Was Silas Weir Mitchell Really a Psychiatrist? / Commentary
Biderman, Aya, Herman, Joseph, Grob, Gerald N., The Israel Journal of Psychiatry and Related Sciences
Abstract: Silas Weir Mitchell was held by many of his contemporaries in the United States, Great Britain and on the continent of Europe to be the greatest medical scientist in the Western Hemisphere. He is considered the founding father of American neurology and made important contributions in the fields of basic science and the delineation of diseases. He was also a best-selling novelist and a public figure of stature. According to Wilder Penfield, the eminent Canadian neurosurgeon, Mitchell was, for the last three decades of the 19th century, the outstanding psychiatrist in the United States. We examine some aspects of this claim by reviewing briefly what psychiatrists did in Mitchell's day, the role played by neurologists in the treatment of the neuroses and his own particular psychiatric interests. We conclude that, contrary to Penfield's contention, Mitchell never really practiced psychiatry beyond what any generalist of today would consider as being within his or her scope. He was, however, a mentor to the psychiatrists of his time.
A recent biographical sketch of Silas Weir Mitchell (1829-1914) defines him as "...toxicologist, neurologist and novelist" (1). There is no disagreeing with any of these elements of his polymathy but, for the sake of completeness, one would have to add public figure (2), physiologist (3), general practitioner (2), medical scientist (2) and, by the lights of some authorities, psychiatrist (4).
According to a biographer who had access to Mitchell's letters and his notes for a planned autobiography, he was Philadelphia's first citizen as no one had been since Benjamin Franklin (2). This accolade was, almost certainly, earned by his energetic work for the city's College of Physicians of which he served for a time as president, bestowing on it many gifts from his private collection of rare books as well as monetary endowments, and by his position as a member of the Board of Trustees of the University of Pennsylvania (1). Mitchell knew President Theodore Roosevelt personally and, despite a serious disagreement between them concerning someone on whose behalf Mitchell attempted to intercede, Roosevelt spoke of him as one who had served his country well, probably alluding to his service in the American Civil War (2). This, in addition to his friendship and correspondence with many of the great scientists, authors, physicians, statesmen and poets of his day and his literary fame- "Hugh Wynne," a novel of which more than 500,000 copies had been sold within a decade of publication, was thought by some to be one of the two greatest works of fiction to appear in the United States - reflected a great deal of glory on his native town (1, 2). Finally, he cut quite a figure in Philadelphia's aristocratic society, holding Saturday night soirees at his home where "good talk" might be heard (2). Those regularly in attendance included Felix Schelling, professor of English Literature at the University of Pennsylvania, an authority on the drama and verse of the Elizabethan period, Talcott Williams and Morris Jastrow, the eminent orientalist, research professor of Assyriology and university librarian. The latter was the son of Rabbi Marcus Jastrow whose "Dictionary of theTargumim, Talmud Babli, Yerushalmi and Midrashic Literature," published in 1903, is still an indispensable tool fortalmudic study (5). Indeed, Mitchell appears to have been close to a number of Jewish scholars and physicians including Dr. Sous Cohen who was numbered among his disciples and of whom the following anecdote was told: Three days before Mitchell's death, the great man was correcting the proofs of a poem entitled "Barrabas" which had to do with the Jews. He feared that it might prove insulting and sent the manuscript to Dr. Cohen, who lived across the street, for his opinion. Dr. Cohen pronounced it inoffensive from the Jewish point of view and it was published posthumously (6). Mitchell's gesture showed considerable delicacy of feeling in a man of patrician background who was a thoroughgoing WASP. …