Medical contributions Benjamin Rush

dr. benjamin rush painted charles willson peale, 1783

rush leading proponent of heroic medicine. firmly believed in such practices bloodletting patients (a practice known harmful @ time common practice), purges using calomel , other toxic substances. in report on philadelphia yellow fever epidemic of 1793, rush wrote: have found bleeding useful, not in cases pulse full , quick, slow , tense. have bled twice in many, , in 1 acute case 4 times, happiest effect. consider intrepidity in use of lancet, @ present, necessary, in use of mercury , jalap, in insidious , ferocious disease. during epidemic, rush gained acclaim remaining in town , treating 100 patients per day (some through free black volunteers coordinated richard allen), many died. rush acknowledged failure of 2 treatments, sweats in vinegar-wrapped blankets accompanied mercury rubs, , cold baths.

william cobbett vociferously objected rush s extreme use of bloodletting, , in rush s day , location, many physicians had abandoned on scientific grounds favorite remedy of rush s former teachers thomas sydenham , hermann boerhaave. cobbett accused rush of killing more patients had saved. rush sued cobbett libel, winning judgment of $5,000 , $3,000 in court costs, partially paid before cobbett returned england. nonetheless, rush s practice waned continued advocate bloodletting , purges, chagrin of friend thomas jefferson. blamed rush s bleeding hastening death of benjamin franklin, george washington (although 1 of washington s medics opposed bleeding rush s former student), , rush insisted upon being bled himself shortly before death (as had during yellow fever epidemic 2 decades earlier).

rush wrote first case report on dengue fever (published in 1789 on case 1780). perhaps greatest contributions physical medicine establishment of public dispensary low income patients, , public works associated draining , rerouting dock creek (eliminating mosquito breeding grounds, decreased typhus, typhoid , cholera outbreaks).

rush concocted mixture of calomel, chlorine, jalap , mercury create proprietary purgative named dr rush’s thunderbolts ; used captain meriwether lewis , second lieutenant william clark during expedition pacific coast.

another of rush s medical views draws criticism analysis of race. in reviewing case of henry moss, slave lost dark skin color (probably through vitiligo), rush characterized being black hereditary , curable skin disease. rush wrote whites should not tyrannize on [blacks], disease should entitle them double portion of humanity. however, same token, whites should not intermarry them, tend infect posterity disorder ... attempts must made cure disease.

rush interested in native american health. wanted find out why native americans susceptible illnesses , whether suffered higher mortality rates compared civilized people. other questions raised whether or not dreamed more or if hair turned gray got older. fascination these people came interest in theory social scientists can better study history of own civilization studying cultures in earlier states of development, primitive men . in autobiography writes review of 3 different species of settlers, appears there regular stages mark progress savage civilized life. first settler related indian in manners. in second, indian manners more diluted. in third species behold civilization completed. third species of settlers proper apply term of farmers. while record vices of first , second settlers, mention virtues likewise. mutual wants produce mutual dependence; hence kind , friendly each other. solitary situation makes visitors agreeable them; hence hospitable stranger.

mental health

moral thermometer. benjamin rush s inquiry effects of spirituous liquors on human body , mind. boston: thomas , andrews, 1790 (library company of philadelphia)

rush published 1 of first descriptions , treatments psychiatric disorders in american medicine, medical inquiries , observations, upon diseases of mind (1812). undertook classify different forms of mental illness , theorize causes , possible cures. rush believed (incorrectly) many mental illnesses caused disruptions of blood circulation, or sensory overload, , treated them devices meant improve circulation brain such centrifugal spinning board, , inactivity/sensory deprivation via restraining chair sensory-deprivation head enclosure ( tranquilizer chair ). after seeing mental patients in appalling conditions in pennsylvania hospital, rush led successful campaign in 1792 state build separate mental ward patients kept in more humane conditions.

rush believed, did many physicians of time, bleeding , active purging mercury(i) chloride (calomel) preferable medical treatments insanity, fact evidenced statement that, difficult prevail upon patients in state of madness, or compel them, take mercury in of ways in administered. in these cases have succeeded, sprinkling few grains of calomel daily upon piece of bread, , afterwards spreading on it, thin covering of butter. while rush followed standard procedures of bleeding , treatment mercury, did not believe coercion , restraint , physical punishment, chains , dungeons, practice of time, answer. reason, aspects of approach seen similar moral therapy, rise prominence in @ least wealthier institutions of europe , united states.

rush considered pioneer of occupational therapy particularly pertains institutionalized. in diseases of mind (1812), rush wrote:

it has been remarked maniacs of male sex in hospitals, assist in cutting wood, making fires, , digging in garden, , females employed in washing, ironing, , scrubbing floors, recover, while persons, rank exempts them performing such services, languish away lives within walls of hospital.

furthermore, rush 1 of first people describe savant syndrome. in 1789, described abilities of thomas fuller, lightning calculator. observation later described in other individuals notable scientists john langdon down.

rush pioneered therapeutic approach addiction. prior work, drunkenness viewed being sinful , matter of choice. rush believed alcoholic loses control on himself , identified properties of alcohol, rather alcoholic s choice, causal agent. developed conception of alcoholism form of medical disease , proposed alcoholics should weaned addiction via less potent substances.

rush advocated more humane mental institutions , perpetuated idea people mental illness people have illness, rather inhuman animals. championed idea of partial madness, or people have varying degrees of mental illness.

the american psychiatric association s seal bears image of rush s purported profile @ center. outer ring of seal contains words american psychiatric association 1844 . association s history of seal states:

the choice of rush (1746-1813) seal reflects place in history. .... rush s practice of psychiatry based on bleeding, purging, , use of tranquilizer chair , gyrator. 1844 these practices considered erroneous , abandoned. rush, however, first american study mental disorder in systematic manner, , considered father of american psychiatry.