Binger, Carl. Revolutionary Doctor: Benjamin Rush, 1746-1813. New York: W. W. Norton,

 

Binger, Carl. Revolutionary Doctor: Benjamin Rush, 1746-1813. New York: W. W. Norton,
1966.

Benjamin Rush is the Father of American Psychiatry. He was a very important physician in his
day as well as an author, politician and educator. He was a signer of the Declaration of
Independence and a major social figure in the Philadelphia of the Revolutionary War. A friend of
Adams and Jackson, he was hated by Hamilton and the other Federalists. He helped develop
Dickenson College and the University of Pennsylvania College of Medicine.

He was also a "...hot-headed, vain prima donna..." He displayed toward enemies (and he had
many of them) stubbornness, egocentricity and irritability. (pp. 183, 184) Regarding psychiatry
he believed: "It is the duty of physicians, he believes, to assert their prerogative and to rescue
mental science from ‘the usurpations of schoolmen and divines,' and this, he says, can only be
accomplished through the discoveries of medicine." (p. 182)

Rush was a firm believer in science and reductionist methods. To him, the mind and the body
were moved by the same causes and subject to the same laws. (p. 281) At the same time, he
recognized deviant behavior as illness rather than deliberate wickedness and thus helped lay the
groundwork for the modern conception of personality disorder. (See p. 280)

"The 18th century physician was an authoritarian figure and Rush, because of his extraordinary
personal magnetism and intelligence and his reputation as America's greatest doctor, was the
very embodiment of authority. He did not hesitate to exploit this by the use of moral and
emotional persuasion. He tried to meet irrationality with cogent reasoning, but he was not above
the use of the ‘pious hoax.' If his patient thought he had a snake in his stomach, Rush did not
hesitate to have one placed in what he called his close-stool. To a hypochondriacal patient who
feared that he had a venereal disease, Rush recommended marriage and at the same time offered
him a bond for a large sum of money if any bad consequences should follow taking this advice."
(p. 273)

Rush was, in his day, considered a liberal and a humanitarian but by modern standards his
"medicine" was a disaster. It is not merely a matter of medicine being mistaken, but a matter of
authoritarianism and arrogance being passed off as knowledge. To me he is embodied in his
famous quote: Great and desperate diseases require great and desperate cures. In fighting disease,
one could do just about anything to a patient. What kind of medicine is that?