Silas Weir Mitchell (physician)
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Silas Weir Mitchell (February 15, 1829 – January 4, 1914) was an American physician, scientist, novelist, and poet. He is considered the father of medical
neurology Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
, and he discovered
causalgia Complex regional pain syndrome (CRPS) is any of several painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trau ...
(complex regional pain syndrome) and
erythromelalgia Erythromelalgia or Mitchell's disease (after Silas Weir Mitchell) is a rare vascular peripheral pain disorder in which blood vessels, usually in the lower extremities or hands, are episodically blocked (frequently on and off daily), then become ...
, and pioneered the
rest cure Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of ...
.


Biography

Silas Weir Mitchell was born on February 15, 1829, in
Philadelphia, Pennsylvania Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Since ...
, to
John Kearsley Mitchell John Kearsley Mitchell (May 12, 1798 – April 4, 1858) was an American physician and writer, born in Shepherdstown, Virginia (present-day West Virginia). Orphaned at the age of eight, and sent to his late father's family in Scotland at the age ...
and Sarah Henry Mitchell. He studied at Philadelphia's renowned
University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a Private university, private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest- ...
and later earned the degree of MD at the city's
Jefferson Medical College Thomas Jefferson University is a private research university in Philadelphia, Pennsylvania. Established in its earliest form in 1824, the university officially combined with Philadelphia University in 2017. To signify its heritage, the un ...
in 1850. During the
Civil War A civil war or intrastate war is a war between organized groups within the same state (or country). The aim of one side may be to take control of the country or a region, to achieve independence for a region, or to change government polici ...
, he was director of treatment of nervous injuries and maladies at Turners Lane Hospital, Philadelphia, and at the close of the war became a specialist in
neurology Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
. In this field Mitchell pioneered the
rest cure Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of ...
for diseases now termed "psychiatric", particularly
neurasthenia Neurasthenia (from the Ancient Greek νεῦρον ''neuron'' "nerve" and ἀσθενής ''asthenés'' "weak") is a term that was first used at least as early as 1829 for a mechanical weakness of the nerves and became a major diagnosis in North A ...
and
hysteria Hysteria is a term used colloquially to mean ungovernable emotional excess and can refer to a temporary state of mind or emotion. In the nineteenth century, hysteria was considered a diagnosable physical illness in women. It is assumed that ...
, subsequently taken up by the medical world. The treatment consisted primarily in isolation, confinement to bed,
dieting Dieting is the practice of eating food in a regulated way to decrease, maintain, or increase body weight, or to prevent and treat diseases such as diabetes and obesity. As weight loss depends on calorie intake, different kinds of calorie-red ...
,
electrotherapy Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term ''electrotherapy'' can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological dis ...
and
massage Massage is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet or a device. The purpose of massage is generally for the treatment of body stress or pain. In E ...
; and was popularly known as 'Dr Diet and Dr Quiet'. Mitchell advocated a high-fat diet to his patients. He believed that a diet rich in fat would "fatten and redden" his patients, leading to a cure. To achieve this, large quantities of
milk Milk is a white liquid food produced by the mammary glands of mammals. It is the primary source of nutrition for young mammals (including breastfed human infants) before they are able to digest solid food. Immune factors and immune-modulat ...
