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BWH c4

Robert B. Brigham Hospital. Records, 1889–1984 (inclusive), 1915–1980 (bulk): Finding Aid.

Center for the History of Medicine (Francis A. Countway Library of Medicine)


Center for the History of Medicine (Francis A. Countway Library of Medicine)

© President and Fellows of Harvard College

Descriptive Summary

Call No.: BWH c4
Repository: Center for the History of Medicine (Francis A. Countway Library of Medicine)
Creator: Robert B. Brigham Hospital.
Title: Robert B. Brigham Hospital Records, 1889–1984 (inclusive), 1915–1980 (bulk).
Date(s): 1889–1984 (inclusive),
Date(s): 1915–1980 (bulk).
Quantity: 9.5 cubic feet (8 record cartons, 4 flat document boxes, and 1 map drawer.)
Language of materials: English
Abstract: Robert B. Brigham Hospital. Records, 1889–1984 (inclusive), 1915–1980 (bulk) are the product of the hospital staff's administrative, fundraising, publications, training programs, legal proceedings, and public relations activities from 1915 through 1980.

Immediate Source of Acquisition:

Records of the Robert B. Brigham Hospital were placed on deposit with the Harvard Medical Library in 2001 by the Brigham and Women's Hospital. Some of the collection was transferred from the Brigham and Women's Hospital Medical Library to the Harvard Medical Library in 2005. Additional material was added as follows:
  • Accession number 2007–006 was transferred from the Brigham and Women's Hospital Medical Library to the Harvard Medical Library in July, 2006.
  • Custodial History:

    Brigham and Women's Hospital (BWH) owns the records described in this finding aid. The Harvard Medical Library entered into a contract in 2001 to act as the repository for some of BWH's archival records. Before the transfer to the Harvard Medical Library, many of the records were in storage at various locations within the BWH. In 2005, additions to the collection were assembled and transferred from a BWH storage facility at 850 Boylston Street, Boston, MA by Anne Fladger, Director of the BWH Medical Library.

    Processing Information:

    Gabriela Burgman created a preliminary box and folder list in 2005. Unprocessed parts of this collection and new acquisitions were processed and this finding aid was written by Catherine Pate at the Center for the History of Medicine. It was published in 2008. A revised version was published in 2016.
    Processing staff in the Center for the History of Medicine started processing the archival records of the Brigham and Women's Hospital under a service agreement with the BWH in 2001. The records, transferred in bulk from the BWH, were made up of records from all the individual hospitals that eventually merged to become the Affiliated Hospitals Center (AHC), which in turn became Brigham and Women's Hospital. Processing staff made the decision to organize the records by their provenance, and processed and described each individual hospital's records separately. Consequently, the original transfer yielded seven groups of records, one of which is the Robert B. Brigham Hospital records.
    The records for each hospital were organized into series and described based on practices used at the Harvard Medical School Archives. Processing for this collection also involved primary preservation, arrangement, and the creation of this detailed finding aid to improve access. Duplicate records and records that did not meet the archival collection goals of the Brigham and Women's Hospital Medical Library were discarded.

    Conditions Governing Access:

    Access requires advance notice. Access to unpublished administrative records is restricted for 50 years from creation date. Patient information is restricted indefinitely. Restricted records, except restricted patient photographs, are noted in the finding aid. Researchers may apply for access to restricted material. Consult the Director of Brigham and Women's Hospital Medical Library for further information. (email: BWHMedicalLibrary@partners.org.)

    Conditions Governing Use:

    Requests for permission to publish material from the collection should be directed to the Director of Brigham and Women's Hospital Medical Library. (email: BWHMedicalLibrary@partners.org.) However, the Brigham and Women's Hospital does not hold copyright on all the materials in this collection. Researchers who obtain permission to publish from the Director are responsible for identifying and contacting the persons or organizations that hold copyright.

    Preferred Citation:

    Robert B. Brigham Hospital. Records, 1889–1984 (inclusive), 1915–1980,(bulk). BWH c4. Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass.

