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Benjamin Rush, MD: The Father of American Psychiatry

history of psychiatry

H

istory: we all have one. So do rocks, for that matter. Thing of it is, for so many reasons, history is important – individually and collectively. And so it goes for our fields of interest, psychiatry and psychology. Let’s get to know Benjamin Rush, MD, the Father of American Psychiatry…

‘For many centuries, they have been treated like criminals, or shunned like beasts of prey. Happily, these times of cruelty to this class of our fellow creatures and insensibilities to their sufferings are now passing away…’

So why bother with history chats? Well, they’re often immensely interesting, as well as educational. But, more importantly, history plays a huge role in defining who we are and why we do what we do. And wouldn’t you agree that history is one of the best predictors of current and future behavior?

Dr. Benjamin Rush: Renaissance Man, Founding Father

Born on Christmas Eve 1745, just outside of Philadelphia, Benjamin Rush was a renaissance man. Physician, politician, humanitarian, social reformer, educator, great husband and father – signer of the Declaration of Independence – Dr. Rush was the total package.

I became aware of Rush’s founding role in psychiatry while doing some research a dozen or so years ago. So when I saw a new biography – Dr. Benjamin Rush: The Founding Father Who Healed a Wounded Nation by Harlow Giles Unger – on a display table at Barnes & Noble, I had to have it (even paid for it).

What you’re about to read comes from the book…

Dr. Rush’s Personal “Intro to Psych”

After visiting a Philadelphia jail in the early-1790s, Rush became furious over the brutally cruel conditions and demanded reforms regarding the treatment of the “insane.” See, Philadelphia authorities sent the insane who “raised the devil” to prisons, almshouses, or the Pennsylvania Hospital. Those who weren’t aggressive or behaving as though under the spell of Satan or other evil spirits were left to roam the streets.

Now, the Pennsylvania Hospital, founded in 1751 by Benjamin Franklin, was the first hospital to at least designate a specific area for the treatment of the insane. But when Rush became connected with the hospital, he found the “area” nothing more than a filthy basement prison, holding patients who were often chained by their waists to iron rings embedded in the floors or walls of cold and damp cells.

The story goes that Rush freaked over the conditions, and the hospital directors wisely turned the care of the “maniacal” patients over to him. Immediately, Rush introduced humane policies and practices such as bathing patients regularly, maintaining spotless linens, discharging aides who wouldn’t deliver care and kindness, and recreational activity.

Dr. Rush was a compassionate no-nonsense difference-maker.

Rush: His Theories & Treatments

who was the first psychiatristSpending endless hours dedicated to, and observing, his patients, Rush came up with so many theories and treatments pertaining to emotional/mental illness. For instance, here’s how he described “a new theory of mania” to a colleague in London…

“I suppose it in nearly all cases to be accompanied by inflammation of the brain. This, the water, blood, pus, and hardness found in the brain after death all demonstrate…In consequence of the adoption of this theory, I have lately cured three deplorable cases of madness by copious bleeding (100 ounces in one case). It was aided afterwards by cold baths.”

Yes, Rush was huge on bleeding for just about every illness he encountered. But we have to remember the times. I mean, luxuries such as the stethoscope and medical thermometer were still years down the road. Oh, and to go along with bleeding were purging (laxatives and emetics), herbal remedies, and painkillers such as opium, rum, and whiskey.

Rush, like any other physician, was only as good as the science of the day.

When it came to cause, Rush declared that “madness” often resulted from “the reciprocal influence of the body and mind upon each other.” He continued…

“They are part of the unity of disease, particularly of fever, of which madness is a chronic form affecting that part of the brain that is the seat of the mind. The cause of madness is seated primarily in the blood vessels of the brain, and it depends upon the same kind of morbid and irregular actions that constitutes other arterial diseases.”

Now, regarding treatment, Rush went well beyond bleeding and purges. Before long, he introduced an early form of talk therapy, as well as occupational therapy. Both were revolutionary, as well as efficacious.

Bottom-line: Dr. Rush became the first American physician to treat emotional/mental illness as a disease, not willful criminal behavior or the work of the devil or evil spirits.

How fortunate we are that Rush transcribed his notes into lectures that filled the fifth and final volume of his hugely influential “Medical Inquiries and Observation” series, Medical Inquiries and Observations upon the Diseases of the Mind.

Final Thoughts

Wanna’ know why the American Psychiatric Association declared Dr. Rush the “Father of American Psychiatry” in 1965? In addition to tireless work, compassion, and revolutionary theories and treatments, consider these words to his students…

“For many centuries, they have been treated like criminals, or shunned like beasts of prey. Happily, these times of cruelty to this class of our fellow creatures and insensibilities to their sufferings are now passing away…The clanking of chains and the noise of the whip are no longer heard. They now taste the blessings of air and light and motion in pleasant shaded walks in summer and in spacious entries warmed by stoves in winter…In consequence of these advantages, they have recovered…their long forgotten relationships to their friends and the public.”

Benjamin Rush, MD: quite a guy, huh? We’ve only scratched the surface here. Go ahead, take the time to learn more about him.

That history thing, right?

Thanks to Dickinson College (Rush was the founder) for the book image.

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