Revolutions in the Atmosphere: Benjamin Rush’s Universal System of Medicine

Sarah Naramore is a PhD student in the History and Philosophy of Science Program at the University of Notre Dame. She was a Consortium Research Fellow in 2014-2015. My dissertation looks at the self-described “universal” system of medicine promoted by Philadelphia physician Benjamin Rush at the turn of the nineteenth century. In this period Rush attempted to provide an “authentic” description of the human body and its relationship to its surroundings by breaking physiology down into simple dichotomies and analogies: excitement and excitability; ill and well; debilitated and functional; putrid and fresh; symptoms and causes. Oftentimes he did not contribute new ideas to the literature, but, rather synthesized his observations with theories from a wide variety of medical source material. In doing so he believed that he created a blueprint for a revolution in medicine, one that would improve human health and society in an uncertain yet optimistic age. He was not alone. Physicians around the world turned away from eighteenth century medical categories and treatments. Historians have labelled some of the new movements as “fringe” like phrenology, botanical medicines, or electrical cures. Others, meanwhile, are lauded as the foundations of “modern” medicine, notably French clinical pathology. Why then did Rush think he was revolutionary? What about his system, taken seriously, if not always positively, by his contemporaries made it stand out, and why did it and the holism it embraced seem to lose out to more reductionist forms of medical inquiry? How did his geography and political context inform his work? These questions help us understand the contingency of medical theory during the Age of Revolutions and revives the role of North America within that context. Despite his cosmopolitain outlook Rush was a relative homebody. A busy private practice, growing family, and a position at the University of Pennsylvania Medical School made Philadelphia the locus of his intellectual activity. As a research fellow at the Consortium I was able to delve into the world of Benjamin Rush on several levels from his public face, to debates with colleagues, to his relationship with students, to his private notes and correspondence. In combination these sources follow Rush’s intellectual development and highlight his prejudices. Influences that remain hidden in published materials, like Rush’s thoughts on the similar, but not identical, physiology of John Brown, are made explicit to students or Rush’s own notes. Over the course of two research trips I was able to work with materials at the American Philosophical Society, the Historical Society of Pennsylvania, the Library Company of Philadelphia, and the College of Physicians of Philadelphia, each has contributed greatly to my understanding of Rush and the main questions of this project. Getting into Rush’s personal papers opened up a new view on a man famous for his published image. At the American Philosophical Society I was able to look at Rush’s commonplace book and drafts of his autobiography. The everyday occurrences Rush depicted are simultaneously mundane and enlightening. Conversations with European travelers (from the unknown to Alexander von Humboldt), lists of deceased friends, and queries based on daily experiences fill the pages and informed his worldview. Reflections on events and second-hand descriptions emphasize his empirical commitments that he applied to professional activities. Further synthesis occurred in his autobiography, where experiences turned to lessons for future generations of the Rush family. On a more professional, but still private level, the Rush papers and publications at the Historical Society of Pennsylvania and Library Company of Philadelphia illustrate the development of medical theory as a synthesis of academic literature and therapeutic experience. The yellow fever epidemics (1793-1805) marked a turning point in Rush’s work. Although the seeds of the new system were in place by the late 1780s a new sense of urgency and bravado appeared in response to the devastating new disease. Polemical medical tracts for and against Rush’s methods appeared in Philadelphia, New York, Britain, and even Germany. Useful for taking the temperature of the profession after the fact, the publications, cannot describe the disease in “real time.” His notes, taken during and after successive outbreaks, however proved a more immediate version of events. The trial and error involved in yellow fever practice and theory play out in the notes where they are smoothed over in finished texts. On the lighter side of empirical inquiry, I also came across stories of Rush’s time in medical school he used to add evidence to his lecture on sex and generation. Apparently a friend of his entered married life sooner than expected based on physiological misinformation. Last, but by no means least, the collections at the College of Physicians have been an invaluable resource. In addition to more of Rush’s own papers and publications the College houses a collection of medical student notebooks from the late eighteenth and early nineteenth centuries. Students tried to take their notes by dictation during this period which provides a fine-grained account of Rush’s theoretical changes over the period. Furthermore, scrapbooks, early University histories, and papers belonging to Rush’s contemporaries contextualize the medical landscape of Philadelphia in the post-Revolutionary period. As this work at the Consortium came relatively early in my dissertation process I do not exaggerate when I say it has fundamentally shaped its development. My research at the American Philosophical Society, Historical Society of Pennsylvania, Library Company of Philadelphia, and the College of Physicians will form the foundation of my project and find its way into each chapter. Beyond the archives themselves conversations with fellow scholars and archivists allowed me to look at my questions from a new angle, hone in on the important issues, and access previously sources previously unknown to myself. I would like to especially thank Beth Lander at the College of Physicians and Cornelia King at the Library Company for their help tracking down sources, making suggestions, and introducing me to new research tools. In addition, the Consortium’s brown bag lunches have been especially helpful both academically and by fostering a sense of community. I am incredibly grateful to the Consortium for making this research possible.