Silas Weir Mitchell

“ The hope proved illusory, as the stump was always too tender to bear any pressure. The hospital referred to was in charge of several surgeons while I was an inmate, and was at all times a clean and pleasant home. It was filled with men who had lost one arm or leg, or one of each, as happened now and then. I saw one man who had lost both legs, and one who had parted with both arms; but none, like myself, stripped of every limb. There were collected in this place hundreds of these cases, which gave to it, with reason enough, the not very pleasing title of Stump-Hospital. ”

“ And as to the nervous system, the only parts really necessary to life are a few small ganglia. Were the rest absent or inactive, we should have a man reduced, as it were, to the lowest terms, and leading an almost vegetative existence. Would such a being, I asked myself, possess the sense of individuality in its usual completeness,—even if his organs of sensation remained, and he were capable of consciousness? ”

“ Where the pains come and go, as they do in certain cases, the subjective sensations thus occasioned are very curious, since in such cases the man loses and gains, and loses and regains, the consciousness of the presence of lost parts, so that he will tell you, "Now I feel my thumb,—now I feel my little finger." I should also add, that nearly every person who has lost an arm above the elbow feels as though the lost member were bent at the elbow, and at times is vividly impressed with the notion that his fingers are strongly flexed. ”

“ We are thus kept endlessly informed as to the existence of parts, because the impressions which reach the brain are, by a law of our being, referred by us to the part from which they came. Now, when the part is cut off, the nerve-trunks which led to it and from it, remaining capable of being impressed by irritations, are made to convey to the brain from the stump impressions which are as usual referred by the brain to the lost parts, to which these nerve-threads belonged. In other words, the nerve is like a bell-wire. ”

“ As I have said, I was next sent to the United States Army Hospital for Injuries and Diseases of the Nervous System. Before leaving Nashville, I had begun to suffer the most acute pain in my left hand, especially the little finger; and so perfect was the idea which was thus kept up of the real presence of these missing parts, that I found it hard at times to believe them absent. Often, at night, I would try with one lost hand to grope for the other. As, however, I had no pain in the right arm, the sense of the existence of that limb gradually disappeared, as did that of my legs also. ”

“ The fractional entities of vitality are embraced in the oneness of the unitary Ego. Life," she added, "is the garnered condensation of objective impressions; and, as the objective is the remote father of the subjective, so must individuality, which is but focused subjectivity, suffer and fade when the sensation lenses, by which the rays of impression are condensed, become destroyed." ”

“ She was, as I learned afterwards, a magnetic patient of the doctor, and had deserted her husband, a master mechanic, to follow this new light. The others were, like myself, strangers brought hither by mere curiosity. One of them was a lady in deep black, closely veiled. Beyond her, and opposite to me, sat the sergeant, and next to him, the medium, a man named Blake. He was well dressed, and wore a good deal of jewelry, and had large, black side-whiskers,—a shrewd-visaged, large-nosed, full-lipped man, formed by nature to appreciate the pleasant things of sensual existence. ”

“ This change, as I have seen in my practice of medicine, passes up the nerves towards the centres, and occasions a more or less constant irritation of the nerve-fibres, producing neuralgia, which is usually referred to that part of the lost limb to which the affected nerve belongs. This pain keeps the brain ever mindful of the missing part, and, imperfectly at least, preserves to the man a consciousness of possessing that which he has not. ”

“ Food was scarce and bad, the water horrible, and we had no cavalry to forage for us. If, as infantry, we attempted to levy supplies upon the scattered farms around us, the population seemed suddenly to double, and in the shape of guerillas "potted" us industriously from behind distant trees, rocks, or hasty earthworks. Under these various and unpleasant influences, combined with a fair infusion of malaria, our men rapidly lost health and spirits. ”

“ As he left us, the sergeant leaned over and whispered to the medium, who next addressed himself to me, "Sister Euphemia," he said, indicating the lady with large eyes, "will act as your medium. I am unable to do more. These things exhaust my nervous system."
"Sister Euphemia," said the doctor, "will aid us. Think, if you please, sir, of a spirit, and she will endeavor to summon it to our circle." ”

“ Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself. ”

“ Just before we emerged into the open ground, we noticed what, I think, was common in many fights,—that the enemy had begun to bowl round-shot at us, probably from failure of shell. We passed across the valley in good order, although the men fell rapidly all along the line. As we climbed the hill, our pace slackened, and the fire grew heavier. At this moment a battery opened on our left,—the shots crossing our heads obliquely. It is this moment which is so printed on my recollection. ”

“ It is said that a burn of two thirds of the surface destroys life, because then all the excretory matters which this portion of the glands of the skin evolved are thrown upon the blood, and poison the man, just as happens in an animal whose skin the physiologist has varnished, so as in this way to destroy its function. ”

“ Hospital No. 2, in which I lay, was inconveniently crowded with severely wounded officers. After my third week, an epidemic of hospital gangrene broke out in my ward. In three days it attacked twenty persons. Then an inspector came out, and we were transferred at once to the open air, and placed in tents. Strangely enough, the wound in my remaining arm, which still suppurated, was seized with gangrene. The usual remedy, bromine, was used locally, but the main artery opened, was tied, bled again and again, and at last, as a final resort, the remaining arm was amputated at the shoulder-joint. ”

“ The impressions made on the cut ends of the nerve, or on its sides, are due often to the changes in the stump during healing, and consequently cease as it heals, so that finally, in a very healthy stump, no such impressions arise ”

“ If they had painful sensations referred to it, the conviction of its existence continued unaltered for long periods; but where no pain was felt in it, then, by degrees, the sense of having that limb faded away entirely. I think we may to some extent explain this. The knowledge we possess of any part is made up of the numberless impressions from without which affect its sensitive surfaces, and which are transmitted through its nerves to the spinal nerve-cells, and through them, again, to the brain. ”

“ The demand for army surgeons at this time became very great; and although not a graduate, I found no difficulty in getting the place of Assistant-Surgeon to the Tenth Indiana Volunteers. In the subsequent Western campaigns this organization suffered so severely, that, before the term of its service was over, it was merged in the Twenty-First Indiana Volunteers; and I, as an extra surgeon, ranked by the medical officers of the latter regiment, was transferred to the Fifteenth Indiana Cavalry. ”

“ I am the son of a physician, still in large practice, in the village of Abington, Scofield County, Indiana. Expecting to act as his future partner, I studied medicine in his office, and in 1859 and 1860 attended lectures at the Jefferson Medical College in Philadelphia. ”

“ This set me to thinking how much a man might lose and yet live. If I were unhappy enough to survive, I might part with my spleen at least, as many a dog has done, and grown fat afterwards. The other organs, with which we breathe and circulate the blood, would be essential ”

“ As a consequence, a large part of the receptive central organs must be out of employ, and, like other idle things, degenerating rapidly. Moreover, all the great central ganglia, which give rise to movements in the limbs, were also eternally at rest. ”