Mitchell's Rest Cure/Mitchell’s Therapy/Mitchell’s Treatment/Weir Mitchell Treatment (for Neurasthenia and Hysteria)

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This was a treatment developed by the Civil War doctor, Silas Weir Mitchell, for victims of nervous disorders, particularly hysteria and neurasthenia. Mitchell ascribed neurasthenia to the hectic “railroad age”. His method drew widespread attention within the medical community in America and Europe and also amongst upper-middle class American women. Some patients found it to be very successful.

Mitchell described it in 1877 when he wrote: “I do not permit the patient to sit up or to sew or write or read. The only action allowed is that needed to clean the teeth.” Treatments were generally given for six to eight weeks. He also said: “For some years I have been using with success, in private and in hospital practice, certain methods of renewing the vitality of feeble people by a combination of entire rest and of excessive feeding, made possible by passive exercise obtained through the steady use of massage and electricity.” He went on to explain that “chiefly” the patients were “nervous women” who were what her referred to as “invalids”. (Fat and blood: an essay on the treatment of certain forms of neurasthenia and hysteria, by S. Weir Mitchell, published by J.B. Lippincott, Philadelphia, 1884 available in full online at: https://archive.org/details/b21900164 and also in full text at: https://archive.org/stream/b21900164/b21900164_djvu.txt.)

He had a separate chapters on each treatment element of his rest cure that were entitled: “Seclusion”, “Rest”, “Massage”, “Electricity”, as well as “Dietetics, and Therapeutics”. Even reading and writing curtailed during the therapy. He also tried to limit any strain on the patient. Massage was used to diminish some of the “evil and pernicious results” of the prolonged rest and seclusion that were considered essential to the treatment (See Chapter VII. Entitled “THE WEIR-MITCHELL TREATMENT” pages 127-148, in Lectures on massage & electricity in the treatment of disease (masso-electrotherapeutics),by Dowse, Thomas Stretch,1889 John Wright & Co.; London: Hamilton, Adams & Co, Bristol available in full online at: https://archive.org/details/b20419910 and in full text at: https://archive.org/stream/b20419910/b20419910_djvu.txt. For the section on the rest cure see: https://archive.org/stream/b20419910#page/127/mode/1up.)

[Author’s comments: Some current treatments for fibromyalgia and chronic fatigue syndrome are similar. These treatments can be described as “eclectic” because the lean on multiple seemingly unrelated approaches. For further perspective see the entry for “fibromyalgia and chronic fatigue syndrome, Eclectic treatments for:” It is very difficult to evaluate the rest cure for several reasons. The treatment group was not homogeneous. Secondly, whenever a treatment has multiple interventions such as rest and electricity, it is very hard to say what did what. His intuition that the patients needed a rest is interesting. We now know that central sensitization (with its attendant over-reaction to a wide range of sensory stimuli) is a key aspect of fibromyalgia and other related diseases. The seclusion would have at least partially lifted the patient out of strains in the home of an emotional nature. Finally, by calling it the “rest cure” he was sending a message to the patients that they needed to rest their mind. This could conceivably have had far-reaching effects, including therapeutic effects.]


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Silas Weir Mitchell.
Public domain image.


One patient who criticized it was the writer poet, and social reformer, Charlotte Perkins Gilman. She claimed it led to insanity and her allegations created controversy at the time. She published The Yellow Wallpaper in 1892. [See Google Books] “Gilman condemned the rest cure and by extension the harmful treatment of women by physicians, most of whom were men at the time. The woman in Gilman’s story is prescribed a strict rest cure, during which she gradually becomes insane.” David Schuster, a medical historian, studied the correspondence between Mitchell and Charlotte Perkins Gilman but also with two other prominent women patients: Amelia Gene Mason, Sarah Butler Wister. He concluded that Mitchell’s prescription of the strict rest cure for her was reasonable in the circumstances based on the information provided to him by Gilman as to her state of mind. “Gilman later acknowledged that her life was unusually bleak and depressive at the time she wrote the description for Mitchell. In contrast, Mitchell prescribed different approaches for the other women, flexibly adjusting their treatments over the years and working with them to determine the best approaches.” (http://exhibits.hsl.virginia.edu/nerves/rest/)


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Massage of the arm, as in the Rest Cure, c. 1890.
Public domain image.


Thomas S. Dowse, a prominent physician in London, credits the Weir Mitchell Treatment with giving rise "to a large following of people, calling themselves masseurs and masseuses," adding that "the physician in truth cannot possibly do without them." (1906, p. 10. See: A Look Back: S. Weir Mitchell and the Rest Cure by Patricia J. Benjamin available online at: https://www.amtamassage.org/articles/3/MTJ/detail/1754.)

Sigmund Freud reviewed Mitchell's book on The Treatment of Certain Forms of Neurasthenia and Hysteria in 1887 (The Life and Work of Sigmund Freud. Jones, Ernest, 1964, p. 210.) Freud used electrotherapy in his work sometime into the 1890s. (Freud: A Life for Our Time. Gay, Peter (2006). W. W. Norton. p. 62.)


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Charlotte Perkins Gilman.
Public domain image found in Wikimedia Commons.


For further information see “Rest cure” at: http://www.sciencemuseum.org.uk/broughttolife/techniques/restcure.aspx