Detail of a handwritten budget estimate with a line for $150 for Medical Books for Office.

New History of the NLM: Origins and Early Years

By Kenneth M. Koyle ~

This the second post in a series of nine which serializes the new book US National Library of Medicine in the popular Images of America series of Arcadia Publishing. A hardback version of the book is available from booksellers, and an electronic version of the complete book and original versions of the 170+ images, which appear in it in black and white, are archived and freely available in NLM Digital Collections.  The Intramural Research Program of the US National Institutes of Health, National Library of Medicine, supported the research, writing, and editing of this publication. We hope that you will add it to your summer reading list!

The official history of the US National Library of Medicine begins in 1836, with the first documented request for funding from the secretary of war to purchase medical books. However, the roots of the Library originated 18 years earlier than this request, in the establishment of the US Army Medical Department and the appointment of the first surgeon general, 30-year-old Joseph Lovell. It was in the office of this young surgeon general that the first few books, which were from Lovell’s personal collection, took their place on a shelf and became the seeds of what would eventually grow to be the world’s largest biomedical library.

The US Army Medical Department in 1818 was small, scattered, and insufficient for its mission. Despite this, Lovell was determined to succeed. Medical officers at the time did not hold regular officer rank, but were instead referred to by the titles surgeon or assistant surgeon. Lovell worked tirelessly to ensure that the department’s surgeons and assistant surgeons could provide the best possible care to the widespread Army. The state of medical practice across the young nation was haphazard and disparate, ranging from highly educated, scientifically minded physicians who had studied at the best schools in Europe to apprentice-trained doctors who had never set foot in a university classroom and had only been exposed to the narrow group of patients available in their small, frontier towns. In order to raise the standards of care and enable his officers to remain current on the latest advances in science and medicine, Lovell subscribed to medical journals for each surgeon and assistant surgeon. In addition to the journal subscriptions, the Surgeon General’s Office provided each post and regiment with a standard set of books on anatomy, surgery, and medical practice.

Prior to 1836, there was no specific budget allocation for medical publications. Instead, a few hundred dollars would be designated for operational necessities, such as books and medical supplies. Lovell was meticulous and careful with his tiny budget, tracking every expenditure and taking pride in the occasions when he could demonstrate a reduction in the cost for medical support. However, throughout his tenure as surgeon general, it appears that he neither requested nor received funding directly linked to procuring books for a medical library. When Lovell died of pneumonia in October 1836, Assistant Surgeon Benjamin King, who was the senior medical officer serving in Washington at the time, assumed control of the office until President Andrew Jackson could appoint a new surgeon general. The budget request for the coming year had to be submitted to the secretary of war during King’s short time as interim surgeon general, and he included $150 for medical books in the request. This was the first funding request specifically identifying books for the Library of the Surgeon General’s Office, and it is with this document that the US National Library of Medicine marks the beginning of its history.

Portrait of Thomas Lawson.
Thomas Lawson (1789–1861) was the second surgeon general of the Army, from 1836 to 1861.

On November 30, 1836, President Jackson selected Thomas Lawson to succeed Lovell as surgeon general. Under Lawson’s leadership, the small collection of books blossomed into a legitimate library. Lawson continued to include funding for books in his annual budget requests, and in 1840, an unidentified staff member in the office compiled the first known catalog of publications in the Library of the Surgeon General’s Office. The handwritten inventory listed 134 titles, including eight journals. Small though it was, the Library included the current standards of medical and scientific literature, along with a few volumes of general scholarly interest.

During this period, the recording of meteorological data became one of the unique tasks assigned by the Army’s leadership to its medical officers at frontier posts. Such data collection had been undertaken almost since the establishment of the medical department, primarily to study the suspected links between climate and disease. Joseph Lovell published the first compilation of this data in 1826, covering the years 1822 to 1825, and in 1840, Lawson proposed that his staff draft a more detailed report examining the data from the subsequent five-year period. He published this report as the Meteorological Register for the Years 1826–1830, appending Lovell’s earlier compilation so that the new book covered nine years of weather data. Along with this book, Lawson had his staff conduct a thorough analysis of medical reports from the field, creating a second text called Sickness and Mortality in the Army of the United States. These two volumes provided Lawson with an alternate means of growing the collection: book exchanges. Lawson sent the books produced by his office to the Medical Department of the British Army and to the libraries at Harvard College and the Philadelphia College of Medicine. In return, the recipients sent copies of their own publications to Lawson. The Library also grew with gifts and donations of various kinds. Occasionally, the author of a medical text sent copies to the Office of the Surgeon General, hoping to gain publicity that would translate to more sales. Publishers of journals and medical books sent free sample copies to Lawson, attempting to entice him to make purchases for his office and for the burgeoning cadre of medical officers in the field. And of course, sometimes medical professionals, either those affiliated with the Army or simply supportive of the military mission, donated books from their personal collections to the Library.

Thomas Lawson served as the surgeon general for 25 years, the longest tenure of anyone in that position. In 1840, four years after he took office, the Library contained a mere 134 titles. Three years after his death, in May 1861, the number of titles was approaching 500. The Library of the Surgeon General’s Office of the US Army was still small, but it was firmly established and growing. During and following the Civil War, Lawson’s successors built upon this foundation to create an institution worthy of its name.

Kenneth M. Koyle is Deputy Chief of the History of Medicine Division at the National Library of Medicine.

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