were prescribed. He requested his patients to consume two quarts or more milk a day. His medical texts include ''Injuries of Nerves and Their Consequences'' (1872) and ''Fat and Blood'' (1877). Mitchell's disease (
erythromelalgia Erythromelalgia or Mitchell's disease (after Silas Weir Mitchell) is a rare vascular peripheral pain disorder in which blood vessels, usually in the lower extremities or hands, are episodically blocked (frequently on and off daily), then become ...
) is named after him. He also coined the term
phantom limb A phantom limb is the sensation that an amputated or missing limb is still attached. Approximately 80 to 100% of individuals with an amputation experience sensations in their amputated limb. However, only a small percentage will experience pain ...
during his study of an amputee. Mitchell discovered and treated
causalgia Complex regional pain syndrome (CRPS) is any of several painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trau ...
(today known as CRPS/RSD), a condition most often encountered by hand surgeons. Mitchell is considered the father of medical neurology and a pioneer of "evidence-based" or "scientific" medicine. He was also a psychiatrist, toxicologist, author, poet, and celebrity in Europe as well as America. His contemporaries considered him a
genius Genius is a characteristic of original and exceptional insight in the performance of some art or endeavor that surpasses expectations, sets new standards for future works, establishes better methods of operation, or remains outside the capabili ...
no less than
Benjamin Franklin Benjamin Franklin ( April 17, 1790) was an American polymath who was active as a writer, scientist, inventor, statesman, diplomat, printer, publisher, and political philosopher. Encyclopædia Britannica, Wood, 2021 Among the leading int ...
. In 1866, he published a short story in the ''
Atlantic Monthly ''The Atlantic'' is an American magazine and multi-platform publisher. It features articles in the fields of politics, foreign affairs, business and the economy, culture and the arts, technology, and science. It was founded in 1857 in Boston, ...
'' resting upon both somatic and psychological insights entitled "The Case of George Dedlow". From that point onward, Mitchell divided his attention between scientific and literary pursuits. In the former field, he produced monographs on
rattlesnake Rattlesnakes are venomous snakes that form the genera ''Crotalus'' and ''Sistrurus'' of the subfamily Crotalinae (the pit vipers). All rattlesnakes are vipers. Rattlesnakes are predators that live in a wide array of habitats, hunting small an ...
venom Venom or zootoxin is a type of toxin produced by an animal that is actively delivered through a wound by means of a bite, sting, or similar action. The toxin is delivered through a specially evolved ''venom apparatus'', such as fangs or a st ...
, intellectual
hygiene Hygiene is a series of practices performed to preserve health. According to the World Health Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases." Personal hygiene refer ...
, injuries to the
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the ...
s,
neurasthenia Neurasthenia (from the Ancient Greek νεῦρον ''neuron'' "nerve" and ἀσθενής ''asthenés'' "weak") is a term that was first used at least as early as 1829 for a mechanical weakness of the nerves and became a major diagnosis in North A ...
, nervous diseases of women, the effects of gunshot wounds upon the nervous system, and relations between nurse, physician, and patient; in the latter, he wrote juvenile stories, several volumes of respectable verse (''The Hill of Stones and Other Poems'' was published in 1883 by Houghton, Mifflin and Co.), and prose fiction of varying merit, which earned him a leading place among American authors at the close of the 19th century. His historical novels in particular, notably '' Hugh Wynne'' (1897), ''The Adventures of François'' (1898), ''The Youth of Washington'' (1904), and '' The Red City'' (1909), are among the best of their genre. He died on January 4, 1914 in Philadelphia and is interred at The Woodlands Cemetery.


