|A1. L#il ^yneffej la Mj^^ / A History of THE NATIONAL LIBRARY OF MEDICINE The Nation's Treasury of Medical Knowledge by Wyndham D. Miles U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health National Library of Medicine Bethesda, Maryland 1982 NIH Publication No. 85-1904 Reprinted August 1985 National Library of Medicine Cataloging in Publication Z Miles, Wyndham Davies 733.N277 A history of the National Library of Medicine : the M643h nation's treasury of medical knowledge / Wyndham Davies Miles.—Bethesda, Md. : U.S. Dept. of Health and Hu- man Services, Public Health Service, National Insti- tutes of Health, National Library of Medicine ; Wash- ington : for sale by the Supt. of Docs., U.S. G.P.O., 1982. p. : ill., ports. — (NIH publication ; no. 82-1904) 1. Libraries, Medical—history—United States 2. Na- tional Library of Medicine (U.S.) I. Title II. Series The photograph of the interior of Ford's Theatre, 1893, is from the National Archives. The photograph of the chemistry laboratory is from the Armed Forces Institute of Pathology. All other photographs are from the National Library of Medicine. Preface The word library is no longer adequate for the National Library of Medicine, as Wyndham Miles makes abundantly clear in this splendid and searching history. The NLM and its offspring have become the central nervous system of American medical thought and research. My unlikely association with the Library goes back more than 50 years because of the Library's juxtaposition to" the old Army Medical Museum. As a lad I visited the Museum out of nothing better than morbid curiosity and then wandered around the Surgeon General's Library. Decades later it was my good fortune to be a member of the Board of Regents twice over a 12-year span that saw a changing in the guard and the movement from the Old Red Building on the Mall to the present site in Bethesda. Few people besides parents can form any reasonable opinion of a newborn babe's future greatness. The birth of an almost invisible library occurred when the brand new Army Surgeon General Lovell needed a few medical books of his own in 1818. The story of the growth and transformation of the Library as it grew up to be a supremely valuable central nervous network of medical memory is detailed in a fashion which embodies Wyndham Miles' dedication, thoroughness, great concentration, and endurance. He has made what might have been a mere chronicle into a story of imagination, of organizations, of ideas, and of many remarkably dedicated persons, military and civilian. Under a variety of governmental auspices they have managed to perform miracles. For there to be an Army medical library there had to be an Army Medical Department, which was established in 1818 when Joseph Lovell became Sur- geon General. A list of the Library's very small holdings was written in a thin notebook in 1840. By the latter part of the Civil War a printed catalog noted 485 titles including about 50 journals. The total number of volumes was a little over 2,000. The shape which the Library took and its remarkable importance as repository and source of a great index are the work of that remarkable genius John Shaw Billings who was the library from 1865 to 1895. In the days of candles and kerosene lamps, before air conditioning, the Library, under Billings' impetus, produced its first general catalog in volume after volume. This catalog would have amounted to very little if Billings had not been a master buyer and exchanger and had not learned the ways of book dealers in American cities and, in particular, those of British and European agents. The massive catalogs and indexes represent in a unique way the work of one person aided, to be sure, by soldier clerks, scribes, and some professional catalogers. in A history of the national library of medicine Today we reckon bureaus as inefficient. They are characterized by the deni- grating term bureaucracy. But here was a government organization run on a shoestring. A surprising book collection in the Army where, in one place, were assembled the major medical books, journals, and indeed the historic medical masterpieces of Western Civilization. Following Billings' retirement the Surgeon General's Library went into a slower phase. The indexes flourished, the search for and purchase of important medical books continued, the serials proliferated. During World War I there was a certain amount of difficulty from reduced staff, but progress continued. Some of the librarians—Phalen, Ashburn, and Hume—achieved real scholar- ship. The beginning of important changes occurred with the arrival of Harold W. Jones in the late depression year 1936. In 1943 Jones got the Rockefeller Foundation to appoint a committee to review the function, policies, and future course of the Library. This was the beginning of the approach to the modern period. Two groups—the Friends of the Army Medical Library and the As- sociation of Honorary Consultants—flourished at different times during this period and many who later served on the Board of Regents, a group of expe- rienced teachers, clinicians, administrators, and scholars, had a strong sup- porting role. This was very helpful during the later period of changing homes for the Library and of developing and broadening the program of accession, indexing, storage and retrieval as the computer and electronic age arrived. Joseph McNinch, the director from 1946 to 1949, with his considerable Army experience was able to introduce many administrative advances and efficiencies. There was a notable improvement in the morale of the staff as the pressures of World War II began to fade into the background. The true coming of age in the modern sense was associated with the arrival in 1949 of Brad Rogers as the Director. He was given the opportunity to study modern librarianship, its arts and techniques, and thus was the first Director whose training gave him insights into the ways and means of solving problems, both those common to all libraries and those unique to a large medical library, particularly one run under Army auspices. Two great achievements of Rogers' 14 years were the building and transfer of books to the splendid modern National Library of Medicine in Bethesda and the development of MEDLARS. An especially important year was 1956, when Senators John Kennedy and Lister Hill supported a bill to create the National Library of Medicine. The dedication of the new building was held in the main reading room on December 14, 1961. A cutting from the Hippocratic plane tree was planted and there were two days of congratulations and speeches, as well as solemn wonder and admiration. Before the books had been moved from the old Library to the new, when there was only one other book in the Library, I presented a copy of Osier's Aphorisms to the Library and was able to say that for about two weeks I had donated half the books in the NLM. Actual movement took IV preface place in two very busy months—March and April—done with amazing skill; and it was open to the public on the 16th of April, 1962. The current era opened with the arrival in 1964 of Martin Cummings as Director. In 1964 and 1965 MEDLARS got into production in many different fields. The Billings Centennial was held in June 1965 and in October President Johnson signed the Medical Library Assistance Act which authorized a grant program to rejuvenate medical libraries throughout the Nation. A Drug Lit- erature Program began this year, followed in 1966 by the Toxicology Information Program. In 1967 the National Medical Audiovisual Center was transferred from the Public Health Service's Communicable Disease Center in Atlanta to the Library, and the Francis A. Countway Library at Harvard became the first Regional Medical Library in a network that ultimately contained eleven. Library research and development was inaugurated by Director Cummings. President Johnson signed the law which designated a proposed National Library of Med- icine Annex as the Lister Hill National Center for Biomedical Communications. It is eminently fitting that this history of the National Library of Medicine be produced on the 25th anniversary of the bill Senators Lister Hill and John F. Kennedy submitted on March 13, 1956, "To promote the progress of med- icine and to advance the national health and welfare by creating a National Library of Medicine." If the ghosts of our ancestors, lineal, literary and bibliographical, could review the state of their works and the state of the art today they would swell with satisfaction. Lovell, Billings, Fletcher, Garrison, Phalen, Ashburn, Hume and many others whose work was often little noticed or appreciated, made this library possible. Fortunately McNinch, Rogers and the contemporary team, Cummings, Blake, Olch, Corning, and the rest can admire the labor of love, skill and endurance of Wyndham Miles, another milestone in the history of a great, perhaps the great, medical library. I conclude with a personal note: One does not have to have done exhaustive biographical or bibliographical work to recognize the vast undertaking this volume represents. One can only have profound admiration for the happy conjunction of the task and the person chosen to perform it. In addition to the interminable hours of seeking and finding, checking, collating, and correlating, Wyndham Miles had a sharp eye out for Walter Reed material. Every so often he would send to me some missed item which I would add to the collected papers, works, and writings which I have been assembling and which rest in the Alderman Library at the University of Virginia. William B. Bean, M.D. August 1981 Sir William Osier Professor of Medicine, Emeritus University of Iowa v CONTENTS PAGE Preface...................................................................... iii I Beginning of the Library of the Surgeon Generals Office............................................................. 1 II Development of the Library During the Civil War .. 15 III The National Medical Library............................... 25 IV The Great Journal Hunt....................................... 41 V Gathering Books and Other Literature for the National Medical Library.................................. 67 VI The Operation and Services of the Library............. 91 VII The Beginning of Indexing in the Library............... Ill VIII The Index-Catalogue and Index Medicus..................... 127 IX Billings Seeks a Building for the Library and Museum........................................................... 141 X The Library-Museum Building on the Mall............. 161 XI Leaders of the Library, 1895-1913.......................... 185 XII The Library in Operation, 1895-1913....................... 201 XIII The Library During World War 1........................... 219 XIV The Library inthe 1920's....................................... 239 XV The Library During the Depression........................ 259 XVI The Library on the Eve of World War II................ 271 XVII The End of the Old Library and the Beginning of the New........................................................... 289 XVIII Modernizing the Library....................................... 311 XIX The Army Medical Library becomes the National Library of Medicine.......................................... 343 XX Evolution of Computerized Bibliographies............. 365 XXI The Library's Program for Awarding Grants............ 393 XXII The Specialized Information Services..................... 411 vii a history of the national library of medicine XXIII The Lister Hill National Center for Biomedical Communications................................................ 419 XXIV The National Medical Audiovisual Center............. 433 XXV Extensions of Traditional Library Service.............. 443 Appendices..................................................................... 471 Honors....................................................................... 471 Statistics.................................................................... 473 Members of the Board of Regents................................. 475 Selected Chronology of the National Library of Medicine................................................................. 480 Sources of Information on the History of the Library......... 487 Biographies of Staff Members...................................... 487 Acknowledgments....................................................... 490 Abbreviations.............................................................. 491 Index............................................................................ 493 Vlll I Beginning of the Library of the Surgeon Generals Office Books in the Office of Surgeon General Joseph Lovell, 1818-1836 FEW of the world's great libraries started out with the intention of being that. The National Library of Medicine, the greatest or one of the greatest medical libraries in number of volumes and service rendered to patrons, began as a few books in the office of a Surgeon General of the Army in 1818 or '19. The officer was Joseph Lovell, 30 years old, a native of Massachusetts, who had joined the Army in 1812 and been appointed chief of the Medical De- partment in 1818.l There had been medical officers with titles of Physician General and Surgeon General in the Continental Army during the Revolution and in the United States Army during the following third of a century but the present-day Medical Department began in 1818 when the Army was reorga- nized, and a regular succession of Surgeons General began with Lovell. Lovell's first office was in one or two rented rooms in some privately owned building (which building is not known) in Washington.2 During the summer of 1819 he moved to a room in an early War Department building, now demol- ished, on Pennsylvania Avenue at Seventeenth Street, N.W. His furnishings were simple; a table, six chairs, and a bookcase.3 From this office, with assistance from a clerk who copied outgoing correspondence, filed incoming letters, and maintained records, Lovell directed approximately three score post surgeons, regimental surgeons, and surgeons' mates who served at forts, barracks, posts, hospitals, and arsenals within the United States. The Army expected medical officers to buy whatever medical and scientific books they preferred to read, study, and consult, but it provided them with a reference book for each branch of medicine.4 Among the volumes purchased by the Medical Department during the early years for distribution to officers were the following: John Pringle, Observations on the Diseases of the Army, with notes by Benjamin Rush;5 Pharmacopoeia of the United States of America;6 Robert Thomas' Modern Practice of Physic and Samuel Cooper's Surgical Dic- tionary;7 "Bell on venereal," Surgeons' Vade-Mecum, and Thomas Sydenham, The Works, on Acute and Chronic Diseases . . . , with notes by Rush;8 John 1 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Joseph Lovell, Surgeon General, United States Army, 1818 to 1836. Syng Dorsey's Elements of Surgery, and Thomas Miner and William Tulley, Essays on Fevers . . . .9 The department also subscribed to a medical periodical for each officer to enable him, even when he was isolated at a frontier post, to keep up with advances in the profession. The Medico-Chirurgical Journal and Review, pub- lished in London, was usually distributed, but apparently a different journal might be sent if an officer preferred. 10 Surgeon General Lovell also procured, within limits of his tiny budget, whatever official documents, medical journals, newspapers, and reference books he needed as director of the Army's physicians. In 1823 he noted that he had purchased, during the 5 years he had been in office, an American atlas, seven maps of states and Mexico, Peter Force's National Calendar,11 Laws of the 16th Congress, the Washington newspaper National Intelligencer, Judah Delano's Washington Directory, the Medical Recorder, and the Medical Repository for 1821.12 He probably bought other publications, but the only one of which there is a record is John Godman's Western Quarterly Reporter of Medical, Surgical and Natural Sciences.13 During 1820 and 1821 the department spent approximately $400 each year for medical publications, presumably for books and journals furnished to offi- cers. In 1822 and '23 the amount dropped to $300 a year. In 1824 the funds spent for books and "vaccine matter" were lumped together at $400 a year and from 1825 to 1836 at $500 a year, without any indication of the proportions spent for publications and vaccine matter.u Books and journals purchased with government funds sat in the office book- 2 BEGINNING OF THE LIBRARY OF THE SURGEON GENERALS OFFICE case, probably in the company of some of Lovell's own books, perhaps those that he had studied at Harvard College and Medical School or purchased to improve his skill as a physician when he was in private practice from 1811 to 1812 and an Army surgeon in the Northern states, 1812 to 1818. There was also a variety of pamphlets, several of which, perhaps all, had been presented to Lovell by their authors.15 And the bookcase probably contained a copy of William Beaumont's Experiments and Observations on the Gastric Juice, for Lovell appreciated Beaumont's investigations, encouraged him and tried to accommodate his requests for favors and furloughs, in appreciation of which Beaumont dedicated his book to the Surgeon General.16 In 1830 the little collection of publications moved with the Surgeon General from the War Department to a State Department building on Pennsylvania Avenue at 15th Street, N.W., and in 1831 to a room or two in "Mr. Vevan's House" at 18th and G Streets. Lovell and his family lived in an attractive home he built across the street from the White House. Now known as Blair House, it is owned by the United States and is used as the residence of visiting foreign dignitaries. In 1836 Lovell died shortly after his wife passed away, leaving 11 children fatherless and motherless. He was buried in Congressional Cemetery in the presence of the President's family, Cabinet members, the faculty of Columbian College Medical School, and officers of the Army, Navy, and Marine Corps. From the few dozen books, journals, and pamphlets whose accumulation took place over a span of 18 years during the presidencies of James Monroe, John Quincy Adams, and Andrew Jackson, when the steamboat and railroad were in their infancies, when the United States was primarily a land of farmers, and the flag had only half of the stars it has today, developed over the next one and one-half centuries the mammoth million-volume National Library of Medicine.17 The Collection of Books Becomes a "Library" during the Term of Thomas Lawson, 1836-1861 Assistant Surgeon Benjamin King, who was on duty in Washington at the time of Lovell's death, was placed in charge of the small office for a few weeks until President Jackson appointed Thomas Lawson, a veteran of 25 years of service, as the new Surgeon General.18 While King was Surgeon General "ad interim," the time arrived for submission of the Medical Department's estimates of expenses for the coming fiscal year. King sent to the Secretary of War an estimate including $150 for "medical books for office."19 This seems to have been the first request for funds to buy books specifically for the Surgeon Gen- eral's office. Even though King signed the document, undoubtedly Lawson, as senior surgeon of the Army and the person expected to be promoted to the rank of Surgeon General, expressed his wishes in the estimates. For several years thereafter, until at least 1841, Lawson submitted the same estimate for books.20 3 A history of the national library of medicine 3/ .4?