Silas Weir Mitchell
Silas Weir Mitchell (1829-1914) was an American physician and writer
Silas Weir Mitchell was a foundational figure in American neurology and neuropsychiatry, renowned for his clinical insights during the U.S. Civil War and as originator of the controversial “rest cure.” Born February 15, 1829, in Philadelphia to prominent physician John Kearsley Mitchell (1792–1858), he graduated from Jefferson Medical College in 1851 and studied further in Paris under Claude Bernard (1813–1878), whose empirical rigor deeply influenced his research philosophy.
During the Civil War, Mitchell headed Turner’s Lane Hospital for nervous injuries in Philadelphia. Working with George R. Morehouse (1829–1905) and William W. Keen (1837–1932), he published key texts including Gunshot Wounds and Other Injuries of Nerves (1864) and Injuries of Nerves and Their Consequences (1872), establishing clinical frameworks for peripheral nerve injuries. He coined the term “causalgia” (now CRPS) and is credited with first describing phantom limb syndrome.
Mitchell pioneered treatment of functional disorders with his “rest cure,” involving bed rest, diet, massage, and isolation—applied notably in women with neurasthenia and hysteria. Though controversial, it gained transatlantic adoption. He also coined or contributed to syndromes such as erythromelalgia (“Mitchell’s disease”).
A polymath, Mitchell was also a prolific novelist and poet. He held professorial roles at the University of Pennsylvania, and served as President of the College of Physicians of Philadelphia. He died in Philadelphia on January 4, 1914.
Biography
- 1829 – Born February 15 in Philadelphia, Pennsylvania
- 1848–1851 – Studied medicine at Jefferson Medical College; MD 1851; Intern, Pennsylvania Hospital of Philadelphia. Along with William Alexander Hammond (1828-1900) he described the neurological aspects of venomous snakebite
- 1851–1852 – Studied in Paris under Claude Bernard and C.P. Robin
- 1861–1865 – Civil War service at Turner’s Lane Hospital, pioneering nerve injury treatment
- 1864 – Co-authored Gunshot Wounds and Other Injuries of Nerves
- 1872 – Published Injuries of Nerves and Their Consequences
- 1875–1900s – Professor at Philadelphia Orthopaedic Hospital and Polyclinic
- 1877 – Published Fat and Blood, outlining the “rest-treatment”
- 1890s–1900s – Literary fame with Hugh Wynne (1897), The Adventures of François (1898)
- 1909 – Oversaw completion of new College of Physicians building
- 1914 – Died January 4 in Philadelphia
Medical Eponyms
Causalgia (Complex Regional Pain Syndrome)
First described by Mitchell during the Civil War, causalgia refers to persistent, burning pain following peripheral nerve injury, typically involving the median or sciatic nerve. His term emphasized the neuropathic origin of pain and distinguished it from ordinary inflammation. Today, causalgia corresponds to CRPS Type II.
Phantom Limb
Mitchell introduced the term “phantom limb” to describe vivid sensations, often painful, in an amputated extremity. Based on meticulous wartime observations, his reports remain foundational in understanding cortical body maps and deafferentation phenomena.
Mitchell’s Syndrome (Erythromelalgia)
Described in 1878, this condition is characterised by episodic red, hot, painful extremities, usually feet and hands. Mitchell identified it as a neurovascular syndrome distinct from simple neuralgia or vascular disorders in his publication On Certain Painful Affections of the Feet
Mitchell’s Rest Cure
Mitchell developed “rest-treatment” for patients diagnosed with neurasthenia or hysteria, the rest cure involved total bed rest, a high-fat diet, electrotherapy, massage, and sensory isolation. Controversial and heavily criticized by later feminists (e.g., Charlotte Perkins Gilman), it was widely used in the U.S. and Europe.
Mitchell’s Syndrome II
This lesser-known eponym describes peripheral nerve injuries with intense hyperaesthesia and trophic changes. Mitchell emphasized its clinical distinctiveness among post-traumatic nerve syndromes.
