But the adventurous physician goes on, & substitutes presumption for knoledge. Or, if the appearance of doing something be necessary to keep alive the hope & spirits of the patient, it should be of the most innocent character. Having been so often a witness to the salutary efforts which nature makes to reestablish the disordered functions, should rather trust to their action, than hazard the interruption of that, and a greater derangement of the system, by conjectural experiments on a machine so complicated & so unknown as the human body, & a subject so sacred as human life. 4 Jefferson wrote Wistar that he agreed that current treatments have some utility-bowel diseases being relieved by purgatives, inflammation by bleeding, syphilis with mercury, for instance-but "symptoms are so infinitely diversified" that it is difficult to establish they are for a specific disease. Wistar, author of the first American textbook on anatomy, was at one time a friend of Rush's, but they had a falling out when Wistar "deserted" Rush by not enthusiastically endorsing Rush's heroic bleeding and purging regime during the epidemic of 1793. Jefferson made his thoughts about contemporary medicine explicit in a letter to Caspar Wistar, another of Lewis's Philadelphia mentors, with whom he discussed fossils and mastodons.
Science should contribute to human welfare to be worthy of the thought of men, he once said.
Another firm belief which underlay much of his thinking was in the practical utility of a method or idea as a test of its value. The first of these mental traits was his firm belief in observation and experiment as sine qua non for any scientific inquiry. Two characteristics of Jefferson's thinking led him to make some rather sharp criticisms of the medical thought of his time. Lewis was undoubtedly aware of Jefferson's belief that science has at its core observation and experimentation, with the aim toward discovering useful knowledge. Theory should develop from facts rather than facts squeezed to support a theory. Jefferson believed that medicine-indeed, all scientific endeavor-should have at its heart experimentation and observation. Jefferson objected to the highly theoretical medicine of his time. In one sense, however, it was out of character for Jefferson to send Lewis to Rush. Jefferson, long acquainted with Rush, knew his merits, his interests, and his politics (Rush supported Jefferson), and deemed a trip to Rush useful for Lewis's preparation. Rush," 2 no documentary evidence exists about how other many times Rush and Lewis might have met or what specifically they discussed. Disappointingly for the historian, besides the lists of questions and health rules, a few brief comments in letters, and a note on a list of medical supplies that says 50 dozen Bilious Pills were obtained "to Order of B. Letters and other documentation contain evidence of only one meeting between Rush and Lewis: May 17, 1803. Rush also prepared a list of health rules that Lewis could use to preserve the health of his men. Thomas Jefferson, who besides being President of the United States was also President of the APS, had written to Rush, fellow APS member and as well as personal correspondent, saying that it would be "very useful to state for those objects on which it is most desirable he should bring us information" and asking Rush "to prepare some notes of such particulars as may occur in journey & which you think should draw his attention & enquiry." 1 Rush responded by preparing a list of questions that Lewis could use to determine the health and religious practices of Native Americans. In 1803, Meriwether Lewis came to Philadelphia to receive scientific training. The transcript is provided in Appendix Two. 43, 1:54-55), is believed to be Jefferson's copy of Rush's original. This version of his directions, as printed in Donald Jackson's Letters of the Lewis and Clark Expedition (No. Rush may have used this page as a reminder during his conversations with Lewis in 1803, or may have given him a clean copy of it. American Philosophical Society, PhiladelphiaĪbove is a page from Rush's "commonplace book"-a blank book in which notes, reflections, quotes, or other matters of importance were written down and perhaps organized for easy reference.