BENJAMIN RUSH, M.D.: COLONIAL PHILADELPHIAN

PHYSICIAN AND SOCIAL REFORMER

by Alison DeLuca

Benjamin Rush (1746-1813) both entered and departed the world either in or around the city that would come to regard him as an important model for academic, social and political activism: Philadelphia. Rush was born on January 4, 1746 in Byberry Township, Philadelphia County, Pennsylvania and died on April 19, 1813 in Philadelphia. He is now buried at the cemetery of Christ Church. He was a revolutionary doctor of his time, stepping outside the traditional role of the colonial physician. During the nineteenth century, the colonial physician occupied a relatively conservative role in society. Doctors were respected, but they were "politically quiescent" members of the communities in which they lived, large or small.1 Rush, on the other hand, merged politics and medicine in his life. He was a man of medical scholarship, playing a major role in Philadelphia’s yellow fever epidemic of 1793. However, Rush also suggested political and social change through many avenues including taxation, slavery, public education, prisons, and drinking habits.

Rush’s early education was at the College of New Jersey in Princeton, where he showed unusual talent for poetry, composition, and public speaking, which prompted his decision in 1760 to become a lawyer. However, Samuel Finley, an earlier teacher of Rush’s and a Presbyterian minister, argued strongly with his former pupil (and nephew) that "the practice of law is full of temptations" and that medicine would be a more appropriate career.2 As a result, Rush studied medicine under Philadelphia’s lead physician John Redman from 1761-1766.

While working for Dr. Redman, Rush attended the lectures of William Shippen and John Morgan at the Medical School of Philadelphia. Both of these men had studied in Edinburgh University and were interested in upgrading American medical education by integrating the best of contemporary European learning. Subsequently, in 1765 Dr. John Morgan founded the first American medical school in Philadelphia modeled after Edinburgh in that it was associated with an arts faculty (the College of Philadelphia).3 At the advice of Morgan, Rush pursued his medical degree at Edinburgh from 1766-1768 under the supervision of Dr. William Cullen. At Edinburgh, Rush received early recognition in the scientific community for his medical thesis on digestion, in which he proposed that the acidity of the stomach is the result of fermentation.4

In 1769, Rush returned to Philadelphia from Europe and began practicing medicine. At this time, Philadelphia was entering its revolutionary period where it played an important role in the American Revolution. It became the hub of revolutionary activity as a result of its strategic location, wealth, industrial and commercial importance, large and cosmopolitan population, and professional and business classes. One month after his arrival in Philadelphia, at twenty-three years old Rush was elected professor of Chemistry at the College of Philadelphia, becoming the youngest faculty member of the school (today the medical school of the University of Pennsylvania).5 The controversial medical practice with which Rush was strongly identified during his career was bloodletting. Bloodletting was a therapeutic method employed by physicians since antiquity that Rush began using more extensively during the yellow fever epidemic of 1793 in Philadelphia which broke out on Water Street. Rush believed and taught that disease, particularly fever, was due to the accumulation of a bodily poison that exerted its noxious effect by causing a nervous constriction of the small blood vessels. Rush’s therapy, bloodletting, was designed to rid the body of the poison and to bring about a relaxation of the nervous excitement.6

In his practice of bloodletting the protocol consisted of daily bleedings of twelve ounces or more of blood and daily purging with a mixture of calomel and jalap, until the patient either recovered or died. When one of Rush’s Princeton classmates, Ebenezer Hazard, fell ill from yellow fever and sent for Rush, the treatment was bloodletting. Rush took twelve or fifteen ounces of blood, and then eight or ten more ounces on the second and third days. However, Hazard felt his own pulse, and objected to further bleeding as unnecessary. As a result of Hazard’s objection, Rush declared he would no longer treat the case and stamped off, leaving Hazard to die. Yet, Hazard did recover after he "drank a little wine, extraordinary, to enrich his remaining blood; and ate nourishing food in small quantities, but frequently."7 This experience caused Hazard to dismiss his old friend as anything but a divine messenger. Even in his obstetrical practice Rush bled his patients, 30 ounces at the beginning of labor, and at the same time administered laxatives, enemas, and other purgatives.8 In November of 1793, Rush resigned from the College of Physicians because of a dispute over his treatment of yellow fever.