The Tendon Hammer
Mitchell’s Civil War research promoted systematic use of reflex hammers in diagnosing nerve lesions. Though he didn’t invent the tendon hammer, his emphasis on neurological examination helped standardize its use in American medicine.
Weir Mitchell provided an early description of tendon reflexes in 1859 as a ‘peculiar contraction‘, ahead of Wilhelm Heinrich Erb and Carl Westphal in 1875. Mentor to John Madison Taylor, the inventor of the tendon hammer in 1888
Horner syndrome (early description)
1864 – American neurologist Silas Weir Mitchell (1829-1914) detailed the classic clinical triad in a 24 year old soldier with a gunshot wound to the right side of his neck:
The pupil of the right eye is very small…slight but very distinct ptosis. The ball of the right eye looks smaller than that on the left…his face became distinctly flushed on the right side only when walking in warm weather…a case of injury of the sympathetic nerve, probably the only one recorded
Major Publications
- Mitchell SW. ‘A Peculiar contraction‘. Reported by Walter F Atlee. In: Proceedings of Biological Department the Academy of Natural Sciences of Philadelphia. March 1859: II (Physiology): 5-6
- Mitchell SW, Morehouse GR, Keen WW. Chapter IV: Wounds of special nerves; wound of the sympathetic nerve. in: Gunshot Wounds and Other Injuries of Nerves. 1864: 39-44 [Horner syndrome]
- Mitchell SW. Wear and tear, or, Hints for the overworked. 1871
- Mitchell SW. Injuries of nerves and their consequences. 1872
- Mitchell SW. Clinical Lecture On Certain Painful Affections of the Feet. Philadelphia Medical Times, 1872, 3: 81-82, 113-115.
- Mitchell SW. Fat and Blood. 1877
- Mitchell SW. Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria. 1883
- Mitchell SW. In War Time. 1884
- Mitchell SW. Lectures on Diseases of the Nervous System: Especially in Women. 1885
- Mitchell SW, Reichert ET. Researches upon the venoms of poisonous serpents. Smithsonian Institution. 1896.
- Mitchell SW. Clinical Lessons on Nervous Diseases. 1897
- Mitchell SW. Doctor and patient. 1897
- Mitchell SW. The evolution of the rest treatment. 1904
- Mitchell SW. The autobiography of a quack and other stories. 1905
- Mitchell SW. Characteristics. 1913
References
Biography
- Keen WW. Silas Weir Mitchell (1829-1914). Proceedings of the American Academy of Arts and Sciences 1925; 59(17): 644-649
- Carlson AJ. Silas Weir Mitchell (1829-1914). Science. 1938 May 27;87(2265):474-8.
- Biderman A, Herman J. Silas Weir Mitchell (1829-1914): the rewards of versatility and its price. J Med Biogr. 2004 May;12(2):66-70.
Eponymous terms
- Lau FH, Chung KC. Silas Weir Mitchell, MD: the physician who discovered causalgia. J Hand Surg Am. 2004 Mar;29(2):181-7.
- Louis ED, York GK. Weir Mitchell’s observations on sensory localization and their influence on Jacksonian neurology. Neurology. 2006 Apr 25;66(8):1241-4.
- Louis ED. Silas Weir Mitchell’s essential tremor. Mov Disord. 2007 Jul 15;22(9):1217-22.
- Louis ED. Weir Mitchell’s 1859 demonstration of “a peculiar contraction” produced by a percussion hammer. Neurology 2008; 70: 969-973
- Kline DG. Silas Weir Mitchell and “The Strange Case of George Dedlow”. Neurosurg Focus. 2016 Jul;41(1):E5.
- Louis ED. Silas Weir Mitchell on the Cerebellum: Rich Neurophysiological Concepts and a Modern Perspective. Cerebellum. 2022 Apr;21(2):172-193.
Eponym
the person behind the name
