Rush felt devastated after leaving the military. But that didn't stop Rush from continuing on his medical career. He began his first postwar effort to be a more "republican machine." In 1782, he created the first "back-country" college, named after John Dickinson, in Carlisle, PA. Rush was the only professor at the medical school who had not been invited to join the prestigious, all-volunteer medical staff of Pennsylvania Hospital. It wasn't until a year later, in 1783, he officially joined the staff at Pennsylvania Hospital.
In 1787, Rush helped establish the first American medical society, following the model of the British Royal College of Physicians: the College of Physicians. The society honored Dr. John Redman, Rush's former mentor, as its first president. At the same time, Rush and other physicians established the Philadelphia Dispensary for the Medical Relief of the Poor, the nation's first dispensary. He had a history of working with poor when he volunteered at the Philadelphia Alm House, a Quaker institution that offered a free clinic as well as food and housing for the poor.
Rush's life began to turn when three people, who influenced his life, were dying. He was called to the home of Dr. John Morgan was in deteriorating heath in his 50s in 1789. Rush was selected to eulogize Morgan for the medical school, then was given Morgan's professorship. He wished his former professor Dr. William Cullen would guide him, but he also died months after Morgan's funeral. In 1790, Franklin died, making Rush the new "Benjamin."
Rush returned teaching at the new University of Pennsylvania in 1791 after the College of Philadelphia closed during the war. The university merged with the newer University of the State of Pennsylvania. Rush was appointed to be both professor of the institutes of medicine and of clinical medicine.
When the yellow fever epidemic began in the summer of 1793, everyone fled from the city except Rush. Rush looked for answers to cure the epidemic, and that was when he thought about bloodletting. There were doctors who disagreed with him about that method. Rush heard about patients were relying on milder treatments, then died. It caused Rush to be upset that his fellow doctors didn't listen to him.
In 1807, Rush made a speech "On the Duty and Advantages of Studying the Diseases of Domestic Animals, and the Remedies Proper to Remove Them" that inspired the establishment of Penn's first veterinary school.
In 1808, Rush was asked to treat a "far more unlikely" patient: Dr. William Shippen, Jr. It was he who summoned Rush to his deathbed. "Rush spent some of his last hours on earth prompting him to acknowledge repentance and forgiveness, a silent confession." (Fried, 434)
Rush devoted his time to his work on mental health, and writing letters to his friend John Adams.
Benjamin Rush Watercolor Portrait
Painted by Thomas Sully 1809: "'...he was as upright as a Reed and his Countenance no less animated than Intelligent. But his Portrait now exhibits... the decrepitude of Old age worn out by long labours in the case of humanity.'" - John Adams (Fried, 446)
Thomas Jefferson was elected the third president in 1800 after defeating John Adams. In 1803, Jefferson was negotiating the Louisiana Purchase, and asked Rush to mentor Meriwether Lewis for his expedition with William Clark. Rush accepted his request, and wrote
'I shall expect to see Mr Lewis in Philadelphia, and shall not fail of furnishing him with a number of questions, calculated to encrease our knowledge of subjects connected with medicine.'
- Benjamin Rush (Fried, 418)
Thomas Jefferson (1743-1826)
Meriwether Lewis (1774-1809)
Jefferson knew Lewis had been 'subject to hypochondriac affection' since 'early life' and while working with him in Washington he saw that he was prone to 'sensible depressions of the mind.' He may have recognized in Rush someone who understood such problems and sympathized with them. (Fried, 419)
Rush wanted to know about the Native American culture and medicine, so he gave the task to Lewis to find out about it while heading west. He wanted Lewis to ask each tribe about madness and suicide.
When Lewis returned to Washington, Rush sent him a detailed list called "Questions to Merryweather Lewis before he went up the Missouri." In it were questions from physical health and medicine to moral and religion of the Indians. Rush then wrote a second list 3 weeks later: Directions for Mr. Lewis for the Preservation of the Health of those who went to accompany him." It was sent first to Jefferson to pass it onto Lewis.