Silas Weir Mitchell has been called the “Father of American Neurology” and is remembered as a renowned doctor of nervous disease, and also a successful author. He is well-known for the discovery of the “Rest Cure” which he applied to nervous women.
His Rest Cure, which involved isolating the patient and removing all external stimulus in an attempt to calm her, was largely hailed at the time as a breakthrough in psychological treatment, but it has gained a darker reputation since. Made infamous by the book “The Yellow Wallpaper,” a short story by Charlotte Perkins Gilman who was a one-time patient of Mitchell, it is now seen as questionable, if not downright abusive.
Was Mitchell a cruel man, or a mistaken one? Gilman’s book, with the narrator herself trapped in an attic room and slowly descending from exhaustion to full-blown madness due to her incarceration, is clear that the treatment itself is inhumane and extremely damaging. So why did Mitchell propose it?
Life of Silas Weir Mitchell
Silas Weir Mitchell was a renowned American physician, novelist, scientist, author, and poet. He is credited with the discovery of several diseases, such as causalgia, localized pain, and erythromelalgia which is also known as “Mitchell’s disease”. But he is most well remembered today for his Rest Cure.
Silas Weir Mitchell was born in Philadelphia, Pennsylvania, on the 15th of February, 1829, to Sarah Henry Mitchell and John Kearsley Mitchell. He studied at the popular University of Pennsylvania in Philadelphia and received his MD degree in 1850 from Jefferson Medical College.
He started his medical career as a surgeon in the Turners Lane Hospital in Philadelphia where he specialized in nervous diseases. Later, he became the director of treatment of maladies and nervous diseases at the Turners Lane Hospital, where he served during the American Civil War.
It was his development of the Rest Cure which made him famous, however. This treatment was to be applied to “nervous” women who were diagnosed with hysteria and neurasthenia, a condition of mental and physical exhaustion. The symptoms of neurasthenia included insomnia, anxiety, depression, and migraine.
Already there are problems in this approach. The symptoms are vague and subject to interpretation, usually by the attending doctor. The patient would be diagnosed as “nervous” for a variety of reasons, ranging from post-natal exhaustion or depression to nothing more than a willful refusal to obey her husband.
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The women who received the Rest Cure were isolated for a period of about six to eight weeks. Treatment included bed rest, electrotherapy, massage, and a high-calorie, high-fat diet. During the Rest Cure, the nervous women had to remain in their homes.
According to Mitchell, a diet that was rich in fat would help in reddening and fattening his patients, thereby resulting in an optimum cure. In order to ensure a diet rich in fat, he prescribed large quantities of milk to the women. His patients were advised to consume at least two quarts or even more milk per day, an alarming amount by modern standards.
Mitchell, along with his medical peers, completely discouraged and restricted the female patients from excessive studying, writing, or making any kind of attempt in order to enter a profession. They were made to lead a domestic life and were not allowed to touch “pencil, pen, or brush”.
The Rest Cure and Men
While Mitchell’s Rest Cure for treating nervous women was quite popular, his method of treating the men who experienced nervousness is less commonly known. It was completely different from how women were treated.
Instead of recommending the nervous men to rest, Mitchell sent the men out to the western United States in order to enable them to engage in activities such as hunting, cattle roping, male bonding, and rough riding for a prolonged period. The treatment offered to the men was known, perhaps with a sly grin, as the “West Cure”.
The anxious men were indeed encouraged in order to engage in a number of vigorous physical activities. They were also encouraged to write about their own experiences. It was believed that such activities could help in rehabilitating the men and ensuring better success in intellectual and commercial pursuits.
Mitchell also believed that the engagement of men in physical activities could strengthen their nervous systems and lessen the potential weakness due to nervous illness. The West Cure also encouraged physical fitness and enabled the patients to attain a muscular, manly build that was popular at the time.
While both men and women experienced the same condition and symptoms of neurasthenia, the treatment offered was completely different. While the treatment was a popular practice for decades and considered an ideal alternative to drug treatment, modern historians view it as almost an act of hatred against women.
The treatment reflected the cultural stereotypes that existed at that time. The Rest Cure provided the nervous women with an unpleasant experience. On the other hand, West Cure reinvigorated as well as refreshed the nervous and anxious men. Even Mitchell was himself diagnosed with neurasthenia and enjoyed the West Cure treatment.
The Rest Cure: Man’s Inhumanity to Women?
The problems with the Rest Cure start with the place of women in society at the time. Denied the education offered to men, women were encouraged and often forced to rely on the men in their lives to make all the important decision, being relegated to domestic lives.
For men to diagnose nervous conditions in women was already an unreliable approach. For Mithell to develop different curative approaches for men and women suggests a strong degree of sexism, and although the good doctor may have meant well, the women he treated felt differently.
Charlotte Perkins Gilman’s story is a stark warning about the damage the Rest Cure could cause. Trapped in the attic after giving birth and separated from her baby by her well-meaning husband, the narrator becomes fixated on the yellow wallpaper of her room, the only external stimulus provided to her.
Her descent into psychosis is inexorable and shocking in its gruesome conclusion. Clearly, Gilman understood the damage the Rest Cure could cause. In ignoring her warning, Mitchell, and male society at large, were guilty of an abusive disregard for the women they sought to “heal” but also sought to control.
A Reputation Tainted
Mitchell was certainly a brilliant doctor. Apart from developing the Rest Cure and West Cure, he contributed to the world of medicine by pioneering scientific as well as evidence-based medicine. He discovered as well as treated the complex regional pain syndrome (CRPS) or causalgia. The condition was mainly experienced by hand surgeons. He is also known for producing monographs on intellectual hygiene, snake venom, nerve injuries, effects of gunshot wounds, and of course nervous diseases among women.
The term “phantom limb” referring to an amputee retaining sensations of the lost arm or leg was also coined by Silas Weir Mitchell. He wrote a number of physical medical texts, and his contribution to the development of surgery is undeniable.
However, for all his treatments and brilliance it is in Charlotte Perkins Gilman’s short story, and in the writing of other women prescribed his cure such as Virginia Woolf, that his posthumous reputation rests. Mitchell died on January 4th 1914, a celebrated doctor.
Today his reputation is more tainted.
Top Image: Silas Weir Mitchell, and Charlotte Perkins Gilman. Source: Fr. GuteKunst / Public Domain; Frances Benjamin Johnston / Public Domain.
By Bipin Dimri
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