attended to by absalom jones and william gray; and, in order that the distressed might know where to apply, the mayor advised that upon application to them they would be supplied. soon after, the mortality increased, the difficulty of getting a corpse taken away, was such, that few were willing to do it, when offered great rewards. the black people were looked to. we then offered our services in the public papers, by advertising that we would remove the dead and procure nurses. our services were the production of real sensibility—we sought not fee nor reward, until the increase of the disorder rendered our labour so arduous that we were not adequate to the service we had assumed. allen noted in his account that because of the increase in mortality, he and jones had to hire five men to assist them in removing corpses, as most people avoided the sick and the dead. in a september 6 letter to his wife, rush said that the "african brethren ... furnish nurses to most of my patients." despite rush's theory, most of the city's people of color, who were born in north america, were not immune to the fever. many of the slaves in charleston in 1742 could have gained immunity before having been transported from africa, by having been exposed to yellow fever in a mild case. people who survived one attack gained immunity. a total of 240 blacks died in philadelphia, in proportion to their population at the same rate as whites. controversy over treatment given the limited resources and knowledge of the times, the city's response was credible. the medical community did not know the natural history of yellow fever, a viral infection spread by the aedes aegypti mosquito. efforts to clean the city did not defeat the spread of the fever, as the mosquitoes breed in clean water as well as in dirty water. philadelphia's newspapers continued to publish during the epidemic, and the doctors and others tried to understand and combat the epidemic. on september 7, dr. adam kuhn, who had studied medicine at the university of uppsala in sweden, advised patients to treat symptoms as they arose. rush claimed that he had tried kuhn's and steven's stimulating remedies but that his patients still died. he recommended other treatments, including purging and bloodletting, and published his theories. the hope offered by any of these treatments was soon dashed when it became clear that they did not cure the disease, and the doctors' competing claims demoralized patients. in his 1794 account of the epidemic, mathew carey noted that other doctors claimed to have used calomel (a mercury compound) before rush and that "its efficacy was great and rescued many from death." carey added that the "efficacy of bleeding, in all cases not attended with putridity, was great." rush taught the african-american nurses how to bleed and purge patients. allen and jones wrote that they were thankful that "we have been the instruments, in the hand of god, for saving the lives of hundreds of our suffering fellow mortals." rush's brand of medicine became the standard american treatment for fevers in the 1790s and was widely used for the next 50 years. dr. mark chesterfield also suggested training prisoners to perform the dangerous jobs of collecting the dead and transporting the sick, but the idea met with great controversy and was abandoned. dr. chesterfield later fell victim to the sickness and died as the result of excessive bloodletting at the hands of dr. benjamin rush. rush's claim that his remedies cured 99 out of 100 patients has led historians and modern doctors to ridicule his remedies and approach to medical science. some contemporaries also attacked him. the newspaper editor william cobbett attacked rush's therapies and called him a sangrado, after a character in gil blas, who bled patients to death. in 1799 rush won a $5,000 libel judgment against cobbett. government responses to crisis the state legislature cut short its september session after a dead body was found on the steps of state house. governor mifflin became ill and was advised by his doctor to leave. the city's banks remained open. but, banking operations were so slowed by the inability of people to pay off notes because of disruptions from the epidemic that banks automatically renewed notes until the epidemic ended. the mayor matthew clarkson organized the city's response to the epidemic. most of the common council members fled, along with 20,000 other residents. people who did not leave philadelphia before the second week in september could leave the city only with great difficulty, and they faced road blocks, patrols, inspections and quarantines. on september 12, clarkson summoned fellow citizens interested in helping the guardians of the poor. they formed a committee to take over from the guardians and address the crisis. on the 14th, clarkson was joined by 26 men, who formed committees to reorganize the fever hospital, arrange visits to the sick, feed those unable to care for themselves, and arrange for wagons to carry the sick to the hospital and the dead to potter's field. the committee acted quickly: after a report of 15-month-old twins being orphaned, two days later the committee had identified a house for sheltering the growing number of orphans. as noted above, richard allen and absalom jones offered the services of members of the free african society to the committee. when the mayor's committee inspected the bush hill fever hospital, they found the nurses unqualified and arrangements chaotic. "the sick, the dying, and the dead were indiscriminately mingled together. the ordure and other evacuations of the sick, were allowed to remain in the most offensive state imaginable... it was, in fact, a great human slaughter-house." on september 15, peter helm, a barrel maker, and stephen girard, a merchant and shipowner born in france, volunteered to personally manage the hospital and represent the mayor's committee. they made rapid improvements in hospital operations: bedsteads were repaired and more brought from the prison so patients would not have to lie on the floor. a barn was adapted as a