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examination as well as monitoring our and prevalance rates for psychiatric facilities in achievements; racism is an erosive process four register areas. Amer J Public Health 56:2033- 2051, 1966 negatively affecting black and white. We 8. Brody EB, Derbyshire RL, Schliefer CB: How the can no longer pretend it does not exist in young adult Baltimore Negro male becomes a psychiatry; we must counter our earlier Maryland hospital statistic, in Psychiatric Epidemi- denial with a hyperawareness that we hope ology and Mental Health Planning. Edited by will be temporary during a period of transi- Monroe RR, Klee GD, Brody EB. Psychiatric Research Report No 22. Washington, DC, The tion. Our own openness and effort can en- American Psychiatric Association, 1967 courage other professional groups to also 9. Mackler B: A report on the “600” schools: dilem- bring the efforts to combat white racism mas, problems, and solutions, in The Urban R’s: out of the shadows to the center stage of Race Relations as the Problem in Urban Educa- tion. Edited by Dentler R, Mack Icr R, Warshauer everyday life where this struggle belongs- ME. New York, Praeger, 1967 if racism is to be eradicated. 10. Gordon S: Primary education in urban slums: a mental health orientation, in The Urban R’s: Race REFERENCES Relations as the Problem in Urban Education. Edited by Dentler R, Mackler R, Warshauer ME. New York, Praeger, 1967 I.Pettigrew TF: A Profile of the Negro american. 11. Chicago Board of Health: Preliminary Report on Princeton, NJ, Van Nostrand, 1964, p xxii Patterns of Medical and Health Care in Poverty 2. Dollard J: Caste and Class in a Southern Town, Areas of Chicago and Proposed Health Programs 3rd ed. New York, Doubleday, 1957 for the Medically Indigent. Chicago, 1966 3. Lind iE: The dream as a simple wish fulfillment 12. Cobbs WH, Grier PM: Black Rage. New York, in the Negro. Psychoanal Rev 1:300, 1913-1914 Basic Books, 1968 4. Rosen H, Frank JD: Negroes in psychotherapy. 13. Coles R: Children of Crisis. Boston, Little, Brown Amer i Psychiat 119:456-460, 1962 and Co, 1964 5. Crawford FR: Variations between Negroes and 14. Grossack MM: Psychology and Negro life whites in concepts of mental illness, its treatment some needed research, in Mental Health and and prevalance. in Changing Perspectives in Men- Segregation. Edited by Grossack MM. New York, tal Illness. Edited by Plog SC, Edgerton RB. New Springer, 1963 York, Holt, Rinehart and Winston, 1969 15. Jones BE, Lightfoot OB, Palmer D, Ct al: Problems 6. Gorwitz K: Changing patterns of psychiatric care of black psychiatric residents in white training in- in Maryland, in Psychiatric Epidemiology and stitutes. Amer J Psychiat 127:798-803, 1970 Mental Health Planning. Edited by Monroe RR, 16. Harrison P, Butts HF: White psychiatrists’ racism KIee GD, Brody EB. Psychiatric Research Report in patient referral to black psychiatrists. Presented No 22. Washington, DC, The American Psychi- at the l25th anniversary meeting of the American atric Association, 1967 Psychiatric Association, Miami Beach, Fla, May 7. Bahn AK, Gardner EA, AlItop L, et al: Admission 5-9, 1969

Benjamin Rush and the Negro

BY BETTY L. PLUMMER

The author describes Rushs interest in the B ENJAMIN RUSH (1745-1813) is best social problems of his day. particularly his known as a signer of the Declaration of concern with relations between blacks and Independence and a prominent Philadelphia whites. Rush was active in the abolition movement,’ his tracts and extensive corre- spondence especially emphasized the detri- Read at the 123rd annual meeting of the American mental effects of slavery on the mind. He Psychiatric Association, San Francisco, Calif., May 11 - 15, 1970. Based on an MA. thesis, “Benjamin Rush was also frequently inlved in such activ- and the Negro,” submitted to the department.of history, ities of Philadelphia ‘.s black community as Howard University, Washington, D. C., May 4, 1969. Miss Plummer is an instructor in the department of the securing of funds for the construction of history, Georgetown University, Washington, D. C. churches. 20007.