    Related Collections in the Francis A. Countway Library of Medicine, Center for the History of Medicine.

    Historical Notes

    The Robert B. Brigham Hospital for Incurables, established via the philanthropic legacy of Robert Breck Brigham at the beginning of the 20th century, became the first American teaching hospital devoted exclusively to the care of arthritis and rheumatic disease. Coming of age during a time of far-reaching changes in the role of the modern hospital and patient care, "The Robert" matured into the Division of Rheumatology, Immunology and Allergy in the Department of Medicine of Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School, by the beginning of the 21st century.
    The intention to create a free hospital for poor citizens with chronic or incurable diseases was articulated in the will of Robert Breck Brigham in 1900. Like his uncle Peter Bent Brigham, Robert Brigham made his fortune as a restaurant owner and real estate developer. And similar to his uncle, whose endowment founded the Peter Bent Brigham Hospital, Robert bequeathed the majority of his estate to several charities. A trust was established to use part of his bequest for the creation of a hospital for the "…medical and surgical treatment of those citizens of Boston who are …incapable of obtaining a comfortable livelihood by reason of chronic or incurable disease or permanent physical disability."
    Elizabeth Fay Brigham, Robert's sister and the director of the corporation organized to create the hospital, died in 1909 adding one-and-a-half million dollars of her estate towards the construction. Although the Robert B. Brigham Hospital for Incurables was chartered in 1903, and 10 acres of land was purchased as a building site on top of Mission Hill in Boston in 1905, the construction was not completed until 1914.
    The hospital opened on April 1, 1914 for admissions with 115 beds, and soon thereafter began to focus on those patients with arthritis and rheumatic diseases—well before rheumatology was a recognized medical specialty. "Incurable" patients received free care and many remained in the hospital for months without charge. Advances in medical technology, surgical repair of deformities, and drugs to manage inflammation, all tested and put into practice over the years at the Robert B. Brigham Hospital, led to more and more of the formerly "incurable" patients resuming normal or near normal functioning in their daily lives. Success led to an increase in requests for treatment. The mounting monetary burden of providing free care for poor patients exceeded the income from the Brigham legacy and financial pressures constantly threatened the hospital's survival.
    In 1917 the hospital was leased by the government for the care of sick and wounded military personnel, causing a suspension of the Robert B. Brigham Hospital's normal operations and scattering the staff. The suspension paradoxically led to a financial reprieve for the struggling hospital and it was reopened in 1923.
    The successful treatment of many chronically ill patients and the hospital's need for more income than that provided by the Brigham charitable trust led to the practice of admitting some paying patients. A lawsuit in 1925 resulted from a claim by one of the hospital's trustees that treating curable patients and taking paying patients violated the stipulations of the Brigham will. By court decree in July of 1926 the argument that Robert B. Brigham's intention was to create an "old-folks home," not a paying hospital or a research hospital, failed in favor of the other trustees' interpretations that allowed them to treat patients who did have hope for a cure, and to admit some paying patients. Declining income in the 1930s caused the beginning of the end of free care and the idea of the hospital as primarily a charity. To avoid closing the hospital, private paying patients were cultivated. By 1949 all patients were charged for the cost of their care.
    It was not until another court proceeding in 1954 that the "for Incurables" was legally dropped from the name of the hospital, although the term had not been not used for many years.
