence had been raging throughout the eastern seaboard for about two years before snaking up to Manhattan. In 1793, Philadelphia was hit so hard that President Washington had to temporarily evacuate his home. In one month, the plague literally decimated the nation’s temporary capital — all told, the body count there reached a staggering 5,000.  


New Yorkers had felt relatively safe until the spring of 1795, when health officials heard of a new outbreak in the West Indies. The city required ships originating from there to be anchored at least a quarter mile from New York harbor. Manhattan’s first casualty was a man named Thomas Foster, who initially sought medical help from Dr. Malachi Treat, the health officer to the city’s port, on July 6, 1795. Two weeks later, Treat himself was stricken, and by the end of the month, he too was gone. By mid-August, two New Yorkers were dying per day, and the city’s physicians were ordered to quarantine all their afflicted patients at Bellevue Hospital.


Two months later, as the death toll in his adopted hometown reached 500, Webster could stand by no longer. In the Oct. 31 edition of his paper, Webster addressed the physicians of Philadelphia, New York, Baltimore, Norfolk and New Haven, the cities hardest hit over the previous three years. “To decide on the nature and origin of the yellow fever,” he asserted, “we want the evidence of facts; and it is not improbable that facts have occurred in the U. States, sufficient in number and clearness to furnish … universal conviction, shall those facts [be] … ordered to the public in a mass.” Webster asked the physicians to pass on whatever information they had gathered from their own practices. This questionnaire was the world’s first scientific survey.


Though the fever disappeared from New York just a few weeks later — the city’s final death toll was 730 people, the proportional equivalent of about 200,000 today — Webster kept up a lively correspondence with the physicians who responded to his query.   


The following summer, he published his preliminary findings in “A Collection of Papers on the Subject of Bilious Fevers, prevalent in the United States for a Few Years Past,” which contained contributions by leading physicians such as his New York neighbors, the doctors Elihu Smith and Samuel Mitchill. Their accounts were short on hard data. For example, noting that poor immigrants constituted a significant percentage of the dead, Smith postulated that “the sudden intermingling of people of various and discordant habits [was] a circumstance favoring the production of disease.” 

    
Webster was unable to prove his hypothesis — that the fever’s spread had something to do with the city’s grime — but he nevertheless saw it as a vindication of the virtues he lived by. Americans, he implored, should “pay a double regard to the duties of order, temperance and cleanliness. The most fatal effects follow from neglect in these particulars.”


After moving to New Haven, Conn., in 1798 and handing off the daily duties of editing the newspaper to his assistant — Webster would not officially retire from journalism until after Alexander Hamilton started a rival paper, the Evening Post, in 1801 — he attempted an even more thorough investigation of the fever. The result of his second year of research was a 700-page tome, curiously titled “Brief History of Epidemic and Pestilential Diseases with the Principal Phenomena of the Physical World Which Precede Them and Accompany Them and Observations Deduced From the Facts Stated.”


Webster traced epidemics throughout history, moving from biblical accounts to medical reports, beginning with the Greeks and continuing up to his day. The first chapter, composed entirely of charts, featured bills of mortality for London, Augsburg, Dresden, Paris, Boston and Dublin over the previous two centuries. After covering this historical turf, Webster tried to explain why his fellow Americans had been dying at such an alarming rate. However, his scattered data didn’t enable him to refine his thinking beyond the vague environmental causes — dirt, pollution and the like — that he had first identified in his earlier book. Wedded to the empirical method, Webster was forced to acknowledge the tentative nature of his findings: “More materials are necessary to enable us to erect a theory of epidemics which shall deserve full confidence.”


While Webster still wasn’t able to pin down the cause of the disease, he did help to fill a gaping hole in the scholarly literature. Few writers, he noted, had ever attempted systematic studies of medical conditions such as the fever. In the final analysis, Webster did manage to put public health on a scientific footing. The Johns Hopkins professor William Osler, a giant of late-19th century medicine, later described this treatise as “the most important medical work written in this country by a layman.”


The fever returned intermittently throughout the 19th century, but never with the same intensity as in the 1790s. Nearly a century later, scientists finally solved the puzzle: The disease had been transmitted by mosquitoes. 


Joshua Kendall is the author of “The Forgotten Founding Father: Noah Webster’s Obsession and the Creation of an American Culture,” published this month.