Amer. J. Psychic:. /27.6, December /970 [93] 794 RUSH AND THE NEGRO physician who, due to his early interest in the were rendered torpid by it ( 1 , p.2). care and treatment of the mentally ill, has In this same pamphlet Rush attempted to been called the father of American psychi- arouse additional antislavery sentiment in atry. Rush’s interests, however, were not his readers by describing the traumatic expe- confined to medicine and the securing of riences of the African en route to the New American independence. He was a true World. He suggested that his readers attempt humanitarian, in the broadest sense of the to visualize the numerous Africans who per- word, who advocated reform in the penal ished because of extreme melancholy (reac- institutions and the educational system of tive depression) or grief, as well as the many his day, especially in regard to the equal others who committed suicide rather than education of women. Moreover, he was an accept the slavery that awaited them. ardent supporter of the crusade against The primary purpose of his second anti- Negro slavery. slavery pamphlet (2) was to defend and The earliest evidence of his antislavery reemphasize several of the antislavery argu- convictions is found in the two antislavery ments that he had voiced in the first. More- pamphlets he wrote in 1773 (at age 28) in over, he presented additional proof of the which he voiced strong opposition to the sys- ill effects of slavery on the Negro’s mental tem of slavery (1, 2). Rush’s correspondence health. Certain proslavery advocates had relating to abolition is voluminous, even maintained that the African’s apathy toward though there is reason to believe that many his family and friends was additional proof of his letters have been lost. His participation of his mental inferiority. Rush strongly in abolitionist activities is also noteworthy. argued that this observation was fallacious. In 1787 he participated in the reorganization Travelers’ accounts clearly showed that the of the Pennsylvania Society for Promoting African did experience separation anxiety the Abolition of Slavery. In 1795 he served on being removed from his family and as National President of the American Con- friends as the cargoes were being sold for vention for Promoting the Abolition of shipment to the New World. Slavery and Improving the African Race. Medical Articles on Blacks Rush’s concern with the Negro was not confined to abolitionist writings and activ- Besides his works devoted specifically to ities. He was also involved with Philadel- abolition, Rush wrote articles and medical phia’s free black community. From 1791 to treatises dealing with blacks, as well as 1793 he was active in the movement to estab- medical texts in which he referred to blacks lish African churches in the city of Philadel- when describing a particular malady. In one phia. Moreover, Rush’s correspondence article relating specifically to the Negro (3), provides evidence that he assisted free blacks he was concerned with both the mental and in a variety of other situations. physical effects of slavery. Many of the arguments that Rush used in Among the ailments cited was hypochon- his first antislavery pamphlet(l) were cer- driasis or mal d’estomac, as it is called in the tainly familiar to readers of abolitionist French islands. This disease, which was one literature. However, his interest in medicine, of the most common ailments among the particularly psychiatry, enabled him to slaves, was described by Rush as being quite emphasize the detrimental effects of slavery painful; moreover, it was undoubtedly psy- on the mind or mental health of the Negro. chosomatic. It usually occurred quite early For example, in refuting the common pro- during the period in which the African was slavery argument that the mental capacity becoming acclimated (acculturated) to the of the African was inferior to that of the vicious and brutalizing system of slavery. European, Rush emphasized the necessity (Today this would be termed culture shock.) of differentiating between an enslaved Afri- Hypochondriasis, which was usually fatal, can and a free African. He maintained that had been erroneously attributed to the one could not accurately evaluate the mental slaves’ administering a slow poison to each capacity of a slave. Slavery, he argued, was other. In reality, Rush maintained, “the so foreign to the human mind that the moral disease was wholly occasioned by grief and faculties, as well as those of understanding, consequently justly attributed to slavery”

