Returning the Symptom to Critique: Reading Epidemiologically

Abstract

In 1798, American physician and signatory of the Declaration of Independence Benjamin Rush published Medical Inquiries and Observations. A collection of treatises that range from a comparative account of Native medicine and disease to a detailed narrative of the 1793 yellow fever outbreak in Philadelphia, Rush’sMedical Inquiries and Observations includes the brief, “An Account of the Influence of the Military and Political Events of the American Revolution Upon theHuman Body.”Here, Rush details hypochondriases he encounters as a field doctor during the Revolutionary War and in the years since: “a violent emotion of political joy” that kills a patriot at the news of Lord Cornwallis’s capture;1 the sudden deaths of Loyalists forsworn by their neighbors, which he terms Protection Fever and distinguishes from the excitations he calls Revolutiana;2 and finally, the resurgent violent passions that erupt in the post-independence years, which Rush diagnoses as Anarchia.3 Hypochondriases for Rush, perhaps the most prominent American practitioner of heroic medicine, were not phantasms of fraud but rather somatic proof of a humoral disturbance—from within the body itself. Anarchia, the “excess of the passion for liberty, inflamed by the successful issue of the war, produced, in many people, opinions and conduct which could not be removed by reason, nor restrained by government” made materially and symptomatically apprehendable a condition shared across bodies.4 For Rush, upsurgent revolutionary sentiment is not symbolic but deeply somatic and contagious. Outbreaks of political insurgency, of violent revolt, appear and repeat. Recur and reinfect. Persist. These are not the revolutionary epidemics Anjuli Fatima Raza Kolb charts in her expansive account of the poetics and politics of disease overmore than two centuries and