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Every Fever Gives Alarm: The 1820-21 Typhus Epidemic at Montpelier

Epidemics in early America were a fact of life – and death. People regarded yellow fever, dysentery, and typhus with the same alarm modern Americans feel toward COVID-19. Where today we at least have a growing knowledge of the coronavirus and the steps we can take to slow its spread, people in the 19th century experienced epidemics with only a limited understanding of what caused and spread diseases, and very little ability to treat illnesses beyond easing the symptoms.


Earlier Epidemics

Both James and Dolley Madison had lost family members during epidemics in the late 18th century. In 1775, a dysentery epidemic caused the death of James’s 7-year-old sister Elizabeth and 4-year-old brother Reuben. James wrote to his college friend William Bradford:

“Since I wrote last a Dysentry hath made an Irruption in my father’s family. It has carried off a little sister about seven & a brother about four years of age. It is still among us but principally among the blacks. I have escaped hitherto, & as it is now out of the house I live in, I hope the danger is over.”1

Yellow fever cut a swath through Dolley’s family in Philadelphia in 1793, while she was married to her first husband, John Todd Jr. Within a three-week period, Dolley lost her father-in-law, her mother-in-law, her husband, and their infant son William Temple Todd.


Typhus Takes Hold

For people who had personally experienced the loss of loved ones to an epidemic, the outbreak of typhus at Montpelier was doubtless an unsettling time. The first cases of typhus seem to have appeared in the late fall of 1820, according to what James Madison wrote several months later, and surged during the winter of 1820-21.

Madison did not describe the symptoms of those who fell ill. Generally, the early symptoms of typhus are similar to the flu: a cough, chills and fever, headaches, muscle and joint aches, and abdominal pain. As the disease progresses, however, a rash of red dots appears, spreading from the torso to the arms and legs. Delirium results in the later stages; we now know that this happens when the infection reaches the membranes surrounding the brain.2


“The Fever Still Continues to Distress Us”

The outbreak was well under way when James Madison first mentioned it in a letter to James Monroe, on December 28, 1820:

“The fever still continues to distress us. A death took place 3 days ago. Another is not improbable in a day or two. And there are several other cases of great illness. New cases also occur faster than compleat cures. As yet the white family escape, except that of the overseer, who with his wife & 3 of his children have been very ill, but are getting well.”3

Madison, with his formal and intellectual turns of phrase, referred to “cases” rather than “people,” but a current of alarm still underlies his words. One person died days ago, and another is near death. People are coming down with sickness faster than the sick are getting well.

In this letter Madison used the word “family,” not in the sentimental sense of people who feel warm emotional ties with each other, but in the more patriarchal and hierarchical sense of “entire household.” The “family” were the people Madison was responsible for as the patriarch. It was comprised of a “black family” (the enslaved community) and a “white family,” which included not only James, Dolley, and Nelly Madison, but also the free white overseer (at that time, Capt. Abram Eddins) and his wife and children.

A few days after writing Monroe, Madison gave a similar report to Jefferson:

“We have had for several months a typhus fever in the family, which does not yield in the least, to the progress of the season. Out of twenty odd cases, there have been six deaths, and there are several depending cases threatening a like issue. The fever has not yet reached any part of our White family; but in the Overseers, there have been five cases of it including himself. None of them however have been mortal.”4

Madison described the typhus outbreak in this letter to Thomas Jefferson, written January 7, 1821. Courtesy of the James Madison Papers at the Library of Congress.

By this point, six of out of twenty infected people had died, with more deaths likely. Madison seemed surprised that the outbreak had not yielded “to the progress of the season;” perhaps he thought that the change from autumn to winter weather would have brought the epidemic to an end. We now know that the bacteria that causes typhus can be transmitted by fleas (murine typhus) or body lice (epidemic typhus), and could be more likely to spread in cold weather when people were indoors in close quarters.

