The quick development of safe, effective COVID-19 vaccines has been one of the great triumphs in U.S. medical history. Nobody would have been more delighted to see it than the nation’s first great physician, the patriotic Philadelphian Benjamin Rush. A strong believer in inoculations to prevent smallpox, he pressed fellow delegates to the Second Continental Congress to get them. (Passing on the advice in late July 1776, John Adams assured Abigail that “Rush has as much success as any without Exception.”) And he convinced George Washington to have his troops vaccinated, the single most important medical decision affecting the outcome of the war. He would have been astounded at the science behind the messenger RNA (mRNA) vaccines and ecstatic at their ability to bring the coronavirus pandemic under control. As for the rest of the U.S. response, however—the early fumbling, the political squabbling, the weaponized misinformation, the hecatombs of corpses—Rush would have found it crushingly familiar. Because it happened to him, too.

By the 1790s, the founders’ idealistic hopes for a new kind of republicanism were curdling. Instead of a reasoned discussion about the public interest, American politics was becoming an existential battle between two warring camps. Each routinely spread lies about the other in scurrilous newspapers that served as party organs. And beneath the surface lay the question of slavery and its legacy. When a devastating yellow fever epidemic struck the new nation’s capital, Philadelphia, in 1793, Rush was thrust back to center stage. The Anthony Fauci of his day, he struggled to offer the best public health guidance possible but couldn’t avoid getting sucked into the political maelstrom. He survived the fever himself, only to see his advice mocked, his expertise and motivations attacked, and his integrated medical staff slandered. After being brought up to speed on everything that happened to us over the last 18 months, Rush would conclude science had improved a lot. People and politics? Not so much.

OUTBREAK

In 1793, the Constitution was six years old, the Bill of Rights two, and George Washington had just been reelected to a second term as president. The French Revolution had created deep divisions across the Atlantic, hardening the personal rivalries that were coming to the fore in the new American republic. Washington’s closest aide, Treasury Secretary Alexander Hamilton, was forming the Federalist Party, roping in Vice President John Adams, and Secretary of State Thomas Jefferson and fellow Virginian James Madison were forming the rival Democratic-Republican Party. And the independent intellectual Rush, good friends with both Adams and Jefferson, was caught in the middle.

In February, Congress passed the Fugitive Slave Act, giving slaveowners new legal power in the South as well as the right to “reclaim” suspected slaves in the North. Free Blacks in Philadelphia—about six percent of the city’s population of 50,000—grew increasingly concerned about their status, especially when some of them were physically ejected from worshiping on the ground floor of St. George’s Methodist Church, which had previously been integrated. Two of the rousted congregants, the Reverends Absalom Jones and Richard Allen, decided the time had come to form their own church, the first free Black house of worship in the country. Rush, a pioneering abolitionist, had been urging them to do this for years, even drawing up building and fundraising plans. And so he was thrilled to attend, on August 22, 1793, a remarkable party to celebrate the raising of the new church’s roof.

First, 100 white people involved with the project sat down at a long table, where they were served dinner by free Black congregants. Then the white attendees rose, 100 Black men and women took their place, and the white guests served them. The church elders insisted Rush take the head of the table for both sittings, and the evening was filled with toasts, tears, and rejoicing.

Believing that all should be able to share in the celebration, earlier in the day Rush had sent a wheelbarrow full of melons to the local prison for “persons who are suffering in the jail for their offenses against society,” hoping that while “partaking of this agreeable fruit they will remember the BEING who created it and still cares for them, and that by this and other acts of kindness conveyed to them by his creatures, he means to lead them to repentance and happiness.” Rush finally retired, he wrote his wife, Julia, after “a day to be remembered with pleasure as long as I live.” It was to be the last for a while.

By the 1790s, the founders’ idealistic hopes for a new kind of republicanism were curdling.

Toward the end of summer in Colonial Philadelphia, as flu season got underway, doctors often became worried: What did that cough mean? Was that ache significant? The night before the roof-raising dinner, Rush had expressed concern about what might be coming this year. “A malignant fever has broken out in Water Street,” he told Julia. It had “already carried off twelve persons” on one block, one of whom had died only 12 hours after the first symptom appeared. Rush had treated 11 patients so far, three of whom had died. All the deaths were concentrated in a small area close to the Delaware River, north of Market Street. Doctors and port officials thought the illness was caused by toxic air “produced by some damaged coffee which had putrefied on one of the wharves.” Rush prayed the fever wouldn’t spread “beyond the reach of the putrid exhalation which first produced it.”

