Benjamin Rush (1746-1813)

Benjamin Rush ( – April 19, 1813) was a Founding Father of the United States. Rush lived in the state of Pennsylvania and was a physician, writer, educator, humanitarian, as well as the founder of Dickinson College in Carlisle, Pennsylvania.

Rush signed the Declaration of Independence and attended the Continental Congress. He served as Surgeon General in the Continental army, and was blamed for criticising George Washington. Later in life, Rush became a professor of chemistry, medical theory, and clinical practice at the University of Pennsylvania.

Rush was a leader of the American Enlightenment, and an enthusiastic supporter of the American Revolution. He signed the Declaration of Independence, and was a leader in Pennsylvania's ratification the Constitution in 1788. He was prominent in many reforms, especially in the areas of medicine and education. He opposed slavery, advocated free public schools, and sought improved education for women and a more enlightened penal system. As a leading physician, Rush had a major impact on the emerging medical profession. As an Enlightenment intellectual, he was committed to organizing all medical knowledge around explanatory theories, rather than rely on empirical methods. Rush argued that illness was the result of imbalances in the body's physical system and was caused by malfunctions in the brain. His approach prepared the way for later medical research, but Rush himself undertook none of it. He promoted public health by advocating clean environment and stressing the importance of personal and military hygiene. His study of mental disorder made him one of the founders of American psychiatry.

Early life and career
Rush was born to John and Susanna Harvey Rush on January 4, 1746 (December 24, 1745 O.S.). The family which included seven children lived on a plantation in the Township of Byberry in Philadelphia County, then about 14 mi outside Philadelphia (the township was incorporated into Philadelphia in 1854 and now remains one of its neighborhoods). Rush's father died when he was five, leaving his mother to care for the large family. At eight years of age, Benjamin was sent to live with an aunt and uncle, to receive a proper education. Benjamin and his older brother Jacob (b. 1738) attended a school in Cecil County, Maryland, run by the Rev. Samuel Finley, which would later become West Nottingham Academy.

In 1760, after further studies at the College of New Jersey (now Princeton University), Rush graduated with a bachelor of arts degree. From 1761 to 1766, Rush apprenticed under Dr. John Redman in Philadelphia. Redman encouraged him to further his studies at the University of Edinburgh in Scotland, where Rush studied from 1766 to 1768 and earned a medical degree. Rush became fluent in French, Italian, and Spanish as a result of his studies and European tour. Returning to the Colonies in 1769 (age 24), Rush opened a medical practice in Philadelphia and became Professor of Chemistry at the College of Philadelphia (now the University of Pennsylvania). Rush ultimately published the first American textbook on chemistry, several volumes on medical student education, and wrote influential patriotic essays.

Revolutionary period
Rush was active in the Sons of Liberty and was elected to attend the provincial conference to send delegates to the Continental Congress. Thomas Paine consulted Rush when writing the profoundly influential pro-independence pamphlet Common Sense. Rush represented Pennsylvania and signed the Declaration of Independence. He also represented Philadelphia at Pennsylvania's own Constitutional Convention, and got into trouble when he criticized the new Pennsylvania Constitution of 1776.

While Rush was representing Pennsylvania in the Continental Congress (and serving on its Medical Committee), he also used his medical skills in the field. Rush accompanied the Philadelphia militia during the battles after which the British occupied Philadelphia and most of New Jersey and the Continental Congress fled to York, Pennsylvania. The Army Medical Service was in disarray, between the military casualties, extremely high losses due to typhoid, yellow fever and other camp illnesses, political conflicts between Dr.John Morgan and Dr. William Shippen, Jr., and inadequate supplies and guidance from the Medical Committee. Nonetheless, Rush accepted an appointment as surgeon-general of the middle department of the Continental Army. Dr. Rush's order "Directions for preserving the health of soldiers" became one of the foundations of preventative military medicine and was repeatedly republished, including as late as 1908. However, Rush's reporting of Dr. Shippen's misappropriation of food and wine supplies intended to comfort hospitalized soldiers, under-reporting of patient deaths, and failure to visit the hospitals under his command, ultimately led to Rush's resignation in 1778.

