Throughout the text, Murphy emphasizes the transitional state of the medical profession in 1793. While doctors at the end of the 18th century are beginning to seek out clear, science-backed understandings of diseases, they continue to prescribe treatments based on folk traditions, some of which date back to the ancient world. Murphy indicates that the transition is not necessarily a smooth one, as it brings controversies and disagreements that go unresolved. The arguments within the College of Physicians as to whether the sickness is yellow fever or whether it is imported are fundamentally divisive and only decided by majority vote, rather than by any scientific testing. It ultimately leads Benjamin Rush to resign from the College.

The strong adherence to folk remedies also opens the door to controversial cures like Rush’s “Ten-and-Ten,” which many found to be excessive. Anyone claiming a cure could potentially be taken seriously, leading to “quack” doctors and treatments, many of which Murphy describes. Efforts to treat the fever were essentially a guessing game, guided by the reigning principles of humoral theory rooted in ancient Greece. Balancing the body’s four humors, which were “phlegm, choler, bile, and blood” (15), required little understanding of human anatomy or physiology.