did know was that yellow fever meant, in most cases, a horrible death. The first symptoms were chills, constipation, nausea, severe pains in the head and back, and high fever. After anywhere from a few hours to a few days, the temperature subsided. This was the turning point. A lucky minority slowly recovered and were thereafter immune; for the rest, the fever would suddenly return, while the skin and whites of the eyes yellowed with jaundice. There would be internal hemorrhages, especially in the stomach. Soon the sufferer would retch up a dark mixture of mucus, blood, and digestive juices—the dreaded black vomit that gave the affliction the name of vomito negro among Latins. Delirious, puking, and pouring sweat, the victim died in agony and stench. And before the body had cooled, the disease was fireballing through the neighborhood.

DOCTORS DISAGREED about the cause of this spread. The best professional opinion was that the “spores” or “seeds” of the illness were somehow carried in a “miasma,” that is, in bad air—especially bad air arising from marshy and swampy ground. But others believed that the infection was transmitted through “fomites”—the excretions of the patients, their soiled and stinking bed-clothes and bedding, their dishes, towels, toilet articles, or anything they had touched.

There was disagreement, too, about what started the fever. “Contagionists” believed (correctly, but for the wrong reasons) that it was brought in by an already sick outsider, so quarantine was a defense. But there were “anticontagionists,” who argued that the fever could start spontaneously in many towns at once. Honest doctors on both sides admitted their uncertainty. As one Memphian later put it, the disease was a “law unto itself in its tenacity of life as well as in its inception, growth, and progress.”

Memphis’s experience with yellow fever grew progressively worse after its 1855 encounter. An outbreak in 1867 took at least 250 lives. And in 1873 the city was very, very badly hit. Memphis was especially vulnerable in a public health sense, and there were circumstances that put a powerful kick into the social as well as medical consequences of an epidemic.

To start with, there was the city’s social geography. The Irish, mostly domestic servants and laborers, lived in crowded districts with names like “Pinchgut” and “Boxtown,” huddled near the riverbank. There they shared alleys with other poor newcomers, black and white. More affluent Memphians were already moving up the bluffs and eastward onto the high ground, away from the brawling, drinking, and crime of the riverfront.

These richer Memphians were disturbed by more than merely the turbulence of the unwashed. Memphis was just emerging from Reconstruction, which had temporarily put a new group into power. Expensive improvements had been undertaken. Many were necessary,

but there had been widespread corruption. By 1878 there was a heavy municipal debt—between $4,000,000 and $6,000,000. Most of the tax burden fell on the professional and mercantile classes. They felt plundered and believed themselves helpless to deal with the situation as long as they were outvoted by the more numerous Irish, so they banded together in a conservative movement, demanding that the city’s charter be repealed and that Memphis be ruled by commissioners chosen by the governor with the consent of the Senate. As they frankly admitted, their problem was too much democracy—“We have in our midst a large and controlling voting element which has but little at stake in the welfare of our city”—and their purpose was to get Memphis and its business future “away from the popular elections of the times and from all partisan influences.”

One of the most visible failings of Memphian government was in sanitation. Garbage and the excrement from 6,000 open privies drained into the Bayou Gayoso, a meandering streamlet in the northern part of town. The few sidewalks were made of decayed wooden blocks that could never be thoroughly cleaned. The streets were sloughs of mud and manure, roamed by hungry hogs and goats—“huge depots of filth, cavernous Augean stables,” wrote one outraged local journalist. Front and back yards were piled with refuse, including the offal of dead animals. Memphis stank. One visitor noted, “I’ve been to Cairo, and there’s dirt for you … I’ve been to Cologne where it’s pure smell—but they all back down before Memphis.”

Not surprisingly, Memphis suffered outbreaks of cholera, dysentery, and smallpox while growing up before the Civil War. Then, in 1867, it got more cholera along with the yellow fever. And by the summer of 1873 cholera and smallpox and yellow fever had returned—5,000 cases of the yellow jack, 2,000 of them fatal. Those citizens who could afford to decamp did, and they returned in the fall to carry on as usual, though with a certain uneasiness. There was a dwindling of projects for the future, a rise in unpaid taxes, a leveling off in population growth. Some Memphians had, says one historian, a sense that they “lived in a temporary world.”

But not even the most fearful could anticipate the scope of the next attack of the vomito negro .