    Significant practices in the rheumatology specialty evolved at the Robert B. Brigham Hospital, including the use of cortisone to manage rheumatoid arthritis and the notion of having separate occupational and physical therapy departments. The Robert B. Brigham Hospital established the first hospital based occupational therapy department. Orthopedic nursing was professionalized at the Robert. B. Brigham Training School for Attendant Nurses. This school produced licensed practical nurses from 1924 through 1951. Sub-specialties, including neurology, ophthalmology, dermatology, roentgenology, pharmacy, artificial joints, documentation standards, and community outreach, as related to orthopedics and rheumatology, were rooted and grew in importance in the research departments, clinics, and wards of Robert B. Brigham Hospital. As a teaching hospital, the Robert B. Brigham had close ties with the doctors and patients of the Peter Bent Brigham, Massachusetts General, Children's, and the Beth Israel Hospitals. By 1944 the relationship between the Robert B. Brigham Hospital and the Peter Bent Brigham Hospital had formalized with a rotation for residents at the Robert B. Brigham Hospital. In 1966, the Robert B. Brigham Hospital became an official Harvard teaching hospital.
    The Robert B. Brigham Hospital's mission and evolution were shaped for over 60 years by many noted individuals, among them, medically progressive orthopedic surgeon, Joel E. Goldthwait (1866–1961), one of the original trustees of the corporation, who guided the hospital towards a progressive (at the time) philosophy of multidisciplinary approaches to treating, not just symptoms, but patients as a whole, considering their family and social context, and their post-discharge well-being; and chief orthopedic surgeon (1917-1935) Loring T. Swaim, who brought a psychosocial approach to patient care and established an arthritis clinic at the Robert B. Brigham Hospital. Other notable "firsts" to practice and teach in the new specialty of rheumatology were Theodore B. Bayles, appointed to head a permanent research program in 1939, and Sydney Stillman, who along with Goldthwait, organized the Clinical Treatment Center for Juvenile Rheumatoid Arthritis in 1963, a prototype in the field for other specialized services for children. Arthur Hall and Peter Barry were early clinician teachers at the Robert B. Brigham Hospital who deeply influenced the following generations of rheumatologists, including Ronald J. Anderson, Director of Clinical Training Programs from 1971 to 2003. Also in the modern era, Clement B. Sledge, Chief of Orthopedic Surgery, was a pioneer in joint replacement surgery; and Physician-in-Chief, K. Frank Austen, played a central role in the merger that created what is known today as the Brigham and Women's Hospital. His team elevated the Robert B. Brigham Hospital immunology research program to international stature by working out the key mechanisms of allergy and inflammation.
    In 1975 the era of the small specialty hospital in Boston ended when the Robert B. Brigham Hospital merged with the Peter Bent Brigham Hospital and the Boston Hospital for Women forming the Affiliated Hospitals Center. (Boston Hospital for Women itself was the result of a 1966 merger of the Boston Lying-in Hospital with the Free Hospital for Women.) In 1980, at the time of the opening of a new state-of-the-art facility, the Affiliated Hospitals Center became known as the Brigham and Women's Hospital, a teaching affiliate of the Harvard Medical School. The original buildings of the Robert B. Brigham Hospital located at the top of Mission Hill in Boston, as of this writing, are part of the New England Baptist Hospital complex.


    Series and Subseries in the Collection

    Scope and Content

    The records of the Robert B. Brigham Hospital consist of those generated by the staff of the institution while conducting administrative business and public outreach from 1915 through 1975, and those generated by the staff of the Robert B. Brigham Division of the Affiliated Hospitals Center after the 1975 merger. Material in the collection dated before 1915 includes a limited number of journal articles written by staff members. The records dated after 1980 include meeting minutes of the Robert B. Brigham Hospital board of trustees, who continued to meet after the merger and after the integration in 1980 of the three hospital divisions into the unified Brigham and Women's Hospital.
    Included in the records are annual reports, meeting minutes and agendas, memoranda, committee records, and transcripts of legal proceedings related to interpreting the intentions of Robert B. Brigham's will. The collection also contains the microfilmed student records from the Robert B. Brigham School for Attendant Nurses. Additional records include press releases, programs, newspaper clippings, copies of serial and stock publications, and the visual material used to create publications. The photographs among the visual materials include images of staff, patients, hospital events, and buildings. Many of the photographs depict staff and patients actively engaged in physical therapy. Other than limited patient photographs, there are no patient records in the collection.

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