The following is an excerpt of an article I recently submitted to an academic journal; I am reprinting it on my blog today because I have some last-minute, end-of-semester loose ends to gather.
Left: Rush's "tranquilizing chair"
American medical philosophy drew heavily from European models in the colonial period, in large part due to the dearth of formal medical schools. Such institutions serve as the training facility for the next generation of physicians, but, more importantly, medical schools also function as important sources of the practical experimentation and theoretical discourse that push forward the knowledge base of the field of medicine. This lack of prestigious medical schools drove Benjamin Rush, like so many of his colonial American compatriots, overseas to complete his medical instruction.
Rush traveled to Edinburgh and London to study under what were then the world’s preeminent medical instructors. The influence of European instruction is evident throughout his writings, but the medical philosophies of Benjamin Rush were equally the product of a mind that was shaped by the American Revolution and the earliest years of the young republic.
In addition to his influence on American medicine, Rush was also noteworthy for his innovative work in the nascent fields of psychology and psychiatry. He led a drive in 1792 to force state funding for a ward for the insane at the Pennsylvania Hospital, arguing that mentally ill patients were deserving of humane treatment. Rush’s practical work with such patients provided the foundation for his theories on the causes of mental illness, and it was in this environment that he developed the material for his well-attended lectures on the nature of the mind.. This series of lectures, developed over a period of nearly three decades, demonstrate the depth and uniqueness of the philosophies of Rush. The collection Benjamin Rush’s Lectures on the Mind bolsters the case for Rush’s reputation as the “father of American psychiatry,” and provides a massive database of the material that influenced thousands of the first American physicians.
Rush, like the rest of the Jeffersonians, was an avowed materialist, and there was a physical basis for every process, including the realms of thought and religion. Rush, however, avoided the label “materialist,” given the association that often existed between materialists and atheists. It is important to note that members of Jefferson’s inner circle of like-minded thinkers did not subscribe to an organized theological or philosophical school per se, save the umbrella-like American Philosophical Society in Philadelphia. Each individual possessed unique religious beliefs, and there was some variety between Jeffersonians in the manifestation of their respective views. Nonetheless, the high degree to which Jeffersonians agreed on philosophical issues makes a strong case for the validity of a model of “typical” Jeffersonian beliefs.
Rush believed that the human mind and the process of thought were material entities, and that physical forces caused them to act as they did. He argued that the Divine creation of man, depicted in the “breath of life” passage in Genesis, “thus excited in him [man] animal, intellectual, and spiritual life, in consequence of which he became an animated human creature.” This physical process of jump-starting the lungs provided the force that drove every human function, including mental activities. In his Lectures on the Mind, Rush left no room for debate on his beliefs over the material basis for the mental faculties:
…there is no such thing as a mind either immaterial or material, but that thought, and all the operations of what is called mind, are the effects of external and internal impressions upon the brain…thought is as much the result of the organization of the brain, as vision is of the structure of the eye, or hearing of the structure of the ear…
For Rush and the Jeffersonians, the human mind and thinking were active, material processes, and they scoffed at metaphysical explanations for thought. Jefferson himself argued that thought was “an action of a particular organization of matter,” much like magnetism and gravity. Continuing on this track, Jefferson questioned how a metaphysical, non-material entity like spirit, “which has neither extension nor solidity, can put material organs into motion.”
Concurrent with this belief in the material basis for human thought was the conviction that the great variety in human minds reflected the variety found in the physical attributes of any animal. Rush declared that the differences in the minds of men were akin to differences in human physiques. Thus intellectual, political, and theological conformity were not ideals to the Jeffersonians any more than, say, blond hair, green eyes, or any other physical characteristic. The development of ideal standards of thought ran counter to the designs of the Creator, in whose infinite wisdom begat intellectual variation among humans. To attempt to build such models of ideal thinking not only risked offending God, but were the vainglorious blunders of fools.
Benjamin Rush, while firmly ensconced in both the philosophy of the eighteenth century and the western European religious traditions, nonetheless advanced the nascent American traditions of psychology and psychiatry. Mental illness was no longer a sign of demonic possession or moral failure, but was seen by Rush and his adherents as a physical disease; this vision of a holistic approach to medicine and psychology has only recently come to bear fruit. We know today, for example, that there is a chemical basis to mental processes, and that any abnormalities are likely the result of an imbalance of neurotransmitters. Modern psychiatry owes a significant debt to the work of Benjamin Rush.
By extension, the demystification of mental illness brought about a revolution in the care of patients with mental illness. Patients were no longer to be feared as agents of Satan, or as moral degenerates who could corrupt those with whom they came in contact. Instead, persons with mental illnesses could be treated with humane measures, and began to receive compassion from the larger society in place of scorn. Rush and his teachings brought the study of the mind to a more elevated science, and imparted a uniquely American imprint upon the fields of medicine, psychiatry, and psychology.