Physician Silas Weir Mitchell is perhaps best remembered for his “Rest Cure” for nervous women, depicted by his onetime patient Charlotte Perkins Gilman in “The Yellow Wallpaper” (1892). In the harrowing tale, the narrator slowly goes mad while enduring Mitchell’s regimen of enforced bed rest, seclusion and overfeeding. This oppressive “cure” involved electrotherapy and massage, in addition to a meat-rich diet and weeks or months of bed rest. Historians now view Mitchell’s “Rest Cure” as a striking example of 19thcentury medical misogyny.
Less well known is Mitchell’s method of treating nervous men. While Mitchell put worried women to bed, he sent anxious men out West to engage in prolonged periods of cattle roping, hunting, roughriding and male bonding. Among the men treated with the so-called “West Cure” were poet Walt Whitman, painter Thomas Eakins, novelist Owen Wister and future U.S. President Theodore Roosevelt.
Although the Rest and West cures involved wildly different therapeutic strategies, both were designed to treat the same medical condition: neurasthenia. First described by American neurologist George Beard in 1869, neurasthenia’s symptoms included depression, insomnia, anxiety and migraines, among other complaints. The malady was not just an illness, he said, but also a mark of American cultural superiority. According to Beard, excessive nervousness was a byproduct of a highly evolved brain and nervous system. A “brain-worker” who excelled in business or the professions might experience nervous breakdowns if he overtaxed his intellect. His highly evolved wife and children could easily succumb to the same malady, particularly if they engaged in excessive study or “brain work.”
While men and women could experience the same neurasthenic symptoms, the different treatments they received reflected cultural stereotypes of the day. The Rest Cure ensured that women remained in their “proper” sphere: the home. Mitchell and his medical peers discouraged female patients from writing, excessive studying or any attempt to enter the professions. Mitchell told Gilman, who underwent the Rest Cure in 1887 during a bout of postpartum depression, to “live as domestic a life as possible” and “never to touch pen, brush or pencil again.”
By contrast, nervous men were encouraged to engage in vigorous physical activity out West, and to write about the experience. These activities would supposedly rehabilitate them for further success in commerce and intellectual pursuits. As Mitchell wrote in his 1871 book “Wear and Tear: Or Hints for the Overworked,” neurasthenic men could strengthen their nervous systems by engaging in “a sturdy contest with Nature.” Such a challenge would allow a man to test his willpower and reinforce his masculinity, which had been weakened by the feminizing effects of nervous illness. (Mitchell elsewhere lamented that under great nervous stress, “The strong man becomes like the average woman.”) The West Cure also promoted physical fitness, allowing patients to attain the manly, muscular build popular at the time.
While the Rest Cure could be an unpleasant experience, West Cure patients typically returned refreshed and reinvigorated. This was particularly true of Eakins, who spent the summer of 1887 at a ranch in the Dakota Badlands at the advice of his friend Mitchell and his physician Horatio Wood. The painter had been suffering from depression after he was fired from his teaching position at the Pennsylvania Academy of the Fine Arts in 1886. Earlier that year, Eakins had caused a scandal by removing the loincloth of a male model in front of female students. The disgraced artist suddenly found himself ostracized by Philadelphia society, as he described in a letter to his sister, “For some days I have been quite cast down being cut deliberately on the street by those who have every occasion to know me.”
Eakins had the time of his life in the Dakotas, where he herded cattle, slept on the ground, mingled with cowboys and wrote fondly of his experiences to his wife, Susan. He returned from his ranching expedition looking “built up miraculously,” according to his friend Walt Whitman.
Mitchell, a self-diagnosed neurasthenic, enjoyed the West Cure himself. He made camping and fishing expeditions in the Western United States and Canada nearly every year. He saw these trips as a necessary respite from his intellectual pursuits and as a means of preventing nervous breakdowns.
Because so many prominent American men experienced the West Cure, the therapy had a major impact on the nation’s culture, particularly its literature and politics. Walt Whitman documented his 1879 journey out West in “Specimen Days” (1882), while novelist Owen Wister channeled his West Cure experiences in Wyoming into the first American Western, “The Virginian” (1902). This successful novel went through 16 printings in the year it was published, and spawned an immensely popular genre of fiction and films that continues to be influential today.
The West Cure also influenced American politics via U.S. President and recovered neurasthenic Theodore Roosevelt. In the 1880s, Roosevelt visited the Dakotas several times to treat his asthma and neurasthenic symptoms (Roosevelt was friends with Owen Wister, Mitchell’s patient and close friend). He also hoped to develop a more masculine appearance.
Before heading West, Roosevelt’s effeminate looks and high voice provoked comparisons to Oscar Wilde; afterward, he became known for his strenuous brand of masculinity. Roosevelt’s motto, “speak softly and carry a big stick,” sums up the ethos of many Westerns, in which stoic men of action engage in constant battles with nature, Indians and rogue cowboys. Like many men of his generation, Roosevelt felt that masculinity was forged by conflict, an attitude that carried over into his imperialist foreign policy.
The dramatic difference between the Rest and West Cures suggests their prescriptive nature. Both cures existed to reinforce “proper” sexual behavior, serving to masculinize effeminate (and possibly homosexual) men and discourage women from entering the professions. Both were supported by the authority of science in an era that emphasized the biological differences between men and women.
Neurasthenia fell out of favor as a diagnosis in the United States following World War I. Postwar American doctors increasingly saw neurasthenia as an umbrella term that could apply to many mental and physical ills. Mitchell’s cures, meanwhile, were gradually supplanted by various forms of psychoanalysis, particularly Freudian talk therapy. Yet aspects of both the Rest and West Cures survive in modern culture and medical practice. Women with difficult pregnancies are still put on bed rest, for instance, while over-stressed business executives of both sexes travel to pristine natural destinations in search of relaxation and self-discovery, sometimes combined with rigorous physical activities, such as biking or mountaineering. Perhaps we are not so different from the nervous rough riders of Roosevelt’s generation after all.
Anne Stiles, PhD, is assistant professor of English at St. Louis University. Katharine S. Milar, PhD, of Earlham College is historical editor for “Time Capsule.”
George Beard, American Nervousness (New York: G.P. Putnam’s Sons, 1881).
Cheryl Leibold, “Thomas Eakins in the Badlands,” Archives of American Art Journal 28 (1988): 2–15.
Tom Lutz, American Nervousness, 1903: An Anecdotal History (Ithaca: Cornell University Press, 1991).
Silas Weir Mitchell, Wear and Tear: Or Hints for the Overworked (Philadelphia: J.B. Lippincott, 1871).
Barbara Will, “The Nervous Origins of the American Western,” American Literature 70 (1998): 293–316.