Campaign against General Washington
Rush criticized General George Washington in two handwritten but unsigned letters while still serving under the Surgeon General. One, to Virginia Governor Patrick Henry dated January 12, 1778, quoted General Thomas Conway saying that if not for God's grace the ongoing war would have been lost by Washington and his weak counselors. Henry forwarded the letter to Washington, despite Rush's request that the criticism be conveyed orally, and Washington recognized the handwriting. At the time, the Conway Cabal was trying to replace Washington with Horatio Gates as commander-in-chief. The letter also relayed General Sullivan's criticism that forces directly under Washington were undisciplined and mob-like, and contrasted Gates' army as "a well-regulated family". Ten days later, Rush wrote John Adams relaying complaints inside Washington's army, including about "bad bread, no order, universal disgust" and praising Conway, who had been appointed Inspector General

Shippen sought Rush's resignation, and received it by the end of the month after Continental Congress delegate John Witherspoon, chairman of a committee to investigate Morgan's and Rush's charges of misappropriation and mismanagement against Shippen, told Rush his complaints would not produce reform. Rush later expressed regret for his gossip against Washington. In a letter to John Adams in 1812, Rush wrote, "He [Washington] was the highly favored instrument whose patriotism and name contributed greatly to the establishment of the independence of the United States." Rush also successfully pleaded with Washington's biographers Judge Bushrod Washington and Chief Justice John Marshall to delete his association with those stinging words.

In his book "1776" David McCullough quotes Rush, referring to George Washington: The Philadelphia physician and patriot Benjamin Rush, a staunch admirer, observed that Washington "has so much martial dignity in his deportment that you would distinguish him to be a general and a soldier from among 10,000 people. There is not a king in Europe that would not look like a valet de chambre by his side."

Post Revolution
In 1783 he was appointed to the staff of Pennsylvania Hospital, of which he remained a member until his death.

He was elected to the Pennsylvania convention which adopted the Federal constitution and was appointed treasurer of the U.S. Mint, serving from 1797-1813.

He became Professor of medical theory and clinical practice at the University of Pennsylvania in 1791, though the quality of his medicine was quite primitive even for the time: he advocated bleeding (for almost any illness) long after its practice had declined. He became a social activist, an abolitionist, and was the most well-known physician in America at the time of his death. He was also founder of the private liberal arts college Dickinson College, in Carlisle, Pennsylvania. In 1794, he was elected a foreign member of the Royal Swedish Academy of Sciences.

Rush was a founding member of the Philadelphia Society for Alleviating the Miseries of Public Prisons (known today as the Pennsylvania Prison Society ), which greatly influenced the construction of Eastern State Penitentiary in Philadelphia.

Corps of discovery
In 1803, Thomas Jefferson sent Meriwether Lewis to Philadelphia to prepare for the Lewis and Clark Expedition under the tutelage of Rush, who taught Lewis about frontier illnesses and the performance of bloodletting. Rush provided the corps with a medical kit that included:
 * Turkish opium for nervousness
 * emetics to induce vomiting
 * medicinal wine
 * fifty dozen of Dr. Rush's Bilious Pills, laxatives containing more than 50% mercury, which the corps called "thunderclappers". Their meat-rich diet and lack of clean water during the expedition gave the men cause to use them frequently. Though their efficacy is questionable, their high mercury content provided an excellent tracer by which archaeologists have been able to track the corps' actual route to the Pacific.

Anti-slavery
In 1766 when Rush set out for his studies in Edinburgh, he was outraged by the sight of 100 slave ships in Liverpool harbor. As a prominent Presbyterian doctor and professor of chemistry in Philadelphia, he provided a bold and respected voice against the slave trade that could not be ignored.

The highlight of his involvement was the pamphlet he wrote in 1773 entitled "An Address to the Inhabitants of the British Settlements in America, upon Slave-Keeping." In this first of his many attacks on the social evils of his day, he not only assailed the slave trade, but the entire institution of slavery. Dr. Rush argued scientifically that Negroes were not by nature intellectually or morally inferior. Any apparent evidence to the contrary was only the perverted expression of slavery, which "is so foreign to the human mind, that the moral faculties, as well as those of the understanding are debased, and rendered torpid by it."

In 1792 Rush read a paper before the American Philosophical Society which argued that the 'color' and 'figure' of blacks were derived from a form of leprosy. He argued that with proper treatment, blacks could be cured and become whit.

Despite his public condemnations of slavery, Dr. Rush purchased a slave named William Grubber in 1776. To the consternation of many, Dr. Rush still owned Grubber when he joined the Pennsylvania Abolition Society in 1784.