With every day that passed, however, the signs became clearer: the yellow skin, the black vomit, the gray, horrible demise. Rush realized he was seeing an outbreak of yellow fever—and a bad one. Many doctors fled town, as did most government officials (who had just returned from summer vacation). On August 25, Rush met with the city’s remaining doctors at the College of Physicians; as the most experienced clinician and educator, he was tasked with drafting emergency public health recommendations for the crisis.

The first measure suggested was “to put a stop to the tolling of bells” for funerals—too many people were dying. Citizens were advised to avoid “unnecessary intercourse” with those infected, and houses with infections were ordered to be marked with a small red flag. The dead were to be buried as privately as possible and the city streets and wharves kept clean. Recommended personal preventive measures included rest, sun and fresh air, warm clothes, and temperance. Rush told Julia he hoped the recommendations would “do good, but I fear no efforts will totally subdue the fever before the heavy rains or frosts of October.”

SPREAD

By August 29, the fever was everywhere in the city. None of the common remedies—bark, wine, blistering, cool baths—seemed to help. On September 3, a desperate Rush tried some of the more aggressive treatments of the day: purges, and then bloodletting. He began with purges using salts and cream of tartar, and when they didn’t work, he upped the strength, turning to small amounts of calomel (mercury chloride) and jalap (a Mexican tuber) downed with some “chicken water or water gruel.” The initial results of this “mercurial antidote” seemed promising, so he recommended it for general use.

Other doctors were skeptical, however, especially after Rush added light bloodletting to the treatment—and then, when the fever wouldn’t relent, pushed more heroic doses of purgatives and bleeding. Two critics published a pamphlet recommending an alternative treatment consisting of nothing more than fresh air, mild purgatives, and laudanum (an opiate) or ammonia to encourage perspiration. Rush fought back vigorously, and all sides cherry-picked scant evidence to support their case. Whenever any patients on the milder course of treatment recuperated, the critics argued it was proof Rush’s extreme methods were unnecessary and counterproductive. And whenever any of them died, Rush argued that bloodletting and purging might have saved them.

Of course, none of these physicians really knew how to prevent or treat yellow fever. (Even today, no treatment reliably targets the yellow fever virus. Some patients recover on their own while being kept hydrated and comfortable, and the rest die.) Nor did they know the true source of the disease—it was carried by infected mosquitoes. But they were doctors and people were dying in cartloads all around them, so they had to do something. And this being the Enlightenment, they had to talk about it. As a result, intense debate broke out over everything—where the disease had come from, what caused it, whether it was contagious, how to counter it, even whether certain sick people had it—or just a seasonal flu. But with no actual information to rely on, partisan rancor filled the void, and the supposedly scientific debates quickly devolved into nasty political mudslinging.

Benjamin Rush by Edward Savage
Benjamin Rush by Edward Savage
Jim Graham / grahamstudios.com

Rush attempted to remain nonpartisan. Yet as someone known to be personally very close to Adams but politically closer to Jefferson and his Democratic-Republican values, Rush was a juicy political target for either side. When Hamilton fell ill in early September, he chose the lighter course of treatment. After recovering, he published a letter in the Federal Gazette, claiming his physician’s treatment “reduces [the disorder] to one of little more than an ordinary hazard.” So the papers began calling this the “Federalist cure” in contrast to Rush’s “Republican cure.”

Jefferson, meanwhile, went around telling people Hamilton’s yellow fever cure was fake because he never had the disease in the first place. “He had been miserable several days before from a firm persuasion that he should catch it,” he wrote Madison. “A man as timid as he is on the water, as timid on horseback, as timid in sickness, would be a phaenomenon if his courage, of which he has the reputation in military occasions, were genuine. His friends, who have not seen him, suspect it is only an autumnal fever.”

The same day Hamilton’s letter appeared in the papers, September 11, so did a front-page announcement signed by Rush’s friends in the Black clergy, the Reverends Allen and Jones. With so many white medical workers having fled the city, they wanted the public to know their community stood ready to help. “As it is a time of great distress in this city, many people of the Black colour, under a greatful remembrance of the favour received from the white inhabitants, have agreed to assist them as far as in their power for the nursing the sick and burial of the dead.” Rush had encouraged the initiative. (Although there is no reason to believe the Black clergy would not have assisted him anyway, Rush did believe one of the only medical journal articles available on yellow fever in America at that point, which claimed Blacks were immune.)