[94] Amer. J. Psychic:. 127.6, December /970 BETTY L. PLUMMER 795

(3, p. 82). Actually, they are examples of hibiting his ability to perform mental com- acting out. putations (5, p. 450). Another manifestation of the ill effects By using blacks as well as whites as ex- of slavery on the black mind was to be amples of individuals affected by certain found in the Negro’s songs and dances. medical conditions, Rush provided addi- Contrary to what many slave masters be- tional clinical evidence of the lack of inher- lieved, these songs and dances were not out- ent racial differences. ward expressions of contentment and joy. In a brief paper written in 1799 (6), Rush Rush was of the opinion that these songs was concerned with uncovering the cause or and dances were “physical symptoms” of causes of the Negro’s blackness. His con- the slave’s melancholy and madness, and clusion was that the black complexion of therefore were certain proofs of his misery the Negro stemmed from a leprous-type (3, p. 82). Actually, they are examples of act- disease. He maintained that by seeking a ing out. cure for this condition and subsequently re- One of the many subjects that Rush dis- moving the Negro’s blackness, a great ser- cussed in Medical Inquiries and Observa- vice would be rendered to mankind. The tions upon the Diseases of the Mind (4), the idea of the oneness of the human race would first textbook in American psychiatry, was be strengthened and many advocates of madness or insanity induced by grief. He white supremacy would lose one of their discovered that this variety of insanity had basic premises if the blackness were re- been observed among the slaves in the Car- moved. ibbean. It appeared that some Africans be- Moreover, Rush was cognizant of the came insane soon after they entered into fact that the reactions of whites to the perpetual slavery in the West Indies (4, p. 41). Negro’s blackness had caused a psycholog- References to blacks also occur in Rush’s ical problem for some blacks. He there- lectures to his medical students at the Uni- fore maintained that the removal of the versity of Pennsylvania (5). For example, in Negro’s blackness would render him a cer- discussing the pleasures of the mind and the tain amount of happiness since it was obvi- ous that some Negroes had difficulty ac- forces that affect mental pleasure, he used the experiences of two Negroes as cases in cepting their blackness: “Forever how well they appear to be satisfied with their color, point. there were many proofs of their preferring In the first example he maintained that a that of the white people” (6, p. 297). Thus we certain pleasure was derived from the mind’s see that almost two centuries ago the Negro association of pleasant experiences, such as lost the identity that he is now desperately those of childhood. Rush related the story trying to recapture with the slogan “Black of an old African who had obtained per- is beautiful.” mission from his master to go to see a lion Rush’s understanding of early American that was being conducted through the state race relations, particularly the acceptance of of New Jersey as an exhibit. The moment blacks by whites, is rather obvious in his the old man saw the animal, “inspite of the leprosy paper. He seemed to believe that ra- torpid habits of mind and body contracted cial harmony would be more easily achieved by fifty years of slavery,” he was moved with by turning black men white than by expect- great joy (5, p. 448). Rush maintained that he ing white men to accept black men. In es- had been familiar with the lion as a child in sence, he understood well the impact of Africa. Consequently, the sight of the ani- physical differences on mental attitudes that mal brought back memories of the liberty, is a vital factor in racial prejudice and that freedom, and pleasure that he had once has persisted into our time. known in childnood. The second example dealt with the mental Correspondence with Abolitionists pleasures that are derived from exploits of memory. Thomas Fuller, a slave from Vir- For many years Benjamin Rush corre- ginia, had experienced this type of pleasure. sponded with abolitionists in the United Moreover, he had received frequent rewards States and in England. The majority of the for amusing strangers and travelers by ex- people he wrote to were statesmen, physi-

