Benjamin Rush

Early life and career

Rush was born to John Rush and Susanna Hall on January 4, 1746 (December 24, 1745, O.S.). The family, of English descent, lived on a farm in the Township of Byberry in Philadelphia County, about 14 miles outside of Philadelphia (the township was incorporated into Philadelphia in 1854). Rush was the fourth of seven children. His father died in July 1751 at age 39, leaving his mother, who ran a country store, to care for the family. At age eight, Benjamin was sent to live with an aunt and uncle to receive an education. He and his older brother Jacob attended a school run by his uncle, the Reverend Samuel Finley, which later became West Nottingham Academy.

In 1760, after further studies at the College of New Jersey, which in 1895 became Princeton University, Rush graduated with a Bachelor of Arts degree at age 14. From 1761 to 1766, Rush apprenticed under 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 an M.D. degree. Rush became fluent in French, Italian, and Spanish as a result of his studies and European tour. While at Edinburgh, he became a friend of the Earl of Leven and his family, including William Leslie.

Returning to the Colonies in 1769, Rush opened a medical practice in Philadelphia and became professor of chemistry at the College of Philadelphia (which in 1791 changed its name to its present name, University of Pennsylvania). After his election to the revived American Philosophical Society in 1768, Rush served as the society's curator from 1770 to 1773, as secretary from 1773 to 1773, and vice president from 1797 to 1801. Rush ultimately published the first American textbook on chemistry and several volumes on medical student education and wrote influential patriotic essays.

Native American health

Rush was interested in Native American health. He wanted to find out why Native Americans were susceptible to certain illnesses and whether they had higher mortality rates as compared to other people. Other questions that he raised were whether they dreamed more and if their hair turned gray as they got older. His fascination with indigenous peoples came from his interest in the theory that social scientists can better study the history of their own civilization by studying cultures in earlier stages of development, "primitive men". In his autobiography, he writes "From a review of the three different species of settlers, it appears that there are certain regular stages which mark the progress from the savage to civilized life. The first settler is nearly related to an Indian in his manners. In the second, the Indian manners are more diluted. It is in the third species only that we behold civilization completed. It is to the third species of settlers only that it is proper to apply the term of farmers. While we record the voices of the first and second settlers, it is but just to mention their virtues likewise. Their mutual wants to produce mutual dependence; hence they are kind and friendly to each other. Their solitary situation makes visitors agreeable to them; hence they are hospitable to a stranger."

Mental health

Rush published one of the first descriptions and treatments for psychiatric disorders in American medicine, 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 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 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.

Rush believed, as did so many physicians of the time, that bleeding and active purging with mercury(I) chloride (calomel) were the preferable medical treatments for insanity, a fact evidenced by his statement that, "It is sometimes difficult to prevail upon patients in this state of madness, or even to compel them, to take mercury in any of the ways in which it is usually administered. In these cases I have succeeded, by sprinkling a few grains of calomel daily upon a piece of bread, and afterwards spreading over it, a thin covering of butter." Rush followed the standard procedures of bleeding and treatment with mercury, he did believe that "coercion" and "restraint", the physical punishment, chains and dungeons, which were the practice of the time, were the answer as proven by his invention of the restraint chair and other devices. For this reason, some aspects of his approach could be seen as similar to Moral Therapy, which would soon rise to prominence in at least the wealthier institutions of Europe and the United States.

Rush is sometimes considered a pioneer of occupational therapy particularly as it pertains to the institutionalized. In Diseases of the Mind (1812), 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, an enslaved African who was 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.

Rush advocated for more humane mental institutions and perpetuated the idea that people with mental illness are people who have an illness, rather than inhuman animals. He is quoted to have said, "Terror acts powerfully upon the body, through the medium of the mind, and should be employed in the cure of madness." He also championed the idea of "partial madness," or that people could have varying degrees of mental illness.

The American Psychiatric Association's seal bears an image of Rush's purported profile at its center. The outer ring of the seal contains the words "American Psychiatric Association 1844". The Association's history of the seal states:

The choice of Rush (1746–1813) for the seal reflects his place in history..... Rush's practice of psychiatry was based on bleeding, purging, and the use of the tranquilizer chair and gyrator. By 1844 these practices were considered erroneous and abandoned. Rush, however, was the first American to study mental disorder in a systematic manner, and he is considered the father of American Psychiatry.

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 October 13, 1778, quotes 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 supposed Conway Cabal was reportedly trying to replace Washington with Horatio Gates as commander-in-chief. Rush's letter relayed General John 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 to John Adams relaying complaints inside Washington's army, including about "bad bread, no order, universal disgust" and praising Conway, who had been appointed to 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 Justice Bushrod Washington and Chief Justice John Marshall to delete his association with those stinging words.

In his 2005 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."