A Physician and Politician from Pennsylvania involved with the army medical department and in political activities
Few Americans today would doubt the greatness of George Washington. The first President of the United States, Washington has been called “the first of men,” and “the father of his country.” Yet in 1778, someone called for Washington’s removal as commander-in-chief of the Continental Army in favor of Thomas Conway. Remarkable as it may seem today, that is precisely what Benjamin Rush recommended. Hated by his enemies and loved by his admirers and students, Philadelphia’s Benjamin Rush was the most famous American doctor of his generation, and a dedicated Patriot. He continuously applied the idealism of the Revolution to every area of his life, whether political, medical, or social; however, Benjamin Rush also displayed an independency of thought and deed that often landed him in trouble.
Benjamin was born on Christmas Eve of 1745 to John and Susanna Hall Harvey Rush in Byberry, Pennsylvania. John Rush, a gunsmith and a farmer, died when Benjamin was just five years old. When Benjamin was eight he went to school under the care of his uncle, Samuel Finley. Benjamin eventually entered the College of New Jersey [now Princeton University], and graduated with an A.B. [Bachelor of Arts] in 1760. At first Benjamin wished to study law but soon became interested in medicine. From 1761 to 1766 he studied medicine in Philadelphia as an apprentice under Dr. John Redman. Benjamin expanded his education by attending lectures in the city, especially those of Dr. William Shippen and Dr. John Morgan at the College of Philadelphia. Benjamin took an interest in politics during the Stamp Act crisis, but advancement in his chosen profession occupied most of his energies. On the recommendation of Dr. Redman, Benjamin sailed to Scotland in 1766 and continued his training at the University of Edinburgh.
In Scotland, Benjamin dedicated most of his time to his studies, though he also debated the growing crisis in America with his fellow students. He received his doctorate in 1768, and went to London to finish his training at St. Thomas’s Hospital. While in London he became a friend of Benjamin Franklin, who helped secure the young doctor an appointment at the College of Philadelphia as Professor of Chemistry. After a short visit to Paris, the young doctor returned to Philadelphia in 1769. Within a year Benjamin published his first book, A Syllabus of a Course of Lectures on Chemistry; it was the first American text published on that subject. He also practiced medicine in the city, at first concentrating on the care of the poor. By 1775, he was making a respectable income as a doctor.
Benjamin’s republican principles resurfaced in the early 1770s, and his rekindled interest in politics led him to other professional pursuits. He became a member of the American Philosophical Society, and helped organize the Pennsylvania Society for Promoting the Abolition of Slavery. His books reflected these expanded interests; he published Sermons to Gentlemen upon Temperance and Exercise in 1772, and An Address to the Inhabitants of the British Settlements in America, upon Slave-keeping in 1773. Absorbed in the idealism of the Revolution, Benjamin remained a committed abolitionist for the rest of his life. He wrote articles to local papers about the growing crisis with Great Britain, and maintained regular correspondence with Thomas Paine, Thomas Jefferson, and John Adams.
Benjamin also found time for a personal life amidst his political activity. He married Julia Stockton of Princeton, New Jersey, on January 11, 1776. The couple went on to raise thirteen children. In June 1776, Benjamin became a member of the Provincial Congress and a leading advocate of independence. A month later he joined the Pennsylvania delegation to the Continental Congress, and signed the Declaration of Independence.
In April 1777, Congress appointed Benjamin as its surgeon-general for the Middle Department [middle states]. He found the medical service in wretched condition, and accused director-general Dr. Shippen of maladministration in an impolitic manner. He wrote a letter of complaint to George Washington, who passed the letter on to Congress. Congress found Shippen to be competent, and Benjamin resigned his commission in protest. Passing the letter on to Congress was an appropriate action, but Benjamin felt abandoned by his commander-in-chief. When Washington was defeated at the Battle of Brandywine in 1777, Benjamin’s resentment turned to active questioning of Washington’s command.
On January 12, 1778, Benjamin wrote an anonymous letter to Governor Patrick Henry of Virginia, suggesting that Washington be replaced by either General Thomas Conway or General Horatio Gates. Ever since Washington assumed command of the army in 1776, disgruntled New Englanders had tried to replace him with a New England general. As Thomas Conway often emerged as a favored candidate, the conspiracy became known as the “Conway Cabal.” The effort was largely limited to New England, but the attempt to involve Governor Henry threatened to make the isolated conspiracy into a national movement. Unfortunately for Benjamin, Patrick Henry was devoted to Washington, and passed the letter to the commander-in-chief. Washington immediately recognized the surgeon-general’s hand-writing, and accused him of disloyalty. This public disclosure strengthened support for Washington in Congress, and the affair ended Benjamin’s military career. In 1778, Benjamin returned to his private medical practice in Philadelphia.
