Mitchell, Silas Weir

   (1829–1914)

   Proponent of the "rest cure" for neurasthenia, Mitchell was born in Philadelphia into a doctor’s family. He graduated with an M.D. from Jefferson Medical College in 1850, began general practice, then served as a Union army surgeon in the U.S. Civil War. Returning to Philadelphia, he took up private practice as a neurologist and consulted for a private nervous clinic, the Infirmary for Diseases of the Nervous System. Although he is widely considered the founder of neurology in the United States, his large practice included many patients with psychiatric illnesses, and, because neurologists were responsible for "nerves," the books for which he is best known are of a psychiatric nature.

   In 1875, in A Series of American Clinical Lectures, edited by the neurologist Edward C. Seguin (1843–1898),* Mitchell first described his "rest cure" for neurasthenia, which involved admitting the patient (usually a woman) to a private nervous clinic, where she would be isolated under the supervision of a private nurse, and given electrotherapy, massage, and a milk diet. The technique emphasized "childlike obedience," and its success was based on the authority of the physician. His 1877 book, Fat and Blood: And How to Make Them, enjoyed great popularity in translation in Europe, even more so his Lectures on Diseases of the Nervous System, Especially in Women (1881). Mitchell’s "rest cure" became internationally known as one of the most popular treatments of the late-nineteenth century for community psychiatric disorders among the well-to-do. (See also Body Image: Disturbances of: phantom-limb [1871].) He was highly critical of the asylum psychiatry of his day.