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A bogus Benjamin Rush quote: contribution to the history of pharmacracy

I.

B
enjamin Rush (1746–1813), the ‘father’ of American psychiatry, is perhaps best known as the inventor of the ‘tranquilizing chair’. In recent decades, political and psychiatric activists have attributed a quotation to him in which he allegedly warned: ‘To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science.’ The source of this quotation cannot be found, and Rush’s remarks about ‘medical despotism’ are inconsistent with the body of his work. Other examples are cited to illustrate the thesis that false attributions, used to support and advance particular ideological causes, are remarkably resistant to efforts at correction.

Keywords: Benjamin Rush; interest groups and their agenda; ‘medical freedom’; truth‑falsehood__

Benjamin Rush (1746–1813) was a Professor of Physic and Dean of the University of Pennsylvania medical school, physician general of the Continental Army, and a signatory to the Declaration of Independence. In 1812 he published Medical Inquiries and Observations upon the Diseases of the Mind, the first American textbook of psychiatry (Rush, 1812/1962). Appropriately, he is considered the father of American psychiatry: his portrait adorns the official seal of the American Psychiatric Association.

It is the fate of such men that activists and writers with an axe to grind often falsely attribute statements to them in their quest to bolster their own arguments. Such misattributions readily assume a life of their own, in accord with the psychological law discovered by Mark Twain. He wrote (Twain, 1882):

[The ] maxim that ‘Truth is mighty and will prevail’ [is] the most majestic compound fracture of fact which any of woman born has yet achieved. For the history of our race, and each individual’s experience, are sewn thick with evidences that a truth is not hard to kill, and that a lie well told is immortal. [...] How easy it is to make people believe a lie, and how hard it is to undo that work again!’

Examples abound. One of the most successful fabrications is H. L. Mencken’s hilarious hoax about the history of the introduction of the bathtub into the United States. Written during the war‑time Prohibition of 1917, the piece ostensibly memorialized the fictitious seventy‑fifth anniversary of this momentous event. Fifty years later, Mencken (1917/1967: 592) commented:

The success of this idle hoax, done in time of war, when more serious writing was impossible, vastly astonished me. It was taken gravely by a great many other newspapers, and presently made its way into medical literature and into standard reference books. It had, of course, no truth in it whatsoever, and I more than once confessed publicly that it was only a jocosity [...] Moreover, it was exposed and denounced by various other men, for example, Vilhjalmur Stefansson, the arctic explorer (and great connoisseur of human credulity) [...] But it went on prospering and in fact is still prospering. Scarcely a month goes by that I do not find the substance of it reprinted, not as foolishness but as fact, and not only in newspapers but in official documents and other works of the highest pretensions. 

The following bogus quotation attributed to Benjamin Rush is a recent example of foolishness masquerading as fact and mistaken for it. This is, we are told, what Rush said about the relations between medicine and the state: _

Unless we put medical freedoms into the Constitution, the time will come when medicine will organize into an undercover dictatorship [...] To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un?American and despotic and have no place in a republic [...] The Constitution of this republic should make special privilege for medical freedom as well as religious freedom. (Grinspoon; 2003: 63; Lord,2 1994)

This bogus quotation – without a scintilla of evidence to support it, and with a plethora of evidence against it – has become a ‘fact.’ A search of the World Wide Web (Internet) with the search engine Google reveals dozens of entries to it. But not a single author supplies a verifiable source for it. Hence, I believe this false attribution, depicting Rush as a medical libertarian, needs to be exposed as bogus.  

It is important to remember that this is not the first time ‘humanitarian’ hagiographers of psychiatry have repainted ugliness as beauty. Famed psychoanalyst and historian of psychiatry Gregory Zilboorg recast Johannes Weyer (1515–88) from medieval demonologist into a proto‑psychiatrist who allegedly ‘recognized’ that witches were ‘mentally ill.’ According to Zilboorg (1941: 216), ‘He [Weyer] leaves no doubt but that one conclusion is warranted: the witches are mentally sick people’. With similar disregard for the truth, psychiatrists have created the legend of Philip Pinel (1745–1826) as a ‘reformer’ who ‘struck the chains off the insane.’ In fact, what Pinel had done is to medicalize the justification for incarcerating innocent persons in insane asylums (Szasz, 1970/1997: 203–4).

II.

In my book, The Manufacture of Madness, I presented a review of Rush’s psychiatric principles and practices and showed that he was a zealous advocate of the medicalization of personal and social problems and their coercive control by means of ‘therapeutic’ sanctions. In short, he was a pioneer champion of pharmacracy and the therapeutic state (Szasz, 1970/1997, 2001/2003). Anyone familiar with the history of psychiatry ought to recognize that the quotation in question is a fabrication.