Prominent patients

He was
Charlotte Perkins Gilman Charlotte Perkins Gilman (; née Perkins; July 3, 1860 – August 17, 1935), also known by her first married name Charlotte Perkins Stetson, was an American humanist, novelist, writer, lecturer, advocate for social reform, and eugenicist. She w ...
's doctor and his use of a
rest cure Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of ...
on her provided the idea for "
The Yellow Wallpaper "The Yellow Wallpaper" (original title: "The Yellow Wall-paper. A Story") is a short story by American writer Charlotte Perkins Gilman, first published in January 1892 in '' The New England Magazine''. It is regarded as an important early work ...
", a short story in which the narrator is driven insane by this treatment. His treatment was also used on
Virginia Woolf Adeline Virginia Woolf (; ; 25 January 1882 28 March 1941) was an English writer, considered one of the most important modernist 20th-century authors and a pioneer in the use of stream of consciousness as a narrative device. Woolf was born ...
, who wrote a savage satire of it in her novel '' Mrs. Dalloway'' (1925): "you invoke proportion; order rest in bed; rest in solitude; silence and rest; rest without friends, without books, without messages; six months rest; until a man who went in weighing seven stone six comes out weighing twelve".


Influence on Freud

Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies explained as originating in conflicts i ...
reviewed Mitchell's book on ''The Treatment of Certain Forms of Neurasthenia and Hysteria'' in 1887; and used
electrotherapy Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term ''electrotherapy'' can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological dis ...
in his work into the 1890s. Freud also adopted Mitchell's use of physical relaxation as an adjunct to therapy, which arguably led to the institutionalization of the psychoanalytic couch.


Honors and recognition

Mitchell's eminence in science and letters was recognized by honorary degrees conferred upon him by several universities at home and abroad and by membership, honorary or active, in many American and foreign learned societies. In 1887 he was president of the
Association of American Physicians The Association of American Physicians (AAP) is an honorary medical society founded in 1885 by the Canadian physician Sir William Osler and six other distinguished physicians of his era for "the advancement of scientific and practical medicine." ...
and in 1908–09 president of the
American Neurological Association The American Neurological Association (ANA) is a professional society of academic neurologists and neuroscientists devoted to advancing the goals of academic neurology; to training and educating neurologists and other physicians in the neurologic ...
. He was a trustee of the Carnegie Institution from 1902 until he died in 1914. In 1912 he was honored by the Guggenheim Honor Cup of the Penn Club of New York. The American Academy of Neurology award for young researchers, the S. Weir Mitchell Award, is named for him.American Academy of Neurology: S. Weir Mitchell award
/ref> ''
Crotalus mitchellii :''Common names: speckled rattlesnake,Campbell JA, Lamar WW (2004). ''The Venomous Reptiles of the Western Hemisphere''. Ithaca and London: Comstock Publishing Associates. 870 pp. 1500 plates. . Mitchell's rattlesnake,U.S. Navy (1991). ''Poisonou ...
'', the speckled rattlesnake, was named after Mitchell.


Terms

*Weir Mitchell skin – a red, glossy, perspiring skin seen in cases of incomplete irritative lesion of a nerve *Weir Mitchell treatment – a method of treating neurasthenia, hysteria, etc., by absolute bed rest (aka a rest cure), frequent and abundant feeding, and the systematic use of massage and electricity *Mitchell's disease –
erythromelalgia Erythromelalgia or Mitchell's disease (after Silas Weir Mitchell) is a rare vascular peripheral pain disorder in which blood vessels, usually in the lower extremities or hands, are episodically blocked (frequently on and off daily), then become ...
:
Dorland's Medical Dictionary ''Dorland's'' is the brand name of a family of medical reference works (including dictionaries, spellers and word books, and spell-check software) in various media spanning printed books, CD-ROMs, and online content. The flagship products are ''Do ...
(1938)


Selected publications


''Rest in the Treatment of Nervous Disease''
(1875)
''Fat and Blood: And How to Make Them''
(1877)
''Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria''
(1884) *Mitchell, S. Weir and Edward T. Reichert. 1886.
Researches upon the Venoms of Poisonous Serpents
'. Smithsonian Contributions to Knowledge, Number 647. The Smithsonian Institution. Washington, District of Columbia. 179 pp.
Characteristics
by S. Weir Mitchell, 1910 The Century Co., New York, NY, USA.
Circumstance
by S. Weir Mitchell, MD. LL.D. Harvard and Edinburgh. Published 1902 by The Century Co. *
The Autobiography of a Quack and other stories
' by S. Weir Mitchell, M.D. printed 1903


Cultural Club Founder

Mitchell and 8 other members of the University Club at Penn founded
The Franklin Inn Club The Franklin Inn Club is a private social club in Philadelphia, Pennsylvania. Founded in 1902 as a literary society, it is one of the four historic gentlemen's clubs in Philadelphia's Center City and was the first to open membership to women in P ...
in 1902.