In addition to his medical and scientific endeavors, Rush firmly advocated republican ideas, served in the Continental Congress, and signed the Declaration of Independence. During the 1770’s and 1780’s Rush wrote essays and public letters, sometimes under a pseudonym, on various state and federal issues. Of particular importance to Rush were the nature of Pennsylvania’s constitution, the need for a navy, and the importance of an alliance with France. After his crusade to replace the Pennsylvania constitution of 1776 with a new document was finally realized in 1790, Rush’s political efforts and publications diminished.9 He did, however, continue to effect social reform through other avenues.

Of these other concerns, temperance was arguably Rush’s priority. Rush, as a child, witnessed the effects of alcohol on his own family, in the army, and in the streets of Philadelphia, a city in addition to having its own distilleries, was the major American seaport and the center of importing distilled spirits. Benjamin Rush attributed the 1793 yellow fever epidemic in part to the physical and moral denigration of the Philadelphian people. It was the city’s excessive ingestion of alcohol which bred extravagance, in various shapes, that he felt lead to the outbreak as well as the eradication of the plain and wholesome habits of the city.10 Rush’s assault on the consumption of hard alcohol is seen in his 1772 Sermons to Gentlemen Upon Temperance and Exercise and in Directions for Preserving the Health of Soldiers, which was first published in 1777. His campaign was apparently successful in the Philadelphia area, exemplified in his letter to Dr. John Coakley Lettsom, his London correspondent and fellow reformer, in which Rush states that "from the operation of sundry publications in our newspapers against spirituous liquors, the sale and consumption of them has diminished one third in the course of the last year in the State of Pennsylvania. The Friends and Methodists have taken the lead in rejecting them from their harvest fields, their stores, and even from their houses."11 After Rush’s death, there was a crusade to condemn the consumption of alcohol all together, a deviation from Rush’s original plan. Rush had approved the moderate use of wine and beer for both table and medicinal purposes.

Rush was also instrumental in the spread of education, both medical and non-medical, throughout the Pennsylvania region which he deemed necessary in order to uphold the ideals of the American republic. He advocated a system of free schools which would be supported by taxes and private funds and which would prepare the citizens for participation in a democracy.12 Rush’s educational vision was rooted in Christian beliefs, and he campaigned for the education of women. Additionally, he was instrumental in the establishment of both Dickinson College and Franklin College (later renamed Franklin and Marshall) for higher learning.

However, Rush was most closely involved in medical education and exerted the most influence in medical education than any other medical professional in the United States in the last quarter of the eighteenth century. Rush proposed a rigorous premedical educational program, but he also believed that a general scientific education was necessary for all physicians. Accordingly, he lengthened the medical course from two to three years.13 Furthermore, Benjamin Rush was a well-known lecturer in the Philadelphia area, and a number of his oral instructions and addresses at the University of Pennsylvania were published, first as Six Introductory Lectures, and later as Sixteen Introductory Lectures.

Thirdly, Rush was involved in penal reform. In 1787 Rush wrote An Enquiry into the Effects of Public Punishments upon Criminals, and upon Society. He contributed to the 1789 replacement of public punishments with solitary confinement and hard labor out of public view.14 He more forcefully, however, attacked capital punishment in his 1788 work "An Enquiry into the Justice and Policy of Punishing Murder by Death," which was published in the American Museum. In 1798 the article was republished in Rush’s Essays, Literary, Moral and Philosophical in which Rush added that capital punishment had been abolished in the state of Pennsylvania for all crimes except first degree murder.

The abolition of slavery was another important humanitarian concern for Rush. In 1788 Rush rhetorically declared: "I love even the name of Africa."15 Accordingly, he felt that slavery was an inherited evil from Great Britain and, if allowed to continued, would lead to the moral fall of Philadelphian society.16 In fact, the first American antislavery society, the Pennsylvanian Society for Promoting the Abolition of Slavery and the Relief of Free Negroes Unlawfully Held in Bondage created in 1774 was influenced by Rush’s 1773 publication entitled Address to the Inhabitants of the British Settlements in America, upon Slave-Keeping which appeared in Philadelphia, Boston, and New York.17 The Address was inspired by Anthony Benezet, a gentle Quaker reformer and philanthropist in Philadelphia whom Rush met after studying abroad. Rush came to serve as secretary (1787-1803) and then president (1803-1813) for the Society.

