1862

Opening in August of Turner’s Lane Hospital in Philadelphia, where S. Weir Mitchell mentored Morehouse and Keen in study of nerve injuries. “Classifying, diagnosing, and treating these disorders were of equal importance in these first investigations”  Circular No. 6 on reflex paralysis (cases of sudden palsy as a result of wounds in remote regions of the body” (Devine, 140, 145). In addition to gunshot wounds, “They also studied “epilepsy, palsies, reflex paralysis, singular choreas, and stump disorders. Thus within the new specialty hospital very specific divisions or categories were created to study Civil War nervous conditions” (142). Most disorders at Turner’s Lane were functional or psychological, which led to research of functional disturbance that involved cases “that exhibited functional disturbances, such as headache, trance, hysteria, delirium, chorea, reflex spasms, and tetanus, which is where the initial focus lay” (142). Mitchell used electricity to exercise muscles in persons at rest (143), and bore out the discovery of medical benefits of induced faradic current of Guillaume Duchenne (144). “But Mitchell was perplexed about the relationship between loss of motion and loss of sensation, which did not equally damage motor and sensory fibers. This apparent contradiction directed his research . . .” (146-7). Mitchell’s interest in pain as symptom of nerve disorder, with classification of pain as: neuralgic, aching, or burning (148). “The physicians at Turner’s Lane were trying to establish a pattern of symptoms or behaviors that could be linked to specific nervous disorders. They took thousands of pages of notes and compiled statistics using the symptoms of the patients to direct their focus. They were thus able to determine “. . . for example, that both cutaneous and muscular hyperesthesia . . . was not uncommon in wounds of nerve trunks or spinal injuries” (151). After War, Mitchell et al. stayed in touch with their patients, enabling them to do follow-up studies on effect of weather patterns on nervous injuries/stumps, how patients did in life after losing a limb (154-158). He published a monograph with his son John Mitchell in 1897 that recovered present histories of 40 Civil War amputees and discussed ongoing physical and social challenges of living without a limb (157)  development neurology as specialty with a clinical approach pioneered by Mitchell et al. at Turner’s Lane Hospital (157-58). Jacob Da Costa given a ward to study exhausted hearts (“irritable [i.e., rapidly beating] heart” or “soldier’s heart”); he analyzed at least 300 cases of heart disease at the Hospital during the war, and his wartime research  articles on passage of functional valvular disorders to organic valvular disease (irritable hearts could  cardiac hypertrophy); meaning of murmurs; nature of “irritable heart” (result of stress, anxiety, cardiac exhaustion, and debilitation); and effectiveness of various drugs (incl belladonna) to lower pulse (Devine, 158-160).