The following day, Rush offered the public his latest findings, noting, “I have bled twice in many, and in one acute case four times, with the happiest effects.” He published the recipe for his “antidote,” tested on several dozen cases in recent days, and suggested patients bleed themselves if they couldn’t get a doctor to do it for them. Leaving the city was no longer necessary, he said presumptuously, “because the disease is now under the power of medicine.”

Hundreds died each day as Philadelphia’s dwindling crew of doctors debated whose “antidote” worked best.

His writings had an immediate impact. Secretary of War Henry Knox told the president a few days later that “Doctor Rush’s success . . . is great indeed. I understand that he has given his medicine to upwards of 500 patients. He does not pretend to say they have all had the yellow fever but many undoubtedly had, and he lost only one since he adopted his new mode. He has acquired great honor in visiting every body to the utmost of his power.” Another Knox dispatch was more succinct: “Everybody whose head aches takes Rush.”

On September 14, however, Rush came down with the fever himself. And soon many of his Black friends and staff did, too—even as they faced racist attacks from many of the whites they were trying to help. “The Negros are everywhere submitting to the disorder,” Rush lamented to Julia. “Rich. Allen . . . is very ill. If the disorder should continue to spread among them, then will the measure of our sufferings be full. . . . O! that God would rend the heavens and come down! And save our guilty city from utter desolation!”

Throughout the fall, hundreds died each day as Philadelphia’s dwindling crew of doctors debated whose “antidote” worked best. Rush’s case worsened dramatically in mid-October, and he assumed he was dying, but he managed to pull through (although his sister and two of his assistants did not). Julia told him he had become a national hero for his efforts, but he gloomily noted the view from inside Philadelphia was different. “I am supposed to have created a great many friends and a large fund of gratitude among my fellow citizens. This is far from being true. The relations and patients of the physicians whose practice I opposed have taken part with them in their resentments, and I am now publicly accused at every corner of having murdered the greatest part of the citizens who have died of the present disorder.”

AFTERMATH

On November 14, Pennsylvania Governor Thomas Mifflin officially declared the epidemic over. The day before, Rush’s friend Mathew Carey published A Short Account of the Malignant Fever Lately Prevalent in Philadelphia, the first history of the epidemic. It sold out printing after printing, not least because it included a comprehensive list of the “most noted inhabitants” of Philadelphia who had died. It also revived all the medical controversies from the fall and fueled a poisonous new one, by accusing Black medical volunteers of having gouged and stolen from their white patients during the crisis. The battle against the fever had ended. The battle over the narrative was just beginning.

In January 1794, Jones and Allen published their response to Carey, A Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, in the year 1793: and a Refutation of Some Censures, Thrown upon Them in Some Late Publications—the first copyrighted book ever written by African Americans. It described what Black Philadelphians had done during the epidemic in extraordinary heroic detail. “We feel a great satisfaction in believing, that we have been useful to the sick,” they concluded, “and thus publicly thank Doctor Rush, for enabling us to do so. We have bled upwards of eight hundred people, and do declare, we have not received to the value of a dollar and a half, therefor: we were willing to imitate the Doctor’s benevolence, who sick or well, kept his house open day and night, to give what assistance he could in this time of trouble.”

They closed the book with a postscript addressed “to Those who Keep Slaves, and Approve the Practice.” It began:

The judicious part of mankind will think it unreasonable, that a superior good conduct is looked for, from our race, by those who stigmatize us as men, whose baseness is incurable, and may therefore be held in a state of servitude, that a merciful man would not doom a beast to; yet you try what you can to prevent our rising from the state of barbarism, you represent us to be in, but we can tell you, from a degree of experience, that a black man, although reduced to the most abject state human nature is capable of, short of real madness, can think, reflect, and feel injuries, although it may not be with the same degree of keen resentment and revenge, that you who have been and are our great oppressors, would manifest if reduced to the pitiable condition of a slave. We believe if you would try the experiment of taking a few black children, and cultivate their minds with the same care, and let them have the same prospect in view, as to living in the world, as you would wish for your own children, you would find upon the trial, they were not inferior in mental endowments.

We do not wish to make you angry, but excite your attention to consider, how hateful slavery is in the sight of that God, who hath destroyed kings and princes, for their oppression of the poor slaves; Pharaoh and his princes with the posterity of king Saul, were destroyed by the protector and avenger of slaves. . . . We wish you to consider, that God himself was the first pleader of the cause of slaves.

