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COLLECTION Identifier: B MS c60

Ernest Amory Codman papers


The Ernest Amory Codman papers, 1849-1981, consist of correpondence concerning Codman’s book on treatment of diseases of the shoulder and other writings; patent and accompanying material for his invention of a surgical cutting tool; and some personal correspondence. Also includes patient records from Codman's service at Massachusetts General Hospital and his private medical practice.


  • 1849-1981


Conditions Governing Access

Collection is open for research. Access requires advance notice. Consult Public Services for further information.

Boxes 1-11 of the Ernest Amory Codman papers are housed in the Center for the History of Medicine stacks. Boxes 12-17 are stored offsite. One record carton of patient note cards is unprocessed and closed to research. One oversized folder is located in XL005. Researchers are advised to contact reference staff for more information concerning retrieval of material.

Conditions Governing Use

The Boston Medical Library does not hold copyright on all materials in the collection. Researchers are responsible for identifying and contacting any third-party copyright holders for permission to reproduce or publish. For more information on the Center's use, publication, and reproduction policies, view our Reproductions and Use Policy.


6.85 cubic feet (11 flat black manuscript boxes, 2 document boxes, 1 record carton, 1 flat half record carton, 1 oversized legal document box, 1 half document box, 1 legal half document box, and one oversized folder.)
The Ernest Amory Codman papers consist of professional and personal papers, including correspondence, research records, and patient records reflecting Codman’s work as a surgeon, his efforts in hospital reform, and his work in improving patient care. There are patient records from Codman’s work at Massachusetts General Hospital, Boston, Massachusetts, and from his private practice, as well as records from the Codman Hospital, Boston. Collection includes papers pertaining to Codman’s personal and professional writings, including his book, The Shoulder, and material relating to his invention of surgical scissors to be used in treating bone sarcoma (1). The groups of records are somewhat fragmentary and do not cover all aspects of Codman’s career over a continuous time period.

1. Karcz, Susan. "BackStory," Harvard Medicine.

Biographical Note

Ernest Amory Codman (1869-1940), A.B., 1891, Harvard College, Cambridge, Massachusetts; M.D., 1895, Harvard Medical School, Boston, Massachusetts, was a researcher and clinician specializing in bones and joints. He pioneered the end-result system, which promoted medical accountability through tracking patient outcomes, and he promoted this system throughout his lifetime.

Ernest Amory Codman was born in Boston, Massachusetts on December 10, 1869 to William and Elizabeth Codman. The Codman family settled in New England in the 1600s and were considered Boston Brahmins, a socially dominant group that Codman’s contemporary, Oliver Wendell Holmes, described as a congenitally elite “race of scholars” (1). Codman was identified as white in the 1930 U.S. Census. Codman attended St. Mark’s School, Southborough, Massachusetts, Harvard College, and Harvard Medical School. During his third year of medical school, he traveled to Europe and Egypt, and he studied medicine with Eduard Albert (1841-1900) in Vienna, Austria. In 1896, he assisted Walter B. Cannon (1871-1945) in using X-ray equipment to identify swallowing mechanisms in geese. After graduating from medical school, Codman was an Assistant in Anatomy at Massachusetts General Hospital, Boston, where he and his friend, Harvey Cushing (1869-1939) used anesthesia charts to track and compare their patients’ data and outcomes. In 1899, Codman briefly served as the first skiagrapher (radiologist) at Boston Children’s Hospital, Massachusetts. Codman became Assistant in Clinical Operative Surgery at Massachusetts General Hospital, and, from 1900 to 1915, Lecturer in Surgery at Harvard Medical School. At Massachusetts General Hospital, Codman promoted his end-result system, which involved tracking patient data and following up on outcomes to improve results. His personality and his determined advocacy for the system led to tense relationships with his colleagues (2). In 1911, Codman left to start his own hospital (known as either The Codman Hospital or the “End-Result Hospital”) where surgical outcomes were carefully tracked (3). He distributed his own annual reports to promote the end-result system, and he also advocated for the system through the Clinical Congress of Surgeons, and through the American College of Surgeons (which he helped found in 1910). In 1915, Codman presented a large poster at a Suffolk Medical Society meeting, which showed ostriches with their heads in the sand laying golden eggs, satirizing the Boston doctors who rejected his end-result system. He was subsequently asked to resign from the Suffolk Medical Society. Codman’s hospital lasted until 1918, when he went to serve in World War I. He kept end-result cards for every patient he treated during the war (4). After the war, he returned to Massachusetts General Hospital. Codman’s end-result system was not widely appreciated during his lifetime, but it was later considered the precursor of evidence-based medicine.

