Page:American Medical Biographies - Kelly, Burrage.djvu/826

NAME MITCHELL 804 MITCHELL lected and published by him and his colleagues, there appeared in 1872 a volume by him on "Injuries to Nerves and Their Consequences," and many years later a work by his son, Dr. John K. Mitchell, on the remote consequences of nerve injuries, based upon a study of the conditions remaining in surviving patients de- scribed in the first volume. "Injuries to Nerves," translated into several languages, holds first rank in neurological literature. Mitchell's researches on the physiology of the cerebellum marked him as a scientific ex- perimentalist. These investigations were con- tinued from 1863 to 1869. In the resume of his work and results, in the American Journal of the Medical Sciences for April, 1869, he shows his thorough familiarity with the htera- ture from the time of Rolando. The experi- ments, upon pigeons, rabbits and guinea pigs, were mainly of three sorts, namely, ablation, partial or nearly complete, freezing with rigo- line spray, and injections of globules of mercury into selected portions of the cere- bellum. He also produced irritation by ap- plying cantharides to exposed parts, or by penetration with an awl-shaped instrument. He ablated the cerebellum eighty-seven times, and performed two hundred and sixty experi- ments on the influence of irritants. He was a close observer of the effects of drugs and of non-medical measures of treat- ment. He introduced inhalations of nitrite of amyl to abort epileptic seizures, and studied its effects in congestive and other nervous states. Opium and its derivatives, atropine, and bromides, were investigated and new light was thrown on their discrimating use. He advocated and illustrated, by records of suc- cessful cases, the use of splints to bring about complete rest in the treatment of painful affec- tions like sciatica, the employment of ice and freezing sprays for the relief of pain and local spasm, nerve section and nerve stretch- ing, for the relief of intractable affections. His fame as a therapeutist rests most firmly upon his origination of the different measures included under the designation "Rest Treat- ment." The first systematic exposition was in "Fat and Blood" (1877). The essentials were isolation, rest in bed, massage, general faradization, full feeding — usually with milk as its basis — general tonics, and other selected remedies. At first received with skepticism, the treatment gradually came to be recognized as an important addition to the resources of the neurologist and internist. In 1881 he published a small volume entitled "Lectures on the Diseases of the Nervous Sys- tem, Especially in Women," and in 1895 an- other, "Clinical Lessons on Nervous Diseases." Both volumes are permeated with original ob- servations and are of value to the student of functional and organic nervous diseases. Throughout these books, as well as his other works written on functional nervous diseases, his wonderful powers in psychoanalysis and psychotherapy are in evidence. His records are chiefly of personal observations, with few references to literature. Mitchell's gift for original clinical research and lucid exposition appears in his study of the seasonal relations of melancholia, of the phenomena of the period immediately preceding and following sleep, of pre- and post-hemiplegic pains, and of joint and nutritive affections occurring in cerebral, spinal and peripheral diseases. He had the faculty of seizing upon unusual and dramatic phases of disease, of describing them in detail, and of relating them to a prob- able etiology. Many references might be made to this tendency, as in his discussion of red neuralgia, the disorders of sleep, of subjec- tive false sensations of cold, and the wrong reference of sensations of pain. As late as 1905 he published a paper on the psychic dis- order to which he gave the name of ailuro- phobia or cat fear. He directed the attention of neurologists to a number of new clinical types, and among them post-paralytic chorea, in 1874. The rare vasomotor neurosis, erythromelalgia, was first fully described by him in 1878, although as early as 1872 he had called attention to its chief features. These studies of erythromel- algia show him at his best in descriptive detail. Every investigation opened up fruitful paths for further research, as seen in his studies on the effects of accidental or surgical nerve section, on the psychic phenomena shown in cases of amputation, on the influence of baro- metric and other weather conditions in nerve injury and disease, and in his elaborate study with Morris Lewis on knee jerk and muscle jerk. Out of the Civil War period came also much that crystallized later in his novels, which deal with hospital incidents and the march, the bivouac and battle. Some of his more im- portant novels also drew their inspiration from the persons and incidents of the war; "Roland Blake" deals largely with espionage, and Grant's sledge-hammer campaign in the Wil-