In early August cases of “malignant fever” broke out among Philadelphlans along the city’s waterfront. Like the last epidemic, thirty years before, it would turn out to be yellow fever. By August 19 Dr. Benjamin Rush knew that an epidemic was under way and felt certain (wrongly) that its cause lay in rotting coffee left on the Bell’s Arch Street wharf in July by a Santo Domingan sloop, the Amelia . The spoiled coffee’s effluvium had permeated the air around the docks, Rush theorized, conducting the hated fever into the lungs of waterfront residents. When he consulted with two of his colleagues about the symptoms they were seeing, the meeting was reported in the local newspapers as confirmation of a city health crisis. “I have not seen a fever of so much malignity, so general,” he wrote to Dr. James Hutchinson on August 24, “since the year 1762.” Dr. Rush stood apart from many of his peers in his belief that rotten coffee was the agent and in his prescription: he was a purge and bloodletting man.