In 1780 Benjamin began delivering lectures at the newly built University of the State of Pennsylvania, which would merge with the College of Philadelphia in 1791 [The united institution was renamed the University of Pennsylvania]. In 1783, he became a member of the staff at Pennsylvania Hospital and served there for the remainder of his life. His experiences at the hospital renewed his interest in social reform and care for the poor; he encouraged Presbyterians to open Dickinson College in Carlisle, Pennsylvania, and in 1783 became one of the school’s founding trustees. He opened America’s first free dispensary in 1786, and when elected to the Pennsylvania ratifying convention, he and James Wilson led the movement in Pennsylvania to adopt the Federal Constitution in 1787. In 1789, Benjamin teamed with James Wilson once again to secure a more liberal state constitution for Pennsylvania.
When Washington’s administration ended in 1797, Benjamin re-entered Federal service as Treasurer of the United States Mint. In 1803, he was elected President of the Pennsylvania Society for Promoting the Abolition of Slavery, but his life remained primarily dedicated to the medical profession. In his 1789 landmark text Medical Inquiries and Observations, Benjamin claimed that all diseases resulted from an excessive excitability of the blood. He recommended bleeding and purging as a cure for every ailment, a practice known as “heroic” medicine. This theory underwent a major test during the 1793 Yellow Fever epidemic; Benjamin claimed that his methods worked when properly employed, but he neglected to keep detailed records of his own cases. A critic, William Cobbett, pointed out a correlation between the increase in bleeding and the increase in mortality, and “heroic” medicine quickly lost favor in the American medical community. Nevertheless Benjamin survived the epidemic with his reputation unscathed, and he continued to employ “heroic” techniques long after others abandoned the approach. In his final years, however, Benjamin turned his attention to mental illness. His 1812 book, Medical Inquiries and Observations upon the Diseases of the Mind, showed a compassion for the mentally ill and anticipated some aspects of psychoanalysis. Benjamin died on April 19, 1813, at the age of sixty-seven.
Primary Source Documents: Benjamin Rush
The following passages are taken from Carl Binger, Revolutionary Doctor: Benjamin Rush, 1746-1813, (New York: W.W. Norton, 1966).
Benjamin Rush’s comments upon visiting the English House of Commons from a 1768 letter to Ebenezer Hazard.
I went a few days ago in company with a Danish physician to visit the House of Lords and the House of Commons. When I went into the first, I felt as if I walked on sacred ground. I gazed for some time at the Throne with emotions that I cannot describe. I asked our guide if it was common for strangers to set down upon it. He told me no, but upon my importuning him a good deal I prevailed upon him to allow me the liberty. I accordingly advanced towards it and sat in it for a considerable time. . .
From this I went into the House of Commons. I cannot say I felt as if I walked on ‘sacred ground’ here. usurping Commons first endeavored to rob the King of his supremacy over the colonies and to divide it among themselves. O! cursed haunt of venality, bribery, and corruption! In the midst of these reflections I asked where Mr. Pitt (alas ! now Lord Chatham) stood when he spoke in favor of repealing the Stamp Act. ‘Here,’ said our guide, ‘on this very spot.’ I then went up to it, sat down upon it for some time, and fancying myself surrounded with a crowded House, rose up from my seat and began to repeat part of his speech. . .
Benjamin Rush delivered his lecture on “The Practice of Physic” many times during the early 1770s. It contained the following lines, which proclaimed his basic view on the causes of disease.
I have formerly said that there was but one fever in the world. Be not startled, Gentlemen, follow me and I will say there is but one disease in the world. The proximate cause of disease is irregular convulsive or wrong action in the system affected. This, Gentlemen, is a concise view of my theory of disease . . . I call upon you, Gentlemen, at this early period either to approve or disapprove of it now . . .
In a letter to the Pennsylvania Journal for October 20, 1773, Benjamin Rush spoke out against the tea tax. He warned that the tea then bound for America aboard English ships, was cover for a British plot against the colonies.
The baneful chests [of tea] contain in them a slow poison in a political as well as a physical sense. They contain something worse than death–the seeds of SLAVERY. Remember, my countrymen, the present era–perhaps the present struggle–will fix the Constitution of America forever.
