Page 36 - Tacoma-Pierce County Lawyer Magazine - September October 2018
P. 36

BOOK REVIEW
Law and Medicine in Revolutionary America:
Dissecting the Rush v Cobbett Trial, 1799 by Linda Myrsiadesi
Introduction
Anyone interested in the evolution of defamation law in America should enjoy this book which provides an in-depth study of the famous libel trial of Dr. Benjamin Rush v William Cobbett which was presented to a three judge panel and a twelve person jury in the Pennsylvania Supreme Court in Philadelphia in 1799.  e case pitted one of the most famous physicians against one of the most powerful political writers in America, each represented by a team of three lawyers.
The Background
 e case was based on a series of articles published by Cobbett in his newspaper, the Porcupine Gazette, which accused
a prominent physician and American patriot of quackery for claiming a cure for yellow fever.
The Plague
He who sitteth upon the Pale Horse, He whose name is Death, will be sent through the streets of Philadelphia -- Quaker Prophecy
In 1793 yellow fever ripped through Philadelphia wiping out ten percent
of the population in ninety days and causing many prominent citizens and government o cials to  ee the scene including George Washington,  omas Je erson and Alexander Hamilton. One who stayed behind to treat the sick, battle the plague and bury the dead, was Dr. Benjamin Rush.
Dr. Benjamin Rush (1749-1813) Source: Wikimedia Commons Public Domain
Who was Dr. Rush?
Dr. Rush graduated from a prestigious medical school in Scotland with  nancial support from Benjamin Franklin. He later served as Chief Physician of the Revolutionary Army, fought in battle with George Washington, and signed the Declaration of Independence on behalf of Pennsylvania. As a reform minded leader of the American Enlightenment, Dr. Rush opposed slavery while supporting free public schools, better education for women and better treatment of the poor and disabled.
What is yellow fever?
Yellow fever is a  avivirus spread by a speci c mosquito.ii
What are the symptoms?
 ree to six days a er exposure, the abrupt onset of fever, chills, aches and pains o en accompanied by yellowing of the skin and eyes. Clinical courses vary widely from a few days of mild symptoms to internal bleeding and death.
How did Dr. Rush treat yellow fever?
Viruses and insects as vectors were not discovered until the late 19th century so Dr. Rush was operating in the dark. He came up with “depletion therapy” which combined large doses of emetics and purgatives like mercury chloride with blood letting.
Where did he get the idea?
Bloodletting was common since ancient times. Taking mercury chloride was common until the twentieth century when its toxicity was fully appreciated.
What distinguished Dr. Rush from many others was taking both to the extreme and claiming it cured yellow fever.iii
18th Century Bloodletting instruments, Source: Wellcome Library, London, Wellcome Images
Did the treatment work?
Dr. Rush claimed it was 90% e ective but the evidence suggests a 46 to 56% mortality rate.iv
Was Dr. Rush following standard medical practice? Back then there were relatively few standard medical practices for anything, much less treating a viral infection
like yellow fever. Dr. Rush had many vocal supporters and detractors as was common in the day.
i. Myrsiades, Linda, Law and Medicine in Revolutionary America: Dissecting The Rush v Cobbett Trial, Lehigh University Press, Maryland, (2012) ii. The genus includes West Nile, Dengue and Zika viruses.
iii. Dr. Rush often drained 20 ounces of blood in the  rst round and then another 50 to 60 ounces or more over the next three to four days.
iv. Shuman, Andrew G., MD et. al., Bleeding By The Numbers-Rush v Cobbett, The Pharos, Vol. 77, 10-14, (2014);North, Robert L., Benjamin Rush, MD:Assassin or Beloved Healer? Baylor U. Med. Cntr. Proc., Jan 2000; 13(1); 45-49.
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