>#/rt/&..W; s'A ^S<7/?J fise /"fa ^343?^ /' rf 6#^ The earliest known list of books and journals in the Library. The collection was less than two decades old, and contained fewer vol- umes than many persons owned in their home librar- ies. ■/)£ SU f/tt *t£4+t< t:4 /2*< / '* 7 f Page of the catalog of 1840, showing the volumes listed under the letter A. After 1843 books and journals for the office were purchased with money from the contingency fund. Books and journals for distribution to officers in the field were bought with money from the appropriations for "medical books and vaccine matter," or "medical books, stationery, printing, etc.," or other groups of supplies. Four years after Lawson became Surgeon General, someone in his group of associates listed in a small notebook the authors and short titles of the volumes in the office. This is the earliest known catalog of the Library; through some miracle it escaped the housecleanings that went on in the department during the 19th and 20th centuries, and today it rests in the History of Medicine Division of the National Library of Medicine.24 At that time there were 134 titles, of which 8 were journals, on the shelves. The exact number of volumes was not stated in the catalog and cannot now be ascertained; it could have been any number between 187 and 226, depending 5 a history of the national library of medicine upon the number of volumes present in each series of journals.115 The entire collection could have been held by a four-shelf bookcase, shoulder high and 7 or 8 feet wide. In the collection were works on anatomy, physiology, fevers, diseases of children, dentistry, epidemics, pharmacy, midwifery, medical jurisprudence, and military surgery. There were books and journals that had been purchased for distribution and others apparently for reference. Among the latter were Robert J. Thornton's Family Herbal, Benjamin Moseleys Treatise on Tropical Diseases, Joseph Nancrede's translation of Orfila's General System of Toxicol- ogy, John M. Good's multivolume Practice of Medicine, works on civil and military law, Robert Ainsworth's Latin Dictionary, Samuel Johnson's English Dictionary, Baron George Cuvier's Theory of the Earth, Erasmus Darwin's Zoonomia, and James Cutbush's Philosophy of Experimental Chemistry. The catalog lists only the titles present in 1840. Other volumes had been purchased for the office between 1818 and 1840, among them Godman's West- ern Quarterly Reporter of Medical, Surgical and Natural Sciences and Miner and Tulley's Essays on Fevers, but they were missing when the catalog was compiled. Perhaps books had been borrowed but not returned, or outmoded works had been thrown away.2fi The Surgeon General's was one of the smaller medical literature collections of the country.27 The Medical and Chirurgical Faculty of Maryland possessed at least 437 books and several journals, the medical library at the Philadelphia Almshouse more than 1,100 volumes plus several journals, and the New York Hospital library about 5,000 volumes and 100 periodicals.28 A decade earlier the library of Pennsylvania Hospital in Philadelphia owned more than 3,400 titles, hundreds of theses, and approximately 150 periodicals.29 Seventeen years earlier the Boston Medical Library contained more than 1,300 volumes and several journals.30 Firmly established medical schools had bigger libraries, and some scholars and physicians possesed larger collections. William Byrd of Vir- ginia had 141 volumes, and Thomas Dale of South Carolina had 325 volumer on medicine back in colonial times.31 The library of John Redman Coxe con- tained 4,835 lots when it was auctioned in 1864, and that of John B. Beck had 784 lots when auctioned in 1851.32 During the late 1830's, 1840s, and 1850's, the little Library continued to expand. Surgeons stationed outside Washington used the following books, cop- ies of which were probably in the Library: John Hennen, Principles of Military Surgery; William P. Dewees, A Compendious System of Midwifery, A Treatise on the Medical and Physical Treatment of Children, and Treatise on the Diseases of Females; "Paris' Med. Dictionary," probably John A. Paris, Pharmacologia; James Copland, A Dictionary of Practical Medicine; William Gibson, The In- stitutes and Practice of Surgery; George Gregory, Treatise on the Theory and Practice of Physic; Benjamin Ellis, The Medical Formulary; William J. Erasmus Wilson, Practical and Surgical Anatomy, Anthony T. Thomson, Conspectus of 6 beginning of the library of the surgeon general's office the Pharmacopeias of the London, Edinburgh, and Dublin Colleges of Physi- cians; John Eberle, A Treatise on the Practice of Medicine; Robert Hooper, The Surgeons Vade-Mecum, and Medical Dictionary; Louis Martinet, Manual of Pathology (or perhaps his Manual of Therapeutics); Bernard M. Byrne's An Essay to Prove the Contagious Character of Malignant Cholera; the United States Pharmacopeia; and dispensatories.33 Some of the books consulted by surgeons of the previous generation, as the works of Rush, Bell, and Cooper, still lingered at forts and posts, perhaps no longer used but still retained because regulations forbade the destruction of government property.34 For the use of surgeons in the General's office was purchased Jean-Nicholas Gannal, History of Embalming; Jones Quain and W. J. E. Wilson, Anatomical Plates; Robley Dunglison, New Remedies and Medical Lexicon; Thomas Watson, Lectures on the Principles and Practice of Physic, Samuel Ashwell, Practical Treatise on the Diseases Peculiar to Women; Charles Meigs' translation of Marc Colombat, A Treatise on the Diseases and Special Hygiene of Females; John Elliotson, Principles and Practice of Medicine; Robert Graves, Clinical Lec- tures; William Stokes and John Bell, Theory and Practice of Physic; Joseph Maclise, Surgical Anatomy; Francois C. Maillot, Aide-Memoire Medico-legal; George B. Wood, A Treatise on the Practice of Medicine; Maximilian Joseph von Chelius, A System of Surgery; William Pirrie, The Principles and Practice of Surgery; Charles D. Meigs, Obstetrics; Samuel D. Gross, A Practical Trea- tise on the Diseases and Injuries of the Urinary Bladder, the Prostate Gland, and the Urethra; William Stokes, Treatise on the Diagnosis and Treatment of Diseases of the Chest; John H. Bennet, Clinical Lectures on the Principles and Practice of Medicine; Joseph Leidy's translation of Gottlieb Gluge, Atlas of Pathological Anatomy; Jonathon Pereira, The Elements of Materia Medica; William B. Carpenter, Principles of Human Physiology; Carl Rokitansky, A Manual of Pathological Anatomy; Robert W. Smith, A Treatise on Fractures in the Vicinity of Joints.35 The department continued to supply journals to regular (not "acting" or temporary) officers for their "professional improvement."36 New York Journal of Medicine and the Collateral Sciences was chosen by a board of officers as the standard periodical in 184337 and was continued until 1851 when Surgeon General Lawson replaced it by American Journal of the Medical Sciences and British and Foreign Medico-Chirurgical Review38 Thereafter officers received both of these journals.39 The Surgeon General himself received two or three other periodicals. In the early 1840's these included American Medical Intelligencer, Boston Medical and Surgical Journal, and Bell's Medical Library.40 When the Intelligencer expired in 1842, Lawson switched to American Journal of the Medical Sci- ences.41 A few years later he was also receiving/ourna/ of the Franklin Institute and American Journal of Science and Arts.42 In the 1850's he took, at times, American Medical Monthly, Half-yearly Abstract of the Medical Sciences, Ret- 7 A history of the national library of medicine rospect of Medicine, and the New York edition of the London Lancet.43 In 1861 he ordered a subscription for American Medical Times, which had recently begun publication.44 That the journals in the General's office were considered part of a library rather than current reading material to be thrown away periodically is indicated by the binding of issues into annual volumes. On one occassion in 1850 Lawson had bound six volumes of New Orleans Medical and Surgical Journal, six of New York Journal of Medicine, four of British and Foreign Medico-Chirurgical Review, three of American Journal of Science, three of Lancet, four of Journal of the Franklin Institute, four of Boston Medical and Surgical Journal, and three of American Journal of the Medical Sciences.45 Early Exchanges and Gifts The Medical Department was the first government organization to collect data on the weather systematically, decades before the U.S. Weather Bureau was established. Surgeons and mates at hospitals, forts, and posts kept diaries in which they noted the temperature at three specified times each day, the course of the winds, and other information. In 1840 the Surgeon General's staff edited and published some of the data in a small volume, Meteorological Reg- ister for the Years 1826-1830. They also compiled observations on the health of soldiers from 1819 to 1839, publishing the material in a book, Sickness and Mortality in the Army of the United States. Lawson sent these works to the Medical Department of the British Army, receiving in return statistical com- pilations which he referred to as "a valuable acquisition to our little library."46 This was perhaps the first exchange. The first gift to another library may have been the meteorological and statistical volumes sent by Lawson to Harvard College library in 1847.4T A few years later the Philadelphia College of Medicine sent Lawson three dozen copies of its constitution and bylaws for distribution. Presumably the college hoped to induce Army surgeons to call the attention of prospective students to the school. This led to another exchange, the Surgeon General sending to the college library copies of the Meteorological Register, Statistical Report on the Sickness and Mortality, Regulations for the Medical Department, Directions for Taking Meteorological Observations, James Espy's meteorolog- ical charts, and Thomas Henderson's Hints on the Medical Examination of Recruits for the Army.4H The first gift to the Library may have come from John Kearsley Mitchell who offered 50 copies of his recent book, On the Cryptogamous Origin of Malarious and Epidemic Fevers. Mitchell, a prominent physician of Philadel- phia who attended Edgar Allen Poe and fathered S. Weir Mitchell, the novelist and neurologist, may have been trying to gain recognition for and to spread his theories rather than help develop the Library, but one copy undoubtedly ended up in the bookcase while the other 49 were distributed to surgeons in the South, Southwest, and West where fevers were more prevalent.49 Daniel 8 beginning of the library of the surgeon generals office Thomas Lawson, Surgeon Gen- eral, United States Army, 1836 to 1861. Drake sent a copy of his Systematic Treatise, Historical, Etiological, and Prac- tical, on the Principal Diseases of the Interior Valley of North America, in return for which the Surgeon General promised to send him suitable Army reports on illness of the region.50 Blanchard & Lea, a Philadelphia publisher, sent the Surgeon General a copy of the latest edition of Robley Dunglison's New Dictionary of Medical Science, perhaps hoping for a large order from the department.51 Because a group subscription to a journal or book from the department meant a sale of up to 80 copies, a number sufficiently large to cause publishers to compete for business, publishers sent sample issues.52 Lindsay & Blakiston sent Lawson numbers of the Medical Examiner, but he would not substitute it for either of the journals being purchased by the department.53 On the other hand three volumes of the Virginia Medical Journal sent by editor James B. McCaw caused Lawson to place an order for 20 subscriptions.54 Thomas Lawson served as Surgeon General longer than any other officer; he died on May 15, 1861, shortly after the Civil War started. During the quarter century of his tenure the practice was begun of calling the small collection of books and journals the "Library," the first estimate of funds for books was made, the Library's first catalog was compiled, and the first exchange and gift of books took place. Yet, the collection was still insignificant and unorganized if the statement of Joseph J. Woodward, a member of the Surgeon General's office from 1862 to 1884, is accepted: "At the time the late Civil War broke out nothing deserving the name of a medical library existed in Washington."55 9 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 1 Histories of the Medical Department may be found in: Louis C Duncan, The Medical Department of the United States Army in the Civil War (1910); Percy M. Ashburn, A History of the Medical Department of the United States Army (1929); Harvey E. Brown, The Medical Department of the United States Army from 1775 to 1873 (1873). Biographies of Surgeons General and other notable medical officers may be found in: James E. Pilcher, The Surgeon Generals of the Army of the United States of America (1905); James M. Phalen, Chiefs of the Medical Department United States Army 1775-1940 (1940); Edgar Erskine Hume, Ornithologists of the United States Army Medical Corps, Thirty-six Biogra- phies (1942). Biographies of individual officers, as of George M. Sternberg, Walter Reed, and John Shaw Billings, have appeared in books, and biographical articles of many officers have been published in journals. 2 Locations of the office are from George A. Sheirer, Notes on the Army Surgeon General's Office in Washington, 1818-1948 (1948), and other sources. 3 "... a suitable case for the papers and books of the office . . .", letter, Lovell to Secretary of War John C. Calhoun, July 31, 1819: NA (Na- tional Archives). 4 ". . . the object in furnishing books to medical officers being merely to secure to them a standard work in each department of medical science, and not to supercede the necessity of their providing themselves with such other books as they may deem necessary"; letter, Surg. Henry L. Heiskell, SGO, to Asst. Surg. J. J. Milhau, Sept. 10, 1852: NA. 5 Letter, Lovell to Surg. William Wheaton, Nov. 9, 1818: NA. Sir John Pringle, Observa- tions on the Diseases of the Army, with notes by Benjamin Rush. 6 Letters, Lovell to Sec. of War Calhoun, Jan. 12, Feb. 21, 1820; Lovell to Apothecary General Francis Le Baron, Aug. 15, 1820: NA. Calhoun directed Lovell to subscribe to 75 cop- ies for use of surgeons and mates. 7 Letters, Lovell to Surg. Sylvester Day, Mar. 1, 1823; Lovell to Surg. Thomas G. Mower, Aug. 13, 1831: NA. Probably, Robert Thomas, The Modern Practice of Physic, with an appen- dix by David Hosack (New York, 1820), and Samuel Cooper, A Dictionary of Practical Sur- gery, with notes and additions by John Syng Dorsey (Philadelphia, 1810). Also mentioned were a dispensatory and the U.S. Pharmaco- poeia. 10 H Letter, Lovell to Surg. Thomas G. Mower, Aug. 13, 1831: NA. Probably, Thomas Syden- ham, The Works, on Acute and Chronic Dis- eases; with their Histories and Modes of Cure, with notes by Benjamin Rush. Dorsey's Cooper was also mentioned. "Bell on venereal" may have been Benjamin Bell, Treatise on Gonorrhoea Virulenta .... 9 Letter, Lovell to Asst. Surg. Samuel W. Dalton, Nov. 14, 1831: NA. Also mentioned were Army Regulations, a dispensatory, Surgeon's Vade-Mecum, Thomas' Practice, Cooper's Sur- gery, Dorsey's Cooper, and the U.S. Pharma- copoeia. Probably, John Syng Dorsey, Elements of Surgery; Thomas Miner and William Tulley, Essays on Fevers and other Medical Subjects, and Alexander P. Wilson Philip's book on fevers or on laws of vital functions. 10 Letter, Surg. Gen. ad interim Benjamin King to Asst. Surg. Lyle Day, Jan. 20, 1837, NA: "I presume there will be no objection to supplying you with the Select Medical Library in lieu of Johnsons Medical Journal which is the periodical usually furnished." James Johnson's Med. Chir.J. Rev. started publication in 1816 and underwent changes in title. 