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The Weir Mitchell Treatment
267 4
Dyson, M (1987). ‘Mechanismsinvolved in therapeutic ultrasound’, physiotherapy, 73, 116-120.
wn,M, Franks, C and Suckling,J (1976). ‘Stimulationof healing
of varicose ulcers by ultrasound’, Ultrasonics, 14, 232-236. €1 Hag, M, Coghlan, K, Christmas, P, Harvey, W and Harris, M (1985). ‘The anti-inflammatory effects of dexamethasone and therapeutic ultrasound in oral surgery’, British Journal of Oral
trauma’, British Journal of Obstetrics and Gynaecology, 96, 1272-80.
McDiarmid, T, Burns, P N, Lewith, G T and Machin, D (1985). ‘Ultrasound and the treatment of pressure sores’,Physiotherapy, 71 66-70.
McLaren, J (1984). ‘Randomised controlled trial of ultrasound therapy for the damaged perineum’, Clinical Physics and
MBxillofacial Surgery, 23, 17-23.
Physiological Measurement, 5, 40.
Grant, A, Sleep, J, Mclntosh, J and Ashurst, H (1989). ‘Ultrasound and pulsed electromagnetic energy treatment for perineal trauma. A randomised placebo-controlled trial’, British Journal of Obstetrics and Gynaecology, 96, 434-439. Hashish, I, Harvey, W and Harris, M (1986). ‘Anti-inflammatory effects of ultrasound therapy: Evidence for a major placebo effect’,
Roche, C and West, J (1984). ‘A controlled trial investigating the effect of ultrasound on venous ulcers referred from general practitioners’, Physiotherapy, 70, 475-477. Sleep, J and Grant, A (1987a). ‘The West Berkshire perineal management trial: Three-year follow-up’,British Medical Journal,
British Journal of Rheumatology, 25, 77-81.
Hashish, I, Hai, H K, Harvey, W, Feinmann, C and Harris, M (1988). ‘Reduction of post-operative pain and swelling by ultrasound treatment: A placebo effect’, Pain, 33, 303-311. Mahomed, K, Grant, A, Ashurst, H and James, D (1989). ‘The Southmead perineal suture study: A randomised comparison of
suture materials and suturing techniques for repair of perineal
295, 749-751.
Sleep, J and Grant, A (1987b). ‘Pelvicfloor exercises in post-natal care’, Midwifery, 3, 158-164. Sleep, J and Grant, A (1988). ’Effects of salt and Savlon bath concentrate post-partum’,Nursing Times, 84, 55-57. Sleep, J, Grant, A, Garcia, J, Elbourne, D, Spencer, J and Chalmers, I (1984). ‘The West Berkshire perineal management trial’, British Medical Journal, 289, 587-590.
HISTORICAL PERSPECTIVE
The Weir Mitchell Treatment Allen Mason There was, in the second half of the nineteenth century, a revival of medical regimes based on hygiene, diet and natural remedies. This was, in part, due to the influence of the French School of Medicine with its vigorous reappraisal of contemporary therapeutics. As a result, many of the old drugs and treatments were discarded or rejected, leaving something of a therapeutic vacuum. This was filled by a number of medical ‘regimes’ or ‘cures’. Silas Weir Mitchell, a Philadelphia physician, devised a scheme for the management of nervous disorders such as neurasthenia or hysteria. He felt that patients suffering from anaemia, wasting of the tissues, poor appetite and a general loss of health were often made worse by medical treatment. These people, mostly women but not exclusively so, became trapped in a vicious circle of irregular hours, an inadequate diet and an overdependence on drugs such as chloral and morphia.
The patient was taken away from the well-meaning attention of family and friends, and allowed to rest in complete seclusion for six to eight weeks. No contact with anyone except the doctor and nurse was allowed. All drugs were discontinued and replaced with what can only be called ‘aggressive feeding’, beginning with a little milk every three hours and building up to a startling dietary regime, viz: 10 oz raw meat soup Cup of black coffee 8 am 9 am Plate of oatmeal porridge, a gill of cream; milk 12.30 pm Milk‘ 1.45 pm Whiting, bread and butter; rumpsteak, cauliflower; omelette; milk 5 am
4 pm
Milk Milk, bread and butter Fried haddock; chicken, cauliflower; apples and cream; glass of Burgundy 9.30 pm Milk 11 pm Raw meat soup
5 pm 7 pm
To stimulate the appetite, and encourage good tissue Author Allen Mason MSc MCSP DipTP is a senior lecturer in the division
health sciences, School of Health and Community Studies, Sheffield City Polytechnic.
Of
Note It is hoped that ’Historical Perspective’ will be a regular feature in the months leading up to the centenary of the founding of the Society of Trained Masseuses. Contributionswhich illuminateand COlour the establishment and development of the profession should be sent to the scientific editor.
nutrition, massage was given for up to 1% hours, night and morning. Muscle stimulating currents were also applied to the whole body (except the head) twice daily.