The church-building efforts celebrated at the gala dinner held on the eve of the epidemic bore fruit the following summer and ultimately yielded not one house of worship but two. Absalom Jones opened the African Episcopal Church of St. Thomas on July 17. Richard Allen opened the Mother Bethel African Methodist Episcopal Church on July 29. Today, the AME Church has more than 2.5 million members across 7,000 congregations.

PORCUPINE

Rush published his own account of the epidemic that June, a 350-page tome with full documentation of everything. He took particular care to review Hamilton’s case, concluding that since the treatment in question was demonstrably ineffective, it could not have caused the recovery. Either the treasury secretary’s illness was “very light, or Mr. Hamilton owes more to the strength of his constitution, and the goodness of heaven, than most of the people who recovered from the disorder.” Then Rush went back to his medical practice, his teaching, and his social reforms.

But yellow fever panic didn’t die with the mosquitoes of late 1793. It returned every August for years, in every major American port city, even when there weren’t major outbreaks. And soon, perhaps inevitably, it got dragged into the Federalist era’s politics of personal destruction—which only worsened after Adams defeated Jefferson for president in 1796.

The following year, Rush found himself in the cross hairs of one of the nastiest figures in early American journalism, a British provocateur named William Cobbett then living in the colonies who wrote under the pseudonym “Peter Porcupine.” In his pamphlets and newspaper, Cobbett mixed reporting with brutal satire, often running fake letters from invented characters that skewered real people—without readers necessarily understanding what was true and what was not. His true passion was tearing down authority figures, and few represented, or claimed, authority as much as the sainted Dr. Rush.

Cobbett took the notion Hamilton had helped publicize—that Rush’s aggressive treatment was wrong—and spun it into a conspiracy theory, saying Rush had actually killed everyone who allegedly died of yellow fever. When an outbreak occurred in the fall of 1797, Cobbett took the occasion to rip into Rush just for fun. A favorite device was writing in the voice of an invented bartender who announced he was quitting the business and devoting his life to bloodletting, because the money was better and “dead men never tell tales.” The bartender added that he would hire “a few nurses,” referring to Rush’s Black volunteer aides. “They will never desert their patients, as I have engaged to supply them with excellent gin and have also promised them the pillage of such of my patients who have determined to die.”

Yellow fever panic didn’t die with the mosquitoes of late 1793.

Rush was infuriated by the attacks—not unlike Adams, who suffered even worse and ultimately signed the Alien and Sedition Acts to suppress the Democratic-Republican press. Hoping a change of scenery might help, he inquired about a job at Columbia College, and four days later, the Columbia faculty voted unanimously to appoint him their new chair of medicine. But Hamilton stepped in to block the appointment at the board level, and Rush withdrew. Adams gave him a well-paid part-time job as treasurer of the U.S. Mint in case his medical practice didn’t survive.

In October, against all his friends’ advice, Rush sued Cobbett and another journalist, launching one of the first high-profile slander cases under the new Constitution. The lawsuit took two years to come to trial, but on December 14, 1799, Rush won a resounding victory. The jury returned a verdict after deliberating for two hours, ordering Cobbett to pay Rush $5,000 (more than $100,000 today) and never write about him in Pennsylvania again. Cobbett promptly fled the state.

A couple of days earlier, George Washington had come down with an infection after working on the farm at Mount Vernon in the rain. It began as a sore throat and steadily got worse, and after being bled and purged and tracheotomied to no positive effect, Washington succumbed--just as the Rush-Cobbett verdict came.

Cobbett saw blood and pounced. He set himself up in New York, started a new newspaper, and picked up his yellow journalism where he had left off. Cobbett gained readers by claiming Rush was responsible for Washington’s death:

Thus, on the fatal 14th of December, on the same day, in the same evening, nay, in the very same hour, that a Philadelphia court & jury were laying on me a ruinous fine for having reprobated the practice of Rush, GENERAL WASHINGTON was expiring while under the operation of that very practice. On that day the victory of RUSH and of DEATH was complete.

