This system of treatment consists in rest, isolation, over-feeding, passive exercise or massage and electricity, and is known by the name of its founder, Dr. Weir-Mitchell. The patient is taken from home and strictly isolated from friends and family; she is put to bed, and in extreme cases is not even allowed to sit up in bed, but is fed by a nurse. The patient should be weighed before being put to bed, and should be weighed at frequent intervals during the treatment. She is first placed on a milk diet, and for the first day or two from three to four ounces of milk are given every two hours. The milk may be slightly warmed, and if it is particularly distasteful to the patient it may be flavoured with a little tea or coffee. The quantity of milk taken is gradually increased, and the intervals lengthened to three hours, till at last two quarts are taken in the twenty-four hours. This rest in bed and the simple milk diet "nearly always dismisses," says Dr. Weir-Mitchell, "as if by magic, all the dyspeptic conditions" from which the patient had previously suffered. The circulation is at the same time stimulated, and the muscles undergo passive exercise by being kneaded by massage and moved by electric currents. The bowels are carefully regulated. After from four to seven days a little solid food is taken, namely, bread and butter for breakfast, and a milk pudding for dinner. A day or two later, fish and chicken or a mutton chop are added, first either at the mid-day or evening meal, and then at both. In about ten days the patient is put on three full meals daily, and the diet is as follows:-

Milk, sixty to eighty ounces.

Breakfast, porridge and cream.

Second Breakfast, cocoa and egg, bread and butter.

Luncheon, fish, bread, pudding, and milk, or chicken, vegetables, and pudding.

Dinner, mutton or beef, two or three kinds of vegetables, milk pudding, or stewed fruit with cream.

Extract of malt may be given with one or more of the supplies of milk, and in some cases cod-liver oil is also prescribed.

Dr. Weir-Mitchell says of this treatment: "No troublesome symptoms usually result from this full feeding, and the patient may be made to eat more largely by being fed by her attendant; "and as to the beneficial effect, he says: "I have watched again and again, with growing surprise, some listless, feeble, white-blooded creature learning by degrees to consume these large rations, and gathering under their use flesh, colour, and wholesomeness of mind ".

Tonics are also given in rather full doses, iron, arsenic, and sulphate of strychnine. Where there is no alcoholic habit to break, a small daily dose of whisky or wine is found to assist in the decrease of fat. As the diet is increased and maintained at its highest point, it is necessary to carefully watch the urine, and if an excess of urates is found, it is an indication that the amount of food must be reduced.

At the end of five or six weeks the patient will be found to have gained considerably in weight and strength, and the muscles to have become firmer and fuller. The massage can then be decreased, and normal exercise on foot allowed. The excessive diet is also slowly reduced; the quantity of the milk is first lessened, then the intermediate meals are dropped, and gradually the patient returns to a normal, active, open-air life. The cure may be completed by a sea voyage or a foreign tour; and the patient, once restored to health and family, and to a life of interest and usefulness, rarely relapses. The following cases will illustrate the treatment and its results: -

Under Dr. Weir-Mitchell.

Mrs. C. Kept in bed and fed by an attendant.

First Day

One quart of milk in divided doses every two hours.

Second Day

Cup of coffee on waking. Two quarts of milk in divided portions every two hours.

Third To Sixth Day

Same diet.

Seventh, Eighth, And Ninth Days

Same diet, with a pint of raw soup in three portions.

Tenth Day

7 a.m., coffee; 7.30, half-pint of milk; 10 a.m., ditto; noon, 2, 4, 6, 8, and 10 p.m., ditto; soup at 11 a.m. and 5 and 9 p.m.

Fourteenth Day

Egg and bread and butter added.

Sixteenth Day

Dinner added and iron.

Nineteenth Day

The entire diet was as follows: 7 a.m., coffee; 8 a.m., iron and malt extract; breakfast, consisting of a chop, bread and butter, a tumbler and a half of milk; 11 a.m., soup; 2 p.m., iron and malt; dinner of anything she liked, with 6 oz. of Burgundy or dry champagne, and at the end one or two tumblers of milk; 4 p.m., soup; 7 p.m., malt, iron, bread and butter, usually some fruit, commonly two glasses of milk; 9 p.m., soup.

(At 12 noon massage for an hour; at 4.30 p.m. electricity applied for an hour.)

At sixth week soup and wine were dropped, iron lessened one half, massage and electricity only on alternate days.

At ninth week milk reduced to a quart. All mechanical treatment ceased.

Result

Gain in flesh about face in second week. Weight rose in two months from 96 to 136 lbs.; gain in colour equally marked. At ninth week drove out. Cure complete and permanent.

Under Dr. Playfair.

A. B., aged 32. Rest in bed, isolation.

First Day

22 oz. of milk in divided doses.

Second Day

50 oz. of milk in divided doses.

Third Day

50 oz. of milk in divided doses. Massage half an hour.

Fourth Day

50 oz. of milk in divided doses; egg and bread and butter; 40 minims of dialysed iron in two doses. Massage 1 1/2 hours.

Eighth Day

50 oz. of milk in divided doses, mutton chop, porridge, and a gill of cream; maltine twice daily. Massage three hours, electricity half an hour; continued to end of treatment.

Fifteenth Day

Three full meals daily of fish, meat, vegetables, cream, and fruit; two quarts of milk, and two glasses of Burgundy.

Twenty-Second Day

Amount of food lessened.

Result

On twenty-second day sat in a chair for an hour; after a month walked downstairs, and went for a drive. Enormous increase in size. Cure complete and permanent.