Amer. J. Psychic:. /27.6, Decemnber 1970 [95] 796 RUSH AND THE NEGRO cians, clergymen, and scholars, and most to accept menial jobs in the city of Philadel- of them were actively engaged in the aboli- phia. Provisions were made for the distribu- tionist movement. There were a few who tion of land as well as for the establishment might have been lukewarm in their anti- of churches and schools in the proposed slavery convictions, but they were influential community. If the plan could be executed persons who could exert a favorable influ- successfully, the benefits derived from it ence for the cause if they so desired. None would be numerous. Moreover, it might appeared to be firmly opposed to abolition. lead to similar enterprises in the southern In the majority of his letters Rush was states. concerned with the progress being made by Another significant letter was written by abolitionists and abolition societies in the Benjamin Rush on behalf of the Pennsyl- colonies. In others he was primarily con- vania Society for the Abolition of Slavery. cerned with plans and proposals that he felt A group of London abolitionists had re- would facilitate the process of emancipa- quested that the Pennsylvania society send tion. In some letters he showed an interest them accounts of mental achievement that in the mental achievements of blacks in an they had observed in blacks with whom effort to gain support for the cause of aboli- they had come into contact. In a letter tion. written November 14, 1788, Rush described The extensive correspondence of Benja- the achievements of James Durham, a for- min Rush and British abolitionist Granville mer slave, who was practicing medicine in Sharp (1735-1831) dealt with many aspects New Orleans. Rush questioned him regard- of the movement, particularly the progress ing diseases that were prevalent in the of abolition in the colonies (7). In a letter Louisiana territory. He found that Durham to Sharp dated November 1, 1774, Rush was perfectly acquainted with modern prac- stated his belief that the success then being tices. He added, “I expected to have sug- experienced by abolitionists was an indica- gested some new medicines to him, but tion that slavery would soon be extinct in the he suggested many more to me” (9, p. 497). colonies. He expressed doubt that there would be a Negro slave in America in 40 Involvement in the Black Community years (7, p. 13). Rush’s interest in the Negro was not con- In a later letter to Sharp, dated November fined to the abolitionist movement. He was 28, 1783, Rush wrote that some progress involved in the activities of Philadelphia’s was still being made by the abolitionists in free black community, particularly those of the colonies. In the middle colonies, he the Free African Society. Consequently, observed, the abolitionists were being when an effort was being made to establish looked upon as the benefactors of mankind. churches for blacks, Richard Allen, founder In the South, however, he noted a very dif- of the African Methodist Episcopal Church, ferent trend; in South Carolina, for ex- and Absalom Jones, first director of the ample, the “negromania” (for certainly it is African Episcopal Church of St. Thomas, a species of madness) still prevailed (7, p. 20). sought the aid of Benjamin Rush. Hence Rush considered racism, i.e., racial This same Richard Allen responded to prejudice, a form of mental illness. Rush’s appeal for help during a yellow fever Significant evidence of Rush’s attempts to epidemic in 1793. Allen organized a group find measures to aid recently emancipated of blacks to assist in providing nursing care, blacks is found in an undated letter that he spiritual solace, blood letting, and purging wrote to the Pennsylvania Society for the for the stricken whites. Rush had incorrectly Abolition of Slavery and the Relief of Free believed Negroes were immune to yellow Negroes Unlawfully Held in Bondage (8). fever because of their blackness; he could This letter contained a proposal for the soci- not detect the yellow tint in their skin. ety to establish a black agricultural commu- Jaundice, a late symptom of yellow fever, nity in Bedford County, Pennsylvania. Rush only became clinically evident in the sclera believed that such a community would en- or the whites of their eyes four to six weeks able these blacks to engage in independent after the onset of the illness. The above ex- agricultural pursuits rather than be forced ample shows Rush’s use of the paramedical