Soon after, Cobbett combined all his Rush attacks in one handy updated guide, and Rush’s oldest son, John, snapped. Seeing himself described in print as “an impertinent puppy, a waylaying coward, a liar, and a rascal,” John, who had anger management issues, immediately jumped on a stagecoach to New York to seek satisfaction. His distraught father dispatched a hasty note to a friend begging him to intercept John and prevent a tragic altercation. The friend caught up with John in time—barely—and persuaded him to let somebody else confront Cobbett in person. The meeting didn’t go well, however, and passions continued to run high. Rush threatened a second slander lawsuit in New York; Cobbett consulted Hamilton, who assured him he had nothing to fear. But the controversy petered out when Cobbett fled back to Great Britain, choosing to torment the powerful there instead of the Colonies.

THE DREAM

The election of 1800 was a rematch between Adams and Jefferson, even more vicious than the first. This time Jefferson won, taking up residence afterward in the new White House in the new national capital farther south on the Potomac. A depressed Rush mourned the loss of his city’s influence and his own close friends. Once Adams and Jefferson left for Federal City, he never saw either again.

But Rush was not sorry to leave politics behind, given what it had become. In an autobiography he was drafting for his children, one that included candid assessments of every signer of the Declaration of Independence and Revolutionary War general, he begged his sons to never run for public office. “In battle men kill without hating each other,” he wrote. “In political contests men hate without killing, but in that hatred they commit murder every hour of their lives.”

Rush spent the early years of the new century focusing on revolutionizing the care of mental illness and addiction, improving medical education, reforming prisons and criminal justice, and fighting racial prejudice and slavery. Jefferson occasionally consulted him as president about scientific and personal health issues—including his own battle with constipation. He also had Rush teach Meriwether Lewis how to care for himself and Clark during their expedition and give them the questions they should ask Native Americans they met. (Because of the mercury in the industrial-strength laxatives Rush suggested they use for almost any ailment, we know where Lewis and Clark went because we know where they went.) But Rush didn’t communicate with Adams, nor did Adams and Jefferson communicate with each other, so deep had the rift between them become.

Then, in February 1805—after Jefferson had been reelected and Hamilton had been killed in a duel—Adams wrote out of the blue to his old friend Rush. “Dear Sir,” it began. “It seemeth unto me that you and I ought not to die without saying good-bye or bidding each other Adieu.” And with that, as if no time had passed, an epic correspondence resumed between the now aging comrades. Rush was thrilled to have Adams back in his life, and their wives were overjoyed when letters arrived because they buoyed both men’s spirits. (Julia Rush joked the letters were less like the correspondence of founders trading wisdom than “two young girls” writing “about their sweethearts.”)

John Trumbull's 1819 painting, "Declaration of Independence"
Declaration of Independence by John Trumbull, 1819
Pixabay

As the years went by, Rush realized that the political was personal: that the greatest remaining gift he could give his country was the balm of reconciliation, somehow bringing Adams and Jefferson together again. In October 1809, he raised it with Adams, describing a dream he’d had in which one of his children read him a page from a future history of the country:

Among the most extraordinary events of this year was the renewal of the friendship & intercourse between Mr John Adams and Mr Jefferson, the two expresidents of the United States. . . . A difference of opinion upon the Objects and issue of the French Revolution separated them during the years in which that great event interested and divided the American people. . . . The former retired with resignation and dignity to his Seat at Quincy where he spent the evening of his life in literary and philosophical pursuits surrounded by an amiable family and a few Old and Affectionate friends. The latter resigned the Chair of the United States in the year 1808 sick of the cares and disgusted with the intrigues of public life, and retired to his Seat at Monticello in Virginia where he spent the remainder of his days in the cultivation of a large farm agreeably to the new System of husbandry.

In the month of November 1809 Mr: Adams addressed a short letter to his Old friend Mr: Jefferson in which he congratulated him upon his escape to the shades of retirement and domestic happiness, and concluded it with assurances of his regard and good wishes for his Welfare. This letter did great honor to Mr Adams. It discovered a magnanimity known only to great minds. Mr Jefferson replied to this letter, and reciprocated expressions of regard and esteem. These letters were followed by a correspondence of several years, in which they mutually reviewed the scenes of business in which they had been engaged, and candidly acknowledged to each other all the errors of Opinion & conduct into which they had fallen during the time they filled the same stations in the Service of their country. . . .

These gentlemen sunk into the grave nearly at the same time, full of years, and rich in the gratitude and praises of their country (for they outlived the heterogenous parties that were opposed to them) and to their numerous merits and honors posterity has added, that they were Rival friends.

