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Dietetics and Therapeutics : Part 6
Fat and Blood
By S. Weir Mitchell, M.D.

On waking, coffee at 7. At 8, iron and malt. Breakfast, a chop, bread-and-butter; of milk, a tumbler and a half. At 11, soup. At 2, iron and malt. Dinner, closing with milk, one or two tumblers. The dinner consisted of anything she liked, and with it she took about six ounces of burgundy or dry champagne. At 4, soup. At 7, malt, iron, bread-and-butter, and usually some fruit, and commonly two glasses of milk. At 9, soup; and at 10 her aloe pill. At 12 M., massage occupied an hour. At 4.30 P.M., electricity was used for an hour in the manner which I have described.

This heavy diet-list, reached in a few days by a woman who had been unable to digest with comfort the lightest meal, seemed certainly surprising. I have not given in full the amount of food eaten at meal-time. Small at first, it was increased rapidly owing to the patient's growing appetite, and became in a few days three large meals.

It is necessary to see the result in one of these successful cases in order to credit it. Mrs. C. began to show gain in flesh about the face in the second week of treatment, and during her two months in bed rose in weight from ninety-six pounds to one hundred and thirty-six; nor was the gain in color less marked.

At the sixth week of treatment the soup was dropped, wine abandoned, the iron lessened one-half, the massage and electricity used on alternate days, and the limbs exercised as I have described. The usual precautions as to rising and exercise were carefully attended to, and at the ninth week of treatment my patient took a drive. At this time all mechanical treatment ceased, the milk was reduced to a quart, the iron to five grains thrice a day, and the malt continued. At the sixth week I began to employ strychnia in doses of one-thirtieth of a grain thrice a day at meals, and this was kept up for several months, together with the iron and malt.

The cure was complete and permanent; and its character may be tested by the fact that at the thirtieth day of rest in bed, and after five years of failure to menstruate, to her surprise she had a normal monthly flow. This continued with regularity until eighteen months later, when she became pregnant. The only drawback to her perfect use of all her functions lay in asthenopia, which lasted nearly a year after she left my care. Fatigue of vision for near work is a common condition of the cases I am now describing, and is apt to persist long after all other troubles have vanished. When there is no asthenopia I usually think well of the general chance of recovery; but in no case of feeble vision do I omit at some period of the treatment to have the optical apparatus of the eye looked at with care, because pure asthenopia, apart from all optical defects, is a somewhat rare symptom.

Neither am I always satisfied with the ophthalmologist's dictum that there is a defect so slight as to need no correction, being well aware, as I have elsewhere pointed out, that even minute ocular defects are competent mischief-makers when the brain becomes what I may permit myself, using the photographer's language, to call sensitized by disease.

The following illustrations of success in this mode of treatment are taken from Dr. Playfair's book:

"Early in October of last year I was asked to see a lady thirty-two years of age, with the following history. She had been married at the age of twenty-two, and since the birth of her last child had suffered much from various uterine troubles, described to me by her medical attendant as 'ulceration, perimetritis, and endometritis.' Shortly after the death of her husband, in 1876, these culminated in a pelvic abscess, which opened first through the bladder and afterwards through the vagina. Paralysis of the bladder immediately followed the appearance of pus in the urine, and from that time the urine was never spontaneously voided, and the catheter was always used. Soon after this she began to lose power in the right leg, and then in the left, until they both became completely paralyzed, so that she could not even move her toes, and lay on her back with her legs slightly drawn up, the muscles being much wasted.

Towards the end of 1877, after some pain in the back of her neck and twitching of the muscles, she began to lose power in her left arm and in her neck, so that she lay absolutely immobile in bed, the only part of her body she was able to move at all being her right arm. Up to this time the pelvic abscess had continued to discharge through the vagina, and occasionally through the bladder, but it now ceased to do so, and there were no further symptoms referable to the uterine organs. Her general condition, however, remained unaltered, in spite of the most judicious medical treatment. She was seen, from time to time, by several of our most eminent consultants, all of whom recognized the probable hysterical character of her illness, but none of the remedies employed had any beneficial effect. There was almost total anorexia, the amount of food consumed was absurdly small, and the necessary consequence of this inability to take food, combined with four years in bed with paralysis of the greater part of the body, and the habitual use of chloral to induce sleep, had reduced a naturally fine woman to a mere shadow.

In October, 1880, her medical attendant was good enough to bring her to London for the purpose of giving a fair trial to the Weir Mitchell method of treatment, with the ready co-operation of herself and her friends, and she was conveyed on a couch slung from the roof of a saloon carriage, so as to avoid any jolt or jar, since the slightest movement caused much suffering. Two days after her arrival my friend Dr. Buzzard saw her with me, and, after a careful and prolonged electrical examination, came to the conclusion that contractility existed in all the affected muscles, and that the paralysis was purely functional. I could find no evidence in the pelvis of the abscess, the uterus being perfectly mobile, and apparently healthy. After a few days' rest the treatment was commenced on October 16, the patient being isolated in lodgings with a nurse of my own choosing; and this was the only difficulty I had with her, since she naturally felt acutely the separation from the faithful attendant who had nursed her during her long illness. Her friends agreed not to have communication with her of any sort. It is needless to give the details of the treatment in this and the following cases. A mere abstract will suffice to indicate the rapid and satisfactory progress made.

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Tags: Diets and Weight Loss

About the Author

Silas Weir Mitchell was an American physician and writer. He studied at the University of Pennsylvania in that city, and received the degree of M.D. at Jefferson Medical College in 1850. During the Civil War he had charge of nervous injuries and maladies at Turners Lane Hospital, Philadelphia, and at the close of the war became a specialist in neurology.


Fat and Blood
Buy this book
  In this book
  1. Introductory
  2. Gain or Loss of Weight Clinically Considered
  3. On The Selection of Cases for Treatment
  4. Seclusion
  5. Rest
  6. Massage
  7. Electricity
  8. Dietetics and Therapeutics
» Part 1
» Part 2
» Part 3
» Part 4
» Part 5
» Part 6
» Part 7
» Part 8
» Part 9
  9. Dietetics and Therapeutics (Continued)
  10. The Treatment of Locomotor Ataxia ...
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