[96] Amer. J. Psychic:. /27.6, Decemnber /970 BETTY L. PLUMMER 797 concept that we now think of as innovative, College of Physicians of Philadelphia.’ i.e., the use of nonmedical personnel in the care of the ill. Conel USI() fl S In an effort to provide the financial assis- In evaluating Rush’s involvement with tance that was needed to establish black blacks, one must first consider him as an churches, Rush solicited funds from several 18th century abolitionist. He falls into the individuals in England and the United group of moderates who lacked the prose- States. In the case of Absalom Jones’s church, he persuaded the comptroller gener- lytizing spirit that was typical of certain 19th century abolitionists. He was primarily al of Pennsylvania, John Nicholson, to ne- a writer of tracts and related literature. It is gotiate a loan with the blacks for completing difficult to actually measure the effectiveness the construction of their church. It should of his writings since he exchanged ideas, for also be noted that the free blacks sought the most part, with individuals who were Rush’s assistance when they were drafting already committed to the cause. It would their plans for church government. appear that Rush’s most significant contri- Rush’s correspondence regarding the bution to the movement was his emphasis on free black community is particularly signif- the ill effects of slavery on the black mind. icant. One easily senses that in many of Perhaps the circle of abolitionists with these letters he was actually making an effort whom he corresponded made use of these to acquaint whites with the black commu- ideas; it is only today that some are begin- nity. Moreover, it appears that he was ning to see the brutalizing effects of slavery attempting to disprove certain stereotypes and racism. about Negroes that were commonly ac- In regard to Rush’s personal involvement cepted by 18th century whites. For example, with Negroes, it appears that his attitude when writing to John Nicholson in an effort to negotiate the loan for the free blacks, he toward the Negro was not paternalistic. The correspondence of the members of the Free felt it necessary to state that he had found African Society clearly indicates that they the members of the African Society to be sought Rush’s aid. In fact, he noted in his “affectionate and grateful,” and he attempt- Commonplace Book that he had read a plan ed to reassure the comptroller general that for church government to the blacks and the loan would be repaid, stating that “from they had agreed to deliberate upon it before their numbers, their increasing prosperity, it was laid before the public (11). and the punctuality in all their engagements” he had no doubt that the interest “will be Rush’s understanding of race relations in early America certainly poses some ques- paid to a day every quarter” (9, p. 624). tions. At times, he appeared overly optimis- The apparent need to acquaint whites tic. For example, in 1774 he believed that with black people is also seen in a letter slavery would soon be extinct in the colonies. Rush wrote to his wife, Julia, in the summer At other times, he appeared quite pessimis- of 1793. In this particular instance, he was tic. For example, in 1783 he considered the relating the incidents surrounding the roof- spread of slavery and racism in South Caro- raising ceremony at the African church. He lina to be indicative of what he called “ne- noted that the “company broke up in good gromania” or an actual form of mental ill- order, few or perhaps any of them having ness. drunk more than three or four glasses of In his dealings with the free black com- wine” (9, p. 639). munity Rush seemed quite realistic. For ex- Perhaps Rush’s most significant relation- ship with a black was that with James Dur- ham. Their correspondence, covering many In a manuscript volume of the proceedings of the meetings of the College of Physicians of Philadelphia, it years, reveals that theirs was both a pro- is noted that on July 7, 1789, Dr. Benjamin Rush pre- fessional and a friendly relationship. There sented “An Account of the Putrid Sore Throat at New is evidence that the two men exchanged Orleans,” by James Durham, Practitioner of Physic at that place, but for want of time the reading was post- medical information. In 1789 Rush read poned until the next meeting. An entry forAugust 4, Durham’s paper “An Account of the Putrid 1789, states that the communication from Dr. James Durham, presented at the last meeting, was now read Sore Throat at New Orleans” before the (10).

