The Yellow Fever Hospital

Archaeologists had a rare opportunity to look at the remains of a major public health crisis from the late 1800s. This school was the site of emergency quarantine hospital during the height of a yellow fever epidemic, just before knowledge about the disease and its transmission spread was fully understood. Most people who get yellow fever have no symptoms. Some get sick with headache and fever. Some get sicker with internal bleeding, black vomit, jaundice (turn yellow). Some die, even today. In 1897, yellow fever struck the city of New Orleans. At this time, the world was beginning to understand how ‘germs’, and 'viruses' rather than polluted air (‘miasma’) caused infectious diseases. Although not fully understood, city officials knew they needed to contain this deadly disease. Quickly.

Yellow fever sufferer in a Veracruz hospital, 1892. Courtesy of Wikipedia Commons.

The Aedes aegypti mosquito that spreads yellow fever. Courtesy of Wikimedia commons. 

                                                                                                                                                                                                                                                                  At that time, most experts believed that yellow fever was caused by germs. In fact, it is spread by a specific type of mosquito, the Aedes aegypti. This fact was widely accepted just a few years after the 1897 outbreak in New Orleans. Still, the basic tools that public health officials used in this emergency - quarantine and disinfection - also happened to be effective in constraining the disease spread from this mosquito.

Quarantine

Charity Hospital was state of the art in 1897, but doctors commonly treated their patients at home. Yellow fever was no exception. When most people got sick with yellow fever symptoms, they were forced to quarantine at home, often at gunpoint. However, indigent people, or very sick people, had no other option than public services such as Charity Hospital. But, doctors and staff at Charity worked to prevent patients with yellow fever from entering in its main location. The city set up a quarantine camp at the edge of the city, but they needed a safe space for very sick people to be treated outside of the main hospital. City Officials and medical professionals commandeered the historic school on the Thurgood Marshall School site to act as a temporary hospital for these patients. One doctor and five Sisters of Charity Hospital came to ready the school to accept patients.

Photograph of old Charity Hospital from circa 1895. Courtesy of Historic New Orleans Collection, 1974.25.3.673

Newspaper headline in the Daily Picayune reporting on the fire started in the temporary yellow fever hospital to-be. Courtesy of Times Picayune archives. 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Hundreds of people marched in the street to protest this yellow fever hospital. Dispersed by police, they came back in the night and vandalized the school, even setting some of the school buildings on fire. According to the newspaper on September 24, 1897, then entire city was in a state of turmoil over this event. Firefighters saved the buildings from complete destruction. In the morning, Mayor Flowers stepped in with police protection and a carpenter crew to modify the school into a hospital. He assured the city residents that the hospital would protect the neighborhood from the spread of yellow fever. Patients were brought a few days later, amidst steady public resistance. This small handgun and ammunition were excavated at this site, possibly part of the protection of the hospital staff and patients.

  • Small caliber open-top pocket pistol recovered from excavations. Courtesy of Goodwin and Associates. 

  • Firearm ammunition including unfired bullets and bird/waterfowl pellets. Courtesy of Goodwin and Associates. 

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Invalid feeder used for yellow fever victims, partially reconstructed from multiple locations. Courtesy of Goodwin and Associates. 

                                                                                                                                                                                                                                                                                                                                                                                                Archaeologists excavated many sick, or invalid, feeders under Thurgood Marshall School playground. These feeders were used in homes and hospitals to feed broth and other fortifying liquids to very ill people. Here, they were used in late 1897 to treat gravely ill yellow fever patients who were kept on a strict liquid diet. In the yellow fever hospital, treatment was much same as today: comfort, hydration, and rest to keep person alive until their body’s immune system produced its own cure. Archaeologists found many other supplies used to treat patients, such as bedpans, pitchers, wash basins, drinking cups, medicine bottles, nursing flask (pictured above), and a syringe.

  • Pieces of glass nursing bottles recovered from multiple units. Courtesy of Goodwin and Associates. 