Status of women
After the Revolution, Rush proposed a new model of education for women that included English language, vocal music, dancing, sciences, bookkeeping, history, and moral philosophy. A utilitarian, Rush saw little need for training women in metaphysics, logic, mathematics, or advanced science. He wanted the emphasis on guiding women toward moral essays, poetry, history, and religious writings because women were especially needed and useful in uplifting America's morals and manners. Rush also promoted what is now called Republican motherhood by instructing the young in the obligations of patriotism, the blessings of liberty and the true meaning of Republicanism. he opposed coeducational classrooms and insisted on the need to instruct all youth in the Christian religion.

Contributions to medicine
Although anatomy was well understood by Rush's time, the causes of disease remained elusive. Doctors therefore relied on various unscientific treatments. Although Rush continued these practices, he also actively sought new explanations and new approaches to treatment, some of which remain influential, and others of which seem incredible today. The third edition of Rush's Observations, a four volume compilation republished in 1809, is excerpted here.

Physical medicine


Dr. Rush firmly believed in bleeding patients (a practice now known to be generally harmful), as well as purges using calomel and other toxic substances. In his report on the Philadelphia Yellow Fever Epidemic of 1793, Rush wrote: "I have found bleeding to be useful, not only in cases where the pulse was full and quick, but where it was slow and tense. I have bled twice in many, and in one acute case four times, with the happiest effect. I consider intrepidity in the use of the lancet, at present, to be necessary, as it is in the use of mercury and jalap, in this insidious and ferocious disease." During that epidemic, Rush gained acclaim for remaining in town and treating sometimes 100 patients per day (some through free black volunteers coordinated by Richard Allen), but many died. Even Rush acknowledged the failure of two treatments, sweats in vinegar-wrapped blankets accompanied by mercury rubs, and cold baths.

William Cobbett vociferously objected to Rush's extreme use of bloodletting, and even in Rush's day and location, many doctors had abandoned on scientific grounds this favorite remedy of Rush's former teachers Thomas Sydenham and Hermann Boerhaave. Cobbett accused Rush of killing more patients than he had saved. Rush ultimately sued Cobbett for libel, winning a judgment of $5000 and $3000 in court costs, which was only partially paid before Cobbett returned to England. Nonetheless, Dr. Rush's practice waned as he continued to advocate bloodletting and purges, much to the chagrin of his friend Thomas Jefferson. Some even blamed Rush's bleeding for hastening the death of Benjamin Franklin, as well as George Washington (although the only one of Washington's doctors who opposed the bleeding was Rush's former student), and Rush insisted upon being bled himself shortly before his death (as he had during the yellow fever epidemic two decades earlier).

Rush also wrote the first case report on dengue fever (published in 1789 on a case from 1780). However, his greatest contributions to physical medicine now appear to have been his establishment of a public dispensary for low income patients, and public works associated with draining and rerouting Dock Creek (eliminating mosquito breeding grounds, which greatly decreased typhus, typhoid and cholera outbreaks).

Another of Rush's medical views that now draws criticism is his analysis of race. In reviewing the case of Henry Moss, a slave who lost his dark skin color (probably through vitiligo), Rush characterized being black as a hereditary and curable skin disease (called "negroidism"). Rush wrote that "Whites should not tyrannize over [blacks], for their disease should entitle them to a double portion of humanity. However, by the same token, whites should not intermarry with them, for this would tend to infect posterity with the 'disorder'... attempts must be made to cure the disease."

Mental health


Rush is considered the "Father of American Psychiatry", publishing the first textbook on the subject in the United States, Medical Inquiries and Observations upon the Diseases of the Mind (1812). He undertook to classify different forms of mental illness and to theorize as to their causes and possible cures. Rush believed (incorrectly) that many mental illnesses were caused by disruptions of the blood circulation, or by sensory overload, and treated them with devices meant to improve circulation to the brain such as a centrifugal spinning board, and inactivity/sensory deprivation via a restraining chair with a sensory-deprivation head enclosure ("Tranquilizer Chair"). After seeing mental patients in appalling conditions in the Pennsylvania Hospital, Rush led a successful campaign in 1792 for the state to build a separate mental ward where the patients could be kept in more humane conditions.

While Dr Rush was uncertain what to do for the mentally ill, he knew that chains and dungeons (the practice of the time) were not the answer. He took patients from that drudgery and placed them in a "normal" hospital setting. This alone resulted in a number of patients recovering sufficiently to return to society. For this reason his approach is officially referred to as the Moral Therapy.

