Fonds Organization and Series Descriptions

Arrangement of Patient Files:

Elements of Dr. Segall's patient files are spread across 10 of the fonds' series (Series A, B, C, D, E, F, H, L, R, & T) and are stored in several different formats including 4 x 6'' notes, 4 x 6'' normal heart sound forms, 6 x 12'' clinical history forms, and electrocardiograms. As Dr. Segall explains in "The evolution of the record system,'' located in Box 308, the organization of the patient records found in the fonds and their format were deliberately chosen at different periods in his career to facilitate convenient record keeping and management practices. His need to write notes during home visits throughout his career required him to have a conveniently sized writing pad. Thus, 4 x 6'' paper was selected. The notes recorded on this paper were stored in envelopes of the same size and arranged in alphabetical order. These envelopes (which contain(ed) many of the patient records for Series A D F, L, & T) often also contained cards with mounted sections of electrocardiograms (begun in 1939), 4 x 6'' "normal heart sounds'' standard pattern sheets (first used in 1949), folded 6 x 12'' clinical history forms (first used in 1949), heart sounds diagrams drawn by Dr. Segall on large folded pieces of paper, as well as correspondence between Dr. Segall and other doctors, medical institutions, health insurance companies, and occasionally the patient himself/herself.

Additional 4 x 6'' patient records, containing the same elements as other 4 x 6'' records, are found in two groups of segregated files (Series E and L). These two groups are the records of patients who died of mitral stenosis (Series E) and who were attached to Trans-Canada Airlines (TCA) and ferry command (Series L). Ferry command referred to Canadian pilots who flew North American made aircraft to England during the Second World War. As Dr. Segall explains in "The evolution of the record system,'' the TCA and ferry command patient records provided normal patterns of heart sounds from which he developed a model pattern. This normal model pattern was then used as the standard against which he could compare the heart sounds of other patients.

Dr. Segall's patient records were rearranged three times between when he began keeping patient records in 1926 and when he retired in 1984. The first rearrangement began in 1939 when any files started between 1926 and 1939, which were also consulted after 1939, were segregated from files which were not consulted after 1939. The files which were not consulted after 1939 came to make up Series A, while those consulted after 1939 became Series B. Furthermore, Dr. Segall's office also segregated the files created between 1926 and 1939 of patients who had died. These deceased patients' files are typically marked with a "D'' and are found in Sub-series F/A.

The second rearrangement of patient files occurred in 1969-1970 when Dr. Segall's office segregated all inactive files created or consulted between 1939 and 1969 from those which were still active. As Dr. Segall explains in "The evolution of the record system,'' this rearrangement was precipitated by a reduction in the amount of office space he was able to dedicate to patient files. Following 1969 his patient files were restricted to one filing cabinet. As a result of this rearrangement, inactive files remained in Series B while the active files were transferred to Series C. While Series C was housed in Dr. Segall's patient records filing cabinet, the records of Series B, like those of Series A, were moved off-site (possibly to Dr. Segall's house). In addition, all of the records of patients who had died between 1939 and 1969 were removed from Series B and came to form Sub-series F/B. These patient files are typically marked with the code number "B99''.

The third rearrangement of patient files occurred in 1973 when active files of Series C were transferred to Series D. This rearrangement may have been the result of Dr. Segall's need to maintain only active files in his one office filing cabinet. Series D remained in the office filing cabinet while Series C was transferred off-site. In addition, the records of patients who had died between 1970 and 1973 were also segregated from Series C, creating what has become Sub-series F/C. They are typically marked with the code number "B99''.

Patient File Coding System:

A large number of the envelopes of 4 x 6'' patient records are marked with a (a) number, (b) a two or three character alphanumeric code (either A1 to A45, B1 to B99, or C1 to C70), and often (c) one or more two to three digit numerical codes beginning with a number between 1 and 80 followed by a digit between 0 and 9 (1-0 to 80-9).

The number (a) corresponds to an electrocardiogram, or the sections of an electrocardiogram not attached to elements of the patient's 4 x 6'' file. (These electrocardiograms are stored as rolls and form Series G. Each electrocardiogram is marked with a number, the name of a patient from whom the electrocardiogram was taken, and the date it was made.)

The two or three character alphanumeric code (b) corresponds to a condition listed in the first five drawers of Series M, a Kardex index of particular patients with certain conditions. Attached to each condition in the index is a list of the electrocardiogram numbers, often, but not always, including the numbers for electrocardiograms of the patients whose files bear that particular three character alphanumeric code. The listed electrocardiograms were determined by Dr. Segall to represent manifestations of their corresponding Kardex index condition.