  • Sears, Roebuck and Co. Spring 1902 catalogue advertisement for nursing flasks noting that the round shape is easy to clean and providing options for measurements on the side and tube fitting. Courtesy of archives of Sears Roebuck and Co. Catalogue.

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Four toys recovered from this site: a chess piece, doll face fragment, and two doll leg pieces. Courtesy of Goodwin and Associates. 

Other artifacts from the emergency yellow fever hospital were games that helped people rest, such as this chess piece (a) and dolls that kept children occupied. Archaeologists found lead for drawing, kaolin pipes for leisurely smoking and a violin mute for quietly playing music. Perhaps these were to brighten the spirits of the patients or the nurses and doctors who were also quarantined. Papers from the time stress the importance of beauty to support healing, such as the bright flower vases and a picture frame found at the site.

A horse-drawn ambulance at Charity Hospital from around 1895. Courtesy of the Louisiana State Museum, TO400.1990.15.08

Complete aqua glass bottle with raised lettering on sides reading "Dr. S. Pitcher's / Castoria", a disinfectant. Courtesy of Goodwin and Associates. 

                                                                                                                                                                                                                                                                                                                                                                                                    As yellow fever expanded in New Orleans, more patients were transported to the emergency yellow fever hospital at the end of Canal Street, many in this horse-drawn ambulance. Between uses, this ambulance would have been thoroughly disinfected with chemicals. Disinfection was the second weapon to fight yellow fever in New Orleans around 1900. In the temporary hospital, staff kept to a strict daily cleaning and disinfection schedule. Specific rooms were used to disinfect the doctors and nurses when entering and exiting. Every effort, even if misguided, was made to keep the yellow fever contagion within the hospital.

Buried under a thick cap of undisturbed clay, archaeologists found a concentrated pile of burned items that were burned rather than disinfected. Archaeologists found burned pieces of cups, wash basins, sick/invalid feeders, bedpans, and other medical supplies. Notice the vastly different levels of fire-blackening on adjacent pieces of the pitcher, below. When these pieces were cleaned in the lab and reassembled, it was clear that they had been crushed, then burned. Afterwards, the crushed medical waste was swept up and deposited in the freshly cleaned privy, or outhouse. This photo shows the inside of this privy before and after archaeologists carefully excavated the medical waste. It is possible that the people cleaning up after the epidemic want to be sure that these items would never be used again.

Wall of excavation unit showing pile of crushed, burned, and buried medical waste. Courtesy of Goodwin and Associates. 

One whole whiteware ceramic teacup and one pieced together cup with burned and unburned sections. Courtesy of Goodwin and Associates. 

Ceramic whiteware pitcher pieced together with a maker's mark on the back. Courtesy of Goodwin and Associates. 

Cleared interior of the medical waste pile showing plastered brickwork sides of the privy. Courtesy of Goodwin and Associates. 

By the end, this emergency hospital had cared for around 250 patients. Of those patients, almost 50 had died. Keep in mind, only the sickest patients with nowhere else to go were treated here. These survival rates are similar to modern survival rates of people who have not been vaccinated with most acute stage of the illness (30-50% of severe cases). The survival rate is significantly better than the 50% death rate of the most acute victims in the previous wave of yellow fever. Just beneath the modern schoolyard, archaeologists located the privy where debris from disinfection cleanup was dumped and capped in December 1897. And the neighborhood? There were no reported cases for many blocks around the emergency yellow fever hospital. The public health officials had kept their word and protected the neighborhood.

In modern times, the best measures to prevent yellow fever are reducing sources of standing water where the mosquitos that spread the virus can breed. By enforcing these sanitary measures, yellow fever has been eradicated from most populated cities around the world. It is still present in rural tropical areas. Although there is still no cure for yellow fever, there is a vaccine that can help prevent the spread of the disease and the ameliorate the symptoms for those who do get sick.

The Yellow Fever Hospital