Rush also was concerned with the religious and educational welfare of the Africans in Philadelphia. According to Rush, many of the 3,000 free blacks in Philadelphia in 1791 were "still in a state of depression, arising chiefly from their being deprived of the means of regular education and religious instruction."18 As a result of his disapproval with this inequality, Rush participated in a drive to purchase land and build the African Episcopal Church of St. Thomas, which was dedicated on July 17, 1794, the first African Episcopal church in America. Therefore, it can be seen that Rush was not solely a man of medical academia, but rather an advocate of social reform.

Sites

Site #1: The John Morgan Building

There are many sites in Philadelphia today that echo with the influence of Benjamin Rush. First, the Medical School of the University of Pennsylvania where Rush attended and gave lectures now stands in West Philadelphia in University City. One of the buildings of the medical school is the John Morgan Building, named after John Morgan, the founder of the medical school in 1765. Rush attended Morgan’s lectures on materia medica at the university in 1765 when it stood at 4th and Arch Streets. The school then moved in 1802 to 9th and Chestnut Streets. The medical school moved once and for all to University City in 1871 when the university purchased part of Andrew Hamilton’s eighteenth-century country estate, the Woodlands, at $8000 an acre.19 The building now stands on a shady Hamilton Walk lined with trees behind the Hospital of the University of Pennsylvania.

The Philadelphia architectural firm of Cope and Stewardson, which did work on the campus between 1892 and 1912 to give the university a unified architectural presence, designed the John Morgan Building in 1904. It was named "Medical Laboratories" in 1904, but was renamed the John Morgan Building in 1987 to honor the memory and work of one of the founders of the Medical College of Philadelphia.20 The conventions of Cope and Stewardson can be seen in the irregular quoins which surround the windows and articulate the corners of the building.21 The roof line is articulated by a parapet with limestone balustrade over the regular registers of the facade. The main north facade, on Hamilton Walk, is symmetrical, with two protruding end pavilions and a central entrance pavilion with "Pathology-Physiology-Pharmacology" inscribed over it. The central pavilion is faced in limestone, as well. The windows of the building are large, rectilinear, and grouped. On the south end of the building is located an octagonal space, now connected to the Anatomy/Chemistry Wing, which originally served as an operating theater. The building also has "egg & dart" molding, a belt course separator between floors, and a water table effect for drainage purposes.22

Sites #2 & 3: Richards Medical Research Laboratories and Goddard Laboratories

Two adjoining research buildings are adjacent to the John Morgan Building that house the medical research buildings of the university’s medical school, the Richards Medical Research Laboratories (1962) and Goddard Laboratories (1964). Both laboratories were completed in the 1960’s by the preeminent architect Louis I. Kahn. The complex has received international acclaim and has been called "one of the most influential facilities constructed following World War II."23 The visual signature of the buildings is the broken roofline of brick towers that rise between concrete piers. The buildings were named for Alfred N. Richards and David Goddard, respectively. Richards was a professor of Pharmacology at the School of Medicine who introduced a technique for producing penicillin on a large scale during World War II. This technique was instrumental is reducing the death rate of allied servicemen to infection during the war. Goddard was a professor of Biology who oversaw expansion of Penn’s facilities and academic programs in the 1960’s and 1970’s.24 The Alfred Newton Richards Medical Research and Biology Building was cited in 1961 by the Museum of Modern Art as "probably the most consequential building constructed in the United States since the war," a work of solid geometrical integrity.25

Site #4: The Pennsylvania Hospital (1751)

The Pennsylvania Hospital had its greatest impact on American medicine and philanthropy during the colonial years of the city. Accordingly, this hospital was a very important learning center for Benjamin Rush, M.D. In the winter of 1765-66, Benjamin Rush was one of thirteen medical students that walked the ward of the Pennsylvania Hospital, and eventually, in 1783, Rush became Senior Staff Physician at the hospital. Rush remained in this position of authority until his death in 1813. During the nineteenth century, however, the hospital was lead by ultra-conservative management, a condition that caused the institution’s momentum to flag. Today, nonetheless, the hospital is one of the most viable medical institutions standing at Eighth and Pine Streets.

