MSS 2/0033-01			Acc. 1989-017
				Acc. 1991-133

FRAZIER, CHARLES H.,
(1870-1936) 

Papers,
1900-1945 


Biographical

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.


Provenance

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.


1900-1945											 
64 boxes (62.5 cubic ft.)							

4/3/1992
kc/wvg