Medical Notes from the 1940s

I found recently a small binder of medical notes that seem to have been recorded by a student or maybe an intern of some sort at Boston City Hospital in the mid-1940s. Neatly divided into sections—Drugs, Gyn/Obs, Psych, Neur, Ortho/Fract, and Skin—they occasionally include a date and the names of different physicians.

The largest section of the notebook treats psychology. At times it seems to offer a history of psychology—at one point the author noted “Ψ The Giants” and listed a handful of names and short histories of each—while at other times it seems a more pragmatic set of guidelines. The Direct and Indirect psychological exam is a great example of this.

A schematic of the “Direct Exam”
A schematic of the “Direct Exam”

The Direct Exam guidelines include:

  1. Gen. appearance + Behavior
  2. Stream of Talk + activity
  3. Mood
  4. Content + Preoccupation
  5. Sensorium + Intellect
  6. Insight
  7. Summary
  8. Contributory Exams
  9. Tx + Rx

On the following page we find “HISTORY—The Indirect Exam:”, which seems to be a form of patient history that includes such things as “thumb sucking,” “fears of the dark,” “school record,” “sex fantasies and dreams and their autoerotic, homo and heterosexual features” and “fears of pregnancy.”

A schematic of the “Indirect Exam”
A schematic of the “Indirect Exam”

Occasionally, the person added detailed, colored illustrations:

Detailed illustration of the brain.
Detailed illustration of the brain.

Other times, the person concentrated more on doodling than illustrating:

Marginal doodles suggest, perhaps, that Dr. Korsakoús’s lesson was not all that interesting.
Marginal doodles suggest, perhaps, that Dr. Korsakoús’s lesson was not all that interesting.

The section “Ortho/Frac” was rather short, running only a handful of pages.

The first page of notes on fractures.
The first page of notes on fractures.

Tucked into the back cover were three leaflets from Boston City Hospital offering information about different skin diseases. Two prescriptions seemed to deal with eye problems.

Early 20th-century leaflets and prescriptions from Boston City Hospital.
Early 20th-century leaflets and prescriptions from Boston City Hospital.

I don’t know what to make of these notes and so offer them without further comment.