Benjamin Rush (1746–1813) was an American physician, patriot, and educator who left a lasting intellectual legacy on medicine, psychiatry, and social reform in the United States. The fourth of seven children, he was born in Pennsylvania in 1746. After his father died in 1751, Rush's mother became involved in the theological currents of the Great Awakening, a period of Puritan revival that had swept through New England in the 1730s and 1740s. Educated by his uncle, evangelist Samuel Finley, Rush developed a deep and abiding religious character that would influence his thinking for the rest of his life. After finishing preparatory school, he entered Princeton University as a member of the junior class. During the course of his studies, he decided not to follow a clerical calling, expressing instead a preference for medicine. Although Finley wanted all his students to become ministers to continue the revival of America, he did not discourage Rush from pursuing a medical calling, acknowledging it as a profession that served pious purposes.
After graduating from Princeton, Rush apprenticed for five years with John Redman, a physician in Philadelphia. As he neared the end of his apprenticeship, his mother arranged to support three years of medical education at the University of Edinburgh. Since the 16th century, the institution had acquired a reputation for its medical faculty, especially in the area of anatomy. In the 18th century, it became the central locus of the Scottish Enlightenment, so when Rush arrived in 1766, a young Puritan man, he was thrust into an intellectual environment that privileged reason and observation over theological explanations of the natural world. Studying medicine under William Cullen and chemistry under Joseph Black exposed Rush to empirical thought. During his brief tenure in Edinburgh, Rush turned in Enlightenment circles, becoming friends with such luminaries as philosopher David Hume and economist Adam Smith.
Returning home two years later as a physician, Rush established himself in Philadelphia. After spending a few more years studying and traveling to London and Paris, he began a medical practice and became a chemistry professor at the College of Philadelphia. He also became acquainted with Benjamin Franklin, with whom he would later form a society promoting the abolition of slavery. In 1776, he married Julia Stockton after a brief courtship. As the split with England approached, Rush became a patriot. Even though he never assumed a leading role in the push for independence, he was always on the periphery. For instance, when essayist Thomas Paine struggled with a title for what would become one of the most influential texts of the American Revolution, it was Rush who suggested Common Sense. His name also appears among the 56 signatures on the Declaration of Independence.
During the war, he served the revolutionary cause in a supporting role as an army physician before being appointed physician general of George Washington's army. But after falling out with the military leadership, Rush resigned his position. From this point, he would support the New Republic as an educator and a reformer. After the war ended, he joined the staff of the Pennsylvania Hospital, where his experience with mental health began. The blend of Enlightenment medicine and Puritan ideals that characterized his views expressed itself in a compassion for the poor, criminals, and mentally ill. Criticizing a penal system that often executed people for relatively minor offenses, Rush advocated a system in which the punishment fit the crime. He also argued in favor of a medical model of mental illness. These views culminated in the publication of Medical Inquiries and Observations, Upon the Diseases of the Mind in 1812, a year before Rush died.
As a founder of the United States, Rush was deeply concerned that without establishing a method to educate future generations with American values, the young nation would falter. As a physician and educator, he was at the center of an emerging medical and general education system tasked with ensuring the continuity of American religious and intellectual thought, playing a leading role in the foundation of several colleges and schools. As a social reformer, Rush remained an active abolitionist, founded societies for prison reform, established poor houses, and continued writing and publishing.
It was also after the American Revolution that Rush began writing about temperance in earnest, which created the legacy for which he is best know today. Although he rarely left Philadelphia, in 1784, he traveled to Carlisle to meet with the trustees of Dickinson College, an institution he had helped found the year before. On his way, he noticed that some farms were well kept but others were run down and poorly maintained. Rush attributed the difference to ethnic drinking habits. Englishmen, he supposed, drank beer and wine—wholesome beverages—while the Scotch Irish drank whiskey, which wasted grain and destroyed their health, industry, and morals. The observation left such an impression on him that, within a few weeks of his return to Philadelphia, he published his first full-length temperance essay.
