Manuscripts and Archives of the Historical Medical Library of The College of Physicians of Philadelphia

Charles H. Frazier papers Edit

Summary

Identifier
MSS 2/033

Dates

  • 1900 – 1945 (Creation)

Extents

  • 64 boxes (Whole)

Agent Links

Subjects

Notes

  • Biographical / Historical

    Charles Harrison Frazier, one of the pioneers of American neurosurgery, was born in Philadelphia on 19 April 1870. He received his A.B. from the University of Pennsylvania in 1889 and graduated from the School of Medicine of the University in 1892. From 1892 to 1894, he served internships at the University Hospital and Protestant Episcopal Hospital under J. William White and John Ashhurst, Jr. To pursue his interest in surgery and surgical pathology, he went to Germany in 1895 and studied under Rudolph Virchow and Gustav von Bergmann. On his return in 1896, Frazier was appointed to the surgical staff of the University of Pennsylvania and to the teaching staff of the medical school. In 1901, Frazier was elected Professor of Clinical Surgery and Dean of the School of Medicine of the University. During his term of office, 1901-1910, he modernized the faculty's teaching methods in light of his experiences in Germany. In addition to his duties as Dean, he had an active surgical practice and established the University of Pennsylvania Medical Magazine.

    Through his association with Philadelphia neurologists, S. Weir Mitchell, C. K. Mills, and, especially, his classmate in the medical school, William G. Spiller, Frazier developed a keen interest in neurological surgery. In 1910, he succeeded in cutting the sensory root of the trigeminal nerve for the relief of pain in tic douloureux. His pioneering work led to the modern operative treatment of major trigeminal neuralgia. His neurosurgical interests ranged over such major areas as pituitary lesions and brain tumors.

    During World War I, Frazier served as Consultant in Neurosurgery to the Surgeon General of the U. S. Army. He was in charge of the neurosurgical service at the Base Hospitals at Cape May, New Jersey, and at Fox Hills, Staten Island, New York. He represented the Surgeon General at the Inter Allied Surgical Conference in Paris in 1920, and presented a paper on the results of the treatment of injuries to the peripheral nerves.f

    In 1922, Frazier was appointed John Rhea Barton Professor of Surgery in the University of Pennsylvania School of Medicine. Under his chairmanship, the department established fellowships for the teaching of young men and laid stress on the coordination between clinical and research activities.

    Outside of the field of medicine, Frazier was also very active in social concerns. In 1910, he helped to establish the Social Service Department in the University Hospital. In 1914, he organized and was the first president of the Public Charities Association of Pennsylvania. The Association focused on the welfare of the handicapped, feeble minded, insane, and penal classes.

    Frazier was a voluminous writer. His works included 200 contributions to medical literature, two monographs, and a textbook, Surgery of the spinal cord (1918). In addition to his landmark work on the surgery of the trigeminal nerve, Frazier's outstanding contribution to medicine was his work on the section of the anterolateral columns of the spinal cord [cordotomy] for relief of pain. His work on surgery of the pituitary gland and suture of the recurrent laryngeal nerve was also widely recognized.

    Charles H. Frazier became a Fellow of the College of Physicians of Philadelphia in 1897. He was also a founder and president (1925-27) of the Society of Clinical Surgeons; a founder and president (1922-1923) of the Society of Neurological Surgeons; president (1928-29) of the American Neurological Association; a fellow of the American College of Surgery; a member of the American Society for the Study of Goitre; an honorary member of the Deutsche Akadamie der Naturforscher; and an honorary member of the British NeuroSurgical Society. He received the honorary degree of Doctor of Science from Hobart College and from the University of Pennsylvania (1925). In 1934, he was elected a trustee of the University of Pennsylvania.

    Frazier married Mary Spring Gardiner (d.1920) in 1901. He died at his summer house in Maine, on 26 July 1936. Despite constant pain, Frazier remained active during the last months of his life. At the time of his death, he was survived by four children, Mary H. Meade, Charles Harrison, William Doane, and Nalbro.