THE FIRST WARNING came early in the summer of 1878, with reports of new yellow fever outbreaks in the Caribbean. When the news reached Memphis, Dr. Robert W. Mitchell, president of the city’s Board of Health, proposed a request to the City Council for money to set up quarantine stations. This triggered an angry debate. The two other medical officers of the board were anticontagionists who refused to support him. Their position was palatable to local businessmen, who thought that interrupting traffic into the city was almost as bad as an epidemic itself. But Mitchell, a stubborn man—and, as it later proved,

a brave one—rounded up twenty merchants’ signatures on a petition endorsing his request for $10,000. His opponents thereupon gathered thirty-two physicians’ names on a counterpetition, and the council turned down the quarantine idea. Mitchell resigned immediately, predicting that if yellow fever came again, it would be the city’s fault for “not taking the known necessary precautions …”

In about three weeks Mitchell was proved right. On July 27, confirmed incidents of yellow fever in New Orleans were reported. The council promptly reversed itself and set up facilities to examine all travelers arriving by boat and rail. Like someone alone at midnight hearing approaching footfalls on the stairway, Memphis waited while the disease came nearer. On August 9 word came of yellow fever in Grenada, Mississippi, only a hundred miles to the south. But boosterism whistled brightly. “Keep cool!” said the Memphis Daily Appeal four days later. “Avoid patent medicines and bad whiskey! Go about your business as usual; be cheerful, and laugh as much as possible.”

On August 13 a Mrs. Kate Bionda gasped her last breath in a room over the small Memphis riverfront shop where she sold snacks to hungry boatmen. Her doctor, however reluctant he may have been to do so, had to report an indisputable fact: she was dead of yellow fever. The plague had arrived. Two days later twenty-two new cases were reported. The day after that, thirty-three.

The panic was on.

“On any road leading out of Memphis,” one survivor recalled, “could be seen a procession of wagons, piled high with beds, trunks, and small furniture, carrying, also, the women and children.” The male refugees walked alongside, either despondent or excitedly shouting to each other. Boats and trains were jammed. People forced open windows and doors and fought their way aboard. “The ordinary courtesies of life were ignored,” recalled John M. Keating, editor of the Daily Appeal and one of several who would write books about that appalling summer and autumn. “There was only one thought uppermost … an inexpressible terror.”

Inside of ten days, some 25,000 people poured out of the city—anyone who had kinfolk or could afford to rent accommodations in places as far off as St. Louis, Louisville, and Cincinnati. Passage was neither easy nor unobstructed. Nearby towns set up quarantines, backed by gun-toting enforcement committees. Many who fled were turned back or forced to camp in the woods. A few unlucky steamboat passengers spent the whole epidemic trapped on board, refused permission to land anywhere.

AUTHORITIES IN Memphis quickly set up temporary evacuation centers outside town that lodged about 1,300 refugees in tents. There they shared a protected but disciplined (and strictly temperate) existence. That left some 20,000 people in a city of shuttered shops and padlocked offices, awaiting the worst. Except for a few gallant or stubborn souls, they were the lower classes, who had neither place nor means of escape—14,000 blacks and some

6,000 whites.

By August 23 the number of cases had already reached epidemic status. One man wrote to his sister: “The fever raging & spreading all over the city … it has now nearly two months to run before frost … our people are falling in every direction. … God help us … where will the end be .”

Before the end, just about the entire city would come down with the fever. For reasons still not fully clear, the black mortality rate of 946 deaths in 11,000 cases was extremely low by comparison with that of the white. Virtually every one of the 6,000 white men and women still in the city fell sick, and there were 4,024 deaths—almost a 70 percent mortality rate. The number of deaths rose in September to nearly 200 per day.

There were weeks of hellish scenes: coffins piled up in wagons or on sidewalks outside houses, waiting to be driven to the cemetery; hospitals (one permanent, two temporary, one of the latter for blacks) loud with the wails of the patients; homes where whole families had died before doctors could arrive; bodies of children stiffening in their own filth; living babies spattered with dried black vomit, trying to nurse at their dead mothers’ breasts; corpses partly gnawed, or so badly decayed that they were “little better than a lot of bones in a puddle of putrid and greenish-looking water”; an occasional delirious and unattended victim wandering naked into the streets.

Yet what left the strongest impression on some was not these grisly sights but the overpowering emptiness. Keating recalled that “an appalling gloom hung over the doomed city. At night it was silent as the grave, by day it seemed desolate as the desert. There were hours … as if the day of judgment was about to dawn. Not a sound was to be heard; the silence was painfully profound. Death prevailed everywhere. … Even the animals felt the oppression and fled from the city. Rats, cats, or dogs were not to be seen.”

