Archival materials reflect the biases and social mores of the historical period when they were created. There may be language or content in these materials that causes readers discomfort or no longer aligns with our societal values. These archival materials are records of the lives of real people, many of them experiencing serious physical ailments. Engaging with the Sayre casebooks can be an emotional experience.

It’s important to remember that there are many reasons (age, class, race or ethnicity, unfamiliarity with medical practices, different attitudes towards medicine) why patients might feel able or unable to advocate for themselves in a medical setting. Nineteenth century medical practices did not operate within the same informed consent framework we use today. Informed consent is an ethical and legal concept that gives patients the right to understand what medical treatments they will receive and agree to, or refuse, those treatments. For more information about the history of informed consent, please see the Encyclopedia of Bioethics entry "History of Informed Consent."

The Sayre casebooks are transcribed for ease of use. Transcriptions are provided beside the digital facsimiles of the pages in our sample case studies. The transcriptions preserve the original format of the documents. No spelling or punctuation has been corrected.