By August 23 the number of cases had already reached epidemic status. One man wrote to his sister: “The fever raging & spreading all over the city … it has now nearly two months to run before frost … our people are falling in every direction. … God help us … where will the end be .”

Before the end, just about the entire city would come down with the fever. For reasons still not fully clear, the black mortality rate of 946 deaths in 11,000 cases was extremely low by comparison with that of the white. Virtually every one of the 6,000 white men and women still in the city fell sick, and there were 4,024 deaths—almost a 70 percent mortality rate. The number of deaths rose in September to nearly 200 per day.

There were weeks of hellish scenes: coffins piled up in wagons or on sidewalks outside houses, waiting to be driven to the cemetery; hospitals (one permanent, two temporary, one of the latter for blacks) loud with the wails of the patients; homes where whole families had died before doctors could arrive; bodies of children stiffening in their own filth; living babies spattered with dried black vomit, trying to nurse at their dead mothers’ breasts; corpses partly gnawed, or so badly decayed that they were “little better than a lot of bones in a puddle of putrid and greenish-looking water”; an occasional delirious and unattended victim wandering naked into the streets.

Inside of ten days, 25,000 people fled the city. Of those who remained, the great majority would come down with the fever.

Yet what left the strongest impression on some was not these grisly sights but the overpowering emptiness. Keating recalled that “an appalling gloom hung over the doomed city. At night it was silent as the grave, by day it seemed desolate as the desert. There were hours … as if the day of judgment was about to dawn. Not a sound was to be heard; the silence was painfully profound. Death prevailed everywhere. … Even the animals felt the oppression and fled from the city. Rats, cats, or dogs were not to be seen.”

Over the streets hung the stink of decomposition, mingling with the reek of carbolic acid and lime, which were sprinkled about as disinfectants. Plumes of smoke rose from burning piles of “contaminated” clothing, mattresses, and bedding. Barrels of tar were also ignited, in hopes of killing whatever it was in the “miasma” that spread the disease. And cannon were fired off, too, to disperse the fever’s airborne “seeds.” For a time, funeral bells were rung at burials, but eventually the incessant tolling became too depressing. In all, Memphis was nightmarish—empty of people and full of smoke by day; bells pealing and cannon booming through the thick, choking silence. In the midst of it all, only a few noticed that mosquitoes were, in the words of one editor, “as vigorous and desperate as ever.”

Sponge baths, laxatives, purgatives, light diets, quack remedies like gin and sulfur—nothing the medical men tried seemed to help. “We poor doctors stand by abashed at the perfect uselessness of our remedies,” wrote Dr. William J. Armstrong to his refugee wife. “Everything with me tonight is terribly blue,” he said in another letter. Sitting with an old friend in his office, both men broke down and cried. “I tell you,” he wrote, “it breaks the stoutest hearts.”

Stout hearts there were. As always, in the evil hour people showed a human mixture of nobility and baseness. With municipal government in collapse, the city had to be administered by volunteers. Every nonimmune volunteer stayed at the conscious risk of life: doctors and nurses who were convinced of the “fomite” theory handled the victims, living and dead, despite believing that everything they touched was deadly poison.

Chief among the emergency medical officials were the members of the Howard Association, a group of some forty businessmen specifically formed for periods of yellow fever attack. The group was modeled after a similar one founded in New Orleans in 1837; the name was that of a British philanthropist. The “Howards” recruited most of the medical personnel and stayed on to supervise the work. Thirty of them got the disease, and eleven died.

There was also a Citizens’ Relief Committee, coordinating the distribution of food, soap, candles, and bedding. Its chairman, a forty-one-year-old cotton broker, died on the job. Like some others, he thought he had already had the disease and was safe. But many such self-professed immunes had actually had dengue, another tropical, mosquito-borne malady with similar symptoms, often misdiagnosed as yellow fever. They were as vulnerable as anyone else.

Other relief services were organized by local fraternal groups—the Masons, Odd Fellows, Knights of Pythias, and Hebrew Hospital Association, as well as the Typographical Union, the Italian Fraternal Union, and the Association for the Relief of French Residents—all supporting in disaster Tocqueville’s observation about the strength of voluntary associations in American life.