Over the streets hung the stink of decomposition, mingling with the reek of carbolic acid and lime, which were sprinkled about as disinfectants. Plumes of smoke rose from burning piles of “contaminated” clothing, mattresses, and bedding. Barrels of tar were also ignited, in hopes of killing whatever it was in the “miasma” that spread the disease. And cannon were fired off, too, to disperse the fever’s airborne “seeds.” For a time, funeral bells were rung at burials, but eventually the incessant tolling became too depressing. In all, Memphis was nightmarish—empty of people and full of smoke by day; bells pealing and cannon booming through the thick, choking silence. In the midst of it all, only a few noticed

that mosquitoes were, in the words of one editor, “as vigorous and desperate as ever.”

Sponge baths, laxatives, purgatives, light diets, quack remedies like gin and sulfur—nothing the medical men tried seemed to help. “We poor doctors stand by abashed at the perfect uselessness of our remedies,” wrote Dr. William J. Armstrong to his refugee wife. “Everything with me tonight is terribly blue,” he said in another letter. Sitting with an old friend in his office, both men broke down and cried. “I tell you,” he wrote, “it breaks the stoutest hearts.”

Stout hearts there were. As always, in the evil hour people showed a human mixture of nobility and baseness. With municipal government in collapse, the city had to be administered by volunteers. Every nonimmune volunteer stayed at the conscious risk of life: doctors and nurses who were convinced of the “fomite” theory handled the victims, living and dead, despite believing that everything they touched was deadly poison.

Chief among the emergency medical officials were the members of the Howard Association, a group of some forty businessmen specifically formed for periods of yellow fever attack. The group was modeled after a similar one founded in New Orleans in 1837; the name was that of a British philanthropist. The “Howards” recruited most of the medical personnel and stayed on to supervise the work. Thirty of them got the disease, and eleven died.

There was also a Citizens’ Relief Committee, coordinating the distribution of food, soap, candles, and bedding. Its chairman, a forty-one-year-old cotton broker, died on the job. Like some others, he thought he had already had the disease and was safe. But many such self-professed immunes had actually had dengue, another tropical, mosquito-borne malady with similar symptoms, often misdiagnosed as yellow fever. They were as vulnerable as anyone else.

Other relief services were organized by local fraternal groups—the Masons, Odd Fellows, Knights of Pythias, and Hebrew Hospital Association, as well as the Typographical Union, the Italian Fraternal Union, and the Association for the Relief of French Residents—all supporting in disaster Tocqueville’s observation about the strength of voluntary associations in American life.

The Catholic Church, whose Irish parishioners made up the majority of the white victims, pitched in unstintingly. Some fifty nuns became nurses, about twenty-five priests struggled to give comfort and last rites, and thirty nuns and thirteen priests died in the process. Approximately half of the Protestant ministers followed their congregants out of the city, but the rest stayed on to help, including all three Episcopal priests and all four Episcopal nuns.

The supervisor of the physicians brought in by the Howards was none other than Dr. Mitchell, who had tried to take precautions in June. His staff of 111 (most of them from out of town) worked themselves to exhaustion, trying to visit up to fifty patients a day. For each week of such days they got sixty dollars, a handsome sum in 1878 to be sure. And some

asked for more—at least the despondent Dr. Armstrong did, though he did not get it. The doctors also organized a research program and snatched time from sleep and work to meet and compare notes on treatment, hoping vainly that someone might empirically find a way to arrest the epidemic. One doctor performed 300 autopsies.

Of these Howard doctors, 54—almost half—came down with the fever, and 33 died, including Dr. Armstrong. Altogether, 45 doctors perished in the line of duty.

There were also about 4,000 nurses of both races, male and female, threequarters of them recruited and paid three to four dollars per day by the Howards and 500 of them volunteers from out of town. The nurses, too, suffered heavy mortality.

EVEN A CITY of the dead and dying needs its basic urban machinery, and there were valorous citizens to provide it. The mayor, the sheriff, the chief of police, and the chief health officer remained in town, as did the congressional representative for Memphis. All got the fever, but everyone recovered except the health officer. Eleven of the 41 city police quit and fled by the end of August; the majority stayed, and at least 12 of them died.