Art patron

He was a friend and patron of the artist
Thomas Eakins Thomas Cowperthwait Eakins (; July 25, 1844 – June 25, 1916) was an American realist painter, photographer, sculptor, and fine arts educator. He is widely acknowledged to be one of the most important American artists. For the length ...
, and owned the painting ''Whistling for Plover''. The Philadelphia Chippendale chairs seen in several Eakins paintings – such as '' William Rush Carving his Allegorical Figure of Schuylkill River'' (1877) and the bas-relief ''Knitting'' (1883) – were borrowed from Mitchell. Following Eakins's 1886 forced resignation from the
Pennsylvania Academy of the Fine Arts The Pennsylvania Academy of the Fine Arts (PAFA) is a museum and private art school in Philadelphia, Pennsylvania.
, Mitchell may have recommended the artist's trip to the
Badlands Badlands are a type of dry terrain where softer sedimentary rocks and clay-rich soils have been extensively eroded."Badlands" in ''Chambers's Encyclopædia''. London: George Newnes, 1961, Vol. 2, p. 47. They are characterized by steep slopes, mi ...
of
South Dakota South Dakota (; Sioux: , ) is a U.S. state in the North Central region of the United States. It is also part of the Great Plains. South Dakota is named after the Lakota and Dakota Sioux Native American tribes, who comprise a large po ...
. The artist
John Singer Sargent John Singer Sargent (; January 12, 1856 – April 14, 1925) was an American expatriate artist, considered the "leading portrait painter of his generation" for his evocations of Edwardian-era luxury. He created roughly 900 oil paintings and more ...
painted two portraits of Mitchell: one is in the collection of the
College of Physicians of Philadelphia The College of Physicians of Philadelphia is the oldest private medical society in the United States. Founded in 1787 by 24 Philadelphia physicians "to advance the Science of Medicine, and thereby lessen human misery, by investigating the disease ...
; the other, commissioned by the Mutual Assurance Company of Philadelphia in 1902, was recently sold (see External Links, below). The sculptor
Augustus Saint-Gaudens Augustus Saint-Gaudens (; March 1, 1848 – August 3, 1907) was an American sculptor of the Beaux-Arts generation who embodied the ideals of the American Renaissance. From a French-Irish family, Saint-Gaudens was raised in New York City, he tra ...
modeled an 1884 bronze portrait plaque of Mitchell. Mitchell commissioned Saint-Gaudens to create a monument to his deceased daughter Maria: ''The Angel of Purity'', a white marble version of the sculptor's ''Amor Caritas''. Originally installed in Saint Stephen's Church, Philadelphia, it is now at the
Philadelphia Museum of Art The Philadelphia Museum of Art (PMoA) is an art museum originally chartered in 1876 for the Centennial Exposition in Philadelphia. The main museum building was completed in 1928 on Fairmount, a hill located at the northwest end of the Benjamin ...
. File:Eakins, Whistling For Plover 1874.jpg, Brooklyn Museum
''Whistling for Plover'' (1874)
by
Thomas Eakins Thomas Cowperthwait Eakins (; July 25, 1844 – June 25, 1916) was an American realist painter, photographer, sculptor, and fine arts educator. He is widely acknowledged to be one of the most important American artists. For the length ...
. File:Seventy-Years-Ago-(1877)-Eakins.jpg, Princeton University
''Seventy Years Ago'' (1877)
by Thomas Eakins. File:Augustus Saint-Gaudens, The Angel of Purity (Maria Mitchell Memorial) (1902).jpg, Philadelphia Museum of Art
''The Angel of Purity'' (1902)
by
Augustus Saint-Gaudens Augustus Saint-Gaudens (; March 1, 1848 – August 3, 1907) was an American sculptor of the Beaux-Arts generation who embodied the ideals of the American Renaissance. From a French-Irish family, Saint-Gaudens was raised in New York City, he tra ...
.


