The Paradoxical Doctor Benjamin Rush

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One of Benjamin Rush’s biographers has compared him to quicksilver, the brilliant and elusive element mercury that changes so unpredictably yet so curiously reflects the images around it. The metaphor is appropriate in another sense, too, for not only was Rush mercurial as a person, but as an eighteenth-century physician he freely resorted to the use of mercury in its various forms to purge patients of certain “morbific” or disease-making substances that were supposed to lurk in their bodily fluids. Dr. Rush, who practiced from 1769 to 1813, believed that illness could be expelled from the human frame in exactly the same way that evil could be driven out of human society. At the bedside, in the lecture room, and in the whole arena of politics and life Dr. Rush saw himself as a purifier.

Intriguing and challenging, Rush was a man of glittering contradictions. Take, for example, his medical record. A professor for much of his life, he trained as many as three thousand doctors, a great proportion of all those who practiced “physick” in the infant United States. He also composed a huge array of pamphlets full of firm advice on every aspect of the healing art. As a result he was probably the most influential figure in American medicine and remained so until long after his death.

But was he a trailblazer in medical progress? The answer can only be equivocal. Although for his day his training was unusually solid, he undertook almost no experimentation after he got his own medical degree. He was an acute observer and recorder of symptoms. But his scrutiny rarely led him to revise an opinion, and he persisted to his life’s end in a simplistic theory that blamed nearly all disease on a single cause. He was the first American doctor to propose intelligent and humane care of the mentally ill in place of the torture and confinement common in the early 1800’s. But he was also addicted to the virtues of bloodletting, and his busy lancet, according to James T. Flexner, shed more blood than any general in history—a hyperbolic statement, certainly, but not out of line with Dr. Rush’s sanguinary enthusiasm.

In politics, too, the record is spotted with inconsistencies. Rush was an early and ardent spokesman for American independence and a signer of the Declaration. He supported democratic reforms in the government of Pennsylvania and was far ahead of his time in battling for popular and practical education, recognition of women’s mental abilities, moderation in drinking, and emancipation of slaves. Yet these progressive views coexisted with rigid religious orthodoxy. Though Rush shifted from the Presbyterian to the Episcopalian fold in middle age, and later into a distrust of denominational machinery, his formative years were marked by faith in an absolute and heavily Calvinistic God.

Rush’s willingness to entertain social change did not come from flexibility in values but rather from ironclad notions of how life could be bettered. Always furiously energetic, he was never slowed by that most debilitating but humanizing of maladies, selfdoubt. Touched with genius but with an excess of zeal, too, he became a kind of second-line founding father. He had the diligence, curiosity, and political drive of a Franklin, an Adams, or a Jefferson, but without the needed leaven of sophistication and patience.

 

Only after it was clear that his character blocked him from political pre-eminence did Rush settle definitively into his medical career. It is there, in the framework of his success, that he can be effectively studied in full dimension, even though his nonmedical activities could independently fill a biography. Rush the physician is in many ways a model eighteenth-century American. He believed that Nature was majestic but could and should be mastered. He yearned to systematize knowledge, and to find the hidden harmonies and balances of the universe and reflect them in human conduct. He saw few potential limits to the betterment of mankind. And finally, he had a strong streak of practical inventiveness about him. If these habits of mind sometimes contradicted each other, that only made Rush a more typical son of his era.

Rush was born Christmas Eve of 1745 (according to the Old Style calendar), on a farm near Philadelphia. His ancestors were among the earliest settlers of Pennsylvania, and his father was both a farmer and a gunsmith. He died when Benjamin was not yet six years old. Susanna Rush, who then had seven children, proved to be a strong and competent widow. She opened a general store in Philadelphia which she ran with considerable success. Perhaps Rush had his mother in mind when he wrote years later that young women in the United States should be taught bookkeeping, for if a wife survived her husband, “she cannot fail of deriving immense advantages from it.” In any case, he was devoted to her and overtly resentful of her marriage to a distiller, Richard Morris, who was, in the boy’s jealous eyes, often abusive of her.