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HOW BENJAMIN RUSH CREATED AMERICAN MEDICINE a Dissertation Submitted to the Graduate School of The I SING THE BODY REPUBLIC: HOW BENJAMIN RUSH CREATED AMERICAN MEDICINE A Dissertation Submitted to the Graduate School of the University of Notre Dame in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy by Sarah E. Naramore __________________________________ Christopher S. Hamlin, Director Graduate Program in the History and Philosophy of Science Notre Dame, Indiana June 2018 Ó Copyright 2018 Sarah E. Naramore ii I SING THE BODY REPUBLIC: HOW BENJAMIN RUSH CREATED AMERICAN MEDICINE Abstract by Sarah E. Naramore In this dissertation I argue that Philadelphia Physician Benjamin Rush (1746-1813) merged medical and political theory in an unprecedented matter to form a concept of biological citizenship for the United States in the years following independence from Great Britain. A graduate of the University of Edinburgh's medical school, Rush began his career in 1769 as one of the few elite colonial physicians who held an MD degree. By the time he died in 1813, however, Rush publicly rejected the medicine he had learned in Scotland. He claimed to have created a new system predicated on simple physiological concepts adjusted to meet the needs of the young republic. In doing so he created an American medicine which had implications far out stripping the comparatively narrow purview of twenty-first century medical practice. Historically Rush's legacy has been fragmented into the histories of medicine, psychiatry, American political history, social history, and the history of reform movements. This informs the question this dissertation seeks to answer: Rush is a perennially-cited iii Sarah E. Naramore player in the history of medicine and that of the early United States, why? He was not the only Scottish-educated American physician nor the only member of a medical faculty; yet, his work stands out in a way which that of his contemporaries does not. To recover Rush's significance and role in the development of early American medicine this project reflects the scope of his intellectual inquiry independent of modern disciplinary boundaries. Rush's status as the American physician between 1790 and 1813 is explained through several characteristics of his work. He achieved his status by becoming an important synthesizer of knowledge both local and foreign. Rush participated in a trans- Atlantic network of physicians, improvers, and intellectuals through personal correspondence and shared publications. In particular he leveraged the work of neo- Hippocratic colonial practitioners in the tropics to claim that the United States had a unique environment. Unlike the hot West Indies or cool Britain, the United States was unified by its variability. In order to succeed as an independent republic populated by moral and rational citizens new institutions were required to promote the country's development and to correct mistakes manifest in immorality, filth, and disease. Rush promoted hybrid political and medical projects some, but by no means all, of which might be considered “public health.” In other instances – like public education, temperance, and personal hygiene -- he used medical theory to make claims about individual choice and the reciprocal relationship between body and society. iv For Nathan ii CONTENTS Figures..................................................................................................................................v Tables.................................................................................................................................vii Acknowledgments............................................................................................................viii Chapter One: Introduction....................................................................................................1 1.1 Benjamin Rush from the Perspective of the Twenty-First Century...................4 1.2 Benjamin Rush in his own time.......................................................................16 1.3 The World of Benjamin Rush..........................................................................30 1.4 Chapter Outline................................................................................................43 Chapter Two: "A Republican in Medicine".......................................................................47 2.1 Colonial Roots..................................................................................................49 2.2 Scottish Medicine.............................................................................................58 2.3 Rush in the Capitals......................................................................................78 2.4 Independent Medicine......................................................................................85 2.5 Conclusion........................................................................................................97 Chapter Three: "Uniformly Variable"................................................................................99 3.1 Volney, Rush, and the American Climate.......................................................105 3.2 Networks of Knowledge.................................................................................112 3.3 Medical Journals and Associations.................................................................122 3.4 Putting Local Knowledge to Work.................................................................127 3.5 Conclusion......................................................................................................140 Chapter Four: Toxic Geographies...................................................................................142 4.1 The American Fever.......................................................................................149 4.2 A Slow-Moving Crisis....................................................................................168 4.3 Conclusion......................................................................................................185 Chapter Five: Variations on a Theme...............................................................................187 5.1 The Americans...............................................................................................192 5.2 The Republican Woman.................................................................................212 5.3 Barometers of Civilization..............................................................................226 5.4 Conclusion......................................................................................................237 iii Chapter Six: "The Likeness of God Himself".................................................................239 6.1 American Education.......................................................................................243 6.2 The Pennsylvania Hospital.............................................................................267 6.3 "Laboratories of Poison".................................................................................279 6.4 Conclusion......................................................................................................289 Chapter Seven: Conclusion..............................................................................................292 Bibliography....................................................................................................................298 iv FIGURES Figure 1-1 Proportion of total mentions of medical authorities in student notebooks by region as surveyed by the author...........................................................................21 Figure 1-2 Total number of letters received by Rush each year as surveyed by the author ................................................................................................................................27 Figure 1-3 Proportion of total letters received by Benjamin Rush by region as surveyed by the author..........................................................................................................28 Figure 2-1 Timeline of Benjamin Rush's time at the University of Edinburgh, London, and Paris based on his correspondence and autobiography...................................69 Figure 2-2 Medical Graduates from the University of Pennsylvania by State (1791-1813) for those students with a home state listed on their records at the University of Pennsylvania Archive............................................................................................88 Figure 3-1 Volney's Journey in 1796 from the Delaware River to Albany, New York, estimated from View of the Climate and Soil of the United States of America (1804)...................................................................................................................108 Figure 3-2 Publication life-span of Early American medical journals in print during Benjamin Rush's lifetime.....................................................................................125 Figure 3-3 Distribution of article authors in the United States from the American Medical and Philosophical Journal (1811-1814), Philadelphia Medical and Physical Journal (1804-1808), Philadelphia Medical Museum (1805-1811), and New York Medical and Philosophical Journal (1809-1810).................................................126 Figure 4-1 American municipalities with at least one published report of yellow fever, 1790-1811............................................................................................................157 Figure 4-2 Image of patients
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