Benjamin Rush was born on January 4, 1746, in Byberry Township, Pennsylvania, the son of John Rush, a farmer and gunsmith, and Susanna Hall Harvey. After his father’s death in 1751, his mother moved to Philadelphia, where she ran a grocery store to support the family. At the age of eight, Rush was sent to live with his uncle, Rev. Dr. Samuel Finley. Finley, a pastor and headmaster of Nottingham Academy, saw to it that Rush received an education. Rush entered the College of New Jersey (now Princeton) in 1759, receiving an A.B. in 1760, at the age of fourteen.
On returning to Philadelphia, Rush came into contact with some of the most prominent American physicians of the time. From 1761 to 1766, he apprenticed under John Redman and attended the first lectures of John Morgan and William Shippen, Jr. at the newly founded Department of Medicine in the College of Philadelphia. During these years, Rush also began his lifelong habit of regularly making entries in his Commonplace Book, including notes that later afforded the only written eyewitness account of the 1762 yellow fever epidemic in Philadelphia.
In 1766, at Redman’s urging, Rush left North America to study at the University of Edinburgh, then one of the most renowned medical schools in Europe. While there, he became the disciple and friend of the highly respected William Cullen, who profoundly influenced Rush’s theoretical approach to medicine. His thesis, “On the Digestion of Food in the Stomach,” reflected his training in chemistry and was based in part on self-experimentation. After receiving his medical degree in 1768, Rush spent several months training at St. Thomas’s Hospital in London, where he had the opportunity to attend dissections by William Hunter and to meet Benjamin Franklin, who was then in London. Franklin persuaded Rush to take a trip to France in early 1769, which he partially financed and which gave Rush the opportunity to meet French physicians, scientists, and literati. While abroad, Rush was elected to the American Philosophical Society back in Philadelphia and later served as its vice president.
On his return to Philadelphia in the summer of 1769, Rush immediately began his practice, having studied medicine for nine years. Because he had few contacts among the well-to-do, he treated mainly the poor. On August 1, 1769, Rush was appointed professor of chemistry in Penn’s medical department. The following year, Rush published A Syllabus of a Course of Lectures on Chemistry, the first American text on the subject.
On July 20, 1776, the Constitutional Convention of Pennsylvania voted to send a less conservative delegation, which included Rush, to represent Pennsylvania in Congress. Rush took his seat in the Second Continental Congress on July 22, and signed the Declaration of Independence on August 2. He was the only signer holding a medical degree.
In April 1777, Rush was commissioned surgeon general of the Middle Department of the Continental Army. It was not long before Rush became outraged at the disorganization and corruption plaguing army hospitals. He repeatedly expressed his dissatisfaction with the situation to his superiors, and later to their superiors and to Congress. In January 1778, Rush resigned from the army, following a series of events stemming from an unsigned letter to Governor Patrick Henry of Virginia that General George Washington attributed to Rush and considered evidence of disloyalty.
Disillusioned, Rush soon resumed his practice and professorship in Philadelphia, turning his attention almost exclusively to medicine. In 1780, he began lecturing at the newly established University of the State of Pennsylvania. He served as a physician on the staff of Pennsylvania Hospital from 1783 until his death. While there, he assumed responsibility for the patients in the psychiatric ward and began advocating changes to humanize psychiatric treatment in American hospitals. In 1786, Rush set up the Philadelphia Dispensary to provide medical care for the poor, the first such institution in the United States and likely modeled on dispensaries that Rush had seen in London.
Rush expressed a firm commitment to promoting higher education. He was a founder of Dickinson College in Carlisle, Pennsylvania, in 1783 and Franklin College (now Franklin and Marshall) at Lancaster four years later. In 1787, Rush helped found the College of Physicians. He proposed a national system of public education with a federal university to train public servants and favored the education of women. He also helped to establish and finance the oldest Negro church in the country.
Rush returned to politics in 1787, when he was elected to the Pennsylvania ratifying convention for the new federal Constitution. He and James Wilson led the movement for adoption. Two years later, the same men mounted a successful campaign to make over the Pennsylvania constitution, Rush’s last involvement in state or national politics.
In 1789, the trustees of the College elected Rush professor of theory and practice of medicine. In 1791, when the College merged with the University of the State of Pennsylvania to become the University of Pennsylvania, Rush held the chair of the institutes of medicine and clinical practice. He assumed the chair of theory and practice of medicine there in 1796.
