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In 1851, when Mitchell returned to the United States, there was little pressure, support, or pay for physicians to do research. It was not expected or rewarded. Therefore,until late in the nineteenth century with only a few exceptions (such as William Beaumont’s experiments on human digestion and the discovery of anesthesia),Americans made few contributions to medical knowledge.Mitchell wrote that in the days of Robley Dunglison and Samuel Jackson, a physiological lecture was “a more or less well stated resumé of the best foreign books, without experiments or striking illustrations. It was like hearing about a foreign land into which we were forbidden to enter.”1 Sitting on hard wooden benches in a large lecture hall required a great deal of imagination in order to comprehend the active functions of living organisms. Even decades later, there were fewer than a dozen full-time physiology professors in American medical schools.2 Mitchell,recalling the first time he saw the living,moving heart of an etherized animal, wrote that “the swift certainty of the successive motions of this bounding thing . . . filled me at once with a fresh conception of the delicacy and wonder of the vital mechanism amidst which I had been moving, so to speak with but the slightest realization of its marvel and mystery.”3 After his time in Paris, experimental medicine was what Mitchell wanted to do, and it would become his great adventure. Pushing aside the warnings and risks, he did everything in his power to engage in the process of making medicine scienti fic. Out of step with his practical colleagues who focused on patients, gave limited time to lecturing, and were doubtful and even suspicious of research, Mitchell, at the age of twenty-two, began to spend afternoons, evenings, and summers in the laboratory. This early experimentation prepared him well to 3 the young physiologist e 03 Chapter 3_Cervetti 6/27/2012 1:55 PM Page 45 successfully engage in a major research project and publication, which in turn became the launching pad for his career. Not everything went smoothly during these years, however. In fact, when Mitchell applied for an internship at Pennsylvania Hospital and was rejected, it was the first of many he would experience.Due in part to bad feelings between his father and members of the board,his failure to gain admission was Mitchell’s first taste of the way social pressures and politics would determine the course of his career.Instead of becoming a resident,he obtained a position as a physician to the poor at the Southward Dispensary.4 Within a year, he began to lecture in physiology at the Philadelphia Association for Medical Instruction,also known as at the Summer Association,and he established a laboratory in the Philadelphia School of Anatomy building. With the use of his new microscope, chemical analysis,and vivisection—as well as the help of other Jefferson graduates,including Jacob Da Costa,George Morehouse,and John Brinton and their students— he began a series of experiments.5 Only through such grit and conviction would American medicine advance beyond the widespread and often debilitating practices of heroic medicine that included cupping,blistering,purging,and bleeding. In his historical novel The Red City, Mitchell addressed heroic medicine through his representation of the great bleeder Benjamin Rush. The novel is set in Philadelphia during Washington’s second administration and contains a detailed section on the 1793 yellow fever epidemic.Benjamin Rush believed that massive bloodletting and large doses of mercury cured yellow fever. Making frequent appearances in the novel, Rush always profusely bleeds his patients. Arriving to examine one patient, he states, “I must bleed him at once. Calomel and blood-letting are the only safety, sir. I bled Dr. Griffith seventy-five ounces today .He will get well.”The patient,who is also the novel’s wisest character,fights with Rush and tears the bandage from his arm,shouting,“Take away that horse leech. He will kill me.” The narrator comments,“The doctor bled everybody, and over and over.” Rush believed that the unifying factor underlying all disease was vascular tension and that bleeding was the way to relieve it.In addition, he understood the body to contain about twice as much blood as it actually did. He often bled patients until 80 percent of the body’s blood was removed (and trained others to do likewise).When colleagues pleaded with him for milder kinds of treatment, he was obstinate, and...

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