It was W S Playfair, professor of obstetric medicine at The London Hospital who introduced the Weir Mitchell system to Britain, where it became extremely popular. He trained a number of nurses to carry out the massage and electrical treatments, and it can be said that he played a significant part in the creation of the occupational group from which the profession of physiotherapy was to emerge.
z
Physiotherapy, April 1992, VOl78, no 4
Dyson, M (1987). ‘Mechanismsinvolved in therapeutic ultrasound’, physiotherapy, 73, 116-120.
wn,M, Franks, C and Suckling,J (1976). ‘Stimulationof healing
of varicose ulcers by ultrasound’, Ultrasonics, 14, 232-236. €1 Hag, M, Coghlan, K, Christmas, P, Harvey, W and Harris, M (1985). ‘The anti-inflammatory effects of dexamethasone and therapeutic ultrasound in oral surgery’, British Journal of Oral
trauma’, British Journal of Obstetrics and Gynaecology, 96, 1272-80.
McDiarmid, T, Burns, P N, Lewith, G T and Machin, D (1985). ‘Ultrasound and the treatment of pressure sores’,Physiotherapy, 71 66-70.
McLaren, J (1984). ‘Randomised controlled trial of ultrasound therapy for the damaged perineum’, Clinical Physics and
MBxillofacial Surgery, 23, 17-23.
Physiological Measurement, 5, 40.
Grant, A, Sleep, J, Mclntosh, J and Ashurst, H (1989). ‘Ultrasound and pulsed electromagnetic energy treatment for perineal trauma. A randomised placebo-controlled trial’, British Journal of Obstetrics and Gynaecology, 96, 434-439. Hashish, I, Harvey, W and Harris, M (1986). ‘Anti-inflammatory effects of ultrasound therapy: Evidence for a major placebo effect’,
Roche, C and West, J (1984). ‘A controlled trial investigating the effect of ultrasound on venous ulcers referred from general practitioners’, Physiotherapy, 70, 475-477. Sleep, J and Grant, A (1987a). ‘The West Berkshire perineal management trial: Three-year follow-up’,British Medical Journal,
British Journal of Rheumatology, 25, 77-81.
Hashish, I, Hai, H K, Harvey, W, Feinmann, C and Harris, M (1988). ‘Reduction of post-operative pain and swelling by ultrasound treatment: A placebo effect’, Pain, 33, 303-311. Mahomed, K, Grant, A, Ashurst, H and James, D (1989). ‘The Southmead perineal suture study: A randomised comparison of
suture materials and suturing techniques for repair of perineal
295, 749-751.
Sleep, J and Grant, A (1987b). ‘Pelvicfloor exercises in post-natal care’, Midwifery, 3, 158-164. Sleep, J and Grant, A (1988). ’Effects of salt and Savlon bath concentrate post-partum’,Nursing Times, 84, 55-57. Sleep, J, Grant, A, Garcia, J, Elbourne, D, Spencer, J and Chalmers, I (1984). ‘The West Berkshire perineal management trial’, British Medical Journal, 289, 587-590.
HISTORICAL PERSPECTIVE
The Weir Mitchell Treatment Allen Mason There was, in the second half of the nineteenth century, a revival of medical regimes based on hygiene, diet and natural remedies. This was, in part, due to the influence of the French School of Medicine with its vigorous reappraisal of contemporary therapeutics. As a result, many of the old drugs and treatments were discarded or rejected, leaving something of a therapeutic vacuum. This was filled by a number of medical ‘regimes’ or ‘cures’. Silas Weir Mitchell, a Philadelphia physician, devised a scheme for the management of nervous disorders such as neurasthenia or hysteria. He felt that patients suffering from anaemia, wasting of the tissues, poor appetite and a general loss of health were often made worse by medical treatment. These people, mostly women but not exclusively so, became trapped in a vicious circle of irregular hours, an inadequate diet and an overdependence on drugs such as chloral and morphia.
The patient was taken away from the well-meaning attention of family and friends, and allowed to rest in complete seclusion for six to eight weeks. No contact with anyone except the doctor and nurse was allowed. All drugs were discontinued and replaced with what can only be called ‘aggressive feeding’, beginning with a little milk every three hours and building up to a startling dietary regime, viz: 10 oz raw meat soup Cup of black coffee 8 am 9 am Plate of oatmeal porridge, a gill of cream; milk 12.30 pm Milk‘ 1.45 pm Whiting, bread and butter; rumpsteak, cauliflower; omelette; milk 5 am
4 pm
Milk Milk, bread and butter Fried haddock; chicken, cauliflower; apples and cream; glass of Burgundy 9.30 pm Milk 11 pm Raw meat soup
5 pm 7 pm
To stimulate the appetite, and encourage good tissue Author Allen Mason MSc MCSP DipTP is a senior lecturer in the division
health sciences, School of Health and Community Studies, Sheffield City Polytechnic.
Of
Note It is hoped that ’Historical Perspective’ will be a regular feature in the months leading up to the centenary of the founding of the Society of Trained Masseuses. Contributionswhich illuminateand COlour the establishment and development of the profession should be sent to the scientific editor.
nutrition, massage was given for up to 1% hours, night and morning. Muscle stimulating currents were also applied to the whole body (except the head) twice daily.
It was W S Playfair, professor of obstetric medicine at The London Hospital who introduced the Weir Mitchell system to Britain, where it became extremely popular. He trained a number of nurses to carry out the massage and electrical treatments, and it can be said that he played a significant part in the creation of the occupational group from which the profession of physiotherapy was to emerge.
z
Physiotherapy, April 1992, VOl78, no 4