The conceptual foundation of Rush’s medical practice drew on the system of Cullen and John Brown, a fellow physician who had studied under Cullen with Rush at Edinburgh. Whereas traditional medicine had based diagnosis and treatment largely on changes in balance among the bodily humors, Cullen emphasized nervous energy and stimulation of the nervous system, believing disease to be caused by either excessive or inadequate nervous stimulation. Thus, excess stimulation required therapeutic depletion by purging or bloodletting, whereas a deficit called for stimulation from diet or brandy. Rush’s own unitary theory of disease held that the “excited” nervous state characterizing all life had only two forms: healthy and morbid. Morbid excitement from convulsive action in the blood vessels, which caused symptoms ranging from fever to insanity, required immediate depletion to restore the body’s balance.
Rush’s therapeutic theories were severely tested during the Philadelphia yellow fever epidemic of 1793, which struck harder than any of the six such epidemics before it. From early August until November of that year, it claimed the lives of between 4000 and 5000 residents of Philadelphia, or about one-tenth of the population. As the epidemic worsened, Rush grew desperate, for nothing he tried seemed to work. In late August, he happened to reread a 1744 manuscript written by John Mitchell, a Scottish physician who had experienced the 1741 yellow fever epidemic in Virginia and who recommended strong purges for even the weakest patients. Rush began “depletion” treatments accordingly, administrating heavy doses of purgatives complemented with bloodletting and applications of cold water. He found his system highly effective, especially when employed early. Rush himself fell ill with fever twice during the epidemic, but recovered quickly after applying his treatment.
When the epidemic lifted, stories of Rush’s untiring devotion to his patients while other physicians were fleeing the city made him a popular hero. Nonetheless, a number of his professional colleagues and a few lay persons accused him of applying his therapy indiscriminately and excessively. His continued use of his therapy in later yellow fever epidemics excited such antagonism between him and the College of Physicians that he ultimately resigned from the body and nearly left Philadelphia for New York. Rush also made a number of professional enemies when he defended unpopular theories on the origins and transmission of disease. His insistence that yellow fever arose from putrid matter left in the open rather than from contagion angered many proud Philadelphians.
As Rush continued practicing, teaching, advocating social reforms, and writing after the yellow fever epidemic, his renown grew at an increasing rate. From 1797 to 1813, he served as treasurer of the U.S. Mint. Rush’s interest in the medical relationship between mind and body resulted in the 1812 publication of Medical Inquiries and Observations upon the Diseases of the Mind, which was reprinted four times by 1835. The work was the first American text on the subject and secured Rush’s position as “father of American psychiatry”. While studying psychiatry, Rush devised two curious instruments, the gyrator, based on the principle of centrifugal action to increase cerebral circulation, and the tranquilizer, “to obviate these evils of the ‘strait waistcoat’ and at the same time to obtain all the benefit of coercion.” These instruments provided a form of shock therapy, which was interpreted as effecting cures according to his theory involving nervous states.
In the spring of 1813, Rush fell ill with a fever and died five days later in his home in Philadelphia. A firm believer in his therapeutic approach, Rush had himself bled twice during his final illness. He was eulogized by Thomas Jefferson and John Adams, among others. Rush’s wife, Julia Stockton, daughter of Richard Stockton, a judge and co-signer of the Declaration of Independence, survived him, as did his three daughters and six sons. His four other children had died in infancy.
Writing prolifically for nearly half a century, Rush was the first American physician to become widely known at home and abroad. By challenging the complex nosology (a branch of medicine that deals with the classification of diseases) of the day, Rush moved medicine toward diagnoses and treatment regiments that were more comprehensible and manageable. His stature elevated the study of medicine in the United States and his position as educator gave him far-reaching influence in the American medical profession. Rush was also one of the first to promote the study of veterinary medicine in North America.
Rush’s professional and political prominence brought attention to his social reforms. His lifelong stance against slavery, including his participation in and later presidency of the Pennsylvania Society for Promoting the Abolition of Slavery, helped free many slaves. Rush also deemed public punishments, then common, to be counterproductive, proposing private confinement, labor, solitude, and religious instruction for criminals. His outspoken opposition to capital punishment contributed to the Pennsylvania legislature’s decision to abolish the death penalty for all crimes other than first-degree murder.
By the late nineteenth century, harsh views of Rush as a benighted blood-letter and enemy of Washington were giving way to favorable reappraisals of his contributions to medicine and politics. In 1904, the Rush Monument, a heroic bronze statue, was erected on the grounds of the U.S. Naval Museum of Hygiene and Medical School in Washington by the American Medical Association to honor the memory of the famous physician.