The two to three digit numerical codes (c) refer to various cardiac symptoms experienced by the patient. Drawers 6 through 10 of the Kardex index (Series M) contain indexed sections for 80 different cardiac symptoms. Each of the 80 symptoms are further divided into 10 (numbered 0 to 9) different sub-sections (possibly for different variations of each symptom), each of which contains a list of the electrocardiogram numbers, often, but not always, including the numbers for electrocardiograms of the patients whose files bear that particular two to three digit numerical code. The listed electrocardiograms seem to have been determined by Dr. Segall to represent manifestations of the corresponding Kardex index symptoms.

The Series:

Series A. - 1926-1939. - approx. 8.32 m of textual records and graphic material.

This series consists of patient records started in 1926 and not consulted after 1939. Each file was originally stored in a 4x6" envelope. Although these files have been transferred to letter-sized file folders, the original envelopes have often been retained. Most of the files contain heart sounds diagrams drawn by Dr. Segall, 6x12'' clinical history forms, sections of electrocardiograms attached to dated cards, as well as 4x6" normal heart sounds record forms completed by Dr. Segall that are often accompanied by sections of electrocardiogram readings. Many files also contain correspondence between Dr. Segall and other doctors, medical institutions, and health insurance companies, and occasionally correspondence between Dr. Segall and the patient and/or the patient's family.

Any files started during the 1926-1939 period that were consulted after 1939 were transferred to Series B by Dr. Segall's office.

Series B. - 1939-1969. - approx. 45.6 m of textual records and graphic material.

This series consists of patient records started and/or consulted between 1939 and 1969, but not consulted after 1969. Each file is stored in a 4x6" envelope. Most of the files contain heart sounds diagrams drawn by Dr. Segall, 6x12'' clinical history forms, sections of electrocardiograms attached to dated cards, as well as 4x6" normal heart sounds record forms completed by Dr. Segall, which are often accompanied by sections of electrocardiogram readings. Many files also contain correspondence between Dr. Segall and other doctors, medical institutions, and health insurance companies, and occasionally correspondence between Dr. Segall and the patient and/or the patient's family.

Any files started or consulted during the 1939-1969 period which were also consulted after 1969, were transferred to Series C by Dr. Segall's office. The remaining files are stored in thirty 12x15.5x10" archival storage boxes, each containing four rows of 4x6" files. Each row of files was originally stored separately (as is the case with Series F), and their physical extent has been measured to reflect that original arrangement.

Series C. - 1969-1973. - approx. 9.84 m of textual records and graphic material.

This series consists of patient records started and/or consulted between 1969 and 1973, but not consulted after 1973. Approximately a quarter of the files have been transferred into 8x10" file folders. The rest of the files are stored in 4x6" envelopes. Most of the files contain heart sounds diagrams drawn by Dr. Segall, 6x12" clinical history forms, sections of electrocardiograms attached to dated cards, as well as 4x6" normal heart sounds record forms completed by Dr. Segall, which are often accompanied by sections of electrocardiogram readings. Many files also contain correspondence between Dr. Segall and other doctors, medical institutions, and health insurance companies, and occasionally correspondence between Dr. Segall and the patient and/or the patient's family.

Any files started or consulted during the 1969-1979 period, which were also consulted after 1973, were transferred to Series D by Dr. Segall's office. The remaining files are stored in thirty 12x15.5x10" archival storage boxes. The physical extent of those containing 4x6" files has been measured to reflect the actual extent of the files stored in each box, where each archival box contains four rows of files. Each row of files was originally stored separately (as is the case with Series F), and thus, their physical extent has been measured to reflect that original arrangement.

Series D. - 1973-1984. - approx. 10.2 m of textual records and graphic material.

This series consists of patient records started and/or consulted between 1973 and when Dr. Segall retired. All of the files are stored in 8x10" file folders. Most of the files contain heart sounds diagrams drawn by Dr. Segall, 6x12" clinical history forms, sections of electrocardiograms attached to dated cards, as well as 4x6" normal heart sounds record forms completed by Dr. Segall, which are often accompanied by sections of electrocardiogram readings. Many files also contain correspondence between Dr. Segall and other doctors, medical institutions, and health insurance companies, and occasionally correspondence between Dr. Segall and the patient and/or the patient's family.

There are two sub-series within this series.

Sub-series D/1. - 19??-1984. - approx. 5.72 m of textual records and graphic material.

This sub-series Consists of patients records started prior to 1973, and which were consulted between 1973 and Dr. Segall's retirement. These files are stored in 8x10" file folders and contain elements of the earlier 4x6" filing system, including the original 4x6" envelope.

