A Talk with Harlow Giles Unger, Author of Dr. Benjamin Rush

Who was Dr. Benjamin Rush, and why is he an important figure in American history?

Dr. Rush was our nation’s first great humanitarian—a champion of abolition, women’s rights, universal free education, and public sanitation. He fought to ban child labor, pioneered humane medical treatment of the insane, and badgered the Pennsylvania state legislature to build public schools and hospitals, reform state prisons, and end capital punishment for noncapital crimes. As a field surgeon in the American Revolution, he saw and treated the ghastliest wounds of war. His courage in battle treating the wounded led to the founding of the Army Medical Corps and the saving of millions of our soldiers’ live. After the Revolutionary War, he helped found two colleges and meddled in “everything under the sun” in his effort to save human lives. He was among the first American doctors to advocate temperance in the use of alcohol and oppose tobacco use, and he was first to condemn patent medicines and scold fellow physicians for carelessness, incompetence, and greed.


Why do you think most Americans aren’t familiar with Dr. Rush?

After signing the Declaration of Independence, Rush was less concerned with winning re-election to Congress than he was with improving the lives and health of Americans: treating the poor (African-Americans as well as whites), releasing the mentally ill from prison chains and treating them in clean hospital rooms. He is well known by American psychiatrists, who put his image on the seal of The American Psychiatric Association, and tens of thousands of people in Chicago mention his name every day as they walk in and out of the huge, world-renowned Rush University Medical Center, the Rush Medical College, the Rush College of Nursing, and other health-related graduate schools.


What impact did Dr. Rush have on American medicine, specifically?

Dr. Rush had an enormous impact on American medicine, establishing the first code of ethics, expanding the scope and length of medical-school education, and bringing medical care and treatment onto the battlefield, where armies had traditionally left wounded soldiers to die. His treatment of wounded men on the battlefields of Trenton and Brandywine led to the founding of the Army Medical Corps and, ultimately, the saving of millions of American troops. Rush also pioneered the treatment of mental illness as a disease—a century before Freud. Recognized as the “Father of American Psychiatry”—his image is on the seal of the American Psychiatric Association—Rush forced Pennsylvania authorities to release the mentally ill from their chains in prison dungeons and put them in hospitals, where he treated them with ingenious therapies he developed—talk therapy, occupational therapy, and physical therapy.


Were his contributions to politics and society as important as his contributions to medicine?

Yes, indeed. Although he never reentered politics after winning election to the Continental Congress and signing the Declaration of Independence, as a Founding Father he remained a towering figure in Philadelphia life, riding about town every day, treating patients, both high and low, in Philadelphia society. As a Founding Father, he routinely walked in and out of the State House, chatting up members of the Continental Congress and Pennsylvania’s state legislature and demanding action to abolish slavery, grant equal rights to women, establish free universal public education, and clean city streets regularly to reduce the spread of disease. He was the first American physician to advocate temperance in the use of alcohol and condemn tobacco use.  He also founded two colleges: Dickinson College and Franklin College (now Franklin and Marshall).


How did Dr. Rush impact the standard of care we have in hospitals today?  

Because medicine and medical care were in their infancy, hospitals were places where the ill went to die. For the most part, those who worked in hospitals, therefore, had few incentives to provide patients with humane care. Rush, however, was a deeply caring individual who believed equally deeply—and often irrationally—that he could save lives with what were then the most common medical treatments. He was dead wrong! A devotee of purge-and-bleed treatments for virtually every disease, he probably killed as many patients as he saved during the devastating yellow fever epidemic of 1793, which claimed more than 5,000 lives in a city of about 50,000. It was an era before the invention of the hollow-point needle and vaccines. The world’s most renowned physicians believed the ancient Greek theory that by ridding the digestive system of all its contents and letting a large amount of blood flow from the patient’s veins the poisons that were infecting the patient would flow out as well. It seemed logical at the time.


You come from a long line of doctors and surgeons. Do you feel that gave you extra insight into—or appreciation of—Dr. Rush?

Absolutely. Born in a medical family (three uncles, a father, an older brother, and a cousin—all doctors) I grew up steeped in almost nothing but “medical talk” at breakfast, lunch, and dinner—and in between. Add to that my personal educational background, which included four years of pre-med studies at Yale and two years of medical school. In all, I acquired an in-depth knowledge and insights into all aspects of a practicing physician’s daily professional and private life, along with knowledge of the history of medicine and all the instruments and medicines used for treating patients before, during, and after Rush practiced medicine—a body of knowledge that few laymen can usually acquire.


Why was it so important to him that education be accessible and affordable to everyone who wanted to attend college?

A great student of Plato as well as writers of the Age of Enlightenment—Locke, Voltaire, etc.—Rush believed an educated voting population was essential to the functioning and survival of a republican form of government. Having studied medicine in England, traveled to France, and socialized with the likes of David Hume, Catherine Macaulay, Samuel Johnson, and the French encyclopedist Denis Diderot—and America’s Benjamin Franklin—he concluded that free, universal public education was essential “for instructing our sons in the principles of liberty and government.” He described the core of that education as “knowledge of the English language…an acquaintance with geography…history, biography, and travels…with the principles of chemistry and natural philosophy [physics].” He declared it essential as well that “our ladies” obtain “a suitable education.” He denigrated objections to education of women as “the prejudice of little minds” and called for equal rights for women under the law.


What were some other major advances in health care attributable to Benjamin Rush?

He was the first doctor who treated the poor and the deprived—blacks and whites—and he did so without charge. A founder with Benjamin Franklin of America’s first dispensary for the poor, he also developed the first code of ethics for doctors, calling on them to cease producing alcohol-based patent “medicines” with no therapeutic value other than pain-relieving intoxication. He also called it unethical for physicians to profit from any medicines or instruments that benefited patients.


How would you sum up Dr. Benjamin Rush’s contributions to the founding of America? 

I think President John Adams said it best: “As a man of Science, Letters, Taste, Sense, Philosophy, Patriotism, Religion, Morality, Merit, Usefulness, taken all together, Rush has not left his equal in America, nor that I know in the world.”