  • Scope and Contents

    The Charles H. Frazier Papers are divided into three series: a general file, 1901-1941; medical manuscripts, papers, and reprints, 1914-1942; and a medical case file [patient records], 1900-1945. Series 1 contains biographical and bibliographical data of Charles H. Frazier; his correspondence; instructional notes and other documents related to his teaching of medicine; records of the various activities, medical as well as social, in which he was engaged; and personal and miscellaneous material.

    Though occupying only one cubic foot, this series provides a comprehensive and historical perspective of Frazier's career both as an internationally renowned neurosurgical pioneer and as a distinguished social activist. The collection documents his commitment to various committees and departments at the School of Medicine of the University of Pennsylvania, particularly his work during his terms as Dean of the Medical School and as chairman of the surgical division of the University Hospital, and the part he played in fund raising for both the University Fund in general and the construction of an addition to the women's surgical ward in the early 1930s. In the field of social service, his activities are documented by material concerned with the Public Charities Association of Pennsylvania and the Social Service Department of the University Hospital.

    Series 2 consists of medical manuscripts written or compiled by Frazier, some of his medical theses, and reprints of either his own works or works done by others in areas of his interest. The most important item in this section is the manuscript of Frazier's textbook material on trigeminal neuralgia. The manuscript exists in several typescript versions, from "rough manuscript" to "office copy," dating from 1932 to 1934.

    Series 3, Frazier's medical case file or patient records, 1900-1945, comprises 60 out of the total of 62 cubic feet. During the mid 1920s, Frazier took responsibility as chief surgeon but left the pre surgery examination and operational practice to his assistants. Some senior assistants, among them Francis C. Grant (1891-1967), played an increasingly important role in the work. The assistants often answered inquiries from patients on behalf of Frazier during his absence. After Frazier's death in 1936, some patients who had been registered in his service became the responsibility of his former assistants. Their case records, however, remained in Frazier's file. This explains why this series runs to 1945 instead of ending in 1936. Another important feature of the file is that it is not constituted only of patient records in the general sense of the term. Like ordinary patient records, each case in this file includes a history of the patient's illness; a description of his family and social background; results of his pre surgical examinations; the surgeon's operation notes; pathological reports; and, in cases where the patient failed to survive the surgery, a death comment by either Frazier himself or the surgeon who had actually performed the operation. But unlike ordinary patient records, this file is not confined to such routine and purely technical aspects. In addition to records of the patient's illness, medical treatment, and follow up matter, there exists in many cases correspondence exchanged either between the patient and Frazier, or between Frazier and other physicians who had referred the patient to Frazier or had participated in consultations over the case. Correspondence in this category often exceeds the scope of medical consultation and extends into matters of social, humanitarian, ethical, or economic concerns. Such concerns on the part of Frazier provide valuable insight into his character and personality.

    The medical case file is arranged in volumes numbered to 103. The actual total of volumes is, however, between 20 and 30, there being a gap between volumes 20 and 99 while the volumes from 99 to 100 exist chiefly in listings of patients. Each volume is sub divided into several sections; each section is sub coded with additional Roman numerals or English capital letters.

    The ordering of the 20-odd volumes seems arbitrary and accidental. The present order was finally set by Frazier himself in 1934. Each volume was to concentrate on one particular disease or a group of similar or inter related diseases. The demarcation between volumes, however, is not absolute. In some cases overlapping is unavoidable. In general, however, the whole file consists of seven major groups: pituitary and other miscellaneous brain and nerve disorders; brain tumors; epilepsy; neuralgia (facial, trigeminal, peripheral, etc.); head wounds and injuries (concussions and contusions caused in accidents, gunshot wounds); spinal cord diseases; and thyroid diseases (goitre, etc.) . Some material, unbound and unclassified, consists of cases which had been either misplaced or only tentatively sorted or cases which were established in 1935 and 1936, after Frazier had set the order for the records established up to 1934. Material in these two groups has been attached to the end of the file under the sub heading "Unbound and Unclassified Records".

    Series 3.1 contains six volumes of medical case files, spanning 1913 to 1933, which were added to the Charles H. Frazier Papers in 1991. Like the volumes contained in Series 3, the volumes in Series 3.1 are arranged in numerical order; each volume contains cases pertaining to a certain disease and method of treatment. The diseases represented in Series 3.1 include atypical neuralgia (Volume 10 1/2), trigeminal neuralgia treated by alcoholic injection (Volume 11-B), and trigeminal neuralgia treated by a major operation (Volume 12-F).