Jefferson had his own theories on treating typhus, replying to Madison, “I am sorry to hear of the situation of your family, and the more so as that species of fever is dangerous in the hands of our medical boys. I am not a physician & still less a quack but I may relate a fact…” Jefferson then described his method for treating such fevers with “nourishment and stimulus” rather than purgatives that could drain a patient’s strength, an approach which he learned from an old English doctor while in France. “I have had this fever in my family 3. or 4. times since I have lived at home, and have carried between 20. & 30. patients thro’ it without losing a single one…”5


Interruptions to Daily Life

Beyond the danger of illness and death, the typhus epidemic interrupted daily life in mundane ways as well. On the same day he wrote to Jefferson, Madison also noted in a letter to merchant Robert MacKay:

“The sickness in my family and other circumstances have suspended the carriage of my flour to Market.” 6

With the overseer ill, there was no one to prepare and coordinate the shipment of flour to market.

The epidemic affected travel as well. By February 1821, Madison was hopeful that his sister- and brother-in-law Lucy and Thomas Todd could safely visit Montpelier:

“I would not bespeak the visit from you if I were not perfectfully confident that it would expose you to no danger from a fever which has lately found its way into our family, & been fatal to some of the black part of it. Besides that we hope the last of the cases has occurred, there is every reason to believe, that no danger whatever attends a transient intercourse even with the sick in the most tainted atmosphere; much less, with the well, in that which is the purest.”7

Without actually knowing how typhus spread via fleas or lice, Madison made an accurate observation: the disease did not spread through “transient intercourse,” or brief time spent with a sick person. Interacting with an apparently healthy person was also safe; asymptomatic carriers were not a factor.


“Such a Loss – At All Times Distressing”

By the spring of 1821, the epidemic seemed to have run its course, but was still very much on everyone’s mind. The Madisons’ friend James Corbin had heard about the situation at Montpelier, writing that

“your nephew Major Madison … informed me that you were both well, but, to my great sorrow, confirmed some intelligence which my Relation Tayloe had given me, concerning your late loss of many valuable Servants by some contagious disorder. Such a loss–at all times distressing–is peculiarly so in these times, by far the most calamitous that I ever saw.”8

These times” seems to be a shorthand for the general downturn in the agricultural economy, a recurring theme in Corbin’s letters to Madison. Since the epidemic had caused deaths only among the enslaved at Montpelier, Corbin seemed to regard it more as an unfortunate loss of property, rather than as a tragic loss of life.

Madison replied to Corbin with further statistics about the epidemic:

“We have had, as you were informed, a severe visitation of a fever of the typhus character. The cases amounted to between 40 and 50; and the deaths to about one-fourth of the cases. We hope the disease has left us, or, at least, is doing so. The last cases have been so mild as to make their real character doubtful. A remarkable circumstance in this endemic is, that it seems to have preferred situations the most elevated and healthy.”9

To Madison, who always contrasted Montpelier’s healthy elevation with lower-lying areas like Washington or Williamsburg, this must have been particularly puzzling.

Madison apparently wrote his friend Robert Briggs a letter similar to what he had written Corbin, for Briggs replied:

“It affords me pleasure to lern [sic] that you are at length likely to be freed from so unpleasant a visitant as the disease with which your family has been long disturbed.”10

An enslaved worker may have endured a bout of typhus in a bed like this one, in a cabin in Montpelier’s South Yard. Curatorial Collections photo, courtesy of Montpelier, a National Trust site.

Dolley Madison confirmed to her son John Payne Todd that the outbreak had ended by spring 1821. She also mentioned that she had written earlier, during the height of the outbreak, when she was considering going somewhere else to escape it:

“… I had a wish to travel a distance from home on acct. of the Typhus fever—but that fear, has been dissipated for the present, by the children in the house geting well, & the negros also.”11

For Dolley, the typhus epidemic had probably awakened memories of the disastrous 1793 yellow fever epidemic, when everyone who could flee Philadelphia, had done so.


“An Indisposition from Which I Am Just Recovering”

Typhus recurred in the fall of 1821, apparently in a milder form, and Madison himself contracted it in late September or early October. His Orange county neighbor James Barbour wrote on October 13 “to express his regret at the indisposition of Mr Madison and to enquire how he does.” Barbour wanted to visit but decided against it, “from an apprehension that company is but ill adapted to a sick man.”12 By October 18 Madison seemed to be on the mend, writing of “an indisposition from which I am just recovering.”13

Jefferson expressed a sigh of relief at his friend’s recovery: “I heard in Bedford that you were attaked with the prevailing fever, and with great joy on my return that you were recovered from it.” Jefferson’s next observation gave voice to the general sense of anxiety:

“In the strange state of the health of our country every fever gives alarm,”14

a sentence that could just as easily have been written during the COVID-19 pandemic two centuries later.