In Rush’s day, psychiatry was a newborn infant. Most mad-house keepers were still clergymen, not physicians. Madness, as the term continues to imply, was associated with anger, lack of self-control, murder and suicide (‘self-murder’), in short, with behaviour regarded as sinful (Szasz, 1999/2002: 1–28). In 1774, when Rush was only twenty-eight-years old, he revealingly declared: ‘Perhaps hereafter it may be as much the business of a physician as it is now of a divine to reclaim mankind from vice’ (Rush, 1774/1967).  

To distinguish himself from the doctor of divinity, the doctor of medicine could not simply claim that he was protecting people from sin or, as Rush put it, from vice.

Badness was still, after all, a moral concept. As medical scientist, the physician had to represent badness as madness, and madness as a bona fide medical malady. He had to demonstrate, by his language and actions, that his object of study was not the immaterial soul, but a material object, a bodily disease. That is precisely what Rush did. In a letter to his friend, John Adams, he wrote: ‘The subjects [mental diseases] have hitherto been enveloped in mystery. I have endeavored to bring them down to the level of all other diseases of the human body, and to show that the mind and the body are moved by the same causes and subject to the same laws’ (quoted in Binger, 1966: 281).

Rush did not discover that certain behaviours are diseases, he decreed that they are: ‘Lying is a corporeal disease. / Suicide is madness. / Chagrin, shame, fear, terror, anger, unfit for legal acts, are transient madness’ (Rush, 1810/1948: 350). Today, some of these and many other unwanted human behaviours are widely accepted as real diseases, their existence ostensibly supported by the modern science of neurobiology.

In addition to deploying the idea of insanity to rationalize the widespread use of ‘therapeutic’ coercion, Rush (1812/1962: 263–70) also championed the insanity defence. He defined crimes as ‘derangements of the will,’ explaining: ‘I have selected those two symptoms [murder and theft] of this disease (for they are not vices) from its other morbid effects, in order to rescue persons affected with them from the arm of the law, and render them the subjects of the kind and lenient hand of medicine’ (Rush, 1810/1948: 264).  

For example, Lester Grinspoon – a Professor of Psychiatry at Harvard and a prominent advocate of so‑called ‘medical marijuana’ – believes, and would have us believe – that Rush stated: ‘To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science’ (Grinspoon, 2003: 63). In fact, Rush is on record stating the exact opposite.  

Among the many mental illnesses Rush invented was the disease he named ‘derangement in the principle of faith or the believing faculty’. Instead of defining this ailment, he illustrated it with examples of two types of ‘patients’: ‘[P]ersons who deny their belief in the utility of medicine, as practiced by regular bred [trained] physicians, believing implicitly in quacks; [and] persons who refuse to admit human testimony in favor of the truths of the Christian religion’ (Rush, 1812/1962: 273–4).

As noted, Rush defined his own ‘medical’ methods as ‘kindly.’ In fact, his ‘treatments’ consisted of inflicting pain on the patient and depriving him of liberty. The following passage illustrates his mind‑set: ‘Lying, as a vice, is said to be incurable. The same thing may be said of it as a disease [...] Its only remedy is, bodily pain, inflicted by the rod, or confinement, or abstinence from food’ (Rush, 1812/1962: 265–6). For good measure, he added: ‘Terror acts powerfully upon the body, through the medium of the mind, and should be employed in the cure of madness’ (p. 211). Rush went so far as to invent a new ‘therapeutic’ device – actually, an instrument of terror and torture – which he presciently called the ‘tranquilizing chair.’ It was but a short ideological step from the tranquilizing chair to the tranquilizing drug, each ‘administered’ against the will of the patient.

In his persona, Rush displayed all of the manifestations of psychiatric megalomania that characterize modern psychiatric thought and practice (Binger, 1966: 200). Not only did he oppose the kind of ‘medical freedoms’ the bogus quote attributes to him, he ‘diagnosed’ the ‘excess of the passion for liberty’ as a form of mental illness. Lamenting this passion, ‘inflamed by the successful issue of the [Revolutionary] war’, he explained: ‘The extensive influence which these opinions had upon the understandings, passions, and morals of many of the citizens of the United States, constituted a form of insanity, which I shall take the liberty of distinguishing by the name of anarchia’ (quoted in Boorstin, 1948: 182). Disappointed with his political efforts, he declared: ‘Were we to live our lives over again and engage in the same benevolent enterprise, our means should not be reasoning but bleeding, purging, low diet, and the tranquilizing chair’ (Rush, 1951: letter dated xxxx, in Butterfield, 1951: 1092).

