RUSH, BENJAMIN

(b. Byberry, Pennsylvania, 4 January 1746; d. Philadelphia, Pennsylvania, 19 April 1813)

chemistry, medicine, psychiatry.

Rush was born the fourth child of seven. He lost his father, John, when he was five but was fortunate in having a sturdy, emotionally and religiously steadfast mother (Susanna Hall Harvey), who opened a grocery store to support her children. At the age of eight Rush was sent to the school conducted by his uncle, Rev. Samuel Finley, and there came under the sway of the “Great Awakening” sweeping the colonies. His religious views were extended and polished under President Samuel Davies at the Presbyterian College of New Jersey (later Princeton), where he received the bachelor’s degree in 1760. He remained devout throughout his life, viewing the world as a great unity, so constructed by a benevolent God that everything was comprehensible, meaningful, and existing for a purpose.

Under Davies’ influence Rush contemplated the law as a career but decided instead in favor of medicine. He apprenticed himself to Dr. John Redman in Philadelphia for the next five years and during that time also took courses at the newly founded College of Philadelphia. He was exposed to some chemistry in the lectures on materia medica by John Morgan, who encouraged him to continue his medical education at Edinburgh, with the prospect of an appointment to the chair of chemistry on his return.

Enrolling in the medical program at the University of Edinburgh late in 1766, Rush furthered his chemical career by attending the lectures of Joseph Black for two consecutive years. In preparing his doctoral dissertation Rush applied his chemical bent to a study of the digestive processes in the human stomach. After vigorous self-experimentation that included induced vomiting of special meals, he decided that the acidity of the stomach contents was caused by fermentation. Rush erred in his conclusion and realized it only in 1804, when faced with the new experimental evidence produced by his student John R. Young.

After his graduation Rush toured factories in England, investigating their use of chemical reactions, and visited leading French chemists: Baumé, Macquer, and Augustin Roux. On his return to America, he was appointed professor of chemistry on 1 August 1769 at the College of Philadelphia (today the University of Pennsylvania Medical College). The following year he issued the nowscarce Syllabus of a Course of Lectures on Chemistry. With the lectures presented in a medical context, it is not surprising that he devoted a quarter of this slim volume to pharmaceutical chemistry.

The appointment of Rush ushered in the formal beginnings of chemistry in America. Rush was pleased to accept this responsibility, not only for the increase in professional stature but also for the satisfaction he derived from following in the footsteps of two leaders of eighteenth-century medicine who also had been professors of chemistry: Herman Boerhaave of Leiden and William Cullen. He was determined that chemistry should be useful to the larger community, and therefore offered a course to the educated public in 1775 and to the students of the Young Ladies Academy of Philadelphia in 1787. In his teaching Rush closely followed the outlines of Joseph Black’s course but, unfortunately, did not follow his teacher’s penchant for experimental demonstrations.

Experimentation in general was not Rush’s forte; he employed his chemical training only to expose the true nature of a quack cancer cure and to study the chemical composition and therapeutic effectiveness of various local mineral waters. He did use his knowledge to good avail during the Revolution, when he served on a governmental committee promoting the local manufacture of gunpowder; at that time his instructions for the manufacture of saltpeter were widely reprinted.

Rush’s teaching of chemistry ended in October 1789, when his early mentor, John Morgan, died and Rush took over his position as professor of the theory and practice of medicine. Rush never lost interest in the selection of his successors, all of whom were his students: Caspar Wistar (1789–1791), James Hutchinson (1791–1793), James Woodhouse (1795–1809), and John Redman Coxe (1809–1818). Another student whom Rush encouraged was John Penington, who organized the first chemical society in the United States in 1789.

Rush began his practice of medicine in 1769. At first largely among the poor, it gradually grew to include a wide spectrum of society. Rush had been trained by Redman to honor the clinical observations and insights of Sydenham and to accept Boerhaave’s theoretical system; but at Edinburgh he enthusiastically shifted his allegiance to Cullen’s theory. With his professorship of 1789 he again began to modify his theoretical focus, and a collegiate reorganization that made him professor of the institutes of medicine (physiology) and clinical practice in late 1791 forced further reconsideration of his views of basic physiological processes. Developed in his teaching during these academic years and in his medical experiences with the yellow fever epidemic of 1793, his ideas were fixed by 1795. Whereas Cullen had made the nervous system (its overenergetic or underenergetic reactions) the center of his theory, Rush narrowed his focus to the responsiveness of the arterial system. Using fever as his paradigm, he said that a state of motion (or what he called the convulsive or irregular action) in the arteries was the sole cause of disease. Since the majority of illnesses appeared to him to arise from increased tension, he logically but overenthusiastically applied bleeding and other depleting remedies to his patients. History has roundly but often excessively condemned him for the vigor of this treatment.

As a physician Rush also must be seen as a successful and popular teacher of some 3,000 students during the forty-four years of his career. Many did not accept his theories, and the doctoral dissertations written under Rush in his later years leave a clear impression that his pupils had outstripped him in their ability to appreciate the growing experimentation in the medical sciences. More important, however, he inspired them; remained their medical consultant for life; and taught them to be observant, dedicated to their patients, and aware of the nuances of the doctor-patient relationship.