The idea for the Pennsylvania Hospital originated with Philadelphia physician Thomas Bond. Bond wanted to create a hospital that would alleviate the growing problem of poverty which was augmented by the influx of Scotch-Irish and German immigrants that occurred between 1736-1750. In 1749 alone, some twelve thousand Germans poured into the city of Philadelphia, a "large proportion" of which were "aged, impotent, diseased," or were "convicts and vagrants."26 In response to the growing poor population in the city, between 1750-1751 Bond "conceived the idea of establishing a hospital in Philadelphia for the reception and cure of poor sick persons."27

The first site for the hospital was decided to be the private home of John Kinsey located on the south side of Market Street below Seventh. Kinsey had died in 1750 and his house was up for lease. Quaker widow Elizabeth Gardner was hired as matron, and in February of 1752, William Sweeting was employed to handle the insane patients. The hospital was modeled after British voluntary hospitals which were maintained entirely by voluntary subscribers and attended by consulting physicians, gratis, while the latter received support both from municipal government and volunteer subscribers. The story of the Good Samaritan was often called upon to rally support for the voluntary hospitals on both sides of the Atlantic.

However, the Kinsey house could hardly keep up with the demand of the city. It could barely hold more than twenty patients at a time. Consequently in 1754, the hospital board considered the purchase of another building site at Eighth and Pine Streets. The lot belonged to the Free Society of Traders in Pennsylvania and covered part of the square bounded by Eighth, Ninth, Spruce, and Pine Streets. However, not until December 17, 1756 were the patients and furniture moved from the Kinsey house to Eighth and Pine.

The hospital was built by Samuel Rhoads and Joseph Fox, yet the general design was probably more the work of Rhoads than Fox.28 The building features two T shaped wings joined by a central building topped by a balustrade. The two wings were to be two and one half stories tall while the center portion was to be three and one half stories. This design was typical of eighteenth century symmetry. The building was not copied from any one contemporary building. However, the design was influenced in general by British voluntary hospitals, and the Royal Infirmary of Edinburgh, Scotland in particular.29 The total building was completed in 1804.

Site #5: Christ Church & Burial Ground

Benjamin Rush became a parishioner at Christ Church when he converted to the Episcopal Church in 1787. He is now buried at the Christ Church Burial Ground along with seven other signers of the Declaration of Independence, one of which is Benjamin Franklin. The cemetery was built in August of 1719 as a final resting place for the members of the church.30 The church bought this cemetery lot on Mulberry (Arch) Street at the corner of Fifth Street to serve as the burial ground. At the time this lot was on the outskirts of town. It still remains at this site today.

Christ Church still stands on Second Street between Arch and Market Streets. It was probably designed by Dr. John Kearsley, a physician of the congregation (1684-1772), and was completed in 1744. The plain white interior of the church today differs dramatically from the original interior of the church. The colonial church had elaborate paintings and plush furnishings. The organ gallery was decorated with crimson velvet drapery and tassels, and elaborate curtains were hung from the gallery windows. The box pews, which were probably unpainted wood (today they are painted white), were upholstered "with cushions, silk lace, crimson velvet, carpets, silver fringe, brass tack and hooks, green binding and tassels."31 It is thought that Benjamin Rush and his family occupied pews #57 and #59. Distinct to the church today is the magnificent chandelier which hangs in the center of the church. It has twenty-four branches and was imported from England in 1744. The candles in the chandelier light up the church along with an unknown number of oil lamps and brass wall scones, three of which remain lighted in the church.

The exterior of the Church today is similar to its original appearance. The church has an ornate Georgian appearance, laid in Flemish bond brick, with extensive wood and stone trim. The two-storied facade is divided into eight bays by brick pilasters. The Palladian window on the east front of the church is notable as is the steeple which was added to the church in 1754.32 The Palladian east window has a theological symbolism. When the sun rises it casts its beams into the church through the window, thereby symbolizing the Resurrection.33 Additionally, there are cast iron flaming urns that adorn the east pediment, which were once wooden. The octagonal wooden spire beneath the brick tower was a cultural and architectural statement of the times, going against the Quaker insistence on simplicity and making certain the Philadelphia sky line was dominated by the Church of England.34