To ascertain further the fabricated provenance of the quotation that is the subject of this essay, I sought the help of the Library of Congress. On 17 October 2003, I received the following reply, which requires no further comment.

Subj:_Benjamin Rush quotation

Date:_10/17/03 3:40:42 PM Eastern Daylight Time

From:_HSSref@loc.gov

To:_tszasz@aol.com

Dear Dr. Szasz:

This is in reply to your letter of September 24, addressed to the Reference Referral Service, Library of Congress. We have not found the quotation, attributed to Benjamin Rush, which you are seeking. Your suspicion that it is bogus is supported by a look at some of its words in the Oxford English Dictionary. The Dictionary records no use of ‘un?American’ until a few years after Rush’s death. ‘Under?cover’ as an adjective meaning ‘operating in secret’ does not appear until 1920.

III.

Rush’s stature in the history of American medicine alone justifies calling attention to the bogus nature of the quotation in question. It is further justified by the fact that many of the persons who cite it are academics, politicians and psychiatrists who ought to know better. The following list is merely a sampling of the individuals and organizations who make use of this bogus quote.

The American Association for Health Freedom and the Access To Medical Treatment Act (AMTA)

We strongly support the American Association for Health Freedom (web site www.apma.net) in their effort to pass the Access To Medical Treatment Act. This is a Federal bill that has been introduced in the House by Representatives Peter DeFazio, Joe Barton, and Ron Paul [...] As things stand now, those who hold one view of health care expect to be allowed to decide what constitutes legal methods of healing. It is just this kind of despotism that our Founding Fathers intended to prevent. Benjamin Rush, MD, a signer of the Declaration of Independence and personal physician to George Washington said: ‘Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an undercover dictatorship to restrict the art of healing to one class of men and deny equal privileges to others; the Constitution of the Republic should make a special privilege for medical freedoms as well as religious freedom’ (American Association for Health Freedom, 2003).

Congressman Ron Paul is trained as a physician. He also supports legislation for ‘medical marijuana’ and physician‑assisted suicide. The reference to Washington is lamentably shameless. Bloodletting – Rush’s panacea – has often, probably rightly, been blamed for Washington’s premature death from what may have the flu.

***

[...] So many massage therapists with so many kinds of training have massaged so many people with so many contraindications so many times for so many years with so many benefits reported in so many publications, but with so few, if any, well?documented cases of harm. [...] Dr. Benjamin Rush, one of the Signers of the Declaration of Independence and Surgeon General of the Continental Army of the United States, believed: ‘The Constitution of the Republic should make special provision for Medical Freedom as well as Religious Freedom. To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic. They are fragments of monarchy and have no place in a republic’. (Schatz and Brewster, 1999)

***

Demand Healthcare Freedom [...] Read the reports on our links and proposed Health Care Freedom Bill with an open mind. [...] ‘Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an underground dictatorship [...] To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic and have no place in a republic [...] The Constitution of this republic should make special privilege for medical freedom as well as religious freedom.’ Dr Benjamin Rush, signer of the Declaration of Independence. (Citizens for Health Care Freedom, 2003)

***

‘The Constitution of this republic should make special provisions for medical freedom as well as religious freedom. To restrict the art of healing to one class of man and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic.’ Benjamin Rush, M.D., Leading Allopath During the Founding of America. (OKHealthfreedom, 2001)

***

Thomas Jefferson and Dr. Benjamin Rush (who was George Washington’s personal physician and a signer of the Declaration of Independence) both foresaw that the federal government might someday attempt to control medicine. Dr. Rush gave this diagnosis: ‘Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an underground dictatorship [...] To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un?American and despotic and have no place in a republic [...] The Constitution of this republic should make special privilege for medical freedom as well as religious freedom’. (Un Sacco di Canapa, n.d.)

***

Our Mission is the advancement of Hyperbaric Oxygen Therapy used in traditional circumstances as well as the prevention and enhancement aspects of your health. [...] ‘Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an undercover dictatorship [] To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un?American and despotic and have no place in a republic [] The Constitution of this republic should make special privilege for medical freedom as well as religious freedom.’ Benjamin Rush, M.D., Signer of Declaration of Independence, Physician to President George Washington (Rapid Recovery Hyperbarics, 2003).

