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#49 Dority, Ivan, 1927

 File — Box: 18

Scope and Contents

From the Collection: 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.

Dates

  • 1927

Conditions Governing Access

The medical case files which comprise Series 3 may be restricted because they contain PHI (protected health information). While the Library is not a covered entity under Health Insurance Portability and Accountability Act of 1996 (HIPAA) and therefore not subject to its regulations, the Library's policy reflects the principles of HIPAA’s Privacy Rule.

Under certain conditions, the Library may authorize access to archival and manuscript materials that contain health information of individuals. Access will be granted to qualified persons doing historical and other research, using statistical or quantitative methods, or methods ensuring that no individual shall be able to be identified from the results of the research.

For more information, please see the full policy regarding PHI at https://collegeofphysicians.org/library/policies.

If you wish to access these materials, please contact the Librarian or Archivist of the College.

Extent

From the Collection: 64 boxes

Language of Materials

From the Collection: English

Creator

Repository Details

Part of the Historical Medical Library of The College of Physicians of Philadelphia Repository

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