11 The National Library of Medicine (here- after referred to as NLM) has a copy of Peter Force's National Calendar, vol. 6, Washington, 1828, with Lovell's name on the title page and front cover. It seems to me that this volume was Lovell's personal property else he would not have written his name in large letters in such prominent places. 12 Letter, Lovell to Sec. of War Calhoun, Jan. 24, 1823: NA. The publications were paid for with money from the contingency fund. 13 Letter, Lovell to Godman, Julv 29, 1822: NA. 14 Letter, Lovell to Sec. of War Calhoun, Nov. 1, 1819; estimate of expenses of the med- ical department for the years 1821, 1822, 1823, 1824, 1825, 1826, 1831; letters, Lovell to Sec. of War James Barbour, Oct. 18, 1826, Oct. 12, 1827; to Sec. of War Peter Porter, Oct. 30, 1828; to Sec. of War John Eaton, Oct. 23, 1829; to Sec. of War Lewis Cass, Oct. 20, 1831, Oct. 20, 1832, Oct. 14, 1833, Oct. 23, 1834, Nov. 2, 1835, Nov. 12, 1836: NA. 15 In NLM is a volume containing 18 medical essays and tracts, 1804-1807, six of which have inscriptions from the authors to Lovell: call no. WZ/270/M4889/1804. Another volume of pamphlets, 1819-1827, presumably presented to Lovell by the authors, was titled "Slang Whanging" by an office hu- BEGINNING OF THE LIBRARY OF THE SURGEON GENERALS OFFICE morist because of the controversies engaged in by the writers: call no. WZ/270/S631/1819. 16 In the records of the SGO, National Ar- chives, are many letters from Lovell to Beau- mont. 17 In the mid-1930's the Librarian, Colonel Edgar E. Hume, decided that the Library ought to have a birthdate. He picked the year 1836. Apparently he did this arbitrarily for he had no evidence to support his claim. Billings had been careful to state that the book collection was be- gun prior to 1836 [Billings, "Who Founded the National Medical Library?" New York Med. Rec. 17: 298-9 (1880)]. Surgeon General Barnes, equally cautious, wrote: "From the purchase of a few common textbooks and one or two current medical journals commenced about 1830 ..." (Letter, Barnes to Senator L. M. Morrill, Chair- man, Joint Committee on Libraries, Feb. 9, 1872: NA). But Hume wrote: "Lovell, in the year 1836—we do not know the exact date—began a collection of books for the use of his officers and himself" ["Buildings for the Army Medical Library," Military Surgeon 80: 45 (1937)]. Hume used this date to bring about the Library's "Centenary Celebration" in 1936. The date has been used on other occasions. 18 Lovell died on Oct. 17, 1836. Lawson was appointed Nov. 30. 19 Letter, King to Secretary of War, Nov. 12, 1836: NA. 20 Letters, Acting Surg. Gen. King to Sec. of War, Nov. 20, 1837; Lawson to Sec. of War Joel Poinsett, Nov. 14, 1838, July 15, 1840; Acting Surg. Gen. Henry L. Heiskell to Sec. of War John C. Spencer, Nov. 3, 1841, re estimates for fiscal year 1842-43: NA. 21 Letter, Acting Surg. Gen. Heiskell to Sec. of War Spencer, Sept. 2, 1842, with endorse- ment by the Secretary of War: NA. 22 Letters, Heiskell to Spencer, above; Heis- kell to Blair and Rives, Sept. 1, 1842: NA. 23 Letter, Surg. R. C. Wood to C. S. Francis &Co., May 1, 1856: NA. From the time of Lewis and Clark Army officers explored the West, and sent back to Washington accounts of birds, fishes, animals, shrubs, climate, minerals, and much else. It is probable that Audubon's writings were used for reference in the Surgeon General's office. 24 A facsimile was published in 1961 to com- memorate the founding of the National Library of Medicine. 25 Fielding H. Garrison, John Shaw Billings, a Memoir (1915) p. 213, wrote: "In 1840, there was prepared a manuscript catalogue . . . which shows, by actual count, that it consisted of 135 works, comprising 228 volumes." Since the 1840 catalog does not give the number of volumes for 10 titles, including 3 journals, I do not know how Garrison could have calculated a precise total. Addition shows that there were 134 titles and at least 187 volumes, but there could have been as many as 226 volumes. 26 Some of the volumes mentioned in the 1840 catalog have disappeared from the Library. Some were judged later to be out of scope and were exchanged away. It is uncertain whether some of the books now in the Library were the copies actually there in 1840, for the Library then had no acquisition book or numbering sys- tem, and rebinding has destroyed the original end papers and covers that might have provided evidence. 27 The first medical library, that of the Penn- sylvania Hospital, was started in 1763. Exclud- ing libraries in medical schools, succeeding li- braries were those of the College of Physicians in Philadelphia, 1788, Medical Society of South Carolina, 1791, and New York Hospital, 1796. By 1800 there were 8 medical libraries, by 1876 60. See J. S. Billings, "Medical Libraries in the United States," in Public Libraries in the United States (1876), pp. 171-82, reprinted in F. B. Rogers, Selected Papers of John Shaw Billings (1965): C. D. Spivak, "The Medical Libraries of the United States," Philadelphia Med. J. 2: 851- 8 (1898). 28 Catalogue of Books Belonging to the Li- brary of the Medical and Chirurgical Faculty of Maryland (Baltimore, 1835). A Catalogue of the Medical Library Belonging to the Philadel- phia Almshouse . . . (Philadelphia, 1824). A Catalogue of the Books Belonging to the Library ojtheNewYorkHospital . . (NewYork, 1845). 29 Catalogue of the Medical Library of the Pennsylvania Hospital (Philadelphia, 1829). 30 Catalogue of Books in the Boston Medical Library . . . (Boston, 1823). 31 Wyndham Blanton, Medicine in Virginia in the Eighteenth Century, pp. 109-111. Joseph I. Waring, History of Medicine in South Car- olina, 1670-1825, p. 205. 32 George L. McKay, American Book Auc- tion Catalogues, 1713-1934. 33 Hennens Military Surgery, Dewees on Females, Dewees on Children, Dewees on Midwifery, Paris' Medical Dictionary, along with Bell on Venereal and Bell on Ulcers, are men- tioned in letter, Lawson to Surg. Edward Ma- comb, Ft. Leavenworth, Aug. 12, 1837. Hen- nen is also mentioned in letter, Asst. Surg. R. H. Coolidge to Asst. Surg. Charles H. Smith, Fort Meade, Fla., Jun. 26, 1854. Copland is men- tioned in letter, Lawson to Surg. W. V. Whea- ton, West Point, Feb. 4, 1840. Gibson's Sur- gery, and Thomas' Practice, are mentioned in letter, Acting Surg. Gen. H. Heiskell to Surg. 11 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Nathan S. Jarvis, Fort Jessup, La., Apr. 26, 1842. Gregory is cited in letter, Heiskell to Surg. Presley H. Craig, New Orleans, July 7, 1843. Ellis is mentioned in letter, Lawson to Asst. Surg. J. H. Bailey, Fort Smith, Ark., Nov. 3, 1845. Wilson's Anatomy, mentioned in letter, Heiskell to Surg. W. L. Booth, Nov. 21, 1849. For Thomson see letters, Heiskell to Asst. Surg. Jonathon Letterman, Ft. Meade, Fla., May 8, 1851. For Eberle, see letter, Heiskell to Dr. S. G. J. DeCamp, Fort Columbus, N.Y., Jan. 21, 1853. For Hooper's Vade Mecum see letter, Heiskell to Dr. J. J. B. Wright, Jan. 27, 1853, and for Dictionary see letter, Coolidge to Lang- worthy, Oct. 19, 1854. For "Martinet's Manual" see letter, Coolidge to Asst. Surg. C. Suther- land, Fort Fillmore, Mo., May 2, 1854. Byrne, a surgeon in the U.S. Army Medical Dept, was courtmartialed in 1859; his book is mentioned in letter, Lawson to Childs & Peterson, Phila., ordering 100 copies of the book "provided the cost does not exceed one dollar per copy." Let- ters in NA. 34 At Fort Defiance, N. Mex., there was a copy of Bell's Anatomy in 1854: letter, Surg. Richard H. Coolidge to Asst. Surg. Elisha P. Langworthy, Oct. 19, 1854. At Fort McHenry there were copies of Rush's Pringle, Rush's Sy- denham, and Bell on Venereal in 1846 according to letter, Acting Surg. Gen. H. Heiskell to Asst. Surg. J. F. Head, Sept. 1, 1846; and of Rush's Sydenham in 1852, letter, Surg. R. H. Coolidge to R. C. Wood, Jan. 3, 1852: SGO records, NA. 35 For Gannal see letter, Act. Surg. Gen. H. Heiskell to Sec. of War Spencer, Nov. 3, 1841. For Quain see letter, Lawson to Sec. of War Porter, May 19, 1843. For Dunglison, Watson, Ashwell, Colombat, Elliotson, Graves, Maclise, and Stokes, see statement of disbursements . . . of contingent expenses ... for year ending 30 June 1846: NA. For Maillot, see statement of contingent expenses ... for year ending 30 June 1850: NA. For Dunglison, Wood, Chelius, Pir- rie, Meigs, and Gross see letter, Surg. Heiskell to Surg. T. G. Mower, Sept. 14, 1852: NA. For Stokes, Bennet, Gluge, Pereira, Carpenter, Rokitansky, and Smith see letter, Heiskell to Mower, Apr. 20, 1853: NA. 36 Letter, Surg. H. Heiskell to J. M. Gait, 1851: NA. 37 Letter, Lawson to Surg. T. G. Mower, Aug. 8, 1843: NA. 38 Letters, Sug. H. Heiskell to Surg. T. G. Mower, Dec. 9, 1851; Heiskell to Blanchard & Lea, Dec. 9, 12, 1851, Jan. 9, 1852; Lawson to Mower, Aug. 8, 1843: NA. Eighty subscriptions of Amer.J. Med. Sci. and British Foreign Med. Chi. Rev. were ordered at a cost of $3.50 a subscription. 39 Letter, Surg. H. Heiskell to Lindsay & Blakeston, Mar. 7, 1854: NA. 40 Letters, Act. Surg. Gen. H. Heiskell to Sec. of War J. C. Spencer, Sept. 2, 1842; Surg. R. C. Wood to D. Clapp, July 3, 1856, stopping subscription to Boston Med. Surg. J.: NA. 41 Letter, Act. Surg. Gen. H. Heiskell to Sec. of War Spencer, Nov. 30, 1842: NA. 42 Letters, Heiskell to editor of/. Franklin Inst., July 20, 1848, Feb. 22, 1850, Dec. 11, 1857. In the Dec. 11 letter the subscription was cancelled owing to shortage of funds. Letter, Heiskell to Silliman & Dana, July 21, 1848: NA. 43 Letters, Surg. R. C. Wood to editor of Amer. Med. Monthly, Dec. 11, 1857, cancelling subscription owing to lack of funds; Wood to Surg. R. S. Satterlee, Dec. 23, 1859, re obtain- ing back issues of Retrospect and Abstract to complete office sets for binding; Surg. R. Cool- idge to Stringer & Townsend, Mar. 14, 1854; Wood to Satterlee, Dec. 23, 1859, re binding of volumes of Lancet; Wood to Asst. Surg. W. H. Babcock, Mar. 2, 1859, stating that Lancet was not distributed: NA. The Lancet was reprinted in New York under the title London Lancet. 44 Letter, Surg. R. C. Wood to Bailliere Bros., Apr. 11, 1861, requesting back issues: NA. 45 Statement of contingent expenses for year ending 30 June 1850: NA. There are several references to the binding of publications in the records of the 1840's and 1850's. 46 Letters, Act. Surg. Gen. H. Heiskell to Maj. A. M. Tullock, London, Jan. 31, 1842; Heiskell to Rep. D. D. Barnard, May 18, 1842; Lawson to Sec. of War J. C. Spencer, Apr. 6, 1843; Lawson to Sir J. McGrigor, June 15, 1843: NA. 47 Letter, Act. Surg. Gen. H. Heiskell to John L. Sibley, Harvard College, Oct. 19, 1847: NA. 48 Letter, Lawson to James Brvan, presi- dent, Med. Ch. College, June 11, Sept. 7, 1849: NA. Although the letter was addressed to the Med. Ch. College, I believe this referred to the Philadelphia College of Medicine, with which Bryan was associated at this date. 49 Letters, Lawson to Asst. Surg. Benj. King, Sept. 21, 1849; to J. K. Mitchell, same date: NA. 50 Letter, Lawson to Drake, Mav 27, 1850: NA. 51 Letter, Surg. R. C. Wood to Blanchard & Lea, June 15, 1858: NA. 52 Perhaps the Army and Navy medical de- partments ordered the only group subscriptions in medical journalism at that time. 53 Letter, Surg. H. L. Heiskell to Lindsav & Blakiston, Mar. 7, 1854: NA. 12 BEGINNING OF THE LIBRARY OF THE SURGEON GENERALS OFFICE 54 Letter, Surg. R. C. Wood to McCaw, Jan. 8, 1856: NA 55 Quoted by F. Harner, "A Plea for an American Medical Library," Med. Surg. Re- porter 38: 449-50 (1878). Woodward was one of the editors of the Medical and Surgical History of the War of the Rebellion. At the time Wood- ward made this statement he was accustomed to the everyday sight of the country's largest medical library, and in his mind's eye the few hundred volumes of 1861 were hardly worthy of being called a "library." 13 II Development of the Library During the Civil War Surgeon General Clement Alexander Finley CLEMENT ALEXANDER FINLEY, who had been in the Army for 43 years and served in the Indian and Mexican wars, was appointed Surgeon General on May 15, 1861. The Civil War was bringing hundreds of physicians to the door of the Medical Department, and Finley needed more office space for his expanding staff. He moved from the Winder Building at F and Sev- enteenth Streets to a building on the southeast corner of F and Fifteenth Streets, where he had several rooms.1 There, with his military aides, at least eight civilian clerks and one messenger, he administered the procurement of medical supplies, construction of hospitals, recruitment of physicians, and all the other tasks that came with the war. The Library moved with the Surgeon General. During the war it was Clement Alexander Finley, Sur- geon General, United States Army, 1861 to 1862. 15 A history of the national library of medicine probably consulted more than any time in the past. Finley preferred certain books for his own use, among them Gross' Surgery, John E. Erichsen's Surgery, Bennet's Practice of Medicine, John Foote's Practitioner's Pharmacopeia, Amos Dean's Principles of Medical Jurisprudence, and Claude Bernard and Charles Huette's Manual of Operative Surgery.2 The standard list of books for distri- bution was revised to fit war conditions. Surgeons in the armies received the following: Thomson's Conspectus, William J. E. Wilson's Practical and Surgical Anatomy, Thomas Watson's Practice of Physic, and Erichsen's Surgery. Sur- geons at hospitals and posts received the same, plus George Fowne's Elemen- tary Chemistry, the Dispensatory of the United States, Robley Dunglison's Medical Dictionary, Alfred S. Taylor's Medical Jurisprudence, and Ellis' For- mulary.3 Finley cancelled the office's subscription to American Medical Times and ordered 35 copies of the Philadelphia Medical and Surgical Reporter for distribution.4 Finley, owing to the seniority system then followed generally in making promotions, was 64 years when he was appointed Surgeon General. He prob- ably would have been a satisfactory leader during placid, peaceful times, but he did not act fast enough, according to his critics, in developing the small medical department into the large, energetic organization needed by the Fed- eral armies during war. In 1862 he was relieved of his duties and transferred, whereupon he retired. Surgeon General William Alexander Hammond Owing to the influence of the Sanitary Commission, seniority was ignored in choosing the next Surgeon General and 34-year-old William Alexander Ham- mond was appointed on April 25, 1862. Hammond had been an assistant surgeon in the Army from 1849 to 1860 and then had resigned to teach in the University of Maryland's Medical School. Energetic and competent, Hammond improved the department as rapidly as chaotic wartime conditions would permit. Shortly after he took office he established the Army Medical Museum and ordered the beginning of the compilation of statistics that was to be published many years later under the title Medical and Surgical History of the War of the Rebellion.5 Two months after Hammond arrived he moved his office to the buildings owned by Riggs and Company, a private banking firm, on the northwest corner of Fifteenth Street and Pennsylvania Avenue.6 Attached to the bank was a two- story brick building that had originally been a private house. In the back yard was a two-story frame structure and a large stable. The general's private office occupied the back room on the first floor of the brick house, and his clerk's office the adjacent pantry. Surgeon John H. Brinton, whom the general ap- pointed to organize the Army Medical Museum, sat in the front room, formerly the parlor, and there he began accumulating the first specimens. Also in the parlor were shelved books and journals, handy for the general.7 On the second floor of the house were several small rooms occupied by officers on the general's staff and their clerks, and a large room for files and clerks. Other officers and 16 development of the library during the civil war William Alexander Hammond, Surgeon General, United States i Army, 1862 to 1864. clerks had desks in rooms on the second floor of the bank building. The frame building housed a printing press, a distribution room where Medical Depart- ment publications and medical journals were sorted and sent to surgeons in the armies and military hospitals, and one or two rooms for clerks. In the stable were two horses and three carriages, used mainly in picking up and delivering mail and packages. In the spring of 1862 Brinton moved with his increasing number of museum specimens into another building, and eventually medical books and journals filled the parlor, which served as the library for a few years. Under Hammond's direction recently published books were selected and purchased for distribution. A score of reference books was provided for each general hospital and permanent post.8 Surgeons attached to regiments in the field could not carry around a box of books, but they were supplied with five of the most useful. Journals for distribution comprised American Journal of the Medical Sci- ences,9 apparently a copy for every surgeon; Boston Medical and Surgical Journal,10 probably for selected officers; British and Foreign Medico-Chirurg- ical Review, for the most senior officers11; and Medical Times.12 For office use Hammond ordered Annales d'Hygiene,13 Charles Lyell's Antiquity of Man,14 Boston Medical and Surgical Journal,15 Recueil de Mem- oires de Medecine, de Chirurgie et de Pharmacie Militaries,16 Archives Gen- erates de Medecine, Virchow's Archiv, Alexander Tweedie's Lectures on . . . Fevers, Charles Murchison's book on "continued fevers," and the publications of the Academie de Medecine and Societe Nationale d'Acclimatation of Paris.17 He stopped the office's subscription to the Medical and Surgical Re- porter, taken by Finley, and subscribed to the Chicago Medical Journal.1H 17 a history of the national