***

A World Without Cancer

[...] In order to abolish the FDA, or at least to restrict its operation, we will need either legislation or a constitutional amendment. We should pursue both. The possibility of a constitutional revision is not as extreme as it may sound. In fact, Dr. Benjamin Rush of Philadelphia – one of the signers of the Declaration of Independence, a member of the Continental Congress, Surgeon?General of Washington’s armies, and probably the foremost American physician of his day – had urged his colleagues to include ‘medical liberty’ in the First Amendment at the time it was drafted. He wrote: ‘Unless we put medical freedom into the Constitution, [...]’. As quoted by Dr Dean Burk in The Cancer News Journal, May/June, 1973: 4. (Griffin, 2003)1.

The reference is bogus as well. This author embellishes the quote by claiming that Rush had ‘urged his colleagues to include “medical liberty” in the First Amendment at the time it was drafted’ (Griffin, 2003).

IV.

The use by various ‘therapeutic’ interest groups of the bogus quotation by Rush illustrates that falsehood can serve expediency, but it cannot serve liberty. The advocacy of so‑called ‘medical marijuana’ – in plain English, marijuana by medical prescription – is a dramatic case in point. It is a bad cause, argued with bad evidence and in bad faith.

For my part, I have long agreed with Gilbert K. Chesterton, the celebrated Christian humanist‑humorist‑philosopher, who stated: ‘The free man owns himself. He can damage himself with either eating or drinking; he can ruin himself with gambling. If he does he is certainly a damn fool, and he might possibly be a damned soul; but if he may not, he is not a free man any more than a dog’ (Chesterton, 1909: 32). Either we have the right to poison and kill ourselves with food, alcohol and drugs, or we do not. For nearly half a century I have opposed drug prohibition, the growing power of the therapeutic state, and mistaken efforts of ‘reformers’ to deal with drug prohibition by multiplying instead of repealing regulations that treat drug use as a crime (and mental illness).  

In one of his recent essays, Lester Grinspoon reprises the medicinal value, as defined by the consumers, of smoking marijuana, and the objections of the government against permitting physicians to dispense it by prescription. His argument is paternalistic both in content and tone. He laments that we are not moving towards a ‘regulatory system that would allow responsible use of marijuana’ (Grinspoon, 2003: 81). No totalitarian authority objects to the ‘responsible use’ of the press, sex, alcohol or anything else. In Grinspoon’s scheme, who – if not agents of the government – would have the authority to define ‘responsible use’? Grinspoon not only begins his essay with a strategic misattribution to Rush, he also ends it by repeating Rush’s non‑existing opposition to ‘medical fascism’ – precisely the type of pharmacracy Rush supported and Grinspoon (2003: 81) now supports:  

If the cynical attitude of the federal government toward patients who use medical marijuana, its attempt to intimidate physicians [the intimidation is a fact, not an attempt] [...] lends credence to Benjamin Rush’s concern about medical fascism, then the patients and the people who help them in a variety of ways constitute a resistance movement against medical dictatorship. 

This is not a plea for medical liberty. It is the self‑congratulation of one medical statist seeking to replace the authority and power of his opponent, defining his coercive regulations ‘to responsibly use this plant’ as helpful, and those of his opponent to do the same thing as harmful (Szasz, 2003; also Szasz, 1992/1996).

The facts, let me repeat, contradict the contents of Rush’s bogus quote and refute the arguments and claims of those who use them. Rush was, quite literally, a prohibitionist. In a letter to Jeremy Belknap (1744–98), a Congregational minister and amateur American historian in Boston, Rush wrote: ‘In the year 1915, a drunkard I hope will be as infamous in society as a liar or thief, and the use of spirits as uncommon in families as a drink made of a solution of arsenic or a decoction of hemlock’ (quoted in Binger, 996: 201).

Sadly, the individuals and organizations who make use of the bogus Rush quote have no interest in separating medicine and the state. If they had such an interest, they could use a genuine quote to support their cause – not by Rush but by Jefferson, who, not by coincidence, considered Rush to be a quack and a medical menace (mainly on account of his enthusiasm for bloodletting). Alluding to the crucial importance of bodily self‑ownership as a political issue, Jefferson (1781/1944: 275) mocked would‑be statist meddlers into our diets and drugs by reminding his readers that ‘in France the emetic was once forbidden as a medicine, the potato as an article of food. [...] Was the government to prescribe to us our medicine and diet, our bodies would be in such keeping as our souls are now’.

Thomas Szasz

Thomas Szasz, "A bogus Benjamin Rush quote: contribution to the history of pharmacracy", History of Psychiatry (UK), 16: 89-98 (March), 2005.