Rush would edit and expand this original essay throughout the rest of his life, developing arguments against alcohol that 19th-century American temperance reformers would recite. His arguments ultimately culminated in his 1805 An Inquiry Into the Effects of Ardent Spirits Upon the Human Body and Mind. Incorporating temperance views developed by the Scottish Enlightenment regarding alcohol, Rush considered drunkenness a disease caused by alcohol, which is a poison directly caused by the disease. He also argued that habitual drunkenness predisposed the drinker to other, chronic diseases. Rush, who enjoyed beer and wine himself, proposed medical treatments for the disease of drunkenness: a supervised regimen in which the drinker stopped drinking liquor through gradual dose reduction and substituting it with weaker beverages like beer or wine.
But even though the part of Rush's mentality influenced by the Enlightenment led him to treat habitual drinking as a disease, as a Puritan, he could not release a theological outlook on the problem. Thus, despite the rational tone of his other medical works, he presented his temperance views with the flair of a revivalist preacher. His Inquiry resembled more of a sermon than a scientific document. He likened intoxication to demonic possession, a state of being that allowed disease into the body and corrupted the soul. He devised a “moral thermometer”—which measured the severity of different types of alcoholic beverages, the vices they produced, and the physical diseases they fostered—and placed distilled liquors at the lowest end of the spectrum.
Thus, blending the line between medical and religious spheres of thought, Rush called drunkenness both a moral and a physical disease. When the new American government did not initially take temperance arguments seriously and did not restrict alcohol, he became disillusioned with secular efforts to curb drunkenness. Not content to merely lay out his case as a physician, hoping the public would take heed, he actively called on religious leadership in society to take up his cause. Comparing drunkenness to covetousness, theft, adultery, anger, malice, and even murder, Rush exhorted the clergy to publicly preach against drinking.
Even though the Scottish Enlightenment certainly influenced Rush's approach to medical research, theory, and practice, his Puritan sensibilities survived as a guiding influence for the rest of his life. While he respected Hume as a thinker and a friend, Rush never adopted Hume's deistic interpretation of theology, repudiating the idea of a watchmaker God who wound creation and withdrew. Instead, Rush reconciled Enlightenment empiricism as a method he could apply to the study of medicine without abandoning his Puritan convictions about the ever-present, personal nature of God and a Calvinist theology of salvation. He believed that the Bible should remain a cornerstone of an American education and played a role in printing the first mass-produced Bible in the United States. Regarding temperance, even though he defined drunkenness as a disease, he nevertheless believed that only a personal religious transformation could reform a habitual drinker even as he advocated civic regulation of alcohol.
Physicians, historians, and biographers who have written about Rush have extended his status as a founding father to the other areas of his career. Since his death in 1813, Rush has been lionized as the father of American medicine, psychology, and the temperance movement. Historians of medicine have even called him an American Hippocrates, crediting him with the invention of medical practice in the United States. One sociologist has even credited him with generating the concept of addiction, an interpretation that still persists in the history of temperance movement. However, a more balanced view has recently emerged. Historians Jessica Warner and James Nicholls have pointed out that English physicians in Edinburgh and Bath had already begun to craft a conception of addiction during the Enlightenment, ideas that Rush would later espouse.
While Rush played a significant role in founding several institutions of medical and general education in the United States and was a fervent abolitionist who advocated prison, mental health, and temperance reform, he did not create these ideas. Despite his puritanical background, Rush—like Franklin and other American intellectuals—served as a conduit for Enlightenment ideas, transmitting them into the newly formed United States. And while he may not have technically founded the temperance movement, his call to action was certainly followed by several generations of reformers who cited his arguments against alcohol in their fight to prohibit the nonmedical use of alcohol and other drugs throughout the 19th century.
See Also: Addiction and Alcoholism, History of; Detoxification, History of; Disease Model of Alcoholism; Marsh, John; Temperance, History of; Temperance Movements; Towns, Charles B.
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