library of medicine Blanchard & Lea, a Philadelphia publishing firm, generously donated volumes "towards forming a library."19 Many years later a person, identity unknown, in the Surgeon General's office, jotted down the following account of Hammond's influence on the book collection: "Up to 1862 there was no library connected with the office except a few common works of reference and such public documents as are annually distributed. Surgeon General Hammond, however, began to buy books which he wished to use himself. The first were brought from Bailliere Bros, in August 1862. From that time on they were bought continuously for use in making up the Medical and Surgical History."20 Hammond might have enlarged the little collection into a first-class library had he not made an enemy of Secretary of War Edwin Stanton. Stanton exiled him to New Orleans in August 1863 and elevated Joseph K. Barnes to the rank of Acting Surgeon General. Hammond was court-martialed and dismissed from the Army in August 1864. He became a prominent physician, textbook writer, teacher, researcher, novelist, and journal editor, and he continually appealed his court-martial sentence. The government finally exonerated him in 1879 and restored his rank, but he never returned to the Army. Surgeon General Joseph K. Barnes21 Barnes, who had been in the Army since 1840, was appointed Surgeon General on August 22, 1864. He retained, with few exceptions, the same standard medical books chosen by his predecessor for distribution. A large number of these were purchased during the war: 7,317 copies of Bumstead on Venereal Diseases, 5,370 of Erichsen's Surgery, 4,850 of the Dispensatory of the United States, 3,895 Power's Sugical Anatomy, 3,442 Gray's Anatomy, 3,254 Watson's Practice of Medicine, 3,251 Stephen Smith's Principles of Surgery, 3,239 Woodward's Hospital Steward's Manual, 3,100 Parkes' Hygiene, 2,671 Sargent's Minor Sugery, 1,905 Dunglison's Medical Dictionary, 1,640 Fowne's Chemistry, 1,542 Bennett's Practice of Medicine, 1,412 Dalton's Physiology, 1,333 Parrish's Pharmacy, 1,237 Hartshorn's Principles of Medicine, 1,178 Longmore's Gunshot Wounds, 1,062 Beck's Jurisprudence, 1,024 Stille's Ther- apeutics, and lesser quantities of Webster's English Dictionary, McLeod's Sur- gical Notes, Virchow's Pathology, Jones' Diseases of the Eye, Bedford's Mid- wifery, Toynbee's Diseases of the Ear, Wilson's Diseases of the Skin, and Guthrie's Commentaries.22 Books and journals for the Library were selected mainly by Brinton, As- sistant Surgeon George A. Otis, and Assistant Surgeon Joseph J. Woodward, who needed works on anatomy, surgery, and other subjects for reference in the museum and for compiling the Medical and Surgical History of the War of the Rebellion.23 Surgeons James R. Smith, Charles H. Crane, and Charles H. Alden sent the orders for books to publishers and booksellers.24 Purchases for Hammond, Brinton, Otis, and Woodward during 1862, '63, and early '64 increased the collection greatly. Books and journals were con- 18 development of the library during the civil war stantly added to the shelves in the front parlor of the brick house, where bookcases probably lined the walls except for door and window openings. In January 1864 Barnes decided that the Library, now containing approx- imately 1,800 volumes, should be reorganized, enlarged, and cataloged.25 On May 10 of that year the first printed catalog of the Library was published, perhaps for distribution to surgeons with the armies and in the many military hospitals.26 Barnes had not yet appointed an officer to act as librarian, and it is not known who superintended the preparation of the catalog of 1864. The catalog was a pamphlet of 24 leaves, the rectos bearing titles and the versos blank for additions or notes. Books were listed alphabetically by authors under nine subject headings: anatomy; physiology; materia medica, pharmacy and therapeutics; general pathology and practice of medicine; surgery; mid- wifery and diseases of women and children; medical jurisprudence and medical police; natural philosophy, chemistry, etc.; miscellaneous, journals, reviews, reports, encyclopedias, etc. A logical assumption is that the volumes were arranged on the shelves in the same order. All-in-all the catalog carried 485 titles, including about 50 journals, showing a total of approximately 2,100 vol- umes.2. The catalog contained the titles of William James Rhees' Manual of Public Libraries (1859) and of William T. Lowndes' multivolume Bibliographer's Man- ual of English Literature (1857-1861). This indicated that the Surgeon General was trying to develop a library on principles advocated by professional librar- ians. If the volumes had been considered previously as an incidental collection, they were no longer. According to the 1864 catalog the Library had not yet acquired any incun- abula, any 16th or 17th century books, or any 18th century works except Robert Hamilton's Duties of a Regimental Surgeon (1787), which had been in the catalog of 1840, and Hamburgisches Magazin, oder Gesammelte Schriften aus der Naturforschung (1747-63), 25 volumes. A number of books mentioned in the catalog of 1840 (among them the works of Gannal, Dunglison, Ashwell, Colombat, Elliotson, Graves, and Maclise) and others acquired during Surgeon General Lawson's term did not appear in the catalog of 1864. Perhaps in the hustle and bustle of the office at the start of the Civil War, along with a shortage of space for the ever expanding volume of medical records accumulating during the conflict, volumes that were obsolete or obsolescent were simply thrown away. Otis and Woodward continued to choose most of the books purchased through 1864 and '65, the orders being sent to booksellers by Crane, by Surgeon William C. Spencer from 1864 to 1866, and by Assistant Surgeon John Shaw Billings from November 6, 1865, onward.28 In the autumn of 1865 Surgeon General Barnes ordered that a new catalog be compiled. One would assume that the primary reason for a second catalog only a year and a quarter after the first was that almost all copies of the 1864 catalog had been distributed to medical officers. A second reason may have 19 a history of the national library of medicine been the accumulation of more than 100 works, about 200 volumes, since the previous catalog had been issued. The second printed catalog was published on October 23, 1865. Like its predecessor it was a pamphlet.29 Titles were on the recto of the leaves while the verso and interleaves were blank so that the owner could add notes or titles. According to this catalog the Library now contained 2,282 volumes.30 Six hundred and two titles were listed, including at least 67 journals.31 The pub- lications were grouped in 11 classes, the differences between this and the previous catalog being the addition of a new class, natural history, and the division of one class into two classes, a) medical journals and reviews, and b) miscellaneous. The largest class was surgery with 120 titles; followed by pa- thology with 116 titles; natural philosophy, chemistry, etc., with 76; medical jurisprudence and medical police, 72; medical journals and reviews, 44; anat- omy, 40; miscellaneous, 39; natural history, 37; midwifery and diseases of women and children, 20; materia medica, pharmacy and therapeutics, 20; and physiology the smallest with 18. Books were listed alphabetically by author, journals by title. .-•msf „ *' Riggs Bank, Pennsylvania Avenue and Fifteenth Street, N.W., Washington. From 1862 to 1888 the small building on the left and the upper story of the bank on the right was the headquarters of the Surgeon General. The Library was shelved in the front parlor of the house on the left from 1862 to 1866. This photograph was taken in the 1890's, a decade before the buildings were torn down. 20 development of the library during the civil war In the latter half of 1865 an unusual source of publications opened up for the Library as the Army began to close temporary military hospitals. Erected during the war for the care of the tens of thousands of wounded soldiers, these hospitals possessed medical books and journals for the use of the surgeons, and a miscellany of fiction and nonfiction works donated by the Sanitary Commis- sion, citizens, and relief organizations for patients. On June 26, 1865, Barnes issued the following order: "when hospitals shall be discontinued and the li- braries disposed of, the most valuable works, Scientific, Historical, etc. shall be carefully selected, packed and turned over to the Quartermaster's Depart- ment for transportation to Surgeon George A. Otis, U.S.V., Curator of the Army Medical Museum."32 It is not known how many publications the Library acquired from hospitals. The following anecdote by Daniel S. Lamb, a pathologist at the museum for half a century, indicates that the men dismantling the hospitals were not very discriminating in the choice of works they forwarded to the Capital: "On May 25,[1866] a lot of non-medical books which had been sent to the Museum from discontinued hospitals were ordered to be divided among four employees who were connected with Sunday Schools in Washington, to be given to the said schools."33 Furthermore among books accessioned after the war were a few on navigation, astronomy, calculus, algebra, geometry, trigonometry, logarithms, geology, and agriculture, hardly the subjects that would have been purchased for a medical library but more likely that would have arrived from closed hospitals.34 Notes 1 The office had moved to the Winder Build- order issued in Circular No. 2, May 21, 1862. ing at F and 17th Sts. in 1848 from "Mrs. Elsey's From the museum developed the Army's Med- House," on G Street between 17th and 18th, ical School and the Armed Forces Institute of whence it had moved in 1845 from "Mr. Vevan's Pathology. House." The latter two buildings no longer ex- The most recent history of the famous mu- jst seum is Robert S. Henry's The Armed Forces 2 "If you have any of the following books in Institute of Pathology, Its First Century, 1862- the purveying dept. the Surg. Gen'l. wishes to 1962 (1964). Daniel S. Lamb, pathologist of the have a copy of each (with the usual lettering) museum for half a century, wrote History of the ... He does not however wish to have them United States Army Medical Museum, 1862- purchased for this purpose": letter, Surg. L. A. 1917, which contains reminiscences and lists of Edwards to Surg. R. S. Satterlee, Nov. 11, 1861: publications of museum members, but which is NA scarce because it was mimeographed in a small The last volume on the above list was prob- edition. ably Illustrated Manual of Operative Surgery The necessity of having reference works for and Surgical Anatomy, by Bernard and Huette, use of the writers of the Medical and Surgical edited with notes by W. H. Van Buren and E. C History was one of the chief reasons why books Isaacs N. Y., 1855. were purchased for the Library during the 1860's. 3 Letter! Surg. Robert C. Wood to Surg. 6 The correct name of the bank was Riggs R. S. Satterlee, Nov. 11, 1861: NA. and Company until 1896 when it incorporated 4 Letters, Surg. L. A. Edwards to Butler & as The Riggs National Bank. Levis, Mar. 10, 1862; Edwards to Bailliere & 7 ". . . there were in the private office of the Bros., Mar. 10, 1862: NA. Surgeon General a few preparations of human 5 The museum was started by Hammond's anatomy, which had long been there, or in the 21 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE adjoining library room" (italic supplied) Lamb, History, p. 1. 8 Titles of books may be found in the stand- ard supply tables of Sept. 20, 1862; of Oct. 20, 1862, in SGO Circular No. 12; and of May 7, 1863, in SGO Circular No. 7. 9 Letter, Asst. Surg. J. R. Smith to Blan- chard & Lea, Apr. 10, 1863, increasing the sub- scription to 200 copies: NA. 10 Letter, Asst. Surg. Smith to editor, Bos- ton Med. Surg. J., July 2, 1863: NA. Fifty copies were ordered. 11 Letter, Hammond to Lindsay & Blakis- ton, Mar. 11, 1863: NA. Ten copies were or- dered. 12 Letter, Asst. Surg. J. R. Smith to Bail- Here & Co., Oct. 22, 1862: NA. The number of copies is not given. 13 Letter, Asst. Surg. J. R. Smith to Bail- liere Bros., Sept. 16, 1862: NA. Bailliere Bros., a New York firm, imported the journal for SGO. 14 Letter, Surg. C. H. Alden to J. Penning- ton & Son, Mar. 23, 1863: NA. 15 Letter, Asst. Surg. J. R. Smith to editor, Boston Med. Surg. J., July 2, 1863: NA. Fifty copies were subscribed to, plus a complete set of back issues—the latter would have been for the SGO. 16 Letter, Asst. Surg. J. R. Smith to Surg. R. S. Satterlee, Oct. 22, 1862: NA. 17 Letter, Surg. Gen. Hammond to Joseph Henry, Smithsonian Institution, Mar. 23, 1863: NA. The volumes were obtained through the Smithsonian's book agents in Europe. Ham- mond requested complete sets of Archives Generales, Virchow's Archiv, and Bulletin of the Academie. 18 Letters, Asst. Surg. J. R. Smith to ed. Med. Surg. Rep., Sept. 10, 1862; Smith to S. W. But- ler, Aug. 5, 1863; Smith to editor, Chicago Med. J., July 6, 1863: NA. Hammond wanted as many back numbers as were available of the Chicago journal. 19 Letters, Asst. Surg. J. R. Smith to Blan- chard & Lea, July 14, 1862: NA. Perhaps the firm continued to donate books throughout the war, for on May 13, 1865, Act. Surg. Gen. J. K. Barnes sent a letter of thanks for a copy of Hodges' Obstetrics. 20 Around 1890 a person in the Medical De- partment began to make notes for a historical sketch of the Surgeon General's office. Only a fragment of the manuscript remains, from which the above quotation is taken: MS/C/64 Bailliere Bros., N.Y., went out of business in 1870. John Shaw Billings, letter to editor, "Who founded the National Medical Library?" New York Med. Rec. 17:298-9 (1880) stated that 359 volumes, including sets of Annales d'Hygiene Publique and Boston Medical and Surgical Jour- nal, were added during Hammond's period. I believe Billings' figure is incorrect because a catalog published in May 1864 listed 2,100 vol- umes, whereas the catalog of 1840 listed aprox- imately 200, a difference of about 1,900 vol- umes, and most of these were purchased, I believe, during Hammond's time. 21 Barnes had no middle name. He took the letter K to distinguish himself from his father, Joseph Barnes. 22 Letter, Gen. Barnes to Sec. of War E. Stanton, Oct. 20, 1865: NA. 23 Billings, "Who founded the National Medical Library?" New York Med. Rec. 17: 298- 9 (1880), credited Woodward and Otis with se- lecting volumes in 1864 and '65. Brinton was the first curator of the Museum from August 1862 to October 1864. Brinton and Woodward were directed to begin preparing the History in June 1862. Otis succeeded Brinton as editor of the History and curator of the mu- seum in October 1864. 24 These three were senior officers in the Surgeon General's office. Copies of letters sent by them to publishers and booksellers may be found in SGO records, NA. I assume they merely ordered books selected by Brinton, Otis, and Woodward, but possibly they also selected books they ordered. 25 Letter, Surg. C. H. Crane to Joseph Henry, Smithsonian Institution, Jan. 25, 1864; "The Li- brary of this office, now being reorganized, con- tains about 1800 volumes, and as it is the in- tention to increase the same, and to make it an institution for the Medical Department [the re- mainder asks for Smithsonian publications]:" NA. 26 There are two copies of the catalog in the History of Medicine Division, National Library of Medicine. One copy has the original paper wrappers and bears the signature of E. Shaw, clerk and assistant of John Shaw Billings. 27 Fielding H. Garrison, John Shaw Billings, p. 213, wrote that a "catalog was prepared and published, showing that at this time, the col- lection comprised 1365 volumes." By my count there are 485 titles, approximately 50 of which are journals, and a total of 2,094 volumes. 28 "During the years 1864 and 1865 about 1000 volumes were added to the library, mainly works selected by Drs. Woodward and Otis"; John S. Billings, New York Med. Rec. 17: 298- 299 (1880). 29 The History of Medicine Division, Na- tional Library of Medicine, has copies of the catalog, two of which have the original paper wrappers, one green and one yellow, bound in. 30 Fielding H. Garrison, John Shaw Billings, 22 DEVELOPMENT OF THE LIBRARY DURING THE CIVIL WAR p. 214, stated that the catalog of 1865 contained 602 entries, comprising 2,253 volumes. Billings, in his memorandum or preface to the catalog of 1872, said that the catalog of 1865 accounted for about 1,800 volumes. My count of 602 entries and 2,282 volumes is approximately the same as Garrison's figure. 31 "Letter from Washington," by an anony- mous writer in Boston Med. Surg. J. 99: 706- 709 (1878), credited the catalog with listing 26 American journals and 17 foreign, or 43 in all. By my count, the catalog gives the titles of at leas,t 67 journals. 32 S.G.O. Circular Orders No. 6. It would appear from this order that Otis had been placed in charge of the growing library and might be considered as the first librarian of the Surgeon General's office. Perhaps he supervised the preparation of the catalogs of May 1864 and Oc- tober 1865. 33 Lamb, History of the United States Army Medical Museum, p. 39. 34 Titles are in the early registers; for ex- ample, Register 3, p. 14. 