On September 16, 1808, Benjamin Rush, generally considered THE MOST IMPORTANT PHYSICIAN in North America, wrote a long letter to former President John Adams describing a dream in which he had been elected president of the United States. At the beginning of this dream, Rush is reluctant to accept the office; but he then realizes that it would give him the opportunity to accelerate the work he was doing to reduce the consumption of “ardent spirits,” which he considered a constituted a major public health problem in the new United States.  In Rush’s dream, he persuades Congress to pass a law “to prohibit not only the importation and distilling but the consumption of ardent spirits.”

Unlike the radical temperance movement of the late 19^th and early 20^th Century that ultimately enacted the doomed 18^th Amendment enacting Rush’s dream (maybe nightmare), Benjamin Rush did not advocate prohibition. Instead, he was deeply committed to educating people about the hazards of distilled alcoholic beverages, which were so abundant and inexpensive in the United States during the late 18th and early 19th centuries that their excessive use contributed to public health problem issues rather than the social problems the teetotalers sought to curtail.  Rush advocated through his pamphlet, An Inquiry into the Effects of Ardent Spirts upon the Human Body and Mind, that distilled spirits should be relegated to medicinal uses rather than consumed directly.  Rush understood that beer and wine have been an integral part of civilization since its earliest origins.  Distilled alcohol, while known to medieval alchemists, was not commonly a staple food for most of history.  Aqua vitae, or “water of life,” as it was called, was not really a beverage; it was a medicine to be taken by the spoonful.

By the 18th century, however, distilled alcoholic beverages were important products of commercial manufacture. In 1690, to create a broader market for grain, Parliament passed a law that promoted the manufacture of spirits (giving rise to the modern Scotch industry). This law launched an era in which gin replaced beer as a standard beverage among the urban poor and it was consumed in enormous quantities giving rise to the “gin epidemic” where excessive gin drinking became a major cause of morbidity and mortality.

Decades later, when Benjamin Rush began his campaign against distilled alcohol.  American whiskey production was rising, particularly on the frontier, where local distilling was a valuable means of converting grain into a form that could be more easily stored or shipped. Consumption of alcoholic beverages was increasing and Rush was concerned about the health consequences.

Most physicians considered the consumption of liquors to be a valuable safeguard against the effects of heat or cold, or to relieve the effects of fatigue.  Workers and soldiers were routinely supplied with a gil of spirits each day to preserve their health and wellbeing.  In times of heavy exertion and during hot days, more than a gil a day was considered “rejuvenate.” Contrary to popular opinion, Rush warned that heavy exercise accompanied by the use of large quantities of distilled beverages, contributed to negative health effects.  Making his arguments in clear and forceful language, Rush suggested alternate beverages such as buttermilk and water or beer.  He advocated for a reduction in the building of stills and distilleries and converting them into brewhouses for the production of cider and beer instead of whiskey. 

In Rush’s dream, Great opposition appears.  He receives many petitions demanding that Congress repeal the law.  When he refuses, a venerable but plain-looking citizen explains in great detail how, as reasonable as the law might seem, it simply cannot work.  The dream ends with the man suggesting that Rush retire from the presidency and go back to his professor’s chair to amuse his students with his “idle

and impracticable speculations.” Rush was then awakened by the “vexation … felt in being thus insulted” and was relieved to find that it had only been a bad dream.’  Unfortunately, in 1919, the United States will attempt to enact Rush’s dream and suffer the same consequence he had in his dream.  Prohibitions, whether for alcohol, abortions, or guns, simply do not work.  As Aristotle taught us long ago, moderation and “nothing in excess” is a far more practical and healthy path than the extremes of totalitarian prohibition.

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