Sub-series D/2. - 1973-1984. - approx. 4.52 m of textual records and graphic material.

This sub-series Consists of patients records started after 1973, and which were consulted between 1973 and Dr. Segall's retirement. These files are stored in 8x10" files folders and do not contain elements of the earlier 4x6" filing system.

Series E. - 1950s. - approx. 24.4 m of textual records and graphic material.

This series consists of case history files of patients with mitral stenosis. The records were separated into their own distinct group in the 1950s when Dr. Segall was involved in a study concerning therapy by surgical commissureotony.

Most of the files are stored in metal card drawers in 4x6" envelopes. Like most other patient files of the fonds, almost all of these files contain heart sounds diagrams drawn by Dr. Segall, 6x12" clinical history forms, sections of electrocardiograms attached to dated cards, as well as 4x6" normal heart sounds record forms completed by Dr. Segall which are often accompanied by sections of electrocardiogram readings. Many files also contain correspondence between Dr. Segall and other doctors, medical institutions, and health insurance companies, and occasionally correspondence between Dr. Segall and the patient and/or the patient's family.

Series F. - 1926-1984. - approx. 93 m of textual records and graphic material..

This series consists of the records of patients who died between 1926 and 1984. Most of the files are stored in metal card drawers within 4x6" envelopes. Like most other patient files of the fonds, almost all of these files contain heart sounds diagrams drawn by Dr. Segall, 6x12" clinical history forms, sections of electrocardiograms attached to dated cards, as well as 4x6" normal heart sounds record forms completed by Dr. Segall which are often accompanied by sections of electrocardiogram readings. Many files also contain correspondence between Dr. Segall and other doctors, medical institutions, and health insurance companies, and occasionally correspondence between Dr. Segall and the patient and/or the patient's family. In addition, some of the series' records are accompanied by a clipping of the patient's newspaper obituary.

There are four (4) sub-series of Series F, each one corresponding to series A-D.

Sub-series F/A. - 1926-1939. - approx. 5.4 m of textual records and graphic material.

Consists of the records of deceased patients who were only consulted between 1926 and 1939. (stored in 4x6" envelopes)

Sub-series F/B. - 1939-1969. - approx. 82.8 m of textual records and graphic material.

Consists of the records of deceased patients who were consulted between 1939 and 1969. (stored in 4x6" envelopes)

Sub-series F/C. - 1969-1973. - approx. 2.91 m of textual records and graphic material.

Consists of the records of deceased patients who were consulted between 1969 and 1973. (stored in 4x6" envelopes)

Sub-series F/D. - 1973-1984. - approx. 2.18 m of textual records and graphic material.

Consists of the records of deceased patients who were consulted between 1973 and when Dr. Segall retired. (stored in 8x10" file folders)

Series G. - 1927-1969. - approx. 11.4 m of graphic material and textual records.

This series consists of rolled electrocardiograms taken of various patients. Each rolled electrocardiogram is labeled with the patient's name, the date on which it was taken, and a unique number. This number is often also indicated on the patient's patient file, as well as under the appropriate condition if the patient is included under the Kardex index (Series M).

Series H. - 1939-1956. - approx. 95 cm of textual records.

According to the series descriptions found in Box 308, this series originally consisted of five (5) bundles of sheets summarizing the patient record details of the files contained in Series A. These bundles were originally in plastic bags, but at some point after the fonds was donated to McGill the summary sheets were transferred into 8X10" file folders and housed in archival storage boxes. Apart from information taken from the notes and forms found in the records of Series A, the summaries of most records also include the Kardex index condition and symptom categories into which each patient falls. However, the electrocardiograms indicated on patient record summaries with such condition and symptom Kardex codes are not necessarily listed in the Kardex index. According to the series description found in Box 308, print-outs of the summary sheets were still at Dr. Segall's home as of 1980. It also notes that Dr. Segall described Series H as containing 11217 sheets, of which approximately 5781 are in the present fonds.

Series I. - 1950-1964. - approx. 6 cm of textual records.

Extra copies of 68 clinical reports printed on Dr. Segall's stationary from the Medical Arts Building. Some of the reports contain sections of electrocardiograms in addition to other information.

Series J. - 1921-1969. - approx. 2.46 m of textual records.

Files loosely arranged by subject or alphabetically by correspondent. Includes some patient records, electrocardiograms, and other clinical material. Also includes some accounting records and society or association records.

Series K. - 1932-1975. - approx. 1.65 m of textual records.