23 II The National Medical Library John Shaw Billings begins to take care of the Books and Journals TO the Surgeon General's office in December 1864 was called a 27-year- old assistant surgeon, John Shaw Billings.1 Billings had joined the Army in 1861, a year and a half after receiving his degree from Medical College of Ohio. He had been a surgeon in military hospitals and had tended wounded soldiers at the battles of Chancellorsville, Gettysburg, the Wilderness, Spott- sylvania Court House, Cold Harbor, and the siege of Petersburg before being assigned a desk job in Washington in August 1864. Billings reported to General Barnes on January 4, 1865,2 and was directed to help manage the myriad of civilian physicians working for the Medical De- partment under contract. A few months later the war ended, and he was given responsibility for some of the financial matters that arose with the closing of military hospitals. His job as a "disbursing" officer was dull compared with his previous duties as a surgeon in the Army of the Potomac, but he had clerks to handle bookkeeping, correspondence, and other routine work, and the flood of invoices, receipts, vouchers, and similar documents soon crested and re- ceded.3 Around the time the second library catalog was published in October 1865, Barnes decided that the growing collection of books and journals should be placed in the charge of one officer. He chose Billings.4 Barnes' reason for picking Billings from among the several staff officers is not known. Billings was a booklover, and this may have been sufficient for the general.5 Billings' duties, whatever they were in caring for the books and journals, did not add much to his workload. He seems to have considered the collection as one of his routine responsibilities, and paid no special attention to it. Oc- casionally he ordered monographs, reference books, texts, and journals re- quested by officers in the museum, chemistry laboratory, Surgeon General's office, or at Army posts.6 But other officers also ordered publications, Surgeon William C. Spencer more often than Billings.7 By the beginning of 1866 Billings had systematized his duties and generally had ample free time to follow paths on which his curiosity led him.8 He browsed 25 a history of the national library of medicine ft'LUAMONILLOSlNCrH AlSMD AlAMMWI WOMKtfU. JoMPM KV«*MCS COWAftOCuMTIS 77ie notable group of officers who developed the Army Medical Museum and Library, and produced the Medical and Surgical History of the War of the Rebellion, in the years following the conflict. through medical books, learned to read a little German, dissected small animals and a tarantula, dabbled with chemistry, and meandered through poetry and literature. He was associated with energetic, competent persons, among them George A. Otis, who was developing the museum, and Joseph J. Woodward, a pioneer in photomicrography. The museum, which was to be adjacent to the Library for the next three- quarters of a century, was not merely a repository for medical specimens of the Civil War. Staff members were studying comparative anatomy, anthro- pology, Indian archaeology, and microbiology; compiling the Medical and Sur- gical History of the War, and teaching such subjects as histology and clinical microscopy to officers. Taking advantage of the laboratory facilities, apparatus, and specimens in the museum and the companionship of talented men, Billings tried his hand at microscopy. He mounted and stained anatomical sections of animals and began to investigate fungi, supposed by some physicians to be the cause of certain diseases called "cryptogamous" fevers.9 26 the national medical library Ford's Theatre, Washington. This view is half of a steroscopic photograph taken around 1870 when the Library was shelved on the second floor of the building. The Library Moves Into Fords Theatre The Civil War brought about a permanent enlargement of the Army and Medical Department. No longer could a handful of military physicians take care of the infantry, cavalry, and other troops as they had in the days of General Winfield Scott. Now surgeons were needed to staff scores of barracks, posts, and forts dotting the United States from the Atlantic to the Pacific, the gulf to the Great Lakes. Surgeons accompanied regiments on active service in the West. The Medical Department was given the job of "providing for the comfort 27 A history of the national library of medicine of sick and discharged soldiers." It was made custodian of hundreds of thousands of pension and medical records. It had to provide artificial limbs and trusses for veterans. In 1866 the department was authorized by Congress to have a Surgeon General, an Assistant Surgeon General, 5 purveyors, 60 surgeons, 150 assistant surgeons, and 5 storekeepers. In addition it had 264 civilian physicians under contract as acting assistant surgeons,10 scores of clerks and messengers, and almost 200 hospital stewards. The Surgeon General needed more space for his office, records, and mu- seum. The museum possessed so many specimens that it had had to move into larger quarters twice, and it still needed additional room. The pension and medical records required an area where they could be filed and consulted. The buildings rented from Riggs Bank in 1862 were simply not spacious enough by the war's end. On Good Friday, April 14, 1865, President Lincoln was assassinated while attending a performance of Our American Cousin at Ford's Theatre on Tenth Street. Citizens protested so violently against further performances that the government took over the theater and purchased it the following year "for the deposit and safekeeping of documentary papers relative to the soldiers of the Army of the United States and of the Museum of the Medical and Surgical Department of the Army."11 During the summer and autumn of 1866 the interior of the building was remodeled. The balcony was removed, and two floors, supported by cast iron columns, wrought iron girders and beams, were inserted in the spacious in- terior, converting the theater into a three-story building. An iron stairway was erected from the first floor to the third. The new floors were brick, covered with tile. The ceiling of the top floor consisted of plaster over lath nailed to wooden joists. The roof was slate over pine sheathing supported by wooden rafters. Thus the interior of iron and brick was fireproof, but the roof and third floor ceiling were not. Attached to the south side of Ford's, along Tenth Street, was a smaller three-story brick building (which originally housed Taltavul's Star Saloon on the first floor, a lounge for dress circle patrons on the second, and Ford's apartment on the third) with wooden floors and stairs, and therefore not fire- proof. Attached to the back of Ford's to the north was another small structure (originally dressing rooms and a carpenter's shop), also not fireproof. After alterations were completed, Surgeon General Barnes allotted the third floor of Ford's to the museum, the second to the Division of Surgical Records and the Library, and the first to the Record and Pension Division. In the adjacent building on Tenth Street rooms were converted into offices for Wood- ward, Otis, and other officers, and into the Medical Department's chemistry laboratory. The small building at the back was converted into workshops for the museum. During November and December 1866 Surgeons Otis and Woodward su- 28 the national medical library perintended the moving of specimens, cases, and apparatus from the museum's temporary location into the third floor of Ford's. Woodward, who managed the Record and Pension Division and the medical and microscopical sections of the museum, was placed in charge of the entire building.12 In December medical records were moved in. Sometime in 1867 the library books and journals were transferred from Riggs to the second floor. The second floor consisted of one large hall approximately 100 feet long, 67 feet wide, and 14 feet high. Light came through four windows at the front, two at the back, and the stairwell in the center. Most of the space was occupied by records of the 200,000 men wounded and the 40,000 operated upon during the war.13 The Library took up a relatively small amount of space at first, and for several years it would be used almost exclusively by the officers compiling the Medical and Surgical History. The fear of a fire that might destroy museum specimens and the irreplace- able Civil War medical records was always in the minds of the staff. Fire hoses connected to a steam pump were kept handy, and a few years later the joists and other woodwork in the attic were soaked with a concentrated solution of sodium silicate which, it was hoped, would act as a fire-retardant. Billings Becomes Librarian in His Spare Time The collection now contained several thousand volumes and needed some- one to keep it in order. General Barnes hired F. L. O. Roehrig as a contract surgeon and on January 10, 1867, placed him in charge of the Library.14 Roehrig did not select or order books; that was done by Billings and other officers at Riggs. Purchases were received at Riggs, examined (Billings' clerks checked books and journals meticulously to make certain that no pages were missing or damaged) and then sent to Roehrig at Ford's for shelving.15 Presumably because of confusion or duplication in ordering by Crane, Spen- cer, Otis, and Billings for the Library and department, an agreement was reached among the officers in mid-1867 to give Billings sole responsibility for procuring publications. "In accordance with the arrangements made with Dr. Otis, by direction of the SG, USA," Billings wrote his British book supplier, "all orders for purchases for the museum or library of this office will be issued in future by myself, and all bills or accounts against this office, with the cor- respondence relating thereto, should in future be sent to me."16 Finally, some- time in 1867 or early 1868 General Barnes asked Billings to devote "all his spare time" to medical bibliography and to developing the Library.17 The upgrading of the Library and the delegation of authority to Billings seems to have given him a personal interest in the collection and crystallized his instincts in book collecting. A few months later he was informing one of his book agents: "I wish in time to make the Library of this office as complete as possible. . . 3'18 His first priority was publications needed by his colleagues for their re- 29 A history of the national library of medicine searches in the museum, for compiling the Medical and Surgical History, and for keeping up-to-date in medicine and allied sciences.19 Otis, for example, sent Billings a list of 22 books on resections that he wanted, recommended procurement of reports of Lt. Charles Wilkes' "Exploring Expedition," and asked for John Cleland's paper, "Cranial measurements of different races."20 Surgeon Joseph H. Bill, stationed at the Army Laboratory, Philadelphia, re- quested Billings to purchase nine scientific books, stating in his letter: "I certify that I need the above books to maintain and increase my knowledge of the subjects of which they treat."21 But generally Billings was the sole selector of the books he ordered. He visualized a library with every type of publication for military surgeon, researcher, scholar, and practicing physician, and he sought all manner of publications, including reports of hospitals and other health agencies, doctoral dissertations, pamphlets, journals,22 books of the 16th, 17th, and 18th centuries, and even incunabula.23 He selected books mainly from catalogs of American and European book- sellers, sometimes tearing out pages, marking them, and returning them to the dealers, other time sending lists of numbers and short titles. He kept an eye on book trade journals and reviews. Occasionally he sent bids by mail to a book auction or asked a friend to bid for him. Once in a while he picked a book from approvals sent by hopeful dealers.24 Possibly the first bookplate designed for the Library. This is in Boston Med- ical and Surgical Journal, volume 79, 1868-69. The accession number, 8613, shows the volume was received July 28, 1869. 30 THE NATIONAL MEDICAL LIBRARY Billings economized in every way, instructing his agents: "when books can be bought secondhand not much damaged it is preferred that they should be so obtained . . . the above request is made for the reason that our fund for the purchase of books is limited. . .',25 He wanted old books but told his agents he could not pay much: "if you meet with any old medical or surgical works (especially if in Black Letter). . . please send them, if obtainable at a reasonable price."26 In purchasing books and journals from European countries Billings found it convenient to deal with a few agents who, in turn, acted on his behalf with booksellers in their geographic areas. Among these agents were Felix Flugel, a physician (though apparently not in practice), lexicographer, and medical book dealer of Leipzig; William Wesley, London; Triibner & Company, Lon- don; Gustave Bossange, Paris; and Frederick Muller, Amsterdam.27 These agents sent Billings catalogs issued by sellers in their areas, trans- mitted Billings' orders to the sellers, received the books and paid for them, packaged the volumes in sturdy water-proof crates and shipped them to the Medical Department purveyer in New York, who forwarded them by express to Washington. In the same manner Billings purchased through these agents microscopes, scientific apparatus, chemicals, and medical instruments for the medical museum and department. The agents distributed Medical Department publications given to or exchanged with European medical libraries, schools, societies, and military medical departments; they also received gifts and ex- changes for the SGO Library and shipped them to New York. This arrangement saved Billings and his clerks much correspondence; min- imized the loss of publications in transit, and kept expenses down through use of periodic large shipments rather than daily small shipments; expedited the delivery of current European journals, which the agents sent by fast mail rather than slow express; and was efficient in that the agents were closer to booksellers, apparatus dealers, medical libraries, and organizations than was Billings, thou- sands of miles away. For their services these agents received a commission of 10 percent (at times more or less) on Billings' purchases, and a stipend for distributing and receiving exchanges and gifts. At the time when Billings became the sole purchaser of books, payment to European agents was made through an American firm which in turn sent payment to European agents. The American firm received a commission for acting as middleman. This roundabout method was necessary because, accord- ing to government regulations, checks had to be made out to someone in the United States. Billings appointed one of his clerks as middleman—Andrew Bischoff in the 1870's, Frederick W. Stone from 1880 onward. After a bill for books arrived, a voucher and check for the amount were made out to the clerk, who used the check to purchase a bill of exchange for transmittal to the agent. Billings thus saved the expense of a commission. This system was the most convenient and inexpensive one for the Library and it expedited payment to agents.28 Unfortunately in 1880 clerk Bischoff took to drink, went off with almost 31 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE $500 instead of sending it abroad, and Billings had to replace the money out of his own pocket.29 The Library's First Bibliographies Another indication of Billing's enthusiasm for developing the small Library was the compilation of the first large catalog and the first bibliographies. Owing to the rapid accumulation of publications during 1866 and 1867, the Library had almost tripled in size since the last pamphlet catalog had appeared in October 1865. Apparently Billings planned and, with the aid of clerks, began compiling the manuscript for another catalog in 1867, for it was in the printer's hands in early February 1868.30 The new catalog, the third to be issued by the Surgeon General's office, was published on June 12.31 There were now 2,887 titles, whereas the previous catalog had listed 602; now 6,984 volumes where there had been 2,282.32 In 1865 there had been no incunabula, 16th or 17th LIST OF WORKS ON YELLOW FFYKR LIBRARY OF THE SURGEON GENERAL'S OFFICE, SURGEON GENERAL'S OFFICE, AUGUST 20, !86». One of the earliest bibliographies published by the Library on topics of major importance at that time. 32 the national medical library century books, and only six books and one periodical from the 18th. Now there were two incunabula, seventeen 16th, fifty 17th, and 162 18th century titles. While selecting books Billings had sought works on three subjects of special interest to the Medical Department: cholera, yellow fever, and military sur- gery.33 Military surgery was important because of accidents at forts and posts and of wounds received by soldiers in battles with Indians in the West. Yellow fever had invaded the country frequently since colonial times, killing soldiers on many occasions. Cholera had arrived less frequently than Yellow Jack but was just as deadly. In 1864 an epidemic of cholera along the coast of North Carolina had caused 278 deaths among Northern soldiers. In 1866 the disease had appeared at several forts. In 1867 cholera was responsible for 139 deaths and yellow fever 427 in the Army. The Medical Department published long reports on cholera and yellow fever,34 and Billings prepared bibliographies that were published as pamphlets on August 20, 1869: List of Works on Cholera in the Library of the Surgeon General's Office, Washington, DC; List of Works on Yellow Fever . . . ; and List of Works on Military Surgery. . . .