Page 26 - Summer2008

Rush Early in his career he was appointed Profes- Rush developed the “heroic dose” of

continued to sor of Chemistry at the College of Philadelphia. calomel during the yellow fever epidemic in
Rush’s lectures were open to the public and he Philadelphia in the autumn of 1793. In Septem-
be vocal in his espoused chemistry only in its relation to medi- ber 1793, he came across a book written in 1741,
support for cine. He was an excellent orator and was highly which Benjamin Franklin had given to him many
heroic doses esteemed as a chemist, despite his ignorance of years earlier. As treatment for “bilious fever,” in
modern theories of his time (including the exis-
particular yellow fever, the book recommended
of calomel tence of oxygen, discovered in 1771). He was “vigorous purges to rid the viscera of their ‘fecu-
for “virtually also well published, thanks to supporters such as lent corruptible contents.’”
30
every Benjamin Franklin, who “encouraged” contribu- Armed with this information, he developed
tions from physicians. In 1774 Rush was chosen a powder consisting of calomel and jalap, another
disease,” as a delegate to the rst Continental Congress and strong purgative, and recommended that it be

and calomel became acquainted with many important histori- given three times daily. Rush later wrote that the

became the cal gures, including George Washington and the medication “perfectly cured four out of the  rst
Adamses, and was a signer of the Declaration of  ve patients to whom I gave it, notwithstanding
first remedy Independence. In 1777, after working as a doc- some of them were advanced several days in the
of choice for tor during the Revolutionary War, Rush left his disorder.” 31

practitioners position in Congress and was appointed Surgeon Rush lost hundreds of patients during the
General (later titled “Physician General”) of the epidemic and prepared so many doses of his “bil-
of what Middle Department of the Continental Army. ious pills” (made from calomel and jalap) that his
became He resigned this post in 1778 and returned to hands were rumored to have turned black from
known as Philadelphia, at which point he became one of the mercury. Even though a great many patients
the most inuential gures, for better or worse, in died “despite” the heavy doses of calomel and

“heroic American medical history. Much of his inuence bleeding and despite the attacks on Rush by his

medicine.” came as a teacher; between 1779 and 1812 he fellow doctors, who did not agree with the harsh-
taught over 2800 students and apprenticed many ness of his “heroic” methods, Dr. Rush’s impact
more. He also served as chairman of the Theory on American medicine regarding high doses of
and Practice of Physic at what would become the calomel would continue for another 70 years,
University of Pennsylvania, and at one time he until the end of the Civil War. 32
was called “the greatest physician in the United
States.” 28 HEROIC MEDICINE AS STANDARD
His was a time of various “bilious fevers” ORTHODOX THERAPY
and acute diseases, such as typhus, typhoid Throughout the 19th century medical
fever, malaria, cholera, dysentery, yellow fever knowledge grew tremendously, but during Rush’s
and dengue. Practitioners had little knowledge day, physicians knew little about pathology,
of hygiene (although Rush was one of the lead- diagnostics or physiology. There were as many
ers in this area), and most fevers were lumped schools of thought on these matters as there were
together into one illness, with similar treat- remedies and therapies.
ment—bleeding and purging—prescribed for Men like Rush practiced “heroic medi-
all. Rush believed in abstaining from alcohol, cine,” believing greatly in the bene ts of copious
but nevertheless often prescribed it in copious bleeding and excessive purging; surgeons were
amounts as a medicine, for example, with a daily becoming skilled in operating even though they
dose of cinchona bark (from which quinine is had no anesthesia; there were homeopaths, who
derived). According to Binger, “his fondness believed in minute doses based on the laws of
for emetics and purges was much in evidence; Samuel Hahnemann; the Thomsonians, eclectics
ipecacuanha, tartar emetic, calomel and jalap” and botanists, followed the teachings of Samuel
were prescribed “freely;”in fact he believed so Thomson; the Indian doctors used Native Ameri-
strongly in the effects of these medicines that he can remedies including sweating; and many who
helped to organize a free pharmacy for the poor used combinations of these approaches.
in Philadelphia in 1786. 29 There was no health insurance, no licens-
24 Wise Traditions SUMMER 2008