Dorothea Dix Hospital Records Collection, 1856-1919

<i>These record collections are not available because they are being updated. The original documents on which these collections are based are held by the State Archive of NC and are publicly available.</i>
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This collection contains photos of the original, handwritten admissions ledgers (1856-1920--), general case histories (1887-1920--), and typescripts of medical staff meetings (1916-1917) held at the State Archives of North Carolina. All these records are publicly available under the North Carolina Public Records Act, which provides that state records created at least 100 years ago may be accessed and copied by the public. The admissions ledgers (Vols 1, 2, and 3), General Case Books (Vols 13-32), and Medical Meeting Minutes (Vol 9) were originally the property of Dorothea Dix Hospital (1959), also known as the North Carolina Asylum for the Insane (1856), the North Carolina Insane Asylum (1879), the Central Hospital for the Insane (1897), and the State Hospital at Raleigh (1899).
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As per historical finding aid at the State Archives of North Carolina (1977), an admissions log (aka admissions ledger) was maintained from the opening of the hospital in 1856 to 1937 (Vol. 1: 1856-1911; Vol. 2: 1911-1929; Vol. 3: 1929-1937). For the period relevant here (1856-1920), this was a hand-written ledger recording both the admission (with identifying admissions number) and disposition (discharged, transferred, escaped [eloped], death) of each patient—more than 7200 admissions. The ledgers are organized as a 19th century version of a modern spreadsheet: each row is a patient, and each column an attribute. Information about each patient includes gender, age, marital status, county of residence, “supposed cause” of admission, form (diagnosis), and condition at discharge. A “free text” field provides cause of death and, in some cases, purported hereditary links.
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In 2017-18, these records were photographed by the Community Histories Workshop and transcribed by undergraduate research fellows of the CHW, under the supervision of Sarah Almond, Assistant Director of the CHW (2018-20). A database was created from the records, providing the first alphabetical index for patients admitted at least 100 years ago. For further information on the dataset created from these records, see Dix Hospital Admissions Ledger Dataset, Patients 0000-7827 (https://doi.org/10.15139/S3/LNTB9R).
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As per the historical finding aid at the State Archives of North Carolina (1977):
<br></br>General Case Books (1887-1920, Vols 13-32) are large format (11”x14”) printed intake forms created upon admission of a patient to the hospital. They contain information about patients unavailable in any other record collection: family history, personal and and medical history, results of a physical examination, and symptomatic expressions (manifestations) of the “supposed cause” of admission. For the first years these records were kept, there are also treatment notes, some of them quite extensive. However, such notes were kept only sporadically after the early 1890s.
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Staff Clinical Notes (1916-1917, Vol 9) are typed minutes of regular (sometimes daily) meetings of the hospital’s medical staff photographed from the original typescript held by the State Archives of North Carolina. Meetings begin with discussion of operational matters, including staffing, deaths and sicknesses, escapes (elopements), and contagious diseases present in the hospital. They also reveal journal articles being read by the staff from the hospital’s library, many of the from the American Journal of Insanity. They conclude with unredacted transcripts of brief interviews with recently admitted patients, intended to confirm or (much less frequently) contest provisional diagnoses made at the time of admission. In some cases, interviews were used to determine suitability for outright or provisional discharge.
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The General Case Books have not been transcribed, nor have redacted versions been prepared. The typescript Clinical Staff Notes were scanned as PDFs by SANC. They are unredacted and contain both patient names and admission numbers.

本数据集收录了北卡罗来纳州档案馆（State Archives of North Carolina）所藏的1856年至1920年及后续时段的原始手写入院登记簿（admissions ledger）、1887年至1920年及后续时段的通用病例簿，以及1916-1917年的医务人员会议打字稿。所有此类档案均依据《北卡罗来纳州公共档案法》（North Carolina Public Records Act）对公众开放：该法案规定，形成于至少100年前的州级档案可被公众查阅与复制。

入院登记簿（第1、2、3卷）、通用病例簿（第13-32卷）与医务人员会议纪要（第9卷）最初为多萝西娅·迪克斯医院（Dorothea Dix Hospital，1959年定名，其前身先后为1856年的北卡罗来纳疯人收容所（North Carolina Asylum for the Insane）、1879年的北卡罗来纳疯人院（North Carolina Insane Asylum）、1897年的中央疯人院（Central Hospital for the Insane）以及1899年的罗利州立医院（State Hospital at Raleigh））的馆藏。

根据北卡罗来纳州档案馆1977年发布的历史档案查找指南，该院自1856年开院至1937年期间均留存有入院日志（亦称入院登记簿）：第1卷涵盖1856-1911年，第2卷为1911-1929年，第3卷为1929-1937年。本数据集涉及的1856-1920年区间内，该手写登记簿记录了每一位患者的入院信息（含唯一入院编号）与转归情况（出院、转院、擅自离院、死亡），累计登记入院人次超7200例。

该登记簿采用19世纪现代电子表格的雏形结构：每行对应一位患者，每列代表一项属性。单患者信息包含性别、年龄、婚姻状况、居住县、入院“疑似病因”、分型（诊断）以及出院时的状态。另有“自由文本”字段记录死因，部分条目还提及疑似遗传关联。

2017-2018年，社区历史工坊（Community Histories Workshop，CHW）对这批档案进行了拍摄，并由CHW的本科生研究助理在CHW助理主任Sarah Almond（2018-2020年任职）的指导下完成转录。研究团队基于这批档案构建了数据库，并为至少100年前入院的患者编制了首份字母索引。如需了解基于本数据集衍生的数据集详情，请参阅《多萝西娅·迪克斯医院入院登记簿数据集：患者编号0000-7827》（https://doi.org/10.15139/S3/LNTB9R）。

根据北卡罗来纳州档案馆1977年的历史档案查找指南，通用病例簿（1887-1920年，第13-32卷）为大尺寸（11英寸×14英寸）印刷式入院登记表，用于患者入院时填写。其中包含其他档案集合未收录的患者信息：家族病史、个人与医疗史、体格检查结果，以及入院“疑似病因”的症状表现（体征）。在该档案留存的最初几年，还附有治疗记录，部分内容篇幅较长；但1890年代初期之后，此类记录仅零星留存。

医务人员临床纪要（Staff Clinical Notes，1916-1917年，第9卷）为北卡罗来纳州档案馆所藏原始打字稿的扫描影像，内容为医院医务人员定期（有时为每日）召开会议的打字版纪要。会议首先讨论运营事务，包括人员配置、患者死亡与患病情况、擅自离院事件以及医院内的传染病情况；同时记录了医务人员研读医院图书馆馆藏期刊的情况，其中多篇刊载于《美国疯人杂志》（American Journal of Insanity）。会议尾声附有未作编辑的近期入院患者简短访谈实录，用于确认或（极少数情况下）反驳入院时作出的初步诊断；部分访谈还用于评估患者是否适合直接出院或临时出院。

通用病例簿尚未完成转录，也未编制脱敏编辑后的文本。医务人员临床纪要的打字稿已由北卡罗来纳州档案馆扫描为PDF文件，未作编辑，且包含患者姓名与入院编号。