** Copies were distributed to surgeons and sent to appropriate libraries and agencies as gifts and exchanges. These were the forerunners of a host of bibliographies to be compiled in the Library during the next century. Billings as Mycologist, Hospital Examiner, Editor Although Billings was selecting publications, managing the collection, and compiling bibliographies, he was not yet concentrating on the Library. He studied mycology, off and on, and ordered books on the subject for the Library and himself. He wrote to Fliigel, the Library's agent in Leipzig: "I am at present specially interested in the study of fungi, particularly as connected with recent theories of the causation of disease by their means. I find much trouble however in verifying some of the specimens that come into my hands, and want several books if not too costly."36 The infant Bureau of Agriculture was also interested in mycology because it was thought that a prevalent cattle disease might be a "cryptogamous" fever. In February 1869 the Commissioner of Agriculture requested the Surgeon General to permit Billings and Assistant Surgeon Edward Curtis, an expert photomicrographist of the museum, to help the Bureau determine if fungi really infected cattle.37 Intermittently from February to June 1869 the two men experimented at the museum.38 Later that year an account of their investigation, which did not move the Bureau of Agriculture any closer to a knowledge of the cause and prevention of the illness, was published as a chapter, "Report of results of examinations of fluids of diseased cattle with reference to presence of crypto- gamic growths" in a government document, Reports of the Diseases of cattle, made to the Commissioner of Agriculture. . . 39 Billings continued to dabble with fungi until the early 1870's, publishing 33 a history of the national library of medicine three articles on the subject. 40 In 1878 he sold his specimens and collection of books to the Bureau of Agriculture, which was building its library.4 In the autumn of 1869 Billings was borrowed by the Treasury Department to make a survey of marine hospitals, at that time loosely organized under the name Marine Hospital Service.42 This agency, in existence since 1798, was composed of hospitals, some government-owned, some privately owned, where ill and injured merchant seamen were treated. The hospitals were located in busy ports on the Atlantic, gulf, and Pacific coasts, the Great Lakes, and major rivers. During the period from September to October 1869 Billings visited many of the hospitals.43 His report, which was not published and which has been lost for almost a century among myriads of government records, has been credited with providing Treasury officials with information and suggestions that led to improvements in the administration and organization of the Marine Hospital Service, which later evolved into the Public Health Service.44 Sometime during the winter of 1869-70 General Barnes considered trans- ferring Billings from Washington to an Army post, purveying depot, or regiment in the field. Billings had been in the Surgeon General's office for 5 years and normally he could expect to be reassigned.45 This was a crucial time for the Library and Billings. If he had been transferred, he would not have had the opportunity to develop into an internationally famous librarian and bibliogra- pher, and the Library might not have risen to prominence as the world's best. But Barnes changed his mind and retained Billings at headquarters. General Barnes now asked Billings to prepare for publication a group of reports that surgeons had been writing and sending to Washington for a year, describing medical facilities at Army posts. Billings edited the documents, wrote to the authors to obtain additional information that he felt was needed, secured supplementary information from regular Army officers stationed in Washington, composed a 30-page general introduction, and shepherded the large manuscript through the press. Published in December 1870 under the title Report on Barracks and Hospitals, with Descriptions of Military Posts, it is referred to today by historians of western America for the information it contains on old forts, now in ruins.46 The National Medical Library By the end of 1870 the Library contained approximately 10,000 volumes, more than 8,000 of which had been accumulated since the middle of the Civil War. In less than a decade the Library had become one of the largest medical libraries in the United States, exceeded only by those of the Pennsylvania Hospital and the College of Physicians in Philadelphia.47 During 1871 discussions must have taken place in the Surgeon Generals office for the purpose of deciding the objective for the Library. Nothing is known of the views expressed there, but alternatives suggest themselves: should the Library level off its rate of growth and merely keep up with new medical literature, or should it continue to expand rapidly; should its use be restricted 34 the national medical library JsIatiojml «JV[edical Library, BURGEON GENEIUL'8 OFFICE, Washington, D. C, ,187 Dear Sir: I have the honor to request that this Library may be furnished with one copy of..................................... in order to complete its files. Very respectfully. Your obedient servant, Surgeon, U. 8. Army, in charge of Library. To............................................................................... Letterhead used by Billings in the 1870's, showing his intention of developing the collection into a national library. This preceded by eighty years the official designation of the collection as the National Library of Medicine. 35 A history of the national library of medicine to government employees, or should it be open to the public? The spirit of ambition that desired to make the Army Medical Museum the greatest medical museum in the world was now directed toward the Library. The important decision, one which required some courage on the part of the Surgeon General because it would necessitate his making annual requests to tight-fisted congres- sional committees for funds, was made to develop the collection into the "Na- tional Medical Library."48 To Surgeon General Barnes and Billings, this meant a library that would contain "every medical book published in this country and every work relating to public health and state medicine,"49 that would be "as complete as possible in all publications relating to military organization, med- icine, and the allied sciences,"50 and would be "an universal library of refer- ences."51 Thenceforth Billings concentrated on developing the Library. He did not put aside all other activities in medicine, but for his remaining quarter of a century in the Army his major goal was the building of a library for the American medical profession. Up to this time the Library was known to Army physicians, to visitors to the museum who passed by as they walked up the stairs to the third floor of Ford's, and to those who heard of it by word-of-mouth. Now Billings set out to inform the American medical profession that the Library existed, was to be developed for the use of all physicians, and that it would welcome support and contributions. During 1871 and 1872 he wrote hundreds of letters to leaders of the profession about the Library. On trips to other towns (at least four trips in 1871 and five in 1872 to Philadelphia, New York, Cincinnati, Louisville, Baltimore, Boston, and other cities) to transact department business he visited influential physicians.52 He compiled a new catalog and distributed copies to libraries, societies, and major donors.53 He advertised for journals and books. He asked friendly editors to publicize the library, as did the widely circulated Boston Medical and Surgical Journal, which informed its readers:54 Many members of the profession are probably unaware of the fact that the Surgeon-General of the U. S. Army has authorized the collection of a medical library in connection with his office and the Army Medical Museum at Wash- ington, and that this collection has so rapidly increased that it has already reached an aggregate of 17,000 volumes. For this national collection of books we are indebted to the intelligent ap- preciation of the Surgeon-General and the medical gentlemen connected with his office; the most active agent in its increase has probably been Dr. J. S. Billings, Assist. Surgeon U. S. A., who for five years has devoted himself con- stantly to the library, and still remains in charge of it. . . . Dr. Billings hopes, by means of appropriations made for the purpose and by the aid he shall receive from the profession, to make it a valuable auxiliary in medical study and research. The establishment of a "national" medical library seems to have been ac- cepted calmly and with approval by the medical profession: at least there is no record of opposition while there is all manner of evidence that influential physicians showed by their subsequent contributions, support, and commu- nications that they favored the idea. 36 THE NATIONAL MEDICAL LIBRARY 1 Billings was relieved from duty with the Army of the Potomac and assigned to the Sur- geon General's office by Special Order 476, Adjutant General's office, Dec. 31, 1864. 2 Letter, Billings to Thomas McParlin, med- ical director, Armv of the Potomac, Jan. 4, 1865: NA. 3 As a disbursing officer Billings paid ac- counts referred to him by the Property Division; accounts for purchase and distribution of arti- ficial limbs and trusses; for apparatus and sup- plies for the museum; for expenses of compiling and publishing the Medical and Surgical His- tory; and for books and journals for the Library. Vouchers that he signed are in NLM. 4 The precise date when Billings was ap- pointed librarian is not known. It is not in Bill- ings' record of military service. Probably the general, seeing Billings several times a day in the small house in which they had their offices, gave Billings an oral order to take care of the books. Fielding H. Garrison, who was associ- ated with Billings for several years in the Li- brary, wrote: "In December 31, 1864, Dr. Bill- ings was assigned to duty in the office, acquiring among other things, nominal, though not offi- cial, care of this collection of books" (John Shaw Billings, a Memoir (1915, pp. 213-214). Billings himself said: "when the library came under my charge, in the fall of 1865. . . ."(New York Med. Rec, 17: 298-299, 1880). I am disposed to be- lieve the date given by Billings, who was there, rather than Garrison. Garrison made minor er- rors in writing the biography of Billings, and I believe that this was one of them. 5 Letter, Surg. Charles S. Tripler to Billings, Mar. 14, 1866; "You are I believe . . . some- thing of a bibliomaniac": MS/C/81. 6 The first letter, to my knowledge, sent by Billings for a book was dated Nov. 6, 1865, to Medical Purveyor R. S. Satterlee, New York. Later letters went to Satterlee on Feb. 9, Apr. 17, 1866; to Blanchard and Lea, Jan. 3, 1866; to David Clapp and Son, Jan. 3, 1866; to Frank Taylor, June 5, 1867: NA. 7 Judging by a comparison of the letters sent by Spencer and Billings for books: SGO records, 1865-1867, NA. 8 See excerpts from Billings' diary, Jan.-Nov., 1866, in Garrison, Billings, pp. 142-150. 9 According to Billings' diary he began to experiment in microscopy in 1866. See Garri- son, Billings, pp. 144-148. 10 Annual Report of the Surgeon General . . 1866, p.8. The number of contract surgeons varied considerably. On July 1, 1865 there were 1997; on July 1, 1866, 264. 11 Information about the Ford Building may be found in: George J. Olszewski, Restoration of Fords Theatre (1963), and Henry's and Lamb's histories, referred to previously. 12 Letter, Asst. Surg. Gen. Crane to Wood- ward, Dec. 18, 1866: NA. 13 "The second floor of the building is chiefly occupied by the division comprising the surgical records"; J. J. Woodward, "The Army Medical Museum at Washington," Lippincott's Mag. 7: 234 (Mar. 1871). The Library was so insignifi- cant at this time that Woodward did not mention it in his 10-page article. On the title page of William Bromfeild, Chi- rurgical Observations, 1723, is stamped: "SURG GEN'S OFFICE/DIV. SURG. RECORDS/454 TENTH STREET." The volume was purchased between 1865 and 1868. One wonders if the Library was considered as part of the Division of Surgical Records for a time. Of course the book may have been purchased for the Division and later placed in the Library, or it may have been stamped accidentally. 14 Letter, Billings to Roehrig, Jan. 10, 1867; "Roehrig ... is hereby assigned to duty in this office in charge of the library ": NA. Roehrig had previously been a contract act- ing assistant surgeon from 1862 to 1865 in Phil- adelphia, 1865 to 1866 in South Carolina, and 1866 in the Dept. of the Platte. Roehrig re- mained at the Library until his contract was terminated on Sept. 1, 1868. See note by Bill- ings re Roehrig, Sept. 1, 1868, NA. 15 There is little information about Billings' routine as a librarian during this period. Gar- rison, Billings, 214-5, and George M. Kober, Reminiscences of George Martin Kober . . . (1930), pp.61-62, 70-71, remark on Billings' quarters at Riggs. 16 Letter, Billings to W. Wesley, London, July 27, 1867: NA. 17 Letter, Barnes to Senator L. M. Morrill, chairman, Joint Comm. on Library, Feb. 9, 1872; "During the past four years a medical officer in this Office has devoted all his spare time to building up the library and to medical biblio- graphical work . . .": NA 18 Letter, Billings to W. Wesley, London, Oct. 17, 1867: NA. 19 Letter, Billings to Frederick Muller, bookseller, Amsterdam, Feb. 19, 1868; "with regard to purchase of books, our fund for that purpose is not large, and as we have to get all new medical and scientific publications, we do not have much to spare for the old books": NA. Billings made essentially the same statement to other booksellers. 37 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 20 Letters, Otis to Billings, Jan. 25, Feb. 14, 1869, Mar. 11, 1871: MS/C/81. 21 Letter, Bill to Billings, Mar. 16, 1868:MS/ C/81. 22 The number and titles of journals sub- scribed to each year may be found in notebooks, as Record of Medical Journals Received, vol. 2, 1869, NLM. 23 The earliest incunabulum ordered was Matthaeus Silvaticus, Liber Pandectarum Med- icinae, Venice, 1488. See letter, Billings to Wesley, Oct. 19, 1867: NA. Perhaps the volume had been sold before Wesley could purchase it for Billings; it is not in NLM. 24 Billings' correspondence with American and European booksellers in NLM and in SGO records NA contain the titles of many books he ordered. Among Billings' early American books sup- pliers were the following firms: Dr. Samuel Butler, Peter Doyle, J. D. Price, W. A. Leary, Jr., H. C. Lea, Lindsay & Blakiston, and John Campbell, all of Philadelphia; J. P. Des Farges, Kelly Piet & Co., R. A. Reed, and Gibson & Co., of Baltimore; James Campbell, Boston; William Wood & Co., L. W. Schmidt, D. Van Nostrand, Stechert & Wolff, E. Steiger, Frank Mackay, B. Westermann & Co., W. A. Towns- end, and F. W. Christern, of New York. 25 Letter, Billings to Bossange, Jan. 13, 1868; also letter, Billings to Weslev, Jan. 4, 1868: NA. 26 Letter, Billings to Wesley, Oct. 17, 1867; also Billings to Wesley, Dec. 13, 1867: NA. On at least one occasion Billings tried to buy books at less than catalog prices by returning a catalog to a dealer, Frederick Muller, with prices he was willing to pay. It is not certain whether Muller agreed to Billings' offer. Letter, Billings to Muller, Mar. 26, 1868: NA. 27 Later, Billings commissioned additional foreign agents. Details of business arrange- ments with agents may be found in the following letters: Billings to Wesley, July 27, Oct. 12, 1867; to Bossange and Son, Oct. 12, Dec. 19, 1867; to Fliigel, Oct. 14, 1867, Mar. 7, 1868; to Muller, Jan. 13, Feb. 19, 1868; Surg. Gen. Bames to Secretary of War, Mar. 14, 1878; Surg. Gen. Sternberg to Second Comptroller of the Treasury, Feb. 16, 1894, and to Comptroller, Mar. 30, 1900: NA. Triibner & Co. to Billings, Oct. 21, 1871; Wesley to Billings, May 12, 1871: NLM. Much of the correspondence between Bill- ings and his agents, with invoices, bills, letter- heads, and other documents, is in NLM. Billings did not inaugurate the custom of using European bookagents. The Surgeon Gen- eral's office had used the services of Fliigel in the 1850's; see letter, Asst. Surg. Charles Smith to J. Henry, Apr. 4, 1861: NA. The Smithsonian Institution, and perhaps other government agencies, also dealt with European bookagents. Billings' agents in Europe were very helpful, particularly Felix Fliigel. When Billings first visited Europe in 1881 he sent his uniform ahead to Fliigel, preferring to wear civilian clothes until he reached Leipzig. Fliigel guided him around the city and introduced him to persons Billings wished to meet. The two men became friends, and thereafter Fliigel occasionally dropped personal remarks into his business let- ters, telling of young Flugel's progress in med- ical school, of his own studies in philology, ex- claiming about the "dreadful news from Washington" when Garfield was shot, and tell- ing sadly of his wife's death in 1885. Billings visited Fliigel again in 1881 and 1884. Fliigel's correspondence is in HMD, NLM. 28 Letters, Billings to Wesley, Oct. 12, 1867, June 19, 1869; to Bossange, Oct. 12, 14, Dec. 19, 1867; Surg. Gen. Barnes to Secretary of War, Mar. 14, 1878; Surg. Gen. Sternberg to Second Comptroller of the Treasury, Feb. 16, 1894, and to Comptroller, Mar. 30, 1900: NA. 29 Letter, Billings to Bischoff, July 3, 1880: MS/C/81. 30 Letter, Billings to W. Wesley, Feb. 7, 1868; "I am now having a catalogue of our library printed . . .": NA. 31 The 1868 catalog has 147 pages. Books and titles are listed alphabetically from A to Z up to page 133, and from A to V in an appendix from p. 135 to p. 147. To the right of each title is the accession number. There is no indication as to why the catalog had to contain an appendix; perhaps the printing proceeded so slowly that Billings accumulated many volumes that he listed in the catalog by means of the appendix. The National Library of Medicine, History of Medicine Division, has five copies of this cat- alog, one of which has the titles of many later acquisitions written on interleaves. During this period Billings probably started the Register or accession book of the Library. The early entries in the Register were not dated, and for that reason the precise date when the Register was begun is not known. But the acces- sion numbers were printed along side of the titles in the June 1868 catalog; therefore the Register preceeded the catalog. Furthermore the listing of titles in the front of Register 1 is similar to that in the catalog of October 1865 but had additional titles, indicating that the Register was started some time after that catalog was published. 