Andrews J
Oxford Brookes University, Oxford, UK.
Soc Hist Med. 1998 Aug;11(2):255-81. doi: 10.1093/shm/11.2.255.
This article is concerned primarily with questions as to how and why case notes were produced and utilized, and how they may (or may not) be used by historians. More specifically, it discusses how the Glasgow Royal Asylum's case notes may be deployed to access patients' experiences of madness and confinement. The deficiencies and biases of the case record are also explored. So too is the relationship of case notes with other asylum based records, including reception order questionnaires, with a separate section on patient writings as part of the case history corpus. This leads into an analysis of how the Asylum's case notes became case histories and for what purposes. These subjects are related to changes and continuities in medical ideologies about insanity, social attitudes to the insane and the nature of medical practice in asylums. Some fundamental shifts in emphasis in the use of the case note and case history occurred in this period. These shifts were associated with an increased emphasis on organic interpretations of mental disease and on clinical approaches to insanity; with the medicalization of asylum records and the wider discourse on insanity, and with declining deference to the public at large in the presentation of cases. The survey concludes by analysing the changing place of patient testimony within the case record.
本文主要关注病例记录是如何以及为何产生和使用的问题，以及历史学家可能（或不可能）如何使用这些记录。更具体地说，它讨论了如何利用格拉斯哥皇家疯人院的病例记录来了解患者的疯狂和禁闭经历。同时也探讨了病例记录的缺陷和偏差。病例记录与其他基于疯人院的记录（包括收容令调查问卷）之间的关系也在探讨范围内，还有单独一部分内容将患者的文字记录作为病例史语料库的一部分进行阐述。这进而引发了对疯人院病例记录如何成为病例史以及出于何种目的的分析。这些主题与关于精神错乱的医学观念、对精神病人的社会态度以及疯人院医疗实践性质的变化和延续相关。在此期间，病例记录和病例史的使用重点发生了一些根本性转变。这些转变与对精神疾病的器质性解释和对精神错乱的临床方法的重视增加有关；与疯人院记录的医学化以及关于精神错乱的更广泛论述有关，还与在病例呈现中对公众普遍尊重的减少有关。该调查通过分析患者证词在病例记录中不断变化的地位来得出结论。
