ABSTRACT
This chapter considers the significance of case notes for the course of Western medicine, with a particular focus on the processes of production and retention by British writers. It explores the form and content of case notes generated by English asylums for the insane over the nineteenth century, and identifies the case notes of patients who were also qualified medical practitioners as representing a distinctive group among asylum residents. The chapter examines case notes generated on behalf of Charles Beard, a physician from Brighton, to illustrate both the potential yield from the genre and its limits. The proliferation and growth of medical institutions across the eighteenth century gave rise to a new genre of case note. The role of case notes in histories of mental illness or disease is problematized by changing aetiologies and the evident instability of symptomatic descriptions across centuries. Closer investigation of the case notes compiled for medical patients reveals substantial parallels with the generalizations found elsewhere.