The police defections were especially serious since the city needed extra protection against looters. And this led to a wholly unexpected consequence. Memphis was as lily-white and racist a town as any in the South (it was, after all, the home of Nathan Bedford Forrest, father of the Ku Klux Klan, and had been the scene of a major race riot in 1866). But the chief needed to replenish his force, and there was no denying that fewer blacks seemed to catch the fever, or at least to die from it. So he chose thirteen blacks “of good character, muscle and pluck. ” When the epidemic was over, they were kept on. As Dennis C. Rousey of Arkansas State University has determined in his study of the epidemic’s impact, Memphis’s allwhite police force thus became about 25 percent integrated. There were still black police officers in 1905, when a Jim Crow administration began to purge the department.

The epidemic actually improved, if only slightly, the overall racial picture in Memphis. There was, at first, some conventional Southern nervousness because the blacks remaining in town so heavily outnumbered the weakened whites. But the social order stood fast. Many black servants, in fact, carefully tended the property of employers who had run away. The Citizens’ Relief Committee added some black members. And the state mobilized three militia companies, of which two were black. These two were sent into the city itself; the white company stayed on the outskirts.

Firemen stayed at their posts, even though at one point only seven of them were well enough for duty. The telegraph office stayed open, but nineteen operators died. The postmaster and nine postal workers succumbed, yet mail continued to flow in and out of the

besieged town. A few banks opened their offices daily to handle the donations coming in from other parts of the country—$700,000 in all, much of it from the North, another proof that the war was truly over. And three of the four newspapers in town kept publishing, even though down to one sheet.

There was also an unexpected heroine. Miss Annie Cook ran a wellknown sporting house in town. When the fever struck, she sent her girls off and opened the place as a private hospital, with herself as one of the nurses. And she died. In recognition, the Howard Association, though drawn from the cream of the pious and proper citizens of Memphis, overlooked her sins and buried her in Elmwood Cemetery under a laudatory headstone.

Of course there were villains too. Among the nurses (two out of three of them men) there were some unscrupulous souls, and small wonder—there was no nursing profession as such, and the job was basically to sit by the bedside. The doctors wanted it that way. “The more ignorant, if obedient … the better, “said one. So there were frequent reports of drunkenness, theft, and even rape by nurses, and a few may have been true. Keating believed many of the stories and was driven to spasms of wrath: “Petty thieving prevailed as an epidemic … principally confined to food and clothing, and wood or coal. … A few who came to nurse died, leaving full trunks of silverware, bijouterie, brica-brac, and clothes, to prove how industriously they could ply two trades and make one cover up and supply the deficiencies of the other. A few of them also made themselves notorious for lewdness and drunkenness. … They shocked decency and outraged humanity, they were no better than the beasts of the field. Male and female they herded together in vileness. … One of these, a woman … while stupefied from wine and brandy allowed a poor woman to leave her bed, naked as when born, and wander out into the country one inclement night, calling as she went for the husband who had preceded her to the grave. … In the house of an ex-judge … four such nurses died, and in the trunks of one … was found the family plate and wearing apparel of the judge’s wife. … In the whole range of human depravity there are few parallels to these cases.”

A more terse-spoken doctor rendered an informal post-mortem thus: “It took four [nurses] to kill her.” One had stolen the patient’s clothes, one had got drunk and neglected her, one had taken sick and died, and the fourth had also got drunk and fell over the bed.

There were cowards who decamped and left sick spouses and children to die alone, and profiteers who

rented space to refugees at gold-rush prices. And there was the undertaker Jack Walsh, who allegedly tumbled many bodies into unmarked mass graves. Perhaps he could not be blamed. He buried some 2,500 in one six-week period, and even with 130 employees hammering together coffins and shoveling relentlessly, he must have been fearfully pressed.

For good and bad alike, the end finally arrived after more than sixty days of ghastliness. The first frost came on the night of October 18; the cold wiped out the insect transmission mechanism, and by the twenty-ninth the number of new cases had fallen virtually to zero. The Board of Health declared the epidemic over, and on November 2 the militia companies paraded down Main Street behind the local cornet band. More formal gratitude was rendered at a Thanksgiving Day mass meeting. The great epidemic was left for historians to record and the clergy to interpret. Devastated families were reunited, and they tried to rebuild their lives around empty chairs and cradles.

BUT THAT WAS NOT the end of the story. There were, inevitably, profound aftershocks.

