Benjamin Rush

 

Benjamin Rush is considered by many as the father of American Psychiatry. In his book he presents a complex taxonomy of mental disorders where many criteria (including severity, course and causality) apart from the kind of symptoms shape the classification.
In this paper his ideas on mania are presented. It is a strictly medical approach, with an emphasis on somatic symptoms which is incommensurable to current psychopathology.
It appears clearly that at the beginning of the Nineteenth-Century American psychiatry was deeply influenced by European descriptions. As the reader can see at that time mania was a wide concept including many symptoms which were later severed in different diagnoses. On this respect, in Rush’s mania there is no sign of the distinction between affective and cognitive illnesses, a distinction that had to characterize the end of the century and (thanks to Kraepelin) had to inform Twentieth-Century nosologies.
In this paper, the concept of agitation is enlarged to include many phenomena that current classifications would consider as part of schizophrenia. However, the current tendency to enlarge the concept of bipolarity in order to include so many forms of agitation and excitation spread a new light on this old book evoking the return of an old, pre-Kraepelinian stance.

 

history of psychiatry, mania, American psychiatry, course, severity, causes