    Volume 1, II A and Volume 1, III contain medical case files that were reclassified in 1931. Volume 1, II A contains cases diagnosed as pituitary tumors that were later reclassified as primary pituitary, unverified at operation. Volume 1, III contains files that were reclassified as primary pituitary, adenocarcinoma.

    The medical case files contained in Series 3.1 contain the same information as the files in Series 3, including correspondence between Frazier and his patients, or between Frazier and other physicians. Also present in some of the files are photographs of patients taken immediately after surgery or treatment; these photographs reveal the practice of drawing lines on the patient's face to signify anesthetized areas.

    Most of the medical case files in Volumes 11-B and 12-F contain responses to a 1923 survey sent to Frazier's former patients. The surveys provide information about the recurrence or non recurrence of the patient's condition, treatment received from other physicians, and the general health of the patient. These surveys provide useful information about the long term effectiveness of Frazier's treatments.

  • Custodial History

    The Charles H. Frazier Papers were donated to the Historical Collections of the College of Physicians of Philadelphia by the Department of Neurosurgery of the University of Pennsylvania in 1989. The collection was processed by Kaiyi Chen in 1989. Processing was funded by a grant from the Groff Family Memorial Trust. The bulk of the papers were housed in loose leaf binders. The binders, being in poor physical condition, were disbound and discarded during processing. Material of the first two series has been sorted and divided according to subject matter. Folders in these two series have retained theirforiginal titles and headings and are arranged alphabetically.

    In the patient record file, each volume represents a particular disease or group of diseases. In many cases, a volume comprising hundreds of cases of a major disease had been physically divided into several binders. Since the binders have been disbound, the individual patient records have been placed in separate folders. As each binder contained a list of all its cases, each list has been kept in a separate folder preceding the relevant folders of cases. Each folder is then marked with the number and title of the original volume as well as the number of the case in the order within the volume.

    Provenance Series 3.1

    The medical case files contained in Series 3.1 of the Charles H. Frazier Papers were donated to the Historical Collections of the Library of the College of Physicians of Philadelphia by the Department of Neurology of the University of Pennsylvania on 2 October 1991.

    The files were originally housed in loose leaf binders. The binders were disbound, and individual patient records were placed in separate folders. The volume distinctions have been maintained in the finding aid. An index of patient names, which Frazier kept at the front of each volume, is housed in a separate folder proceeding the case files from that volume. Series 3.1 consists of approximately one half cubic foot of material.

    Series 3.1 of the Charles H. Frazier Papers was processed in 1992.

