Handwritter: I am trying to form a great National Medical Library here - a work of great labor - which I am satisfied can only be done under Government.

A New History of NLM: Civil War and the Era of John Shaw Billings

By James Labosier ~

This is the third 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!

Surgeon General Thomas Lawson died on May 15, 1861, barely a month after the Civil War began with the Confederate bombardment of Fort Sumter in South Carolina. Clement A. Finley succeeded Lawson and held the position for less than a year before a young surgeon named William Alexander Hammond formally replaced him in April 1862. Despite his arrogance and abrasive personality—traits that would result in a court-martial and dismissal from the office after just two years—Hammond was an effective and visionary surgeon general, notable for recognizing the potential of the Library and working to ensure its continued growth.

As medical officers struggled to cope with the devastating injuries they witnessed during the American Civil War, the need for new research dictated accelerated acquisitions by the library. The war presented opportunities for expansion of the Surgeon General’s Office and for a new orientation of the library’s collections. In 1862, the Library moved from rented offices to the Riggs Bank Building in downtown Washington, DC, and Hammond established the Army Medical Museum as a corollary to the Library to collect specimens and data for research in military surgery. Hammond also initiated a plan to create a comprehensive medical and surgical history of the Civil War, a plan that his successor, Joseph K. Barnes, would bring to fruition. The result was the monumental Medical and Surgical History of the War of the Rebellion, a multi-volume compilation of medical knowledge and illustrations unlike anything previously produced. Both the museum work and the Medical and Surgical History required varied and specialized medical knowledge heretofore unnecessary in the library. This need for unique medical information would continue after the war as the Library began acquiring studies of yellow fever and cholera, which were regular scourges of Army personnel in scattered outposts.

The momentum of the war had shifted to favor the Union forces when Barnes succeeded Hammond as surgeon general in August 1864, but months of hard fighting still lay ahead. Barnes assigned Assistant Surgeon John Shaw Billings to the Surgeon General’s Office in January 1865. The Library was not a high priority within the medical department’s operations, and its management was initially an informal addition to Billings’s regular duties. Army surgeons and assistant surgeons routinely filled the administrative positions of the medical department. Like his fellow staff members, Billings was a physician, not a librarian. He did, however, possess a love of books and an appreciation for knowledge, which he avidly applied to the library. In satisfying the library’s growing needs and his own predilection for what should be collected, Billings oversaw expansion of the collection from 602 titles in 1865 to 2,887 titles in 1868. Billings’s devotion to and consummate concern for the library’s development paid off when, around 1870, the Library became his primary responsibility. By the end of 1871, with Surgeon General Barnes’s concurrence, Billings embarked on a mission to transform the surgeon general’s library into a national medical library holding every American medical publication possible. He envisioned it as a medical counterpart to the collection of the Library of Congress. The Library relocated from cramped office shelving in the Riggs Bank Building to the roomier second floor of the remodeled Ford’s Theatre on Tenth Street. After President Lincoln’s assassination there in April 1865, contemporaries believed that the building was no longer appropriate as an entertainment venue, so it was converted to house several military offices. The Office of the Surgeon General eventually occupied the building to accommodate the growing Army Medical Museum and vastly expanded postwar administrative activities. The drive for acquisitions quickly expanded beyond American-produced works and increasingly included medical books and journals produced in all corners of the world. From this point onward, though it remained under the surgeon general of the US Army, the Library publicized the availability of its resources to all medical professionals and researchers. This was the moment in the history of the Library when its trajectory to become the largest repository of medical knowledge in the world began.

Billings soon recognized the need to provide a means for searching this vast ocean of knowledge by medical term or topic so that it could be accessed more effectively. To this end he conceived the Index-Catalogue of the Library of the Surgeon-General’s Office, a published record of the library’s holdings listed alphabetically according to medical subject and also by author name. It was an audacious project on an unprecedented scale. This was the first time anyone had attempted to index the entire range of medical subject matter. The first series of the Index-Catalogue comprised 16 volumes, which were successively published from 1880 to 1895.

Timely dissemination of new medical research is essential, but the meticulous indexing that went into the Index-Catalogue slowed its production. In response, Billings initiated the Index Medicus. Issued on a monthly basis, organized by subject, and with a cumulative year-end index, it was a use companion to the Index-Catalogue.

The library’s constant flow of acquisitions continued unabated during the 30 years Billings oversaw the institution. In 1865, when he began work at the surgeon general’s library, its 602 titles amounted to 2,282 individual volumes. When he retired from the Library in 1895, the total collection of books, pamphlets, theses, and other volumes numbered 619,558. Upon leaving the military and the Army Medical Library in 1895, Billings applied his 30 years of library knowledge and experience to the organization and development of the New York Public Library. Beyond driving collection development, he conceived the original design of the New York Public Library’s main building and was instrumental in persuading Andrew Carnegie to build branch libraries throughout New York City.

John Shaw Billings is renowned for his vision and realization of a national medical library, a repository of all available medical knowledge in the interest of advancing medical science. He is equally revered for conceiving the Index-Catalogue and Index Medicus, pioneering works in medical bibliography that revolutionized methods for the dissemination and use of medical knowledge.

James Labosier is Associate Curator for the Archives & Modern Manuscript in the History of Medicine Division at the National Library of Medicine.


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