English colonists in Philadelphia and the French in the Mississippi River Valley record major outbreaks in 1669, as well as additional yellow fever epidemics in Philadelphia, Baltimore, and New York City in the eighteenth and nineteenth centuries.

Yellow fever travels along steamboat routes from New Orleans, causing some one hundred thousand–to one hundred and fifty thousand deaths in total.

Yellow fever is most prevalent in tropical-like climates, but the northern United States are not exempted from the fever.

The first outbreak in English-speaking North America occurs in New York City in 1668.

Five of thirteen states—Delaware, Pennsylvania, New Jersey, Georgia, and Connecticut—have ratified the new Constitution by January 1788, with Connecticut being the first in New England to do so.

The Continental Congress, effectively a caretaker government, elects Cyrus Griffin as its last president on January 19, 1788.

New Hampshire, after an equally close struggle, becomes the ninth state to ratify the Constitution—making it the law of the land—on June 21, 1788. (Maryland and South Carolina had voted for ratification on April 28 and May 23, respectively.)

The Virginia Ratifying Convention ratifies the United States Constitution on June 25 and becomes the tenth U.S. state under the new government.

Article Seven of the proposed Constitution sets the terms by which the new frame of government will be established.

The new Constitution will become operational when ratified by at least nine states.

Only then will it replace the existing government under the Articles of Confederation and will apply only to those states that have ratified it.

Following contentious battles in several states, the proposed Constitution had reached that nine-state ratification plateau in June 1788.

On September 13, 1788, the Articles of Confederation Congress certify that the new Constitution has been ratified by more than enough states for the new system to be implemented and directs the new government to meet in New York City on the first Wednesday in March the following year (the first elections under the Constitution will be held late in 1788).

George Washington is inaugurated as the first President of the United States in front of Federal Hall, New York City, in 1789.

The first Congress under the new Constitution is convened the same year.

Jefferson returns to the US to become the first Secretary of State; Hamilton becomes the first Secretary of the Treasury.

The 1st United States Congress, which meets in New York City's Federal Hall, is a triumph for the Federalists.

The Senate of eleven states contains twenty Federalists with only two Anti-Federalists, both from Virginia.

The House includes forty-eight Federalists to eleven Anti-Federalists, the latter of whom are from only four states: Massachusetts, New York, Virginia and South Carolina.

James Madison, Patrick Henry's chief opponent in the Virginia ratification battle, is among the Virginia delegation to the House.

In retaliation for Madison's victory in that battle at Virginia's ratification convention, Henry and other Anti-Federalists, who control the Virginia House of Delegates, had gerrymandered a hostile district for Madison's planned congressional run and recruited Madison's future presidential successor, James Monroe, to oppose him.

Madison had defeated Monroe after offering a campaign pledge that he would introduce constitutional amendments comprising a Bill of Rights at the First Congress.

Originally opposed to the inclusion of a bill of rights in the Constitution, he had gradually come to understand the importance of doing so during the often contentious ratification debates.

By taking the initiative to propose amendments himself through the Congress, he hopes to preempt a second constitutional convention that might, it is feared, undo the difficult compromises of 1787, and open the entire Constitution to reconsideration, thus risking the dissolution of the new federal government.

Writing to Jefferson, he states, "The friends of the Constitution, some from an approbation of particular amendments, others from a spirit of conciliation, are generally agreed that the System should be revised. But they wish the revisal to be carried no farther than to supply additional guards for liberty."

He also feels that amendments guaranteeing personal liberties would "give to the Government its due popularity and stability".

Finally, he hopes that the amendments "would acquire by degrees the character of fundamental maxims of free government, and as they become incorporated with the national sentiment, counteract the impulses of interest and passion".

Historians continue to debate the degree to which Madison considered the amendments of the Bill of Rights necessary, and to what degree he considered them politically expedient; in the outline of his address, he wrote, "Bill of Rights—useful—not essential—".

George Washington, on the occasion of his April 30, 1789 inauguration as the nation's first president, addresses the subject of amending the Constitution.

He urges the legislators,

    whilst you carefully avoid every alteration which might endanger the benefits of an united and effective government, or which ought to await the future lessons of experience; a reverence for the characteristic rights of freemen, and a regard for public harmony, will sufficiently influence your deliberations on the question, how far the former can be impregnably fortified or the latter be safely and advantageously promoted.