Referred to in Dr. Segall's "The evolution of the record system" as "Correspondence 1932-", this series initially consisted of three (3) file cabinet drawers, each 55 cm deep. The drawers contained:

Drawer 1: Papers in alphabetical order (from C D J) relating to groups and societies.

Drawer 2: Papers in alphabetical order (from J D Z) continuing from Drawer 1, unorganized papers.

Drawer 3: Papers concerning groups and societies ordered by indices O D Z; groups and societies; personal correspondence including expenses for 1974-5, etc.

Series L. - 1950s. - approx. 76 cm of textual records and graphic material.

Case histories of Trans Canada Airlines and Ferry Command pilots. (Files stored in metal card drawers.) As Dr. Segall explains in "The evolution of the record system" (Box 308), the TCA and ferry command patient records were segregated in order to provide a collection of normal patterns of heart sounds from which he could develop a model pattern for heart sounds. This normal model pattern was then used as the standard against which he could compare the heart sounds of other patients.

Series M. - 1939-19??. - approx. 5.2 m of textual records.

This Series consists of ten drawers of a Kardex index, each of which is approximately 52 cm long. The top five drawers consist of indexed conditions, each of which is identified by a two or three character alphanumeric code (either A1 to A45, B1 to B99, or C1 to C70). Attached to each condition in the index is a list of the electrocardiogram numbers of particular patients. Dr. Segall seems to have determined that the listed electrocardiograms represent manifestations of their corresponding Kardex index condition. The individual electrocardiograms are located in Series G and are marked with their electrocardiogram numbers, the date on which they were created, as well as the names of the patients from which they were taken.

Drawers 6 through 10 of the Kardex index (Series M) contain indexed sections for 80 different cardiac symptoms. Each of the 80 symptoms are further divided into 10 (numbered 0 to 9) different sub-sections (possibly for different variations of each symptom), each of which contains a list of the electrocardiogram numbers, often, but not always, including the numbers for electrocardiograms of the patients whose files bear that particular two to three digit numerical code. The listed electrocardiograms seem to have been determined by Dr. Segall to represent manifestations of the corresponding Kardex index symptom.

Series N. - 1964-1972. - approx. 1.17 m of textual records.

Identified as "Office Files" in the series descriptions found in Box 308, this series consists of chequing records, cheque stubs, federal and provincial taxation records, daily record books (professional charges), donation records, bank deposit records, and account statements of Dr. Segall's practice.

Series O. - 19??-197?. - approx. 3 m of objects and sound recordings.

This series consists of various medical apparatuses, 3 voice recording machines, 4 electrogardiogram recording machines, magnetic recordings, Audiograph recordings, and glass slides.

Series P. - 192?-1990. - approx. 2.76 m textual records, graphic material, and sound recordings.

This series consists of notes and collected documents related to Dr. Segall's History of medicine research. This material includes records related to his various history research projects including his N.S. Korotkov book (1980), "Pioneers of Cardiology," material concerning the Osler Library of the History of Medicine, and correspondence with other medical historians.

Series Q. - 191?-1990. - approx. 4.92 m of textual records, graphic material, and objects.

This series contains personal and family records of various kinds. Examples include correspondence, school and university study notes, official and unofficial documents, financial records, and photographs.

Series R: - 192?-198?. - approx. 4.8 m of textual records, graphic material, and objects.

This series consists of Dr. Segall's medical research records, lecture notes, presentations, publications, and related material. While wide-ranging, the subject matter of these various kinds of materials often intersects. For example, his research records often influenced his publications and were reflected through his lectures. This interconnectivity may explain why such different forms of records were stored together. However, there are also many examples of files and boxes within the series where there are no obvious interconnections between different records.

Series S. - 1922-1988. - approx. 42 cm of textual records.

This series consists of alphabetically ordered office files, mostly from the 1980s. The files contain material concerning various medical and history of medicine associations. There are also a small number of files on various colleagues and patients. These files do not include patient files with case histories.

Series T. - 192?-1984. - approx. 4 m of textual records and graphic material.

This series consists of patient records which are not arranged as part of a larger set of patient files. The reason(s) why these records were separated from the patient records in series A through F, H, or L is/are not known.

Series U. - 192?-198?. - approx. 4.8 m of textual records, graphic material and objects.

This series contains miscellaneous medical practice files, medical practice financial records, medical practice correspondence, and decorations, memorabilia, and other objects from Dr. Segall's office. While various materials from this series may be found within a single box, there is not necessarily any recognizable connection between those materials.

Series V. - 193?-198?. - approx. 2.16 m of textual records and graphic material.

This series is formed of publications and other materials concerning various medical and history of medicine associations and organizations, including correspondence between Dr. Segall and others about such associations and organizations.