Rush is sometimes considered a pioneer of occupational therapy particularly as it pertains to the institutionalized. In Diseases of the Mind Rush wrote:
 * "It has been remarked, that the maniacs of the male sex in all hospitals, who assist in cutting wood, making fires, and digging in a garden, and the females who are employed in washing, ironing, and scrubbing floors, often recover, while persons, whose rank exempts them from performing such services, languish away their lives within the walls of the hospital".

Furthermore, Rush was one of the first people to describe Savant Syndrome. In 1789 he described the abilities of Thomas Fuller, a lightning calculator. His observation would later be described in other individuals by notable scientists like John Langdon Down.

Rush pioneered the therapeutic approach to addiction. Prior to his work, drunkenness was viewed as being sinful and a matter of choice. Rush believed that the alcoholic loses control over himself and identified the properties of alcohol, rather than the alcoholic's choice, as the causal agent. He developed the conception of alcoholism as a form of medical disease and proposed that alcoholics should be weaned from their addiction via less potent substances.

In honor of his service to mental health, the American Psychiatric Association uses Dr. Rush's image as part of their seal.

Educational Legacy
During his career, he educated over 3000 medical students, and several of these established Rush Medical College (Chicago) in his honor after his death. One of his last apprentices was Samuel A. Cartwright, later a Confederate States of America surgeon charged with improving sanitary conditions in the camps around Vicksburg, Mississippi, and Port Hudson, Louisiana. Rush University Medical Center in Chicago, formerly Rush-Presbyterian-St. Luke’s Medical Center, was named in his honor.

Religious views and vision
Rush advocated Christianity in public life and in education, and sometimes compared himself to the prophet Jeremiah. Dr. Rush regularly attended Christ Church, Philadelphia in Philadelphia and counted William White among his closest friends (and neighbors). Ever the controversialist, Rush became involved in internal disputes over the revised Book of Common Prayer and the splitting of the Episcopal Church from the Church of England, as well as dabbled with Presbyterianism, Methodism (which split from Anglicanism in those years), and Unitarianism. In a letter to John Adams, Rush described his religious views as "a compound of the orthodoxy and heterodoxy of most of our Christian churches." Christian Universalists consider him one of their founders, although Dr. Rush stopped attending that church after the death of his friend, former Baptist pastor Elhanan Winchester in 1797.

Rush fought for temperance, and both public and Sunday schools. He helped found the Bible Society at Philadelphia (now known as the Pennsylvania Bible Society), and promoted the American Sunday School Union. When many public schools schools stopped using the Bible as a textbook, Rush proposed that the U.S. government require such use, as well as furnish an American bible to every family at public expense. In 1806 Rush also proposed inscribing "The Son of Man Came into the World, Not To Destroy Men's Lives, But To Save Them." above the doors of courthouses and other public buildings. Earlier, on July 16, 1776, Rush had complained to Virginia's Patrick Henry about a provision in that state's constitution of 1776 which forbad clergymen from serving in the legislature.

Rush felt that the United States was the work of God: "I do not believe that the Constitution was the offspring of inspiration, but I am as perfectly satisfied that the Union of the United States in its form and adoption is as much the work of a Divine Providence as any of the miracles recorded in the Old and New Testament". In 1798, after the Constitution's adoption, Rush declared:" The only foundation for a useful education in a republic is to be laid in Religion. Without this there can be no virtue, and without virtue there can be no liberty, and liberty is the object and life of all republican governments."

Before 1779, Rush's religious views were influenced by what he described as "Fletcher's controversy with the Calvinists in favor of the Universality of the atonement." After hearing Elhanan Winchester preach, Rush indicated that this theology "embraced and reconciled my ancient calvinistical, and my newly adopted (Arminian) principles. From that time on I have never doubted upon the subject of the salvation of all men." To simplify, both believed in punishment after death for the wicked. His wife, Julia Rush, thought her husband like Martin Luther for his ardent passions, fearless attacks on old prejudices, and quick tongue against perceived enemies.

Rush also helped Richard Allen found the African Methodist Episcopal Church. In his autobiography, Allen wrote:

"...By this time we had waited on Dr. Rush and Mr. Robert Ralston, and told them of our distressing situation. We considered it a blessing that the Lord had put it into our hearts to wait upon... those gentle-men. They pitied our situation, and subscribed largely towards the church, and were very friendly towards us and advised us how to go on.

