In 1877, the neurologist Silas Weir Mitchell of Philadelphia published a therapeutic guidebook called Fat and Blood. In its pages, he laid out a comprehensive treatment programme for patients of a class well known to every physician, – nervous women, who, as a rule, are thin, and lack blood. Most of them have … 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.
Mitchell was not alone in his disdain for these patients, whose illness had no cause detectable with the tools of the era. To him, they represented a particular kind of moral menace, a refusal to perform one’s gendered duties, which could infect all of society. With unselfconsciously hysterical rhetoric, Mitchell stoked fear that the United States’ disciplined, masculine-bodied economy would be engulfed by hysteria. The menace had to be contained.
The treatment he described, the rest cure, was correspondingly extreme. Patients were confined to bed for at least six weeks, at first not allowed to read, visit the bathroom or even roll over unaided. They consumed heroic amounts of milk, about two quarts a day, gradually supplemented with as much food as the patient could eat (and probably more: Mitchell advised that complaints of over-fullness be disregarded). Finally, they began strengthening exercises and were gradually allowed to walk. ‘A large number of women,’ he claimed, ‘have been rescued by my treatment after all else had failed, and … have ever since enjoyed the most absolute and useful vigour of mind and body.’