  • Inventory

    Series 1. General File, 1901-1941

    Box 1 Biographical data (correspondence, etc.), 1926-38 Biographical sketches written by others, 1936-37 Miscellaneous notes collected for biography material, 1918-36 Bibliography, 1930-34 Bibliography of Charles H. Frazier, 1936 List of reprints of articles by Charles H. Frazier Correspondence Account collecting and other matters, 1935-41 Edsall, D. L., 1910 Faculty of the medical school, 1910-11 Family members, 1935 General, 1935-36 Lucas, Marjorie, 1930-36 (2 folders) Miscellaneous, 1932-38 Medical activities Agnew and Hunter Department of Clinical Surgery, 1922-25 Animal experimentation and public reaction, 1914 Committee for the Filling of the Chair of Medicine, 1934 Committee for the Filling of the Chair of Pediatrics, 1933 Committee on Nursing, correspondence, 1935 Committee on Organization of Medical Staff, 1927-28 Out patient Committee, reports, 1935 Convalescent Center, 1926 Dean of the Medical Department, minutes extracts, 1902-11 Department of Surgery, report, 1931 Foundation for the Study and Treatment of Brain Tumors and Surgical Diseases, 1931 Hospital management, notes, 1920, 1927, u.d. Neurosurgical Clinic and Laboratory, 1936 Neurosurgical Clinic, "Brain surgery instruments made by Pilling Co.", 1926 Neurosurgical Out patient Department, 1929-1930 New administration building, 1925-26 Occupational therapy, 1934 Operating room, 1916, 1919 Radium therapy, 1914-15 Resident physicians and chief resident physicians, 1913, 1916 University Hospital Department of Surgery Inventory f neurosurgical material on file, 1913 Medical Superintendent, 1921 Reports of activities, 1923-31 Seventh annual report, 1929 University of Pennsylvania Committee on Honorary Degrees, 1930-31 Delegate to the Celebration of Centenary of Joseph Leidy, 1923 Legal case, Edmond A. W. Hunter Estate, 1924 News clippings, 1910 Survey of medical departments, 1930 University of Pennsylvania Fund 1892 Class Committee, 1925 Funds raised or given to University of Pennsylvania by Charles H. Frazier, 1919-36 Medical Committee Correspondence, 1925-26 Fund campaign, 1926 Joseph Leidy Endowment, 1926 Philip Syng Physick Foundation, 1926 Publications, 1925(?) 27 Publicity Department, 1925 Special Gifts Committee Correspondence, 1925-28 Prospect records University Hospital Women's Surgical Ward Addition Fund Correspondence, 1930-35 Lists, 1930-36 Moving and opening, 1931 Ward Requirements of the surgical division, undated Personal Charles H. Frazier Professorship Fund, 1936-37 Charles H. Frazier Trust Fund, 1927 Contributions to Lewy Fund, 1934 Financial, ledger, 1932-38 Medical Protective Company, 1919-34 Medical protective insurance companies, 1934-35 Miscellaneous News clippings, 1933-36 Security transactions, 1935-37 Taxes, tax reform and correspondence, 1935-37

    Social service Public Charities Association of Pennsylvania Board of Directors, 1935-36 Report, 1937 Social Service Department, memorial meeting for Charles H. Frazier, 1937 Teaching of medicine Classes in neuro surgery for War Department, 1918 Lecture notes, 1934-36 Brain Abscesses Congenital Malformations Fracture of the Skull Gunshot Wounds Head Injuries Hemorrhage Miscellaneous Spine and Spinal Cord Letters of congratulation on appointment to Barton Professorship, 1922 Letter to Provost, with regard to upheaval in Medical School of 1901-10, 1925 Medical education Correspondence, etc., 1911-28 Description of course in clinical surgery, 1917-18 Post graduate instruction, 1920 Teaching notes, miscellaneous, 1917

    Series 2. Medical Manuscripts, Papers, and Reprints, 1914-1942

    Box 2 1. Manuscripts and Papers Gastric ulcer Paper: "Review of the Effects of Gunshot Wounds of the Head," 1919 Reprints Acknowledgements for reprints, 1931-32 Replies from foreign doctors on receiving reprints Copies, 1929 Original, 1929 Reprints of research papers Russian magazine, 1936, with citation of C. H. Frazier Textbook: Surgical pathology, syllabus, etc. Trigeminal neuralgia Manuscripts (in parts) "Anatomy" "Clinical portrait" and statistical studies by M. J. Cooper, 1932 "Clinical portrait" by M. J. Cooper, original and with charts and illustrations "Etiology" Historical and bibliographical surveys, 1936 "Historical sketch" Loose pages on miscellaneous topics "Physiology" "Sensory Innervation of the Head" "Symptomatology" "Tumors of the Gasserian Ganglion" Manuscript copies Copy to A. M. Jastrow, 1932(?) Copy with Revisions and additions Office copy, 1934 Rough manuscripts 2. Reprints and Other Material Related to Manuscripts and Publication Case register (2 folders) Correspondence Assistants for publication, 1923-35 Publication, 1930-36 Notes and correspondence, 1924-34 Directions for treatment, 1920-29 Dr. Fothergill, John, biography and work 500 operation cases "Form A" statistical sheets Map scheme of the sensory distribution of the fifth nerve Photographs Copies of peripheral nerves illustrations, 1942 Johannes Laurentius Bausch, founder and first president of the Imperial German Academy of Natural Sciences Reprints of works by other authors, 1914-34 "Subtotal Resection of Sensory Root," reprint "Surgery of the Cranial Nerves"

    Series 3. Medical Case File (patient records), 1900-1945 Boxes 3 – 64 General Index Summary and statistics, 1931 Index to the patient records is available at the Library.

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