32 According to Garrison, Billings, p. 214, the catalog of June 12, 1868 contained 2,887 entries, amounting to 6,066 volumes. But Reg- 38 THE NATIONAL MEDICAL LIBRARY ister No. 3, the accession book, recorded vol- ume no. 6984 on June 15, 1868. Therefore there is a discrepancy of 918 volumes; I assume that Garrison was wrong in his estimate or there is a difference in the definition of "volume." 33 Letters, Billings to S. W. Butler, Jan. 14, 1868, and to F. Muller, Mar. 26, 1868, empha- sizing his desire for works on cholera and yellow fever: NA. 34 Report on Epidemic Cholera in the Army of the United States, during the Year 1866. War Dept, SGO, Circular 5, May 4, 1867. Report on Epidemic Cholera and Yellow Fever in the Army of the United States during the Year 1867. War Dept., SGO, Circular 1, June 10, 1868. 35 Copies in NLM have the original wrap- pers, and are interleaved with additional titles written in. Titles are arranged alphabetically by author, and are accompanied by the accession numbers. The cholera bibliography has 35, mil- itary surgery 22, and yellow fever 10 pages. 36 Letter, Billings to Fliigel, Sept. 3, 1868. Also letters to F. Muller, Aug. 27, 1868; to Wesley, Aug. 28, 1868, Jan. 19, 1869; to Bos- sange, Nov. 7, 27, 1868, regarding orders for works on fungi: NA. 37 Letter, Asst. Surg. Gen. C. H. Crane to H. Capron, Commissioner of Agriculture, Feb. 17, 1869, in reply to Capron's letter: NA. 38 Letter, Surg. Gen. J. K. Barnes to Cap- ron, July 1, 1869, transmitting report: NA. 39 This 190-page book published by the Gov- ernment Printing Office, 1869, also contains chapters by C. N. Riley, John Reid, H. W. Rav- enel, and the noted British veterinarian John Gamgee. 40 "The Study of Minute Fungi," American Naturalist 5: 323-9 (1871); "The Genus Hyster- ium and Some of its Allies," American Natu- ralist 5:626-31 (1871); "On Some Minute Fungi," (abstract of a talk by Billings, Feb. 5, 1872) Bul- letin of the Philosophical Society of Washington 1: 42-3 (1871^4). Billings also may have written a humorous, fictitious article, "Microscopical Memoranda, by Dr. Newlenz," Philadelphia Med. Times 1: 200 (March 1, 1871). In a letter to S. Chaille, April 3, 1876, Bill- ings wrote: "I have not done anything with the microscope for several years": MS/C/81. A state- ment by Garrison in Billings, p. 152-3, also con- firms that Billings put away his specimens in the early 1870's. 41 Letters, W. LeDuc, Commissioner of Ag- riculture to Billings, Mar. 15, 1878; Billings to LeDuc, Mar. 25, 1878: MS/C/81. Attached to the letter of Mar. 25 is a list of Billings' books and specimens with prices—the total price that he asked was $1,123, a large sum in those days. 42 Billings was ordered to report to the Sec- retary of the Treasury on Sept. 11, 1869, by A.G.O. Special Order 219. Surgeon General Barnes may have inad- vertently brought about this inspection by his comments on a bill to appoint a supervising sur- geon general for the Marine Hospital Service; letter Barnes to Senator CD. Drake, May 14, 1868: NA. 43 Billings was absent from Washington in- specting hospitals from mid-September to mid- October 1869 according to letters to W. Wesley, Sept. 13, 1869, and October 1869: NA. 44 This report has not been seen since the 19th century. Therefore some of the statements about Billings' influence on the reorganization of the Marine Hospital Service by biographers are not based on an examination of records and may not be reliable. Billings published an unsigned editorial, "The Marine Hosptial Service," Philadelphia Med. Times 1: 97 (Dec. 15, 1870), giving views based on his inspection. 45 Letter, Billings to Flugel, Mar. 29, 1870, "My connection with this office will probably cease on the 1 of June ... I will notify you as to who is to be my successor . . ."; letter, Bill- ings to Wesley, April 1, 1870, with same infor- mation: NA. 46 The volume was published by the War Department, Surgeon General's Office, as Cir- cular No. 4, Dec. 6, 1870. The book has been reprinted by Sol Lewis, New York, 1974, with an introduction by Col. Herbert M. Hart, U.S. Marine Corps. 47 During the Civil War money called the "slush fund" was accumulated at hospitals from the sale of fat, swill, and soap. Upon the closing of the hospitals after the war, Surgeon General Barnes ordered that the fund, amounting to some $80,000, be used to develop the Army Medical Museum (Circular Orders 15, Sept. 27, 1865; reprinted in Lamb, History . . . Medical Mu- seum, p. 37: letter, Barnes to J. M. Brodhead, 2d comptroller, July 21, 1866; NA). George Otis, curator of the museum, spent the money for specimens and apparatus, and to have illustra- tions prepared for the Medical and Surgical History. Billings was given responsibility for the accounting of the "slush" and other funds of the Surgeon General's office in 1870. His records (now in NLM) of the disbursement of the slush fund show that the money was used for the museum, not the Library. While it is possible that some money may have been spent on books, it could not have been a large amount. This explanation of the slush fund is given here to modify the statement made by S. Wier Mitchell in his obituary of Billings (Science 38: 830 (1913)), 39 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE copied by Garrison in his biography of Billings (p. 214), that the early growth of the Library after the war was owing the availability of the slush fund for the purchase of books. 48 Letter, Surg. Gen. Barnes to J. Eaton, Nov. 25, 1872; "about one year ago it was de- cided to make this the National Medical Li- brary, and it is intended to make it as complete as possible in that branch of science": NA. One wonders how much of this decision Surgeon General Barnes and Billings were each respon- sible for. It is possible that Billings was the prime mover and that Barnes merely signed Library letters written for him by Billings, but in view of the continual support given the Library by Barnes this seems improbable. 49 Letter, Barnes to Rep. J. A. Garfield, Jan. 6, 1872; also letter, Barnes to Sen. L. M. Mor- rill, Feb. 9, 1872: NA. 50 Letter, Billings to Gen. A. de Gorloff, Russian Legation, N.Y., [Nov.] 1871: NA. An editorial in Boston Med. Surg. J. n.s. 9: May 9, 1872, p. 305, quoted Billings as stating that the Library's scope was: "military hygiene, medicine and surgery; public hygiene, medical police, and state medicine, including epidemics and quarantine; vital and medical statistics; medical and scientific journals and periodical literature; chemistry, meteorology and phys- ics." 51 Letter, Billings to A. Jewett, May 13, 1872: MS/C/81. 52 Information on trips is from documents in the National Archives, Xerox copies of which are in MS/C/273. For example, he visited W. H. Mussey, book collector, Cincinnati (letter, Mussey to Billings, Sept. 20, 1872) and T. G. Griffiths and D. W. Yandell, editors, Louisville (letters, Billings to Griffith and Yandell, Oct. 10, 1872: MS/C/181). 53 Billings and his clerks began compiling the catalog in 1871, and delivered the manuscript to the printer perhaps around the beginning of 1872. Billings hoped to have it "thro the press" in February 1872 (letter to Surg. Eugene Abadie and Surg. Warren Webster, Jan. 17, 1872: MS/ C/81) but apparently it was not completed until Apr. (letter to Paul Eve, Mar. 12, 1872: MS/C/ 81). This catalog was thrice as large as the pre- vious catalog of 1868 (454 to 147 pages) and listed twice as many volumes (13,330 to 6066). Books were listed alphabetically by author, pe- riodicals alphabetically by title. From p. 433 on is an index of the principal subjects. 54 Editorial, Boston Med. Surg. J., n.s. 9: 305-6 (1872). 40 IV The Great Journal Hunt Billings Concentrates on Collecting Journals THE purchase of medical publications was restricted by funds appropriated by Congress. For fiscal year 1872 Congress gave the Medical Department $7,000 to be divided between the Library and museum. From 1873 until 1884 Congress appropriated $10,000 each year, to be shared. Even though the price of publications was lower than now, Billings did not have much money to build a"national" medical library. He never had sufficient funds to buy all the books and journals that were published, and he had to decide what works were most useful and would be bought and what works would have to be passed over. From the beginning to the end of each fiscal year he had to watch the balance of appropriations. The necessity for conserving funds was a constant influence in Billings' life during all his years as Librarian. Billings' collecting had two characteristics: an effort to collect every type of publicaton relating to medicine, and to obtain publications from every possible source. In addition to perusing book catalogs in search of bargains, he used every other legitimate means of obtaining printed materials. He wrote to phy- sicians, publishers, editors, health officials, government officials, librarians, and society officers, in short, to every person and organization that had works he desired, hoping to receive donations, arrange exchanges, or, as a last resort, buy publications at a low price. He was an unusual bibliomaniac. He did not covet books for himself but for the Library, almost as though the Library were his own. Indeed, after his family, he considered the Library the most important thing in his life, telling a friend: "Providence has put three duties straight before me, i.e. 1, my wife + children: 2, this library + catalogue: 3, The Johns Hop Hospl. They are too much for me, by themselves, but I am doing my best for them ..." Billings' letter writing and bibliomania set him apart from other departmental librarians of his time, who continued to enlarge their libraries in the customary manner, obtaining publications through the usual trade channels. Nowhere was Billings' tenacity, persuasiveness, and perserv- erance better illustrated than in his quest for journals. During the acceleration of collecting in 1871 Billings added 3,760 publi- cations to the Library, three times as many as in his previous most active year.! 41 A history of the national library of medicine Most of the new arrivals were books and pamphlets. Billings did not ignore journals, but neither did he show any unusual interest in them. Toward the end of 1871, as he and his clerks were readying titles for a new catalog, Billings came to realize that there were large gaps in the Library's collection of American and foreign medical journals. He began to gather bib- liographical information on the subject. He sent a clerk to the home of his friend collector-bibliographer-historian Joseph Toner to copy Toner's list of American periodicals.2 He had a duplicate made of the list of current journals in Physician's Annual.3 Undoubtedly he obtained information from journals themselves, from their practice of citing exchanges and reprinting or abstracting articles from other journals. He asked his European book agents for lists of foreign periodicals.4 Once Billings became aware of the incompleteness of the periodical collection he began to fill the gaps as fast as possible.5 Medical Officers Serve as Billings' Book Scouts Billings soon learned that booksellers could not supply out-of-date American journals quickly, if at all. One of his colleagues reported that New York book dealers looked upon old periodicals as "useless lumber, seldom called for, usually bought by weight as waste paper."6 Billings had little response, other than promises, from dealers to whom he wrote. He decided to try to obtain old journals from elderly physicians with the assistance of his brother officers. Medical officers had collected and sent thousands of exhibits to the Army Medical Museum; perhaps this gave Billings the idea of asking them to seek out and send obsolete journals. The Medical Department had more than 200 surgeons, assistant surgeons, purveyors, and storekeepers stationed at barracks, forts, posts, and depots. Some officers were in the western wilderness, but others were close to pop- ulated areas, and it was to the latter that Billings wrote and asked for help. He drafted a letter for his clerk to copy and send to Surgeons Andrew K. Smith, McPherson Barracks, Atlanta; James F. Weeds, Nashville; John F. Randolph, New Orleans; Alexander B. Hasson, Charleston; and Assistant Surgeons Bolivar Knickerbocker, Savannah; William J. Sloan, Louisville; and probably others: We are trying to make the files of medical journals (American) in our Library complete, so that there may be one complete collection of that sort to refer to, which at present is not the case. To this end we want to procure by purchase, exchange or otherwise the journals mentioned in the enclosed memorandum. Will you please try to procure for us all or a part of the journals wanted. It is unlikely that this can be done by a bookseller, though it would be well to put one on the look out, but they are undoubtedly in the hands of some of the physicians in the city, who might be willing to part with them in consideration of the purpose for which they are wanted. Please give the matter your best attention, and forward the journals by mail as you procure them, with memo- randum of the cost which I will refund. Or if the publications of this Office in exchange can be used I will send them. Billings wrote similar but more expansive letters to officers whom he knew 42 the great journal hunt personally, as the following note to Surgeons Eugene Abadie, Detroit, and Warren Webster, Fort Independence, Boston:8 I have been as you know trying to buld up a Lib for this Off. + have succeeded very well so far. We have now about 14000 vols + I hope by the middl of the next month to have a cat of it thro the press. The prep of this cat has enabled me to discover the gaps, + my next labor is to try -I- fill them up; especially do I wish to complete the files of Am. med. pers. [periodicals] for I think that we ought to have here every Am. med. j. good, bad, or indif, wh has ever been pub. I inclose herewith a list of some desiderata wh. you may be able to help me to procure -I- if you have the time + opportunity you will confer a favor not only upon myself but upon the Off if you will try to pro[cure] these for us. I am willing to pay any reasonable price for them, or to exchange the pub's of this Off or some of our dups for them. If you cannot procure all of the jrs asked for, odd vols, or even odd nos., will be better than nothing, as I may be able to complete the sets elsewhere. You will see by a glance at the list that there is little hope of finding anything on it fr. any regular book seller. This last chance is to find some public spirited old phys, or descendant of an old Phys who may have the books + be willing to part with them for the purpose for which they are designed, for a Nat Med Lib to represent Am. med. lit. The lists of wanted journals that Billings attached to his letters were handwritten at first.9 A few months later he had several different want-lists printed in editions of from 40 to 250 copies for distribution to his colleagues, agents, and corre- spondents.10 Receiving Billings' message, his volunteer book scouts ransacked second- hand bookstores, contacted editors, tracked down descendants of dead doctors, and raided libraries of living physicians. They cajoled physicians into donating desirable publications by appealing to patriotism and professional pride; and when appeals failed they offered exchanges or, as a last resort, money. Assistant Surgeon Charles Smart, New York, sought out Samuel Smith Purple, one of the leading medical book collectors of his time. Smart told Billings of his reception:11 I found Dr. Purple at home this P.M. He was very amiable, disposed of many duplicates he had a few years ago on the occasion of moving to a new house, but is hopeful that he may be able to assist a little yet as he has a box which contains he knows not what, but it may pay to overhaul it. He inquired if I had been to Miller and Christopher and gave me directions to find an Irishman named Lalor in University Square who has lots of old used medl books which may repay the time spent in looking over them. I shall hunt him up tomorrow and make a list of what he may have for your selection. I left a note of the journals wanted with Dr. P. and will call again about the end of the week. He says the four at the end of the list are quacks, more especially Hunters Specialist and you need not be anxious about them. He showed me them. He has a very handsome library, spent years in completing his magazine files, advertising, etc. found great difficulty anent certain western journals, and is extremely proud of the result of his labors on the well filled shelves around him. . Smart visited the shop suggested by Purple, and told Billings of his success:12 The old book store mentioned in my note of yesterday is a hard place to find 43 a history of the national library of medicine J-,ist of Medical Journals Wanted to com/j/ere Files in the Library of the Surgeon (U'lieml's Office, Washington, 1). (J. Dr. J. S. B1LLLVGS, • iast. Suriieon, U. S. Army, Librarian. lmmsil AMKKK A. Quebec Medical Journal. By Xuvier Tc- British-American Medical and Physical »•«". Quarterly. Quebec. Journal. By Arch. Hall. New Series. Want all after (whole) no. Oi April, \*?