Ghost story

Some time during the late 1800s, a ghost story was published about Dr. Mitchell that he was never able to lay to rest. The story tells how a very young girl in rags and threadbare shawl came to his door in bad weather and begged him to come take care of her sick mother. The girl guided Mitchell to the sick woman, who turned out to be a former house servant of his who was suffering from pneumonia. Mitchell helped the woman, then congratulated her on having such a fine daughter, but the woman told him her daughter died a month earlier. In a cupboard, Mitchell found the shawl the girl had been wearing; it had not been worn out that night. A 2011 study determined that the ghost story was likely originally told by Mitchell himself as entertainment at a medical meeting, then took on a life of its own. In his 1910 book "Characteristics," Mitchell wrote about a man who told a story "about a little dead child who rang up a doctor one night, and took him to see her dying mother;" the man was then constantly bothered by believers and disbelievers, and unable to stop the story. In context, it seems that Mitchell was referring to himself.


"The Yellow Wallpaper"

Charlotte Perkins Gilman Charlotte Perkins Gilman (; née Perkins; July 3, 1860 – August 17, 1935), also known by her first married name Charlotte Perkins Stetson, was an American humanist, novelist, writer, lecturer, advocate for social reform, and eugenicist. She w ...
claimed her short story "
The Yellow Wallpaper "The Yellow Wallpaper" (original title: "The Yellow Wall-paper. A Story") is a short story by American writer Charlotte Perkins Gilman, first published in January 1892 in '' The New England Magazine''. It is regarded as an important early work ...
" was directed at Mitchell that he might reconsider the rest cure. Although she has claimed to have sent a copy of the story, Mitchell never acknowledged his connection to the infamous story or that he ever received a copy. Perkins Gilman also claimed that Mitchell altered his Rest Cure treatment after reading "
The Yellow Wallpaper "The Yellow Wallpaper" (original title: "The Yellow Wall-paper. A Story") is a short story by American writer Charlotte Perkins Gilman, first published in January 1892 in '' The New England Magazine''. It is regarded as an important early work ...
," but there is no evidence that Mitchell ever changed or altered the Rest Cure.


References


Further reading

* Anna Robeson Brown Burr
''Weir Mitchell: His Life and Letters''
(Duffield & Company 1929). * Nancy Cervetti, ''S. Weir Mitchell, 1829–1914: Philadelphia's Literary Physician.'' University Park, PA: Pennsylvania State University Press, 2012. * E. P. Oberholtzer,
Personal Memories of Weir Mitchell
" in the '' Bookman'', vol. 39 (1914). p. 132 * A. Proust and G. Ballet,
The Treatment of Neurasthenia
'' 1902. * Tucker, Beverly R.,
S. Weir Mitchell
'' Gorham Press, Boston, 1914. * Talcott Williams,
Dr. S. Weir Mitchell
in the ''
Century Magazine ''The Century Magazine'' was an illustrated monthly magazine first published in the United States in 1881 by The Century Company of New York City, which had been bought in that year by Roswell Smith and renamed by him after the Century Associati ...
'', vol. 57 (1898). * Talcott Williams, in several articles in the '' Book News Monthly'', vol. 26 (1907). *
A Catalogue of the Scientific and Literary Work of S. Weir Mitchell
'' Philadelphia, 1894.


External links

* Finding aid to th
S. Weir Mitchell collection
at th
University of Pennsylvania Libraries
Biography at ''WhoNamedIt''
Silas Weir Mitchell papers from the Historic Psychiatry Collection, Menninger Archives, Kansas Historical Society
* *
Works by Silas Weir Mitchell
in the Ball State University Digital Media Repository
Portrait of Silas Weir Mitchell by John Singer Sargent

S. Weir Mitchell Award of the American Academy of Neurology
* * *


Sources

{{DEFAULTSORT:Mitchell, Silas Weir 1829 births 1914 deaths 19th-century American male writers 19th-century American physicians American male non-fiction writers American medical writers American neurologists Burials at The Woodlands Cemetery Foreign Members of the Royal Society High-fat diet advocates Members of the American Philosophical Society Physicians from Philadelphia Thomas Jefferson University alumni