Visual Material in Medical Records

The patient case files of neurosurgeon Sir Geoffrey Jefferson (JCN) are rich in visual materials which enriches the textual information given in the notes. The visual material comes in the form of clinical, operative, and pathological photographs, x-rays and positive copies of x-rays, and medical illustrations (which have been mentioned in a previous blog post).  They help to give a multifaceted view of the patient giving as much information as possible to the practitioner over the course of a patient’s treatment. This is particularly true of x-rays in which a further insight not visible to the naked eye is made possible.

JCN/9/276 – positive copy of an x-ray of a patient with a meningioma of the left middle fossa & JCN/10/248 – a positive copy of a x-ray resulting from air ventriculography

As well as assisting in diagnostics and treatment such images were and are integral to engaging medical students, and Jefferson comments on certain cases how he has used them time and time again to teach his students. Additionally they support academic research and we can see how the material in these files would have supported Jefferson’s own research interests. The study of pituitary tumours was one of Jefferson’s interests on which he published a number of papers and there are a great number of these cases within the collection. A common symptom of some pituitary tumours is acromegaly (the increased production of growth hormone) which Jefferson documents in his patients by photographing their hands to demonstrate the increase in size.

JCN/14/86 & JCN/14/202 – photographs of the hands of two different patients diagnosed with pituitary neoplasms and acromegaly, 1939

Medical photography also exists as a useful tool in documenting unusual or rare cases, and there a number of images of young children suffering from spina bifida and large meningocele. The importance of recording the progress of certain cases can often go beyond the life of the patient to include post mortem images and pathological specimens which often reveal things not evident when the patient was alive.

JCN/14/238 – pathological specimen of a meningioma removed at operation, 1939

All in all the visual material in the collection and associated collections (VFA.7 – Medical Illustrations of Dorothy Davison) add much greater depth to a patient’s medical history as well as raising questions of how the patient was viewed and the ethical concerns surrounding the creation of such exposing images, the way the patients were posed, and consideration of the impact it would have had on them.

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