Free How Everyone Became Depressed by Edward Shorter Page B

of the day, also received nervous patients from all over the world in his private clinic. He wrote in his Textbook of Nerve Diseases, a leading neurology textbook, “Neurasthenia has become a widespread illness in our society. One encounters it with special frequency among the residents of the big cities. Even though it might have been present in all epochs, and has long been familiar under the term nervousness, nonetheless in recent decades it has doubtlessly increased phenomenally, with the constantly growing haste and unrest of existence, with the extreme increase in challenges that life, work, livelihood, and pleasure-seeking that all demand.” 31
    What gave impetus to the business side of neurasthenia was the discovery in 1875 of a “cure” for it: Weir Mitchell’s rest cure. Rest cures had a long history in medicine, putting patients to bed in the hopes that they would more or less recover. But in a world awash with neurasthenia, Mitchell’s particular rest cure was a brilliant innovation as it involved isolating the patient in a private room, subject completely to the authority of an authoritarian physician (and enforced by Amazonian nurses); a milk diet to fatten up these emaciated women—and they were almost all women—many of whom had been eating poorly; small peripheral doses of electricity to get those exhausted muscles contracting again; and vigorous massage: some claim that by introducing massage into medicine, Mitchell was the founder of physiotherapy. 32 Because the rest cure demanded private rooms, special nurses, electrical apparatus, and other equipment, it could be most easily performed on in-patients, and the number of physicians willing to raise the capital for exclusive private clinics catering to wealthy female neurasthenics was very large. Of course these private clinics treated nervous and mental diseases other than neurasthenia, but it was a flagship diagnosis, and in their advertising to the medical profession, the owners featured it prominently, along with the availability of the “milk diet,” as the Mitchell cure was often called in Europe, among other physical and dietetic treatments.
    The private clinics that conducted rest cures were legion, but to give a concrete sense let’s look at Anton Frey’s “Sanatorium Frey-Gilbert” in Baden-Baden, Germany, an exclusive watering-place noted for its casino— one that exists even today, along with the famous Brenner’s Park Hotel—and for Baden-Baden’s numerous private clinics located near the warm springs. (It was to these springs that the town owed its rise to fame, in contrast to the cold springs that previously had ridden the hydrotherapy crest elsewhere; Baden-Baden physicians claimed to treat nervous disease in particular.) At the Frey-Gilbert sanatorium, nervous diseases were the first order of clinical indications for admission, and included “neuralgia, neurasthenia, hysteria, hypochondria, and insomnia.” Therapeutically, the clinic specialized in dietary cures, especially the “milk cure—Mitchell, Playfair.” 33 (Named after William S. Playfair, the London gynecologist who introduced the Mitchell rest cure to England in 1881.)
    In the United States, neurasthenic patients had an array of choices, including Weir Mitchell’s own private clinic in Philadelphia. Yet there were private nervous clinics in many places; in Des Moines, Iowa, neurasthenics were received at “The Retreat: A Private Hospital for Nervous and Mental Cases.” Led by Gershom Hill, then 67 years old and a graduate in 1886 of Rush Medical College in Chicago, the Retreat billed itself as “a large, quiet home, for neurasthenic and mild mental cases.” Its treatments included “rest.” 34 The “Oconomowoc Health Resort for Nervous and Mental Diseases” in a town by the same name in Wisconsin, “three hours from Chicago” by rail, possessed an imposing building, newly built in 1913, and equipped “to supply the demand of the neurasthenic,