Materiality, Fragility, and Loss in the Medical Archive

Damage, Decay, and Material Loss

Preservation, housing, and display protocols help in caring for the collection of historic books, photographs, and medical artifacts. These measures maintain the collection in optimum condition so that they can be studied and shown in exhibitions. Nevertheless, some objects begin their life among the collections with pre-existing damage.

Certain books, like this volume purchased by Dr. Harvey Cushing in 1932, entered the collection damaged. The indentations on its cover and on many of its leaves suggest that it was eaten by rodents. Fortunately, the text is well preserved and we can still identify the author, whom the scribe refers to as “Constantine the African, monk of Monte Cassino.” Constantine, who immigrated from Tunisia to Southern Italy in the late eleventh century, is known for his Latin translation and adaptation of ‘Ali ibn al-‘Abbas al-Majusi’s “Book of the Whole Art of Medicine.” The damage on this volume reveals how medieval books were made. Pages were bound between oak boards covered in parchment. The remains of a strap-and-pin clasp, which was used to hold the book closed, is also visible.

The parchment and hand-made paper of early books remain relatively stable even over long periods of time. In contrast, paper produced after the mid-nineteenth century tends to deteriorate easily due to the mechanical pulping process of wood, which came to replace cotton and linen as the raw materials for paper. Mechanical pulping shortens the cellulose fiber in the paper, producing weaker paper that is more susceptible to acid damage. Paper after the mid-nineteenth century also commonly contains additives with higher acid content, further risking acid damage. 

The library's collection of "Nursing Times" journals spans the early twentieth century. However, it is now rendered unusable because of acid damage. Acids could have been introduced to the paper during the paper-making process, handling or through storage conditions. The brittle pages completely disintegrate in the reader's hands. 

Like paper, cellulose film negatives are unstable and pose significant conservation issues. Once flexible, the cellulose negatives from Dr. Harvey Cushing’s Brain Tumor Registry are now stiff and brittle. This damage is caused when the long cellulose polymers are cut by acetic acid contained within the film. This process leads to deterioration, including color change, iridescence, crystallization, and bubbling, known as “channeling.” 

Cellulose nitrate and cellulose acetate were used for photography until the 1950s. Not only is cellulose nitrate film highly flammable, the chemicals in nitrate and acetate negatives cause them to deteriorate drastically, sometimes even damaging the files they are stored in. Fortunately, the majority of Cushing's photographic records survive on glass plates, such as this striking frontal image of a patient at the beginning of the twentieth century.

Photographs on this page by Terry Dagradi.