place for convalescing patients. on september 17, the managers hired 9 female nurses and 10 male attendants, as well as a female matron. they assigned the 14 rooms to separate male and female patients. with the discovery of a spring on the estate, workers were organized to have clean water pumped into the hospital. helm and girard informed the committee that they could accommodate more than the 60 patients then under their care, and soon the hospital had 140 patients. girard found that the intermittent visits by four young physicians from the city added to the confusion about patient treatment. he hired jean devèze, a french doctor with experience treating yellow fever in saint-domingue (now haiti). devèze cared only for the patients at the hospital, and he was assisted by french apothecaries. devèze admired girard's fearlessness in his devotion to the patients. in a memoir published in 1794, devèze wrote of girard: i even saw one of the diseased ... the contents of his stomach upon . what did girard do? ... he wiped the patient's cloaths, comforted ... arranged the bed, inspired with courage, by renewing in him the hope that he should recover. —from him he went to another, that vomited offensive matter that would have disheartened any other than this wonderful man. news that patients treated at the hospital were recovering encouraged many people to believe that medicine was gaining control of the fever. but, it soon became clear that mortality at the hospital remained high; about 50% of those admitted died. reactions by other cities as the death toll in the city rose, officials in neighboring communities and major port cities such as new york and baltimore established quarantines for refugees and goods from philadelphia. new york established a "committee appointed to prevent the spreading and introduction of infectious diseases in this city", which set up citizen patrols to monitor entry to the city. stage coaches from philadelphia were not allowed in many cities. havre de grace, maryland, for example, tried to prevent people from philadelphia from crossing the susquehanna river to maryland. neighboring cities did send food supplies and money; for example, new york city sent $5000 to the mayor's committee. woodbury and springfield, new jersey; chester, pennsylvania and elkton, maryland, were among towns that accepted refugees. carey's accusations in his 1793 account of the epidemic, mathew carey contrasted the sacrifices of men like joseph inskeep, a quaker who served on the mayor's committee and also visited the sick, with the selfishness of others. when inskeep contracted the fever, he asked for the assistance of a family whom he had attended when several of its members were sick. they refused. he died, which might well have happened even if they had aided him. carey reported their refusal. he published rumors of greed, especially by landlords who threw convalescing tenants into the street to gain control of their flats. while he praised richard allen and absalom jones for their work, he suggested that blacks had caused the epidemic, and that some black nurses had charged high fees and even stolen from those for whom they cared. allen and jones quickly wrote a pamphlet to defend the people of color in the crisis. the historian julie winch believes they wanted to defend their community, knowing how powerful carey was, and wanting to maintain the reputation of their people in the aftermath of the epidemic. the men noted that the first nurses from the free african society had worked without any pay. as the mortality rate increased, they had to hire men to get anyone to deal with the sick and dying. they recounted that the great prices paid did not escape the observation of that worthy and vigilant magistrate, matthew clarkson, mayor of the city, and president of the committee. he sent for us, and requested we would use our influence to lessen the wages of the nurses. but on informing him of the cause, i.e. that of the people over-bidding one another, it was concluded unnecessary to attempt any thing on that head; therefore it was left to the people concerned. allen and jones noted that white nurses also profited and stole from their patients. "we know that six pounds was demanded by and paid to a white woman, for putting a corpse into a coffin; and forty dollars was demanded and paid to four white men, for bringing it down the stairs." many black nurses served without compensation: "a poor black man, named sampson, went constantly from house to house where distress was, and no assistance, without fee or reward. he was smitten with the disorder, and died. after his death his family were neglected by those he had served. sarah bass, a poor black widow, gave all the assistance she could, in several families, for which she did not receive any thing; and when any thing was offered her, she left it to the option of those she served." response of churches church clergy continued to hold services, which helped keep up residents' morale. rev. j. henry c. helmuth, who led the city's german lutheran congregation, wrote a short account of the yellow fever in philadelphia for the reflecting christian. he also left a diary. on september 16 he reported that his church was "very full" the day before. in one week in october, 130 members of his congregation were buried. on october 13, he wrote in his diary: preached to a large gathering about jes.26,1. i showed that philadelphia a very blessed city—the lord is among us and especially in our congregation. i proved this with examples of dead and still living people. baptized a child. announced that i could not be with the corpses, that the sick should be reported to me in the morning so that i could visit them in the afternoon. the yearly meeting of the society of friends at the arch street meeting house drew 100 attendees, most from outside the city. the meetinghouse is not far from the waterfront where the epidemic had started. in their yearly epistle following the meeting, the friends wrote that to have changed the time or place of the meeting would have been a "haughty attempt"