Their “Abracadabra”: Benjamin Rush’s Influence on the Ohio Valley

From his base in Philadelphia, Benjamin Rush attained a reputation as the most prominent, well-respected physician of his era. As Rush’s students moved into the Ohio River valley, so too did Rush’s approach to the practice of medicine, for between 1790, when his protégé Frederick Ridgely opened his practice in Lexington, Kentucky, and 1813, the year of Rush’s death, many of his former students in the Ohio Valley wrote to him requesting his medical counsel. While Rush’s influence in the mid-Atlantic region and the South has received attention, an examination of the letters Rush’s alumni wrote to him from the Ohio Valley provides abundant evidence of his substantial influence on medical practices in the West. This correspondence indicates that in the decades before Rush’s death these men were adhering closely to his heroic, that is, aggressive, depletive practices with bloodletting and mercury purges the most common techniques employed to treat a variety of conditions.¹

Medical-school-trained physicians in general shared a faith in bloodletting and deemed it a matter of professional ethics. Yet it was a dangerous procedure. A psychiatrist has made the point that a dangerous remedy in the hands of a prestigious physician, like Rush, actually creates a placebo effect. “How else,” asks John S. Haller Jr., “could one rationalize the ‘cures’ brought about by bleeding, blistering, and the heroic uses of calomel and tartar emetic?”²

Bloodletting instruments (c. 1838). u.s. national library of medicine

Venesection, calomel and other cathartics, emetics, and blisters had the virtue of producing a rapid effect, thereby demonstrating dramatically to the patient and onlookers that the physician was in control. Historian Elaine Breslaw writes, “The real power in the doctor’s arsenal of cures was in his…aura of authority and omniscience.” Naturally, Rush’s protégés in both the urban and rural Ohio Valley aspired to possess this gift. By the same token, being known as Rush’s correspondents and former students no doubt convinced their patients and communities, as well as themselves, that they were full-fledged members of the medical establishment.³

Benjamin Rush (1746-1813). library of congress

What was it about Rush that persuaded his students to believe in him? First, he was one of the most eminent Americans of his day. A signer of the Declaration of Independence, he practiced and taught medicine in Philadelphia his entire adult life and was regarded as the most prominent American physician of that period. Standing five feet, nine inches, he had “the look of a savant grown old in the service of science,” said one biographer. A student in the doctor’s later days described him as “very erect and rather slender…His face was thin,…his head…was nearly bald from the crown forward, his hair clubbed behind and powdered.… His cheeks were fallen in and many of his front teeth were missing,… His bearing was rather military… To everyone who bowed to him, poor or rich, he took off his hat, greeting them…with ‘I hope you are very well, sir.’”⁴

Dr. Rush taught at the College of Philadelphia and the University of Pennsylvania for forty-three years (1769–1812). He taught “perhaps three-quarters” of U.S. medical students who graduated in those years, 2,872 students having been registered in his classes from 1779 to 1812. An American intellectual historian noted in 1803 that Rush did “more in his capacity as teacher than all the other physicians in the United States, collectively, to diffuse a taste for medical inquiries, and to excite a spirit of observation, and of laudable ambition, among the students of medicine in our country.” Lamentably, however, Rush was misguided in his narrow theory that all disease needed to be treated by restoring the body’s equilibrium through aggressive treatment to relieve vascular tension. Breslaw even maintains that “he alone may have held back American medicine for at least two generations” by promoting his wrongheaded approach.^5...