Letter of October 10, 1777 from Benjamin Rush to John Adams, complaining about Dr. Shippen’s administration as Director General and the sickly condition of the army.
Our hospital affairs grow worse and worse. There are several hundred wounded soldiers in this place who would have perished had they not been supported by the voluntary and benevolent contributions of some pious whigs. The fault is both in the establishment and in the Director General [Dr. William Shippen]. He is both ignorant and negligent in his duty.
Letter of January 12 1778 from Benjamin Rush to Patrick Henry, Governor of Virginia. Rush called for replacing George Washington with either Horatio Gates, Charles Lee or Thomas Conway as commander-in-chief of the Continental Army. Rush sent the letter unsigned to conceal his identity. Patrick Henry, despite Rush’s declared wishes, forwarded the letter to Washington.
The common danger of our country first brought you and me together. I recollect with pleasure the influence of your conversation and eloquence upon the opinions of this country in the beginning of the present controversy. You first taught us to shake off our idolatrous attachment to royalty, and to oppose its encroachments upon our liberties with our very lives. By these means you saved us from ruin . . .
But, sir, we have only passed the Red Sea. A dreary wilderness is still before us, and unless a Moses or a Joshua are raised up in our behalf, we must perish before we reach the promised land. We have nothing to fear from our enemies on the way. General Howe, it is true, has taken Philadelphia; but he has only changed his prison. His dominions are bounded on all sides by his outsentries. America can only be undone by herself. She looks up to her councils and arms for protection, but alas! . . . Her army–what is it? A major general belonging to it called it a few days ago in my hearing a mob. Discipline unknown, or wholly neglected. The quartermaster’s and commissaries’ departments filled with idleness and ignorance and peculation. Our hospitals crowded with 6,000 sick but half provided with necessaries or accommodations, and more dying in them in one month than perished in the field during the whole of the last campaign . . .
But is our case desperate? By no means. We have wisdom, virtue, and strength enough to save us if they could be called into action. The northern army has shown us what Americans are capable of doing with a GENERAL at their head . . . A Gates, a Lee, or a Conway would in a few weeks render them an irresistible body of men . . . You may rest assured of each fact related in this letter. The author of it is one of your Philadelphia friends. A hint of his name, if found out by the handwriting, must not be mentioned to your most intimate friend [Washington]. Even the letter must be thrown into the fire. But some of its contents ought to be made public in order to awaken, enlighten, and alarm our country. I rely upon your prudence . . .
Letter from Benjamin Rush to his wife, Julia Stockton Rush, January 15, 1778. Rush relates his feelings about appearing before Congress to accuse Dr. William Shippen of negligence.
“. . . It will be a disagreeable task to accuse him [Shippen] publicly of ignorance and negligence of his duty. But the obligations I owe my country preclude all other ties. I shall act strictly agreeable to the dictates of my conscience, and if the system is altered and Dr. Shippen can be restrained by proper checks from plundering the sick, I shall not resign my commission but shall serve another campaign. This resolution is taken not only from a sense of duty and a love of country, but in consequence of the advice of some very worthy members of Congress, who assure me that a contrary step will be ascribed to want of perseverance or to downright disaffection . . .”
Letter from George Washington to Patrick Henry, March 27, 1778, in reply to Rush’s anonymous letter to Henry of January 12, 1778.
“. . . Being intimately acquainted with the man I conceive to be the author of the letter . . . and having always received from him the strongest professions of attachment and regard, I am constrained to consider him as not possessing, at least, a great degree of candor and sincerity, though his views in addressing you should have been the result of conviction and founded in motives of public good. This is not the only secret, insidious attempt that has been made to wound my reputation.”
Letter from George Washington to Patrick Henry. March 28, 1778, continuing his reply to Rush’s letter to Henry of January 12. 1778.
“ . . . The anonymous letter, with which you were pleased to favor me, was written by Dr. Rush, so far as I can judge from a similitude of hands. This man has been elaborate and studied in his professions of regard for me . . . I cannot precisely mark the extent of their views, but it appeared in general, that General Gates was to be exalted on the ruin of my reputation and influence . . . General Mifflin, it is commonly supposed, bore the second part in the cabal; and General Conway; I know, was a very active and malignant partisan; but I have good reason to believe, that their machinations have recoiled . . .”
For Further Reading:
Lester King, Transformations in American Medicine (1991).
Oscar Reiss, Medicine in Colonial America (2000).