Yellow fever in the 1790s: the British army in occupied Saint Domingue

IN THE Caribbean and on the North Atlantic seaboard, 1793-98 were years of notably high mortality, the result of a pandemic of yellow fever spread by the great population movements caused by revolution and war.In the West Indies, as in Philadelphia- but far more strangely-the disease was often treated as a ghastly novelty.Fifty thousand British soldiers and seamen are said to have died in the West Indies in this period and an equal number had to be discharged as invalids.'The forces which for five years occupied the French colony of Saint Domingue are remembered for having suffered particularly disastrous losses.However, although there is still no cure for yellow fever, scholars nowadays stress that it is not usually a high-fatality disease.2While revising some well-known mortality estimates and comparing British and French modes of treatment, this paper looks at the public reaction to the pandemic of the 1790s and at the experience of the troops in Saint Domingue in an attempt to establish how exceptional such losses were and exactly why they were so severe. I. YELLOW FEVER IN THE WEST INDESIt is not entirely clear how unusual outbreaks of yellow fever were in the eighteenth- century Caribbean.Relying only on contemporary clinical descriptions, one cannot be sure.The eighteenth-century mind tended to confuse one fever with another and medical men were especially contradictory on the subject of "yellow" fever.His- torians, however, mostly agree that the disease was introduced into the West Indies from Africa in the 1640s and that thereafter it enjoyed a spasmodic history, appearing as epidemics of the "black vomit fever" or maladie de Siam."Yellow fever begins with lassitude, a sudden headache, and burning fever.It can vary greatly in severity, but in "classic" cases the eyes become inflamed, nausea is experienced, and pain in the muscles and back.The pulse is initially high but falls as