Rush: Revolution, Madness, and the Visionary Doctor Who Became a Founding Father. Stephen Fried. New York: Crown, 2018.

Summary: A full-length biography of this doctor-founder of the American republic covering his personal life and beliefs, advocacy, war service, and friendships with the Founders, and estrangement from Washington.

He turns up in almost every biography of an American founder or account of the American War of Independence. He played a pivotal role in battle field hygiene, the training of American doctors, and in the field of mental illness. His profile adorns the logo of the American Psychiatric Association. But one has to look hard for accounts of the life of Dr. Benjamin Rush until recently. Even John Adams expressed displeasure that Ben Franklin received far more notice although he believed Benjamin Rush the better man. In the past year, this balance has begun to be redressed. Harlow Giles Unger, who has written on most of the Founders has published a biography on Rush.

A fellow Philadelphian, journalist Stephen Fried, has completed what may be the definitive account of Rush’s life, using a growing archive of Rush’s correspondence and other documents, to give us a many-faceted portrait of one of America’s most distinctive Founders.

He begins with a spirited young boy who lost his father before turning six, lived with an aunt and uncle while attending Reverend Samuel Finley’s school. He graduated from Princeton at fourteen, apprenticed under Dr. John Redman for the next five years, and then went to Edinburgh for medical studies.

On his return, he is offered a chair in Chemistry at the College of Philadelphia, while alienating two of his mentors, John Morgan and William Shippen over credits on publications. With Shippen, this is just the beginning.

He is friends with nearly all the Founders, particularly as their paths crossed in Philadelphia. His welcome and advice to John Adams was critical in winning the support of the other colonies to the resistance that began in Massachusetts. He was highly esteemed by Franklin and succeeded Franklin as chair of the Philosophical Society of which they were both a part. He was a sounding board to Thomas Paine as he composed Common Sense. He is one of the youngest signers of the Declaration of Independence.

Like others, he sets aside personal interests to head a surgical department for the war effort, and confronts horrible battlefield conditions and Dr. Shippen’s mishandling of funds and resources as Surgeon General. His efforts to protest this ultimately fail, but here, as elsewhere, his pen achieves what he otherwise could not in his manual for battle field hygiene, implemented over the next hundred years and saving many lives. The other, and more profound controversy of the war concerned an unsigned letter he sent to Patrick Henry expressing reservations about Washington’s leadership. Henry passed the letter along to Washington, who recognized Rush’s handwriting. Relations were never warm, thereafter. In later years, he expressed both regret for the letter, and admiration for Washington.

The same passion that got him into trouble also made him an effective advocate with many causes. He was a devout believer, but participated in both Presbyterian and Anglican congregations and was an early proponent of religious tolerance. He loved conversation with skeptics like Jefferson while remaining orthodox in his own beliefs (even reciting an Anglican prayer book prayer on his deathbed). He advocated for the rights of blacks and the abolition of slavery (although he owned a slave that he only eventually and quietly emancipated) and helped start the first African church in Philadelphia. He was a proponent of education, founding Dickinson College, and advocated for the education of women. Perhaps most significant, with his appointment to the Philadelphia Hospital, he noticed the poor conditions of those suffering from mental illness, campaigning for separate and more humane treatment facilities. One of the most poignant aspects of this focus was that his eldest son John was one of his patients. He pioneered occupational therapies and treatments for addiction.

As a doctor, Fried’s portrait is of a dedicated, even heroic figure, tragically wedded to the dubious or even harmful methods of his day, notably the bleeding and purging of patients, which may have hastened mortality in a number of cases. His medical treatises often are extended defenses of these measures. Still, he remained in Philadelphia through a horrendous yellow fever epidemic, contracting (and surviving) the disease himself. He was considered one of the leading medical figures of the day, consulting with Lewis and Clark, provisioning them with medicines, including what they reported to be a very effective laxative! His greatest medical contribution may have been the hygiene and sanitation measures he recommended for the military that no doubt reduced the number of deaths from conditions in military camps.

While Rush’s correspondence got him in trouble in the early part of his life, at another point, he was responsible for a reconciliation that led to a most amazing exchange of letters. For a dozen years, Adams and Jefferson had been estranged from each other since the election of 1800. Rush was friends with both. He began by sharing a “dream” with Adams (a common device in their letters) about Adams and Jefferson resuming their friendship. Slowly, he helped the two of them resume correspondence, which eventually swelled to over 280 letters before both died July 4, 1826, fifty years after signing the Declaration of Independence with Rush. Both would outlive Rush, who died either of typhus or tuberculosis in 1813.

Altogether Rush and his wife Julia had thirteen children, a number dying in infancy or youth (not uncommon at this time). Richard, the second born served in both the Madison and Monroe administrations in cabinet positions while James followed in his steps as a physician and became a prominent figure, marrying into wealth.

Fried’s portrayal drew me in by exploring this distinctive man in his greatness and flaws. His youthful ambition and sense of rectitude overpowers his judgment of what is both appropriate and possible. He could be quite prickly in defending his own reputation, especially during the yellow fever epidemic, where his methods, if not his dedication, could be questioned. He shines in his friendships, his advocacy, and his love for his wife. He also seems something of a tragic figure as he watches the dissolution of his eldest son’s sanity, and the hopes that he would follow in his steps. I suspect he wasn’t an easy man to have as a father.

Fried has done us a great service. He has chronicled in full the life of one of the Founders who obviously deserves far more attention than he has received. Instead of being a bit player in the stories of others, we are introduced to Rush on his own terms, and begin to understand why he was in all the other stories. Were it not for him, we would not have the sparkling correspondence between Adams and Jefferson and the humane treatment of the mentally ill. You might say, he was the doctor who assisted at the birth of a nation.

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Disclosure of Material Connection: I received this an advanced review e-galley of this book from the publisher via Netgalley. I was not required to write a positive review. The opinions I have expressed are my own