Site #6: Eastern State Penitentiary

Echoing the ideas of penal reform of Benjamin Rush, Eastern State Penitentiary’s 30-foot walls stand today at 22nd Street and Fairmount Avenue, where it remains a popular city attraction. The prison was completed in 1829 and used as a place of corrections for over one hundred years. The prison was vacated in 1971 just six years after it was registered as a National Historic Landmark, but it has reopened for tours since 1994. In building Eastern State, noted architect John Haviland designed an engineering marvel to accommodate a Pennsylvania prison system that advocated solitary confinement. Haviland’s design embodies the Building Commissioner’s instructions to "convey to the mind a cheerless blank indicative of the misery which awaits the unhappy being who enters within its walls."35 The Philadelphia Society for Alleviating the Miseries of Public Prisons believed this solitary confinement would make criminal’s penitent, hence the word penitentiary. The prisoners were given only a Bible and their private thoughts as they were locked up in Eastern State. Famous inmates include bank robber Slick Willie Sutton and gangster Al Capone.

As Haviland’s plan dictated, "Cherry Hill," as Eastern State Penitentiary was commonly known, consisted of an octagonal center connected by corridors to seven radiating single-story cellblocks, each containing two ranges of large single cells with individual exercise yards. As inmates were to serve their entire sentence in their cells, the cells were very generously proportioned by nineteenth-century and even late-twentieth-century standards. The thirty-eight cells in block one, the first constructed, were eight by twelve feet and had brick vaults ten feet high at the crown. Initially, there were no doors from the corridor to the individual cells; access to the cell was only allowed through an outside iron door in the wall of each inmate’s exercise yard. However, there were rectangular openings in the corridor wall through which food and work materials were passed. There was also a small peephole so guards could observe the prisoner without being seen.36 To minimize communication between inmates, Haviland also decided against customary toilet buckets and instead designed a rudimentary flush toilet for each cell, with individual soil pipes leading directly to a central sewer under the corridors. Although the functioning of "Cherry Hill" as a prison has long since eroded, its architecture has inspired the construction of over three hundred prisons worldwide.37

 

 

Endnotes

1. Charles B. Strozier, "Benjamin Rush, Revolutionary Doctor," The American Scholar 64, (Summer 1995): 415.

2. Ibid., 417.

3. Richard Harrison Shryock, Medicine in America: Historical Essays (Baltimore, Maryland: The Johns Hopkins Press, 1966), 10.

4. Clarie G. Fox, Gordon L. Miller, and Jacquelyn C. Miller, Benjamin Rush, M.D.: A Bibliographic Guide (Westport, Connecticut: Greenwood Press, 1996), I:xiv.

5. Strozier, 418.

6. James Bordley, III, M.D. and A. McGehee Harvey, M.D. Two Centuries of American Medicine 1776-1976 (Philadelphia: W.B. Saunders Company, 1976), 34.

7. J.M. Powell, Bring Out Your Dead (Philadelphia: University of Pennsylvania Press, 1993), 128-9.

8. Barbara Ehrenreich and Deirdre English, For Her Own Good, 150 Years of the Experts Advice to Women (New York: Doubleday, 1978), 46.

9. Fox, et. al, I: xvii.

10. Eve Kornfeld, "Crisis in the Capital: The Cultural Significance of Philadelphia’s Great Yellow Fever Epidemic," Pennsylvania History (July 1984): 193.

11. Rush to John Coakley Lettsom, 16 August 1788, Letters of Benjamin Rush, ed. L.H. Butterfield, 2 vols. (Princeton, N.J.: Princeton University Press, 1951), I: 480.

12. Fox, et. al, I: xviii.

13. Ibid., I: xix.

14. Ibid., I: xix.

15. Donald J. D’Elia, "Dr. Benjamin Rush and the Negro," Journal of the History of Ideas 30, no. 3 (1969): 413.

16. Fox, et. al, I: xviii.

17. D’Elia, 413.

18. Fox, et. al, I: xviii.

19. Beers, Dorothy Gondos. "The Centennial City, 1865-1876" in Russell F. Weigley, ed, Philadelphia: A 300-Year History (New York: W.W. Norton & Company, 1982), 425.

20. "John Morgan Building," May 27, 1998, <http://www.upenn.edu/fm/facts/bi/bi0335.html> (25 October 1999).

