After describing orthodox medicine and its alternatives in early America, this chapter discusses the rise of country’s earliest medical licensing laws, in the late eighteenth and early nineteenth centuries. These schemes strove to exclude unorthodox practitioners from the medical profession. American arguments for freedom of therapeutic choice were born in opposition to these original licensing systems. The chapter examines in detail the medical liberty advocacy of Benjamin Rush, an influential Founding Father who was also the most prominent American physician of the early national period. The chapter analyzes the genesis during this time of various strains of medical freedom rhetoric that would persist, to varying degrees, throughout American history.