RUSH, Benjamin (1745-1813). Autograph letter signed ("Benjn Rush"), countersigned by Philip S. Physick (1768-1837), resident of the City Hospital, to an unnamed correspondent ("Dear Sir"), 29 August 1799, City Hospital, Philadelphia. 2 pages, folio, cleanly separated along central horizontal fold, minor age-toning, cloth slipcase.
AN IMPORTANT LETTER ON THE YELLOW FEVER EPIDEMIC IN PHILADELPHIA. Rush--the only physician to have signed the Declaration of Independence--defends his treatment methods. In 1793, 1797 and again in 1798-99, Philadelphia was ravaged by the disease; victims were admitted to the City Hospital and given free treatment and medicines. But an acrimonious controversy erupted within the medical profession. One faction accused Rush and his colleagues of bleeding and purging its patients to death. The City Hospital, caught in the debate, thus became reluctant to admit patients and treat the disease.
Rush replies to a correspondent (perhaps associated with the City Hospital) who had requested a full account of the situation at the City Hospital. First, Rush writes, it is important to note that "the force of the disease which now prevails in the city is very much influenced by climate, season, and occasional... changes in the weather; also by the peculiar Constitutions of the sick, & the nature of the accidental causes which excite it into action. Our Remedies of course are suited to all the above circumstances. Such is the disparity in the violence of this disease, that medicines of the same force in all cases, would be as absurd as it would be to make clothes of the same size for all the inhabitants of our city....We are bound by no System, not books, nor names, in our prescriptions, but according to the force of the disease, we adopt different remedies. While we prescribe powerful medicines in cases that require them, we are sometimes happy in using such as are mild by lenient means. We lament that remedies of the latter kind are not constantly indicated. It would be to trifle with human life...to prescribe them in all cases..." Rush draws parallels from the 1793 outbreak and pleads that the hospital remain open for treatment of the disease: the Board, he argues, "may be assured that their accomodations, comforts, and attendance, will be far superior to what persons of the same Condition in life, can obtain in private houses."
Rush had earlier published An Account of the Bilious Remitting Yellow Fever (Philadelphia, 1794) describing the 1793 epidemic, and followed it with Observations upon the Origin of the Malignant Bilious, or Yellow Fever in Philadelphia (1799). Rush suspected that unsanitary conditions were connected with the contagion and continued to prescribe blood-letting. One vocal critic, William Cobbett, commented that Rush's method was one of the "great discoveries...which have contributed to the depopulation of the Earth!" It was not until 1900 that Walter Reed identified the actual cause, a mosquito-borne bacillus.