Rush’s restless mind explored many spheres: theory and practice, medical jurisprudence, the physiology of balloon ascents, transcultural and especially Indian medicine, geriatrics, dentistry, veterinary medicine. Although active in many areas, he was concerned primarily with medicine and became widely recognized as the leading physician in the United States.

In 1787 Rush was placed in charge of the insane at the Pennsylvania Hospital. Psychiatric reform was accelerating throughout the Western world; and Rush was in step with such leaders as Vincenzo Chiarugi of Italy, Philippe Pinel of France and the Tuke family of Great Britain. Recognizing the need to see man as a whole, with body and mind “intimately united,” Rush was deliberately unorthodox in devoting a large part of his physiological lectures to a discussion of the operations and functions of the mind. As he passed from his physical theories to psychology, he developed a complex body of theory based on a mixture of associationism and faculty psychology. Rush’s practice and teaching of psychiatry culminated in the publication of Medical Inquiries and Observations Upon the Diseases of the Mind (1812), the first book on psychiatry by a native American. In this work he discussed, among many other topics, “moral derangements,” a concept that had concerned him as early as 1786, when he published An Enquiry Into the Influences of Physical Causes Upon the Moral Faculty. He realized that not only intellect but also behavior and the emotions can be disturbed, and his attempts at understanding these phenomena represent his most creative contribution to psychiatric thought.

A man of the Enlightenment, Rush evinced the best qualities of the age–humanism, optimism, and a fervent belief in the progress of knowledge. These traits were visible in his political reform activities: he signed the Declaration of Independence and fought for the federal constitution. He helped found Dickinson College, supported greater education for women, and called for a network of colleges culminating in a national university. He opposed slavery and capital punishment, supported temperance and penal reform. As a proselytizer and inspirational teacher Rush had a great impact on the American scientific scene. But for all his confidence in the clarity of his observations, Rush’s usual mode of validating his hypotheses was through analogy; and he never came to appreciate the experimental method for its true worth. As a medical theorist he belonged ’much more to the eighteenth-century system builders. For the field of science his importance lies, as Lyman Butterfield has so aptly said, in his role as “an evangelist of science.”

BIBLIOGRAPHY

I. Original Works. Rush’s chemistry is in the reprint of his Syllabus of a Course of Lectures on Chemistry (Philadelphia, 1954), which contains a thoughtful introduction by L. H. Butterfield, and in the student notes of his lectures. Rush collected what he considered to be his most important writings in Medical Inquiries andObservations, 2nd ed., 4 vols. (Philadelphia, 1805). To this should be added his Medical Inquiries and Observations Upon the Diseases of the Mind (Philadelphia, 1812: repr. New York, 1962) and his earlier An Inquiry Into the influence of physical Causes Upon the Moral Faculty (Philadelphia. 1786). The Autobiography of Benjamin Rush, G. W. Corner, ed. (Princeton, 1948): and Letters of Benjamin Rush, L. H. Butterfield, ed., 2 vols. (Princeton, 1951), provide a rich background to his life and associations and contain bibliographies listing all published works and MSS .

II. Secondary Literature. Two major biographical studies exist: N. G. Goodman, Benjamin Rush, Physician and Citizen, 1746–1813 (Philadelphia, 1934), is more of an intellectual history: C. Binger, Revolutionary Doctor: Benjamin Rush, 1746–1813 (New York, 1966). is a warm, humanistic account of the man himself. D. J. D’Elia, “The Republican Theology of Benjamin Rush,” in Pennsylvania History, 33, no. 2 (1966). 187–203, provides important insights into Rush’s philosophical stance. Essential to a study of his early career is W. Miles, “Benjamin Rush, Chemist,” in Chymia, 4, (1953), 33–77: and H. S. Klickstein offers additional information in “A Short History of the Professorships of Chemistry of the University of Pennsylvania School of Medicine, 1765–1847.” in Bulletin of’ the History of Medician, 27, no. 1 (1953), 43–65. Rush’s use of chemistry in his doctoral dissertation is discussed in D. F. Musto, “Benjamin Rush’s Medical Thesis, ’On the Digestion of Food in the Stomach.’ Edinburgh, 1768,” in Transactions and Studies of the College of Physicians of Philadelphia, 4th ser., 33, no. 2 (1965), 121–138.

A good evaluation of Rush the physician is given by R. H. Shryock in “Benjamin Rush From the Perspective of the Twentieth Century,” in Transactions and Studies of the College of Physicians. of Philadelphia, 4th ser., 14, no. 2 (1946), 113–120. J. H. Powell, in Bring Out Your Dead (Philadelphia, 1949), shows Rush’s dedicated but vehement behavior in the Philadelphia yellow fever epidemic Rush’s psychiatry is summarized in Shryock’s “The Psychiatry of Benjamin Rush,” in American Journal of Psychiatry, 101 (1945), 429–432: and in E. T. Carlson and M. M. Simpson, “The Definition of Mental Illness: Benjamin Rush (1746–1813),” ibid., 121, no. 3 (1964), 209–214. Carlson and Simpson have also shown the importance of his writings on the moral sense in their “Benjamin Rush’s Medical Use of the Moral Faculty,” in Bulletin of the History of Medicine, 39, no. 1 (1965), 22–33.

Eric T. Carlson