A,ner. J. Psychic:. /27:6, December /970 [97] 798 PROBLEMS OF BLACK PSYCHIATRIC RESIDENTS ample, he thought that the establishment of 3. Rush B: An account of the diseases peculiar to the African churches was necessary. He also Negroes in the West Indies, and which are produced by their slavery. American Museum or Repository advocated the establishment of black agri- of Ancient and Modern Pieces, etc., Prose and cultural communities. Rush’s suggestion was Poetry 4:81-82, July-December 1788 in line with some of today’s proposals for 4. Rush B: Medical Inquiries and Observations upon separation on the part of blacks. Rush the Diseases of the Mind. Philadelphia, Kimber & wanted integration but obviously became Richardson, 1812 5. Rush B: Sixteen Introductory Lectures to the disillusioned and compromised for separa- Courses and Lectures upon the Institutes and Prac- tism, much as some blacks have currently tice of Medicine, with a Syllabus of the Latter to done. Consequently it appears that he was Which Are Added Two Lectures upon the Pleasure more a realist than an idealist in his dealings of the Senses and of the Mind with an Inquiry into Their Proximate Causes. Philadelphia, Fry & with free blacks, i.e., Rush’s ideal society Kammarer Printer, 1811 would have been completely integrated but 6. Rush B: Observations intended to favour a supposi- he knew that for all practical purposes sepa- tion that the black color (as it is called) of the ratism was necessary to some extent in the Negroes is derived from the leprosy. American Philosophical Society Transactions 4 (old series): 18th and 19th centuries. 289-297, 1799 7. Woods JA: The correspondence of Benjamin Rush REFERENCES and Granville Sharp: 1773-1809. Journal of American Studies 1:1-37, April l967 1.Rush B: An Address to the Inhabitants of the 8. Historical Society of Pennsylvania: Unpublished British Settlements in America upon Slave-Keeping. Rush manuscripts. vol 39, p 64 Philadelphia, John Dunlap, l773 9. Butterfield LH (ed): Letters of Benjamin Rush, vol 2. Rush B: A Vindication of the Address to the Inhab- 1. Princeton, Princeton University Press, 1951 itants of the British Settlements on the Slavery of 10. McDaniel WB II: Personal communication, April Negroes in America, in Answer to a Pamphlet En- 1, 1969 titled “Slavery Not Forbidden by Scripture, or a 11. Corner GW (ed): The Autobiography of Benjamin Defence of the West India Planters from the Asper- Rush: His “Travels Through Life” Together with sions Thrown out Against Them by the Author of Commonplace Book, 1789-1813. Princeton. the Address.” Philadelphia, John Dunlap, 1773 Princeton University Press, 1948. p 37

Problems of Black Psychiatric Residents in White Training Institutes

BY BILLY E. JONES, M.D., ORLANDO B. LIGHTFOOT, M.D., DON PALMER, M.D., RAYMOND G. WILKERSON, M.D., AND DONALD H. WILLIAMS, M.D.

The authors, who recently completed resi- T HIS PAPER is an outgrowth of the train- dencies in three predominantly white psy- ing experiences of five black psychia- choanalytically oriented training programs. trists, four of whom completed their training believe that such programs are failing to at the end of June 1969 and one in October produce psychiatrists-black or white-who 1967. The paper presents conclusions we are prepared to address themselves to the have reached on the basis of our experiences mental health needs of the black commu- nity. They offer a number of recommenda- in community psychiatry, Harvard University, Cam- tions for correcting this situation. bridge, Mass. Dr. Palmer is a psychiatrist in the health service at Massachusetts Institute of Technology. Boston, Mass. Dr. Wilkerson is an assistant professor. department of psychiatry. University of Illinois Col- Read at the 125th anniversary meeting of the Ameri- lege of Medicine, 912 5. Wood, Chicago, Ill. 60612. can Psychiatric Association, Miami Beach, Fla., May Dr. Williams is associate director, Woodlawn Mental 5-9, 1969. Health Center, and instructor, University of Chicago Dr. Jones is a captain in the U.S. Army; he is cur- College of Medicine, Chicago, Ill. Reprint requests rently stationed in Viet Nam. Dr. Lightfoot is a fellow should be sent to Dr. Wilkerson.

[98] Amer. J. Psychic:. 127.6, December 1970