Neurology in frontier America before Mitchell: Fort Scott records.

The American Civil War and Weir Mitchell were instrumental in the birth of American clinical neurology. Before this period, medical practice in frontier America was undisciplined and inchoate. In these times, Fort Scott, a federal military outpost in what was then Indian territory (now Kansas), maintained an active hospital. At this fort, meticulously kept records between the years of 1842 and 1853 have been preserved. These records reveal that military surgeons of that day were aware of several neurological illnesses, such as post-traumatic epilepsy, cephalalgia, meningitis and delirium tremens. There are autopsy descriptions of cerebral hemorrhage and meningitis. The fort surgeons used thermometry routinely, at least before autopsy, even though clinical thermometer usage was very uncommon until the late 1860s. The Fort Scott records provide insight into the prevailing clinical beliefs of the day. They also reveal that some knowledge of neurology was extant before Mitchell, even in frontier America.