University of Virginia Historical Collections at the Claude Moore Health Sciences Library

The Neurasthenia Rest Cure and Dr. Silas Weir Mitchell

Image: “Mistress and Her Maid,” by Jean Louis Forain. University of Virginia Fralin Museum of Art. Gift of the Frederick and Lucy S. Herman Foundation.


Simon Weir Mitchell

Image: “Silas Weir Mitchell,” Source: Wikipedia.

A prominent Philadelphia physician and graduate of Jefferson Medical College, Silas Weir Mitchell, M.D., developed the rest cure for neurasthenia in the 1870s. His most prominent books were Wear and Tear, or Hints for the Overworked (1871), Injuries of Nerves and Their Consequences (1872), Fat and Blood (1877), and Doctor and Patient (1888).

As the most prominent U.S. physician in the treatment of neurasthenia, Dr. Mitchell was consulted by patients and their families throughout North America and Europe. His patients were a roll call of leaders of U.S. society.

Dr. Mitchell is most often associated with the rest cure for women. He admired active, intellectual women, and in later years when he was the preeminent specialist in neurasthenia, colleagues and friends would try to persuade him to take a new patient by extolling her intelligence and accomplishments.



Image: “Charlotte Perkins Gilman,” Source: Wikimedia Commons.

Dr. Mitchell’s reputation fell after the 1970s because of the revival of the semi-autobiographical short story “The Yellow Wallpaper” (1892) by Charlotte Perkins Gilman, a writer, poet, and social reformer. The story became a standard part of the curriculum in U.S. cultural history, women’s studies, and medical humanities. In the story, 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.

Recently, medical historian David Schuster has studied Mitchell’s relationships with his women patients and concluded that his reputation has been unjustly damaged by Gilman’s story and modern critiques based on it. Schuster studied years of letters between Mitchell and three of his prominent women patients: Amelia Gene Mason, Sarah Butler Wister, and Charlotte Perkins Gilman.

Schuster concludes that Mitchell prescribed a strict rest cure for Gilman based on a reasonable interpretation of the description Gilman wrote for him of her state of mind and condition. 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.

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