First, the old city government disappeared, universally damned for having allowed Memphis to become a debt-ridden pesthole. The conservatives—helped by the decimation of the Irish—quickly secured repeal of the charter. In January of 1879 the Tennessee legislature abolished home rule for Memphis and created the taxing district of Shelby County. The state collected municipal taxes and ran the city through two boards of commissioners. One controlled the police and fire departments, and two of its three members were named by the governor. The other board of commissioners was responsible for public works. Three of its five members were chosen by the voters, but that did not matter: the board could neither borrow nor spend without the explicit permission of the state, and it had to submit regular, careful accounts to the courts and the governor, Suddenly, almost twenty years ahead of the rest of America, Memphis had—at least for a time—something close to progressive, nonpartisan, “commission government.” In the summer of 1879 the Daily Appeal exulted, a little prematurely, that the sun had set on “the corrupt ward politican, the eager contractor, the incompetent official, alderman and councilman.”

Among the first acts of the modernized government was empowering the Board of Health to undertake a major cleanup. Statistics show just how major. The wood-block sidewalks were replaced with 95 miles of hard pavement. Over 7,000 water closets, emptying into 152 miles of sewer, replaced the malodorous outdoor privies. Cisterns in which Aëdes aegypti eggs had hatched gave way to a waterworks that pumped 30,000,000 gallons of water daily from artesian wells 400 feet deep. A garbage-collection service was established, and the refuse was incinerated. The Bayou Gayoso was covered over. And strictly enforced regulations provided for meat and milk inspection and sanitation inspections of plumbing facilities.

IT TOOK TWENTY YEARS , but

from being one of the Mississippi valley’s most pestilent places, Memphis became one of the cleanest. There was a temporary setback in the autumn of 1879, when the work was only starting. A new epidemic of yellow fever hit. This time there were 2,000 cases and 583 deaths—and this time was the last. Though yellow fever raged again in the valley in 1888, 1897, and 1989, Memphis remained untouched. Its mortality rate from all causes dropped from 46.6 per thousand in 1872 to 21.5 per thousand as early as 1889. A medical journal marveled that the change in the city in a decade seemed “more like the tales of romance than the mere realization of a scientific and economic truth”—the truth being that sanitation paid off.

All the same, the change was too late for glory. The epidemic struck at Memphis when it was one of many cities scrambling to became a mercantile and industrial capital. While Atlanta, Birmingham, Dallas, and other rival towns were growing in numbers from 1870 to 1880, Memphis dropped from 40,000 to 33,000, and climbed to over 100,000 only by 1900. No one can prove that other towns would not have outgrown it in any case, thanks to advantages of location, and there are some who even hold that the “ruination” of Memphis by the yellow jack is a myth of local historians. But if a front-runner in a race trips and falls, then recovers and finishes far back in the pack, only stubbornness would maintain that the tumble had no effect at all.

And Memphis was almost certainly set back in another way too. A paved, sanitary, outwardly modern city did replace the disheveled, overgrown, old river landing. But urban modernity is more than public works. Sophistication and cosmopolitanism figure in the equation, too, and these Memphis did not regain. Back-country blacks and whites replaced the vanished Catholic Irishmen as well as the Germans with their choral societies, beer gardens, and gymnastic clubs. By 1900 the foreign-born population of Memphis stood at under 10 percent.

The elite of the renewed city was a Southern rural elite. The city’s major historian, Gerald Capers, defined its cultural view: “From every man was demanded allegiance to four conventional ideals: to an unadulterated Protestant fundamentalism; to a fantastic entity called the Old South; to the principle of white supremacy; and, rather paradoxically, to the Constitution of the United States.”

Twentieth-century in externals, Confederate at heart, Memphis became renowned for Beale Street and Boss Crump (whose father died in the epidemic). Writing in 1938, Capers found the reborn city nothing like Christopher Wren’s London, built on the ashes of the Great Fire of 1666. “Hopelessly provincial,” Memphis lacked “that unnameable quality which conspicuously differentiates Boston, Charleston, and New Orleans from Pittsburgh and Kansas City.”

Things may have changed in Memphis

(and Pittsburgh and Kansas City) in forty-six years, but nothing has transformed the city so rapidly and dramatically as three months of yellow fever did in 1878. And it will not happen again. Once Walter Reed and others had found that the mosquito was the essential element in sustaining an outbreak of yellow fever, the disease proved conquerable with screens for windows and doors and, later, with vaccines and eradication of the mosquito from the Western Hemisphere. Yellow fever disappeared from American cities after 1905. And one by one, other epidemic diseases fell before the advance of research.

So although we who live in cities today have our share of plagues—crime, pollution, economic decay, abandonment—we need no longer fear mass death by viral infection.