We appointed Mr. Ralston our treasurer. Dr. Rush did much for us in public by his influence. I hope the name of Dr. Benjamin Rush and Mr. Robert Ralston will never be forgotten among us. They were the two first gentlemen who espoused the cause of the oppressed and aided us in building the house of the Lord for the poor Africans to worship in. Here was the beginning and rise of the first African church in America."

Family
Benjamin Rush's great-great-grandfather, John Rush, came to America with his wife, Susannah (Lucas) Rush from England in 1683. Susannah Lucas was first cousin to William Penn who established Pennsylvania. Their mothers were sisters. Before the Revolutionary war, Rush was engaged to Sarah Eve, daughter of prominent Philadelphian, Captain Oswell Eve, Sr. Their wedding date was set for mid-December 1774. Unfortunately, Sarah became ill and died on December 4, 1774, 2 weeks before their intended date.

On January 11, 1776, Rush married Julia Stockton (1759–1848), daughter of Richard Stockton, another signer of the Declaration of Independence, and his wife Annis Boudinot Stockton. They had 13 children, 9 of whom survived their first year: John, Ann Emily, Richard, Susannah (died as an infant), Elizabeth Graeme (died as an infant), Mary B, James, William (died as an infant), Benjamin (died as an infant), Benjamin, Julia, Samuel, William.

Ann Emily married the Honorable Ross Cuthbert; Richard Rush (1780–1859) became an attorney and married Catherine Elizabeth Murray; Mary married Major Thomas Manners; James became a medical doctor and married Eugenia Frances Heister and Elizabeth Upshur Dennis; Benjamin did not marry, moved to New Orleans, LA; Julia (1792–1860) married Henry Jonathon Williams Esquire; Samuel (1795–1859) became an attorney and married Nancy Anne Wilmer; William became a doctor and married Elizabeth Fox Roberts. Samuel's daughter Julia Williams Rush (1833–1898) married Alexander Biddle of the Philadelphia Biddle family.

Rush's eldest son, John, initially followed his father into medicine, then joined the navy. During his tour, a friend and fellow officer challenged him to a duel. John shot and killed the challenger and was soon consumed by feelings of guilt. When he returned home unable to care for himself, Rush placed him in the mental ward at the Pennsylvania Hospital, where he died 30 years later without having recovered.

Rush was the man who, in 1812, helped reconcile the friendship of Thomas Jefferson and John Adams by encouraging the two former Presidents to resume writing to each other.

Writings

 * Letters of Benjamin Rush, volume 1: 1761-1792 (1951), editor L.H. Butterfield, Princeton University Press
 * Essays: Literary, Moral, and Philosophical (1798) Philadelphia: Thomas & Samuel F. Bradford, 1989 reprint: Syracuse University Press, ISBN 0-912756-22-5, includes "A Plan of a Peace-Office for the United States"
 * The Autobiography of Benjamin Rush: His "Travels Through Life" Together with his Commonplace Book for 1789-1813, 1970 reprint: Greenwood Press, ISBN 0-8371-3037-9
 * Medical Inquiries And Observations Upon The Diseases Of The Mind, 2006 reprint: Kessinger Publishing, ISBN 1-4286-2669-7. Free digital copies of original published in 1812 at http://deila.dickinson.edu/theirownwords/title/0034. or http://collections.nlm.nih.gov/muradora/objectView.action?pid=nlm:nlmuid-2569036R-bk
 * The Spur of Fame: Dialogues of John Adams and Benjamin Rush, 1805-1813 (2001), Liberty Fund, ISBN 0-86597-287-7
 * Benjamin Rush, M.D: A Bibliographic Guide (1996), Greenwood Press, ISBN 0-313-29823-8
 * ''An Address to the Inhabitants of the British Settlements in America, Upon Slave-keeping. Philadelphia: Printed by J. Dunlap, 1773.

Buried
After dying of typhus fever, he was buried (in Section N67) along with his wife Julia in the Christ Church Burial Ground in Philadelphia, not far from where Benjamin Franklin is buried. At the site, a small plaque honoring Benjamin Rush has been placed. However, the box marker is next to the plaque on the right, with inscriptions on the top. The inscription reads,

"In memory of Benjamin Rush MD he died on the 19th of April in the year of our Lord 1813 Aged 68 years Well done good and faithful servant enter thou into the joy of the Lord"

Mrs Julia Rush wife of Benjamin Rush MD Born March 2, 1759 Died July 7, 1848"