The Adams family loved a good Benjamin Rush dream letter. “A Dream again!” the patriarch wrote back. “I wish you would dream all day and all Night, for one of your Dreams puts me in spirits for a Month. I have no other objection to your dream, but that it is not History. It may be Prophecy.”

When a year went by without a move from Massachusetts, however, Rush started working the other side of the fence. “Your and my Old friend Mr. Adams now & then drops me a line from his Seat at Quincy,” he wrote Jefferson at Monticello.

When I consider your early Attachment to Mr. Adams, and his to you; when I consider how much the liberties & Independence of the United States owe to the Concert of your principles and labors, and when I reflect upon the sameness of your Opinions at present, upon most of the Subjects of Government, and all the Subjects of legislation, I have ardently wished a friendly and pistolary intercourse might be revived between you before you take a final leave of the Common Object of your Affections.

Rush’s letter prompted Jefferson to mull the history of his long and tortuous relationship with Adams, remembering some of their best moments. He recalled a crystallizing dinner with Adams and Hamilton in the early 1790s, as they discussed constitutional politics in a room hung with portraits of remarkable men on the walls, including “Bacon, Newton & Locke. Hamilton asked me who they were. I told him they were my trinity of the three greatest men the world had ever produced. . . . He paused for some time: ‘the greatest man, said he, that ever lived was Julius Ceasar.’” Adams, he told Rush, “was honest as a politician as well as a man; Hamilton honest as a man, but, as a politician, [he believed] . . . in the necessity of either force or corruption to govern men.”

Rush could tell he was getting close and kept up the pressure with both men. The turning point came when Jefferson reported hearing from a friend who visited Braintree telling him that Adams had railed against “the unprincipled licenciousness” of media attacks on the Virginian, saying, “I always loved Jefferson, and I still love him.” Jefferson told Rush, “This is enough for me. I only needed this knowledge to revive towards him all the affections of the most cordial moments of our lives.”

As the years went by, Rush realized that the political was personal.

Finally, on New Year’s Day 1812, Adams wrote to Jefferson. “I wish you sir many happy New Years and that you may enter the next and many Succeeding years with as animating Prospects for the Public as those at present before us. I am Sir with a long and Sincere Esteem your Friend and Servant, John Adams.” Jefferson quickly wrote back, and soon all three friends began exchanging letters excitedly.

Rush died the following year, to the deepest sorrow of his devoted companions. “Another of our friends of 76. is gone, my dear Sir,” Jefferson wrote Adams, “another of the Co-signers of the independence of our country. and a better man, than Rush, could not have left us, more benevolent, more learned, of finer genius, or more honest.” Adams responded, “I lament with you the loss of Rush. I know of no Character living or dead who has done more real good in America.” The reconnected friends, however, would continue their extraordinary correspondence in 280 letters over the next 13 years. They then died within hours of each other, exactly as Rush’s dream had predicted, on July 4, 1826—the 50th anniversary of their greatest triumph.

Rush’s passing was met with tributes and memorials across the country. City and state medical societies commissioned lectures in his honor, and many held an official period of mourning. The lectures became popular pamphlets and books, and Rush portraits and busts became popular collectibles. And then, after a while, his memory faded.

Adams and Jefferson knew just how open they had been with their friend and asked for their letters back. Rush’s son Richard, an ambitious politician in his own right (he was John Quincy Adams’s running mate in 1828), suppressed his father’s more controversial papers. Rush’s work as a reformer of prisons and asylums was first forgotten, then rediscovered and reviled, as Foucauldian theory reclassified his humanitarian projects as the beginnings of oppressive modernity and the carceral state. His groundbreaking ideas about mental illness and substance-use disorder—which helped spawn psychiatry, clinical psychology, and addiction medicine—were eclipsed by the end of bloodletting and the rise of Freud, and then Thomas Szasz abused his legacy as part of his anti-psychiatry screed in the 1970s. In 2015, the American Psychiatric Association decided it wanted a modern, generic logo and replaced one featuring a portrait of Rush—somebody few current members even recognized.

Given all that Benjamin Rush saw over the course of his life, none of this would have shocked him, although it would have saddened him somewhat. As would the return, more than two centuries later, of the exact same furies that bedeviled the republic in his day, as dangerous now as they were then. Still, he might think, I managed to get Adams and Jefferson back together. Can’t they find a way to heal, too?

Editor's Note (July 21, 2021)

A previous version of this article misidentified Henry Knox. In 1793, he was secretary of war, not George Washington's personal secretary.

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