Fat and Blood | Page 2

been thoroughly
discussed by the medical section of the British Medical Association,
and warmly endorsed by William Playfair, of London, Ross of
Manchester, Coghill, and others; while a translation of my book into
French by Dr. Oscar Jennings, with an introduction by Professor Ball,
and a reproduction in German, with a preface by Professor von Leyden,
have placed it satisfactorily before the profession in France and
Germany.
As regards the question of originality I did not and do not now much
concern myself. This alone I care to know, that by the method in
question cases are cured which once were not; and as to the novelty of
the matter it would be needless to say more, were it not that the charge
of lack of that quality is sometimes taken as an imputation on a man's
good faith.
But to sustain so grave an implication the author must have somewhere
laid claim to originality and said in what respect he considered himself
to have done a totally new thing. The following passage from the first
edition of this book explains what was my own position:
"I do not wish," I wrote, "to be thought of as putting forth anything
very remarkable or original in my treatment by rest, systematic feeding,

and passive exercise. All of these have been used by physicians; but, as
a rule, one or more are used without the others, and the plan which I
have found so valuable, of combining these means, does not seem to be
generally understood. As it involves some novelty, and as I do not find
it described elsewhere, I shall, I think, be doing a service to my
profession by relating my experience."
The following quotation from Dr. William Playfair's essay[1] says all
that I would care to add:
"The claims of Dr. Weir Mitchell to originality in the introduction of
this system of treatment, which I have recently heard contested in more
than one quarter, it is not my province to defend. I feel bound, however,
to say that, having carefully studied what has been written on the
subject, I can nowhere find anything in the least approaching to the
regular, systematic, and thorough attack on the disease here discussed.
"Certain parts of the treatment have been separately advised, and more
or less successfully practised, as, for example, massage and electricity,
without isolation; or isolation and judicious moral management alone.
It is, in fact, the old story with regard to all new things: there is no
discovery, from the steam-engine down to chloroform, which cannot be
shown to have been partially foreseen, and yet the claims of Watt and
Simpson to originality remain practically uncontested. And so, if I may
be permitted to compare small things with great, will it be with this.
The whole matter was admirably summed up by Dr. Ross, of
Manchester, in his remarks in the discussion I introduced at the meeting
of the British Medical Association at Worcester, which I conceive to
express the precise state of the case: 'Although Dr. Mitchell's treatment
was not new in the sense that its separate recommendations were made
for the first time, it was new in the sense that these recommendations
were for the first time combined so as to form a complete scheme of
treatment.'"
As regards the acceptance of this method of treatment I have to-day no
complaint to make. It runs, indeed, the risk of being employed in cases
which do not need it and by persons who are not competent, and of
being thus in a measure brought into disrepute. As concerns one of its

essentials--massage--this is especially to be feared. It is a remedy with
capacity to hurt as well as to help, and should never be used without the
advice of a physician, nor persistently kept up without medical
observation of its temporary and more permanent effects.


CHAPTER II.
GAIN OR LOSS OF WEIGHT CLINICALLY CONSIDERED.
The gentlemen who have done me the honor to follow my clinical
service at the State Infirmary for Diseases of the Nervous System[2] are
well aware how much care is there given to learn whether or not the
patient is losing or has lost flesh, is by habit thin or fat. This question is
one of the utmost moment in every point of view, and deserves a larger
share of attention than it receives. In this hospital it is the custom to
weigh our cases when they enter and at intervals. The mere loss of fat is
probably of small moment in itself when the amount of restorative food
is sufficient for every-day expenditure, and when the organs are in
condition to keep up the supply of fat which we not only require for
constant use but probably need to change continually. The steady or