21. Michelle Huff, tour guide with Philadelphia’s Foundation for Architecture, 23 October 1999.

22. Ibid.

23. "Richards Medical Research Laboratories and Goddard Laboratories." May 13, 1998, <http://www.upenn.edu/fm/facts/bi/bi0180.html> (25 October 1999).

24. Ibid.

25. Clark, Joseph S., Jr. and Dennis J. Clark. "Rally and Relapse, 1946-1968." in Russell F. Weigley, ed., Philadelphia: A 300-Year History (New York: W.W. Norton & Co., 1982), 689.

26. Williams, William H. America’s First Hospital: The Pennsylvania Hospital, 1751-1841 (Wayne, Pennsylvania: Haverford House Publishers, 1976), 2.

27. Ibid., 3.

28. Ibid., 22.

29. Ibid.

30. Gough, Deborah Mathias. Christ Church, Philadelphia: The Nation’s Church in a Changing City (Philadelphia: University of Pennsylvania Press, 1995), 29.

31. Ibid., 51.

32. Bronner, Edward B. "Village Into Town, 1701-1746" in Russell F. Weigley, ed., Philadelphia: A 300-Year History (New York: W.W. Norton & Co., 1982), 50-51.

33. Gough, 51.

34. Ibid., 49-51.

35. Johnston, Norman. Eastern State Penitentiary: Crucible of Good Intentions (Philadelphia: University of Pennsylvania Press, 1994), 7.

36. Ibid., 40.

37. Ibid., 105.

38. "John Morgan Building," May 27, 1998. <http://www.upenn.edu/fm/facts/bi/bi0335.html> (25 October 1999).

39. Clark, 689.

40. Gough, 50.

41. Williams, 22.

42. "Eastern State Penitentiary History," n.d. <http://www.EasternState.com/history.html> (5 November 1999).

 

 

Bibliography

Butterfield, Lyman, ed. Letters of Benjamin Rush, 1746-1813. New York: W.W. Norton, 1966.

Bordley, James and A. McGehee Harvey. Two Centuries of American Medicine: 1776-1976. Philadelphia: W.B. Saunders Company, 1976.

D’Elia, Donald J. "Dr. Benjamin Rush and the Negro." Journal of the History of Ideas. Vol. 30, No. 3: p.413-422.

"Eastern State Penitentiary History." n.d. <http://www.EasternState.com/history.html> (5 November 1999).

Ehrenreich, Barbara and Deirdre English. For Her Own Good, 150 Years of the Experts Advice to Women. New York: Doubleday, 1978.

Fox, Claire G., Gordon L. Miller, and Jacquelyn C. Miller. Benjamin Rush, M.D.: A Bibliographic Guide. Westport, Connecticut: Greenwood Press, 1996.

Gough, Deborah Mathias. Christ Church, Philadelphia: The Nation’s Church in a Changing City. Philadelphia: University of Pennsylvania Press, 1995.

"John Morgan Building." May 27, 1998. <http://www.upenn.edu/fm/facts/bi/bi0335.html> (25 October 1999).

Johnston, Norman. Eastern State Penitentiary: Crucible of Good Intentions. Philadelphia: University of Pennsylvania Press, 1994.

Kornfeld, Eve. "Crisis in the Capital: The Cultural Significance of Philadelphia’s Great Yellow Fever Epidemic." Pennsylvania History. July 1984: 189-201.

Powell, J.M. Bring Out Your Dead. Philadelphia: University of Pennsylvania Press, 1993.

"Richards Medical Research Laboratories and Goddard Laboratories." May 13, 1998. <http://www.upenn.edu/fm/facts/bi/bi0180.html> (25 October 1999).

Shryock, Richard H. "Benjamin Rush from the Perspective of the Twentieth Century." Medicine in America. Baltimore: Johns Hopkins Press, 1966.

Strozier, Charles B. "Benjamin Rush, Revolutionary Doctor." The American Scholar 64 (Summer 1995): 415-21.

Weigley, Russell F., ed. Philadelphia: A 300-Year History. New York: W.W. Norton & Company, 1982.

Williams, William H., Ph.D. America’s First Hospital: The Pennsylvania Hospital, 1751-1841. Wayne, Pennsylvania: Haverford House Publishers, 1976.

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