UNIV. OF M1CH*
Aim m iw*
S. WEIR MITCHELL, M.D., LL.D.
BY GUY HINSDALE, A.M., M.D.,'
Assistant Physician to the Infirmary for Nervous Diseases.
EPRINTED FROM INTERNATIONAL CLINICS, VOL. I., TWELFTH SERIES.
Copyright, iqoa, by J. B. Lippincott Company, Philadelphia, Pa.

Fig. 1.—Dr. S. Weir Mitchell's clinic at the Infirmary for Nervous Diseases, Philadelphia, January, 1902.
S. WEIR MITCHELL, M.D., LL.D.
BY GUY HINSDALE, A.M., M.D.,
Assistant Physician to the Infirmary for Nervous Diseases.
Dr. Weir Mitchell's career as an army surgeon is one of the
most interesting chapters in the record of an eventful life. In
May, 1863, Dr. William A. Hammond, who was then Surgeon-
General of the United States Army, on the request of Dr. Mitchell,
ordered Dr. Mitchell and Dr. George R. Morehouse to take charge
of a hospital for soldiers suffering from nervous diseases. At first
the patients belonging to this class were assigned to separate wards
in the hospital on Christian Street between is: inth and Tenth Streets
in Philadelphia. The scope of the hospital was soon enlarged so
as to include patients suffering from injuries of the nerves. This
hospital becoming insufficient, a new hospital, with a capacity of
four hundred beds, was created in Turner's Lane, corresponding
to what is now Nineteenth Street and Columbia Avenue, Philadel-
phia. Surgeons Charles PI. Alden, U.S.A., and William W. Keen,
U.S.A., were put in charge, and the Surgeon-General wisely left
the surgeons free to devote their entire time to the treatment
of patients, relieving them of most of the administrative duties
usually connected with army hospitals. Dr. Hammond, when he
left office, had established special wards or hospitals for diseases
of the eye, for syphilis, for stumps, for diseases of the heart and
lungs, and in this way vastly promoted the interests of the wounded
and sick soldier, as well as those of science.
The Turner's Lane hospital received a multitude of cases repre-
senting almost every conceivable type of obscure nervous disease.
The medical inspectors forwarded from various fields and hospitals
V S. WEIR MITCHELL, M.D., LL.D.
a vast number of cases of wounds and contusions, including rare
forms of nerve lesion of almost every great nerve in the body.
Few persons have ever at any time had such an opportunity
for study, and the mass of material presented was not neglected
from any stand-point. The responsibility involved in the possession
of an experience so unusual was conscientiously met. Careful his-
tories of every case were taken personally by the surgeons in charge
and were methodically continued until the patient was discharged.
Two thousand pages of notes were thus recorded in two years and
formed the foundation of many valuable publications. The physi-
cians to whom fell this unique chance had the spirit of Lord Bacon,
who said, "I hold every man a debtor to his profession; from the
which as men of course do seek to receive countenance and profit,
so ought they of duty to endeavor themselves, by way of amends,
to be a help and ornament thereunto."
Two important papers soon appeared as a result of the service
at Turner's Lane hospital,—one on "Reflex Paralysis" (Circular
ISTo. VI., Surgeon-General's office, 1864), by Mitchell, Morehouse,
and Keen, which records cases of sudden palsy, the result of wounds
in remote regions of the body; and a paper on " The Antagonism
of Morphia and Atropia," by Mitchell, Morehouse, and Keen.
At that time (1864-65) hypodermic medication was somewhat
novel, and in the terrible burning pain following injuries to nerves,
which Dr. Mitchell described under the name of " causalgia," ample
use was made of hypodermic injections. It was found that the sub-
cutaneous administration of morphine in that affection was more
rapid and useful if made near the site of the pain. The combined
use of atropine and morphine was here first suggested, and has since
been unanimously adopted in daily practice. The effects of each
drug used alone were studied, then of the two together, their antago-
nisms made clear, and also their agreements in action and in a
common tendency to enfeeble the bladder. The narcosis of mor-
phine is lessened by the presence of atropine, but its analgesic power
is unaltered.



Fig. 2.-United States Army Hospital for Injuries and Diseases of the Nervous System at Turner's Lane, Philadelphia, 1864.

Fig. 3.—Dr. S. Weir Mitchell. (From a photograph taken during the Civil War.)
S. WEIR MITCHELL, M.D., LL.T>. '6
A remarkable paper on " Malingering" was among the interest-
ing products of this period. It was written by Drs. Keen, Mitchell,
and Morehouse. An important book followed,—" Gunshot Wounds
and other Injuries of Nerves/' by Mitchell, Morehouse, and Keen,
in 1864; "Injuries of Nerves and their Consequences/' by S. Weir
Mitchell, 1872, sums up all the later knowledge.
The remote after history of the soldier patients suffering from
nerve wounds has been an interesting and untouched study, attended
by all sorts of difficulties. Dr. John K. Mitchell has succeeded in
securing the history of many of these Civil War cases and recorded
them in a volume, published in 1895, entitled "Remote Conse-
quences of Injuries of Nerves and their Treatment." This record
is of singular value and is not confined to a study of the Turner's
Lane hospital patients.
Although nearly forty years have passed, now and then a veteran
of the Civil War, who remembers the faithful service in the army
hospital, returns for advice, and never fails to find a welcome and
a kind word of encouragement at the Infirmary for Nervous Dis-
eases. Here Dr. Mitchell for the last thirty years has held a clinic
on Friday afternoons.
Dr. Mitchell's influence on younger men in the profession has
been a marked characteristic. Many a medical student has found
in him a sympathetic and helpful friend. Dr. Mitchell is con-
stantly suggesting to younger men new fields of labor and instinct-
ively knows the lines upon which investigations may be profitably
pursued. Many of these have been reported with his collaborators
to the National Academy of Science, the highest scientific body in
America.
The titles of Dr. Mitchell's contributions to physiology and medi-
cine number about one hundred and forty. He has published a
number of novels and volumes of poems. He holds the belief that
a physician in active practice may do what else he pleases, provided
that his medical life and works assure him of his competence. For
4 S. WEIR MITCHELL, M.D., LL.D.
this emancipating example and influence the profession owes him a
grateful acknowledgment.
[Note.—The illustrations show Dr. Mitchell examining one of
his patients of war time, a man who had a gunshot wound of the
median nerve (Fig. 1), the Turner's Lane hospital of Philadelphia
(Fig. 2), and a photograph of Dr. Mitchell (Fig. 3) taken during
the Civil War.]


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