THOMAS SZASZ* - State University of New York

* Address for correspondence: State University of New York, Upstate Medical University, Syracuse, NY, USA. Email: tszasz@aol.com

[Send correspondence and proofs to: 4739 Limberlost Lane, Manlius, NY 13104, USA] 


Notes

1. For additional web sites citing the quote, see:

http://www.drbrodie.com/beliefs.shtml; http://www.quackcenter.com/questiondoc.html

Quotes http://www.city?net.com/~davekle/newqt.html

David Wallace Croft Compilation. http://www.alumni.caltech.edu/~croft/quotes.txt. Copyright released to the Public Domain by the author, 2003/03/19.

2. Dr Nancy Lord Johnson is both a lawyer and physician. In 1992, she was the vice presidential candidate of the Libertarian Party.


References

The American Association for Health Freedom (2003) TITLE?? [PO Box 458, Great Falls, VA 22066, USA]. Retrieved from www.apma.net; http://www.citizenshealth.org/amta.htm

Binger, C. (1966) Revolutionary Doctor: Benjamin Rush, 1746–1813 (New York: Norton).

Chesterton, G. K. (1909) Orthodoxy (London: John Lane).

Citizens for Health Care Freedom (2003) Philosophy of Health Freedom [PO Box 62282, Durham, NC, 2771–2282, USA]. Retrieved from CHF@nc.rr.com; http://www. citizensforhealthcarefreedom.org/vision.html

Griffin, G. E. (2003) A World without Cancer [Worldwithoutcancer.org.uk, PO Box 2038, Leigh?on?Sea, SS9 2ZB, UK]. Retrieved from http://www.worldwithoutcancer.org.uk/aworldwithoutcancer.html

Grinspoon, L. (2003) "The medical marijuana problem". Journal of Cognitive Liberties, 4, 63–81.

Jefferson, T. (1781/1944) Notes on the State of Virginia [1781]. In A. Koch and W. Peden (eds) (1944), The Life and Selected Writings of Thomas Jefferson (New York: Modern Library).

Lord, N. (1994). Excerpts from closing argument in the trial of Alternative Health Care Provider Rodger Sless versus The United States Food And Drug Administration, Albuquerque, NM, USA. Retrieved from http://gos.sbc.edu/l/lord.html

Mencken, H. L. (1917/1967) A neglected hoax [1917]. In Mencken, H. L. (ed.) (1967), A Mencken Chrestomathy (New York: Knopf).

OKHealthfreedom (2003). Religious and cultural issues impede attempts to license natural healing arts in Oklahoma. 2001. Retrieved from http://okhealthfreedom.homestead_com/files/page17.html

Rapid Recovery Hyperbarics (2003) TITLE. Retrieved from http://www.hbot4u.com/introduction.html

Rush, B. (1774/1967) Letter to Granville Sharp (1774). Quoted by J. A. Woods (1967) The correspondence of Benjamin Rush and Granville Sharp, 1773–1809. Journal of American Studies, 1, 8.

Rush, B. (1810/1948). Lectures on the medical jurisprudence of the mind (1810). In G. W. Corner (ed.) (1948), The Autobiography of Benjamin Rush: His ‘Travels through life’ together with his ‘Commonplace book for 1789–1812’ (Princeton: Princeton University Press).

Rush, B. (1812/1962) Medical Inquiries and Observations upon the Diseases of the Mind (Reprinted 1962, New York: Macmillan – Hafner Press).

Rush, B. (1951) TITLE. In L. H. Butterfield (ed.), Letters of Benjamin Rush (Princeton: Princeton University Press).

Schatz, A. and Brewster, M. (1999) A declaration of independence for massage therapists. Massage Law Newsletter, 7 (4), PAGES. Electronic version, retrieved from
 http://www.healingandlaw.com/_Massage_Law_Newsletter/MLN_Vol.7/MLN_Vol.7.No.4/mln_vol.7.no.4.html

Szasz, T. (1970/1997) The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (Syracuse, NY: Syracuse University Press).

Szasz, T. (1992/1996) Our Right to Drugs: The Case for a Free Market (Syracuse, NY: Syracuse University Press).

Szasz, T. (1999/2002) Fatal Freedom: The Ethics and Politics of Suicide (Syracuse, NY: Syracuse University Press).

Szasz, T. (2001/2003) Pharmacracy: Medicine and Politics in America (Syracuse, NY: Syracuse University Press).

Szasz, T. (2003) "Marijuana medicalization: bad cause, bad faith". Journal of Cognitive Liberties, 4: 83–5.

Twain, M. (1882) Advice to youth. Retrieved from http://www.twainquotes.com/lies.html

Un Sacco di Canapa (date). TITLE. Retrieved from http://www.unsaccodicanapa.com/htmlpages/jdi.html

Zilboorg, G. (1941) A History of Medical Psychology (New York: Norton).


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