Cullen Lynsey
Fam Community Hist. 2012;15(1):3-14. doi: 10.1179/175138111X13153986167697.
The purpose of this article is to highlight the value and potential of patient case records as an historical source. Previous histories of the hospital (and of other healthcare providers more generally) have neglected to consider the patient. This is partly as a result of the 'history from above' approach of past histories which have focused on the founders and medical staff of such institutions and never on the people who were treated. During the early 1990s Porter called for the patient to be brought into the focus of medical history, and Risse and Warner drew attention to patient case records as a means of doing so. In the near twenty years which has passed since, however, patient records have still not been utilized by historians and the patient remains largely absent from history. By using the project 'Royal Free Hospital Patient Case Records' as a working example, this article will illustrate the benefits of using these records as a source as to patient identity, experience of medical treatment, use of the medical market, and life-cycle of individual, family, and community ill-health. The type of information the historian can extract from patient case records will be discussed and the example sampling method explained. The wider use and potential of patient records in history will then be considered and some practical advice given to help prepare historians to use such records to fill the void that is the history of the patient.
本文旨在强调患者病历作为一种历史资料的价值和潜力。以往关于医院(以及更广泛意义上的其他医疗服务提供者)的历史研究往往忽视了患者。部分原因在于过去的历史采用“自上而下的历史”方法,聚焦于这些机构的创始人及医务人员,而从未关注接受治疗的患者。20世纪90年代初,波特呼吁将患者纳入医学史的研究重点,里斯和华纳也提请注意患者病历是实现这一目标的一种方式。然而,自那时起近二十年过去了,历史学家仍未利用患者记录,患者在很大程度上仍被排除在历史之外。本文将以“皇家自由医院患者病历”项目为例,说明将这些记录用作资料来源在患者身份、治疗体验、医疗市场利用以及个人、家庭和社区健康问题生命周期等方面的益处。将讨论历史学家可从患者病历中提取的信息类型,并解释示例抽样方法。随后将探讨患者记录在历史研究中的更广泛应用和潜力,并给出一些实用建议,以帮助历史学家利用此类记录填补患者历史这一空白。