Fat and Blood An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria   By: S. Weir Mitchell (1829-1914)

AN ESSAY ON THE TREATMENT OF CERTAIN FORMS OF

NEURASTHENIA AND HYSTERIA.

BY

S. WEIR MITCHELL, M.D., LL.D. HARV.,

MEMBER OF THE NATIONAL ACADEMY OF SCIENCES.

EIGHTH EDITION.

EDITED, WITH ADDITIONS, BY

JOHN K. MITCHELL, M.D.

PHILADELPHIA:

J.B. LIPPINCOTT COMPANY.

LONDON: 5 HENRIETTA STREET, COVENT GARDEN

1911.

Copyright, 1877, by J.B. LIPPINCOTT & CO.

Copyright, 1883, by J.B. LIPPINCOTT & CO.

Copyright, 1891, by J.B. LIPPINCOTT COMPANY.

Copyright, 1897, by J.B. LIPPINCOTT COMPANY.

Copyright, 1900, by J.B. LIPPINCOTT COMPANY.

Copyright, 1905, by S. WEIR MITCHELL.

ELECTROTYPED AND PRINTED BY J.B. LIPPINCOTT COMPANY, PHILADELPHIA, U.S.A.

PREFACE TO THE EIGHTH EDITION.

The continued favor which this book has enjoyed in Europe as well as in this country has rendered me doubly desirous to make it a thorough and clear statement of the treatment of the kind of cases which it discusses as carried out in my practice to day.

In the endeavor to do this, the present edition, like the last two, has been carefully revised by my son, Dr. John K. Mitchell, and there is no chapter, and scarcely a page, where some alteration or addition has not been made, besides those of the sixth and seventh editions, as the result of added years of experience. Especially in the chapters on the means of treatment some details have been thought worth adding to help the statement so often repeated in the book that success will depend on the care with which details are carried out. The chapter on massage, rewritten for the last edition, has been once more revised and somewhat extended, in order to make it an accurate as well as a scientific, if brief, statement of the best method which use and observation have taught us. A chapter on the handling of several diseases not described in former editions has been added by the editor.

S. WEIR MITCHELL.

SEPTEMBER, 1899.

CONTENTS.

PAGE CHAPTER I. INTRODUCTORY 9

CHAPTER II. GAIN OR LOSS OF WEIGHT CLINICALLY CONSIDERED 14

CHAPTER III. ON THE SELECTION OF CASES FOR TREATMENT 33

CHAPTER IV. SECLUSION 50

CHAPTER V. REST 67

CHAPTER VI. MASSAGE 80

CHAPTER VII. ELECTRICITY 108

CHAPTER VIII. DIETETICS AND THERAPEUTICS 119

CHAPTER IX. DIETETICS AND THERAPEUTICS ( Continued ) 171

CHAPTER X. THE TREATMENT OF LOCOMOTOR ATAXIA, ATAXIC PARAPLEGIA, SPASTIC PARALYSIS, AND PARALYSIS AGITANS 197

INDEX 233

CHAPTER I.

INTRODUCTORY.

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 excessive feeding, made possible by passive exercise obtained through the steady use of massage and electricity.

The cases thus treated have been chiefly women of a class well known to every physician, nervous women, who, as a rule, are thin and lack blood. Most of them have been such as had passed through many hands and been treated in turn for gastric, spinal, or uterine troubles, but who remained at the end as at the beginning, invalids, unable to attend to the duties of life, and sources alike of discomfort to themselves and anxiety to others.

In 1875 I published in "Séguin's Series of American Clinical Lectures," Vol. I., No. iv., a brief sketch of this treatment, under the heading of "Rest in the Treatment of Nervous Disease," but the scope afforded me was too brief for the details on a knowledge of which depends success in the use of rest, I have been often since reminded of this by the many letters I have received asking for explanations of the minutiæ of treatment; and this must be my apology for bringing into these pages a great many particulars which are no doubt well enough known to the more accomplished physician.