Just as the coronavirus has colored nearly every aspect of 2020, continuing into 2021, the typhus epidemic seemed to be James Madison’s overarching theme in his summaries of the events of 1820-21. In November 1821 he wrote to Richard Rush:

“The year past has been distinguished by much sickness throughout a great portion of the U.S: tho’ the mortality has not been very considerable, except in particular spots. Virginia has had a large share of the calamity; and this part of the State more than an equal one. In my own family the fever has been very severe. At present we are happily freed from it. It was of the typhoid character, and seemed to select for its visitations the more elevated & healthy, rather than the situations most subject to annual complaints. Its type has been most malignant also in the cold season.”15


Typhus or Typhoid?

Madison in this instance referred to “typhoid” fever rather than “typhus;” it was not until the 1830s that typhus and typhoid fever were recognized at two different illnesses with several shared symptoms (See “What an 1836 Typhus Outbreak Taught the Medical World About Epidemics”.) People with typhus or typhoid can have chills, fever, a rash of red dots, and delirium. Unlike typhus, however, typhoid fever is an intestinal illness, with more intense intestinal symptoms. In typhoid, delirium results from fever and dehydration, rather than infection surrounding the brain, as in typhus. (For more specifics, see “What’s the Difference Between Typhus and Typhoid?”)

Typhoid fever can be spread through contaminated food and water. If someone handled a sick person’s soiled bedding, and then prepared a meal without thoroughly washing their hands, typhoid could infect the people who ate the meal. Typhoid fever can also be spread by asymptomatic carriers, such as the infamous case of the early 20th-century cook known as Typhoid Mary.

It’s impossible to say whether the 1820-21 outbreak was typhus or typhoid, since Madison didn’t describe the symptoms of anyone who became ill at Montpelier. We might make a more educated guess if we knew which members of the enslaved community had become ill, and where they worked. Were they agricultural workers who lived near outlying fields? Were they domestic workers, and did they handle the Madisons’ food? Did the disease affect clusters of people who were in close quarters, or people who ate the same food and drank the same water?

Excerpt from an 1819 medical bill from Dr. Charles Taylor to James Madison. Each line records “A Visit” to treat various members of the enslaved community, including Josiah, Dinah, Sukey and child, John, an unnamed boy, Sawney, and Sam. Three surviving bills from Dr. Taylor cover the period from November 1816 to November 1819. (Click to see the entire firstsecond, and third bills.) If doctors’ bills for 1820-21 had survived, we might have learned who among the enslaved fell ill and what treatments they received. Courtesy of the James Madison Papers at the Library of Congress.

Two Years of “Much Sickness in Our Own Family”

As the year 1821 drew to a close, Madison again mentioned the epidemic in letters to friends. He offered George Joy several excuses for not writing earlier, adding

“I might find an apology also, in a very afflicting fever of the typhoid character which has been constantly in my family for a year past, and from which I did not escape myself.”16

Finally, to his brother-in-law John George Jackson, Madison wrote:

“We have had for a great part of the last & present years, much sickness in our own family; and among the black members of it not a little mortality. Mrs. Madison & Payne were so fortunate as to escape altogether. I was one of the last attacked, and that not dangerously. The disease was a typhoid fever. At present we are all well…”17


The typhus epidemic had played itself out at this point. There had been over 40 or 50 cases at Montpelier, with a dozen or more deaths. For James Madison, it had been a brush with illness and an economic loss of enslaved property. For Dolley Madison, it had been a time of worry that made her think of going away to escape the danger. The overseer experienced the illness of his entire family, as well as the disruption of his work. Those enslaved at Montpelier bore the brunt of the epidemic. Most of the illnesses, and apparently all of the deaths, occurred within the enslaved community. Although we don’t know the names of the dead, their passing tore the social fabric and left spouses, parents, siblings, and children bereaved. For the families of the dead, life at Montpelier could never return to exactly what it had been in 1819. Yet by December 1821, while the disease itself was still a mystery, the long season of loss had come to an end.