Dr. Benjamin Rush and His Views on Alcoholism

In 1784, Benjamin Rush, M.D., a noted and influential physician from Philadelphia and one of the signers of the Declaration of Independence, published his book,  Medical Inquiries and Observations upon the Diseases of the Mind.  This book included Rush’s views on alcoholism and his forward-thinking ideas on temperance. 

Rush,  the former surgeon general of the Continental Army during the Revolution,  was the first prominent physician of his time (and for many years beyond his time)  to see alcoholism as a disease and also as a problem that required treatment.  He urged the establishment of special hospitals specifically designed to treat alcoholics, which he called “sober houses.”

Today Rush is viewed as the father of American psychiatry. However, Dr. Rush was primarily concerned with the health risks of distilled spirits, and he saw no problem with drinking beer,  wine,  or hard cider. Today it is known that individuals can become dependent on these substances as well.

Rush said of alcoholism, “The use of strong drink is at first the effect of free agency.  From habit it takes place and from necessity.

That this is the case, I infer from persons who are inordinately devoted to the use of ardent spirits being irreclaimable, by all the considerations which domestic obligations, friendship,  reputation,  property,  and sometimes even by those which religion and the love of life, can suggest to them. An instance of insensibility to the last,  in an habitual drunkard,  occurred some years ago in Philadelphia.  When strongly urged, by one of his friends,  to leave off drinking,  he said, ‘Were a keg of rum in one corner of a room, and were a cannon constantly discharging balls between me and it, I could not refrain from passing before that cannon, in order to get at the rum.’ “

Dr. Benjamin Rush shared his concern, publishing in 1785 his now famous “Inquiry into the Effects of Ardent Spirits Upon the Human Body and Mind.” Enumerating the diseases of the body and mind which plague the drinker of distilled liquors, Dr. Rush outlined the symptoms, including “unusual garrulity, unusual silence, captiousness ... an insipid simpering ... profane swearing ... certain immodest actions” and “certain extravagant acts which indicate a temporary fit of madness” (Rush, 1943: 323, 325-326).

Although the rumblings of the temperance movement were thus perceptible in the late 18th century, there is no evidence that its effects were felt. In 1766, it is recorded that the repeal of the Stamp Act was greeted in Providence, Rhode Island with “32 of the most loyal, patriotic and constitutional toasts” (Lee, 1963: 18). Notwithstanding this evidence of devotion to His Majesty. it was often thereafter the tavern which provided the meeting places for the most defiant revolutionaries.

Subsequently, when the colonial period disappeared into the post-Revolutionary era, Alexander Hamilton adopted the idea earlier effected by the individual colonies, to tax distilled liquors for revenue purposes. In 1791 , the tax was enacted as part of the Revenue Act. The following year, the Second Congress of the United States added license fees for distilleries and taxes on liquors distilled from imported materials.

Rush continued, “Who can calculate the extensive influence of a drunken husband or wife upon the property and morals of their families,  and of the waste of the former,  and corruption of the latter,  upon the order and happiness of society?”
Who indeed?


Mark S. Gold, M.D. and Christine Adamec



  1. Amethyst Initiative.  Statement.  Available online.  Accessed March 1, 2009.
  2. Beirness,  Douglas J.,  and Erin E.  Beasley.  Alcohol and Drug Use Among Drivers: British Columbia Roadside Survey, 2008. Ottawa, Ontario: Canadian Centre on Substance Abuse, 2009.
  3. Berridge,  Virginia,  and Sarah Mars.  “History of Addictions.”  Journal of Epidemiology and Public Health 58 (2003): 747–750.
  4. Blanco,  Carlos,  M.D.,  et al.  “Mental Health of College Students and Their Non-College-Attending Peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions.”  Archives of General Psychiatry 65, no. 12 (2008): 1,429–1,437.
  5. Blocker,  Jack S.,  Jr.  “Did Prohibition Really Work: Alcohol Prohibition as a Public Health Innovation.” American Journal of Public Health 96,  no.  2 (2006): 233–243.

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