Codman was an early user of the X-ray in clinical settings. He began practicing surgery in 1905, specializing in diseases of the bones and joints. He was considered an authority on bone tumors and diseases of the shoulder. His book, The Shoulder (1934) is still considered a classic (5) and includes an autobiographical preface and epilogue. Codman also established a registry of bone sarcoma (see Related Collections), with funding from the American College of Surgeons and the family of one of his patients, however it did not reach its full potential because his colleagues did not support it. In 1899, Codman married Katherine Putnam Bowditch (1870-1961), who was from a prominent family in Boston with medical connections. Codman died on November 23, 1940, in Ponkapoag, Massachusetts, of melanoma.

1. Mallon, Bill. “Amory Codman: The End Result of a Dream to Revolutionize Medicine.” Boston Shoulder Institute. Accessed August 13, 2020.

For a description of “Boston Brahmins” see Holmes, Oliver Wendell. “Chapter 1.” In Elsie Venner. Boston: Houghton Mifflin, 1891.

2. Neuhauser, Duncan. “Ernest Amory Codman.” In Brittanica.Com, n.d.

3. “The Codman Affair.” Proto: Massachusetts General Hospital: Dispatches from the Frontiers of Medicine, September 9, 2015. http://proto

4. Neuhauser.

5. Ibid.

Series and Subseries in the Collection

  1. I. Professional Correspondence and Related Records, 1891-1946, 1956, 1975, undated
  2. ___ A. Professional Correspondence with Individual Correspondents, 1907-1941, 1946, undated
  3. ___ B. General Professional Correspondence, 1894, 1903-1938, undated
  4. ___ C. Patient Correspondence, 1900-1935
  5. ___ D. Related Professional Correspondence, 1905-1926
  6. ___E. Hospital Standardization, Efficiency, Etc., Records, 1913-1920, undated
  7. ______ 1. General Correspondence, 1913-1920
  8. ______ 2. EAC Hospital Standardization and Efficiency Publications Correspondence, 1913-1920, undated
  9. ___ F. Codman Hospital Correspondence and Records, 1891, 1901-1941, 1956, undated
  10. ___G. Writings, 1896-1935, 1975, undated
  11. ______ 1. Manuscripts and Typescript Items, 1917, undated
  12. ______ 2. Printed Matter, 1896-1935, 1975
  13. II. Personal Correspondence and Records, 1849-1981, undated
  14. ___A. Personal Correspondence, 1880-1955
  15. ______ 1. Correspondence with Individual Correspondents, 1880-1939
  16. ______ 2. Chronological Correspondence, 1890s-1939, undated
  17. ______ 3. Katherine Bowditch Codman Correspondence, 1909-1955, undated
  18. ___ B. Legal and Financial Papers, 1885-1959
  19. ___ C. Biographical Records, 1849-1940, undated
  20. ___D. Personal Writings, 1856, 1895, 1900, 1906-1981, undated
  21. ______ 1. Manuscripts, 1895, 1900, 1917, undated
  22. ______ 2. Poetry, 1906-1933, undated
  23. ______ 3. Printed Items, 1856, 1926, 1934-1981
  24. ___ E. Photographs, undated
  25. III. Patient Data and Research Records, 1897-1921, undated
  26. ___A. Massachusetts General Hospital Correspondence and Records, 1895, 1900-1918, undated
  27. ______ 1. Correspondence, 1903-1918, undated
  28. ______ 2. Related Records, 1895, 1900-1914, undated
  29. ___B. Private Practice Records, 1897-1921, undated
  30. ______1. Patient Records, 1897-1917, undated
  31. _________ a. Patient Case Notes and Records, 1900-1917, undated
  32. _________ b. Patient Note Cards, 1897-1917, undated
  33. ______ 2. Subject Files, 1914-1921, undated

Immediate Source of Acquisition

  1. Accession number 2005-050, Margaret Richardson, June 9, 2005

Related Collections in the Center for the History of Medicine

Codman, E. A. (Ernest Amory), 1869-1940. Papers, 1849-1981: Finding Aid.
Francis A. Countway Library of Medicine. Center for the History of Medicine.

Repository Details

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

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