A “Malignant Epidemick”

Can you imagine a disease where no one knows what it is or how it is spreading? All they know is that it is killing people, quickly. During William Alexander Graham’s time, a disease described as a “malignant epidemic” ravaged his surroundings. Later physicians speculated that this “malignant epidemick” might have been yellow fever, typhus fever, spotted fever or something else entirely, but whatever it was, it had an impact on William Alexander Graham’s life and profession.

The first time Graham encountered this “malignant epidemick” was in 1818 while attending medical school at the University of Pennsylvania.  Graham described how he wrote a letter to Dr. Johnston, the mentor with whom he had apprenticed in Virginia. No sooner had he finished writing his letter to Dr. Johnston when “the penny post entered my apartment with a letter.  How great was my shock, when upon breaking the seal I found it contained the melancholy tidings of the death of my friend and preceptor.” Graham was saddened by the death of his friend Dr. Johnston, but hearing that he had died of the “malignant epidemick” did not scare him away.  Within a year, Graham had finished his formal medical education and returned to Abingdon to set up his medical practice.

Starting up his practice was not a simple undertaking; at first, Graham experienced much difficulty getting patients. He described the people of Abingdon as “cold, reserved, and distant;” the only family “by whom he was always treated with the utmost kindness and cordiality,” was that of General Francis Preston (ms, p 119).  Another supporter, Colonel Thompson, sent him to a family that was sick with a bilious fever and “they all recovered, except one child that died.” After this first family, his practice started to take off, and he was being sent to other patients.

In the winter of 1819, the “malignant epidemick” started to infect the people of Virginia; “Many persons old and young had died” (ms, p 124). Graham claimed that “a large Majority of Doctor M. Tate’s patients had died; recent graves marked the trail of his profession” (ms, p 124). Doctors were trying everything in order to save their patients, but “in vain they attempted to rouse and stimulate the system [and] death in a few days closed the scene”. Though doctors were trying their best to cure this “malignant epidemick,” patients continued dying. Sometimes “the disease was so rapid as to preclude the idea of the possibility of medical aid” (ms p 125). This malady harmed the body so quickly that the patient was dead before the doctors could even help. The symptoms varied from patient to patient; some patients having “all the symptoms of violent inflammation of the pleura” and others “ a dangerous attack of colick” (ms p 125). Graham’s practice had been satisfactory, but after saving one patient from the “malignant epidemick,” the overall number of patients increased immensely.

Dr. Tate, a rival physician, who was also treating this “malignant epidemick,” was commissioned to treat the sons of Mr. and Mrs. Leech who had been infected; one was 25 years old and the other was 27. “On the third day the youngest died: on the 4th day before the first was burried the eldest was a corpse in the house.” After these two young men, “robust and healthy”, had died under Dr. Tate’s care, Mr. and Mrs. Leech had “no further use for him,” (ms p 127). When their daughter became ill, they asked Dr. William Alexander Graham to treat her.

Hutton’s Creek, today

The “malignant epidemick” spread swiftly and soon Graham had 60 patients in the vicinity of Hutton’s Creek, a one hour and fifteen minute horse ride from Abingdon. He must have stayed overnight with the patients, going back to Abingdon only to get more medicine. As he was riding into town one day, he was talking to a gentleman who said “Well Graham I understand you are becoming unfortunate in the cold plague; as well as the other Doctor who gave [me] that information.” To which he responded, “It is true I am not as successful as the Doctor; he succeeded in killing all his patients, I kill about one half.” While Graham was surely joking, his reputation as a doctor was becoming more prestigious because his patients were doing better than Dr. Tate’s patients. Out of the 60 patients William Alexander Graham had, he only lost two.

Eupatorium perfoliatum

So how did he treat them? At the beginning stages of this disease, Graham prescribed ipecac root to induce vomiting, opium to calm patients, and a “warm Eupatorium Perfoliatum tea,” known to promote sweating and induce vomiting.(1) Graham also believed in giving cathartics, “such as Marshall’s Mixture, until the intestinal canal was scraped clean of this offensive and poisonous matter” (ms p 128).  During this time, doctors still believed that the balance of fluids determined a person’s health, so they gave treatments that induced the excretion of bodily fluids. After a few days of that treatment, the disease became more like ordinary typhus, whereupon, Graham prescribed stimulants, such as Alkali French Brandy, opium, and red pepper tea when the “tongue was coated with a black soot like coat” (ms p 128). He also believed in applying some remedies to the skin, such as “Mustard plasters” and “horse radish Blisters” (ms p 129), which were prescribed to decrease the heat of the skin. If those remedies didn’t improve symptoms, he prescribed a cold bath as well.

During a time where doctors bled patients frequently, Graham only bled two of his patients during the time of the “malignant epidemick,” which was rare. One of these patients died, but the patient who survived was the daughter of Major Jamison. A messenger told Graham that the Major’s daughter was “dead; or nearly so.” He went to the Major’s daughter and used all of his medicine and “great exertion” to save the young woman’s life. People admired Graham for he was “diligent in his attention” and “indefatigable in his exertions.” He never gave up on his patients and he was willing to “accommodate his remedies to the varying forms of the disease.” Graham understood that disease could have different forms so he adjusted his treatment accordingly, and in “six weeks the disease had disappeared from the Hutton settlement” (ms p 131).

After Graham cured all of those people, he had “ an unrivaled reputation as a physician; and an extensive practice” (ms p 131). However, after seven years of

North Carolina Map of Gold!

practice, he had reached his “ultima thule” with nothing more to aspire towards. He was considered a good doctor, but didn’t see this as any better than “a good blacksmith, or a good shoemaker.” Graham “sighed for further conquest.” The manuscript, written about 1827, ends on that hopeful note.  In 1828, the Gold Rush of North Carolina began. Graham was one of the first to catch “gold fever,” and begin prospecting. (2) Graham had an ambition that just couldn’t be tamed.

By: Randl Dent


Citing the manuscript:

William Alexander Graham, “A Narrative [1827] of Graham’s Journeys, Medical   Training and Career 1816-1819 in Lexington, Va., Abingdon, Va., and Philadelphia,” Washington and Lee University Library, Special Collections


  1. Dunglison, Robley. General Therapeutics and Materia Medica: Adapted for a Medical Text Book. Lea and Blanchard: Philadelphia, 1843. Pg.319
  2. Davis, Curtis Carroll. “Chronicler of the Cavaliers: Some Letters from and to William Alexander Caruthers, M. D. (1802-1846).” The Virginia Magazine of History and Biography 1947, 55.3, pp. 213-232.


Eupatorium perfoliatum.    Charles Frederick Millspaugh, Medicinal plants: an illustrated and descriptive guide to plants indigenous to and naturalized in the United States which are used in medicine, their description, origin, history, preparation, chemistry and physiological effects fully described.   J. C. Yorston & Company, 1892

Hutton’s Creek.   Reproduced with permission of the photographer, Janet Burks.  Original published on  Humphrey Baker: The Elder, The Immigrant 

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