>\. \l.....hly. Montreal. Unfettered Canadian. By 11. Dick. Month- Want n... lo. vol. vi; no. 10. vol. vii (1&W-52K \y. Brockville, V. W. Canada 1-ancel. By W. K. Bowman. Want niM.7, «. etc.. vol. if]8ti»; and all xuW- Mtniihly. Montreal. qucnt. W;1),t ,,„.<. n. 23. ano,ncnt of vol. i Upper Canada Journal of Medical, Sur- 'WBMi: «n.l all „f,,r vol. i. gicttl 8tl(, pfcyrf^i S«.ici.ce. By S. J. S.rat- Canadian Journal of lloiiueopalliv. By ford. Toronto. W. A. (i.conkaf »i..| A. T. Bull. Monthly. Want no. 7. vol. i (October. 18f,1>; ..,*. 2. .1..",, vol. Si. Catharine*. ii; no*. 10.12, vol. iii; ami nil fiil>*c..iii ]y,. Wam )f,j (n n|jy ^ ^ pnwpcctUK. *» hii! all or any part. La Lancettelanadienne. , 1847). fOXSKCTKTT. Want all or any part. Hartford Annlcctic Journal .,1 Medicine an.I Montreal Medical liazette. By I'. Badgley Sl"Kl'ry. Hartford. :ind Win. Sutherland. Monthlv. Ko. Coininciired al.oul It'-".. »'»! all alltr vol. i |»u-:,, XVnnt a" "ra"y l'»rt; perhap* hiiiiu- a- Ahoithlj t, •,,.,.. Journal of .Modi, inc. Provincial Medical Journal. By W I! t j j ^ .. Slaw.,, ,, Kan-,1. an,. H. W. mL^- ^ffP^ent Botanic Vdvoentc By Cm, rMarterlv llalif-.x m»M">- Bo.amc Meduul Society. Monthly. Mantord. u , ' ', ' ','.', Want vol. i: no. .!. vol. ii < Aiicu-t. lK|oi- w,| ;;. «».■« -.-.1.-,.).v.,l.1:l^,;,,„lallM,W<111,„l. .....I all .,ib. C, the following Medical Journals :— New York Medici Intelligencer. 1845. .„, ] New York Med. Gsxett* and JourtudI of Hglth. Edited by D. M. New York Medical Magazine. Edited by Mott & Onderdonk. 18K ' Beese. Want Nos. 41, 22, of vol III. 1852. New Y^ Director. 184V48. ^^^»'.^^^l^ie^S^}^Ftaix,T^^J*!'!S^^7TfM New York Monthly Chronicle of Medicine and Bttrgeiy. 1824 New York Register of Medicine and Pharmacy. 1856. New Yorker Medidniscber MoaatsxAriit. Medical Reformer. New York. 1823. Ohio Medical Repository. American Lancet. Philadelphia, 18381 New York Medical JonrnaL Conducted by Peixotto and others. 1881. Pattisonami J. Hagan. Want Nos. 17, 24, *>, 48, 47, VOL L vol. IX. 18B8-8&. Transylvania Journal of Medicine. Want VoL X., Nos. 1, 8, 4. Vol. XL. Nos, 2, 8. Vol. XII. 1837-39. Traimlvania Medical Journal. Want No. 8. Vol. I. Nos. 1, 2. 3, 6, VoL II. 1849-51. New Series: Want Nos. 14, 24, Vol. 1. No. 8, Nos. 8, 4, 8, 7, 14, of Vol. I. (1854, and all after No. 15 of VoL L New York Med. and Surf?. Reporter. Want Vol. IL 1846-47. Northern Lancet and Gazette of Legal Medicine. Platttburg, N. Y. Want Vol L No. 1, Vol. IL Nos. 1, *, Vol. HI. 1849-51. Philadelphia Med. and Sore. JonrnaL Edited by Bryan. Want Vols. L, EN». 8, 4. 5, 6, 9, Vol. UL No. 2, VoL II. Nos. 1, 8, 7, 11, VoL VL 18B2-*8. Register and Library of Med. and Chirurgical Bcienoe. Edited byG.S. New York Medical Press. • Edited by Klernan and O'Meagher. Qf the above, all or any part an desired. Annalist. Want No. 8, VoL II.; No. 10, andaU after No.^18, Vol. til. Berkshire Medical JonrnaL Want Nos. 5. 8, 7, ofVoL I. (1881), and all Boston Medical Intelligencer. Want Vols. n. HI-TV. (l^*-*)" Bulletin of Medical Science, Pbila. Want Nos. 8. 1J, Vol. IV. (1848). Cleveland Medical Gazette. Want Vols. II. III. (18S0-81). New York Lancet. Want Nos. 1, 2, 8, 4, of VoL III. VoL 2. 1861-58. Western Medical Gazette. United States Med. and Surg. Journal, N. Y. 1834-35. Want Nos. I, 18,18,19, and all after Nos. 19. JOH2V S. BILLINGS, Ajss't Stugaon V. S. Army, Librarian Surgeon-General's Office. One of the advertisements placed in medical publications by Billings, at- tempting to fill gaps in the Library's collection ofjournak. This appeared in the New York Medical Record, September 15, 1873. 55 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE not provide back copies. All of the supply of Medical Investigator had burned during the great fire that destroyed 31/2 square miles of Chicago in October 1871. Editor Thomas C. Duncan tried to find a complete set among his sub- scribers to send to Billings, but physicians who owned sets refused to part with them.79 Samuel Butler, one of the country's most industrious medical publish- ers, wanted to assist Billings but could not because he had kind-heartedly helped another physician some time before. "Several years ago," he wrote, I permitted a Dublin, Ireland, surgeon to make a raid on my files of journals and he made very nearly a clean sweep up to that time (1867). I have never ceased regretting it."80 Postmasters Locate Editors for Billings Unable to find the addresses of editors of several extinct journals, Billings conceived the idea of writing to postmasters in towns where the periodicals had been published and asking them to pass his message to a local physician who might know something about the journal. He sent the following letter to the postmaster at Keokuk, Iowa:81 The Surgeon General is desirous of obtaining, for the Library of this Office, all that was published of a medical periodical called 'The Western Medico Chirurgical Journal' edited by J. F. Sanford and S. G. Armor and published monthly at Keokuk in 1851-54 and perhaps longer. You will confer a favor if you will place this communication in the hands of some physician who will probably be willing and able to assist us. The Surgeon General will be glad to purchase the journal, or to furnish some of the valuable publications of this office in exchange. Through this postmaster or someone to whom the postmaster gave the letter, Billings learned that Armor had moved east and was now associated with Long Island College Hospital. He wrote to Armor who promised to donate his own copy of the journal when his books, in transit, arrived from the West.82 Billings' clerk used the Keokuk letter as a model in writing to postmasters at Knoxville regarding East Tennessee Record of Medicine and Surgery; Bridge- port, Belmont County, Ohio, for Belmont Medical Journal; Sandersville, Geor- gia, for Georgia Medical and Surgical Encyclopedia; Princeton, Indiana, for Indiana Scalpel; Galveston, Texas, for Galveston Medical Journal; Syracuse for New York Eclectic Medical Journal, Union Medical Journal, and Syracuse Medical and Surgical Journal; Concord for New Hampshire Medical Journal; Hartford, Connecticut, for Monthly Journal of Medicine; Abbeville, South Carolina, for Peoples Medical Gazette; Bloomsburg, Pennsylvania, for Middle States Medical Reformer and Journal of Health; and London, Ontario, for Canada Health Journal .83 Postmasters at Knoxville, Princeton, Concord, Abbeville, Bloomsburg, and London apparently were unable to help, but other postmasters assisted. The clerk at Galveston carried the letter to Greensville Dowell, an editor of Gal- veston Medical Journal from 1866 to 1871. Coincidentally, Surgeon Lewis A. 56 the great journal hunt Edwards, stationed at San Antonio, had written to Dowell seeking the journal for Billings. Back issues were scarce, for Dowell's office had burned twice, but he told Edwards, "I am anxious to fill the file in the Surgeon General's office,"84 and he gave the post office clerk several numbers to send to Washington.85 The postmaster at Bridgeport handed the letter to John G. Affleck, publisher and an editor of Transactions of the Belmont Medical Society, 1847 to 1855, and of Belmont Medical Journal, 1858 to 1860. Affleck advertised in the two county newspapers trying to obtain copies of the periodicals, but when he received no replies he sent his own sets to Billings, asking for "no recompense," but willing to accept any new or interesting publications.86 At Hartford the postmaster passed the letter concerning Monthly Journal of Medicine to Nathan Mayer, who had been a surgeon with a volunteer reg- iment during the Civil War.87 Mayer tried unsuccessfully to obtain the old journal, already almost half a century out-of-print, but the Library acquired it a few years later. The postmaster at Syracuse passed the letter to Edward E. Van de Warker, another ex-surgeon of volunteers.' Van de Warker could not locate a complete set of Eclectic Medical and Surgical Journal (later, Union Journal of Medicine), but he offered Billings individual issues.88 In Sandersville the postmaster apparently presented his letter to Horatio N. Hollifield, one of the coeditors of Georgia Medical and Surgical Encyclo- pedia, a journal that lived less than a year in 1860. Hollifield obtained all the issues except one and mailed them to Billings.89 Obtaining Journals From Irregulars During Billings' day there existed several different "schools" of physicians, each with its own philosophy about the cause and cure of disease. There were botanic, Thomsonian, eclectic, and homeopathic physicians, all derisively re- ferred to as "irregulars" by orthodox physicians, who called themselves "reg- ulars." Rivalry existed between the schools, each believing its opinions and methods to be correct. Regulars looked down on the irregulars and would not consult with them or mingle with them professionally. Initially Billings was a typical regular. His bias toward irregulars was mir- rored in the suggestions he sent to his journal scout Acting Assistant Surgeon L. A. James: "as to the Eclectic and Homeopathic Journals you can get some non-professional person to go and see the Editors of those now in existence and see what they can do."90 James accepted this advice, telling Billings: "I have placed the collection of these homeopathic journals into the hands of a homeopathic doctor, who has promised me to get a large number."91 John J. Woodward, Billings' associate in the Surgeon General's office, felt the same way. Questioning Billings about the policy for acquiring publications he asked: "a friend writes to know the extent to which homeopathic books are acceptable? Please tell me how to answer. Of course we will receive all that are presented will we not? But do we care to buy? and if so how far?"9 57 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The aloofness of Billings and his fellow medical officers kept them from making the personal, friendly contacts with irregulars that they had made with regulars, consequently the Library did not at first acquire homeopathic, ec- lectic, Thomsonian, and botanic journals with the same rapidity as it acquired regular journals. But Billings' desire to build the collection soon overcame his prejudice, and he wrote to editors of these periodicals. He found them as cooperative as editors of regular journals. Roberts. Newton, editor of American Eclectic Medical Review, received the following appeal from Billings:93 Surgeon Moore USA wrote me that you would furnish some medical journals for the Library of this office and I have been hoping to hear from you especially in regard to eclectic journals. I have not been able to get any satisfactory bib- liography of eclectic medical literature, and I have no doubt that there are several eclectic journals which I have not on my list. I should be much obliged for any information which you can give me on this subject. I have sent to press a list of all American journals that I know of, showing what we have, and I should like to receive your reply and any journals which you can let us have in time to use in correcting proof. I send you this day by mail circ's 1, 2, 3, 4 of this office, and will have other exchanges for you. Pamphlets relating to eclectic medicine or its history in this country will be much appreciated. Newton not only contributed but offered to become one of Billings' book scouts:94 During the latter part of this week I will send you a small library. I find in this city several volumes of the rarest journals in your list of wants for which the holders ask from 500 to $1.50 per vol. Shall I purchase such for you. If you give the order and you should obtain duplicates I would receive them back and place them in my own library. So far as my own publications are concerned I will take great pleasure in donating them to the Library. I think I can send you from 40 to 50 volumes. Is it your purpose to make a collection of medical books as well as journals. I am highly gratified and pleased to know that the Government, tnrough your department has determined to carry out the purposes you have in view. Every medical man of every school no doubt will be proud of this National Museum and Library connected with and under the control of the War Department. Amos R. Thomas, professor of anatomy at Hahnemann Medical College in Philadelphia and editor of American Journal of Homeopathic Materia Medica and Record of Medical Science, contributed homeopathic and eclectic journals, pamphlets, and books, and arranged exchanges between the libraries of Hah- nemann and the Surgeon General. He spoke about the Library at a meeting of the American Institute of Homeopathy, resulting in the Institute's contrib- uting periodicals and offering to help Billings fill his want list. He told Edward D. Buckman, a teacher at Eclectic Medical College of Philadelphia and editor of Philadelphia University Journal of Medicine and Surgery, that Billings needed a set of that periodical. Buckman offered the journal plus other journals to Billings as an exchange.95 As news of the "National Medical Library" spread among irregulars Billings benefitted. He received a letter from Isaac M. Comings, New York City, asking for a list of wanted journals. Then Comings, who had edited Southern Botanico- 58 THE GREAT JOURNAL HUNT Medical College Journal in 1843, Journal of Medical Reform from 1854 to 1856, and Southern Medical Reformer and Review from 1857 to 1858, sent 20 volumes of rare journals. He later provided information on dates of publication and other data concerning botanic journals and sent names and addresses of editors and publishers.96 Edwin A. Lodge, publisher and editor of American Homeopathic Observer, received the want list and offered to sell volumes of 10 journals from his private library.97 Later he sent lists of other journals and pamphlets that he was willing to part with.98 Medical officers fared as well as Billings. Assistant Surgeon James, "stirring up the Quack Doctors" in Cincinnati, obtained volumes of the following scarce periodicals: American Medical Journal, Family Journal of Health, Journal of Rational Medicine, Journal of Education and of Physiological and Medical Reform, Syracuse Medical and Surgical Journal, Thompsonian Recorder, and Physio-Medical Recorder.99 Surgeon Alden, making a thorough sweep through the Buffalo medical fraternity, approached A. T. Bull, a homeopathic physician. Alden told Bill- ings:100 I had better luck with the homeopath yesterday than I expected & send you by express tomorrow morning a box of pamphlets chiefly homeopathic & eclectic & quack. There are a good many things as you will see from enclosed list that fill gaps in your files but there is a good deal besides. I thought best to send you all the duplicates as they were freely given & I fancy material of this kind may not be so easily obtainable as regular journals, & they may be therefore useful for exchanges. Among the periodicals were issues ofCanada Journal of Dental Science, Canada Lancet, Canada Health Journal, Canada Medical Journal, Chicago Medical Times, Medical Investigator, New England Medical Gazette, Western Hom- eopathic Observer, American Homeopathic Review, Bistoury, Herald of Health, Medical Gazette, North American Journal of Homeopathy, Dental Advertiser, Homeopathic Sun, American Homeopathist, Ohio Medical and Surgical Re- porter, Eclectic Medical Journal of Pennsylvania, Philadelphia University Jour- nal of Medicine and Surgery, and Medical Independent. Bull also sent a copy of Billings' list of wanted journals to a physician in Canada, hoping to get missing periodicals for the Library. With the help of Thomas, Lodge, Newton, Buckman, Comings, and other kindly disposed "irregulars," Billings obtained for the Library an excellent collection of Thomsonian, botanic, eclectic, and homeopathic periodicals, some of them already scarce in Billings' time and virtually impossible to obtain today. Acquiring Foreign Journals With the Aid of Bookagents and Consuls Since the Library did not receive sufficient funds to subscribe to every journal that touched on medicine in North and South America, Europe, Asia, 59 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Africa, and Australia, Billings chose the best known British, French, German, Austrian, Swiss, Scandinavian, and other journals, and directed his European agents to subscribe. In the early 1870's he sometimes depended upon his agents for advice on the quality of periodicals he was unfamiliar with; for example, in 1871, having no experience with Italian journals, he instructed his agent Felix Fliigel to select the best two from that country and obtain them for the library.lf)1 As he became acquainted with the world's periodical literature he made such decisions himself. He also depended on his agents for news of the birth and the death of journals. He subscribed to new journals for at least a trial period but did not hesitate to discontinue a journal after examination showed it to have little use. From time to time he cancelled the least important and added newly established journals. He had difficulty finding agents in Spain, Russia, and a few other countries, but he persisted. He badgered his agents, Bossange in Paris, Brock- haus and Fliigel in Leipzig, Muller in Amsterdam, Triibner in London, to forward journals as soon as they appeared. He had journals mailed instead of being shipped by cheaper but slower express. As with extinct American journals, Billings had difficulty obtaining sets or issues of defunct foreign periodicals. He sent want-lists to his agents.102 He belabored them to obtain volumes he needed, urging them to advertise in booktrade and medical journals.103 His agents obeyed him because he was a good customer, not because they believed it would yield results. They were not very successful, still Billings persisted. In 1875 the firm of Triibner, stung by Billings' complaints about their inability to locate old journals, replied:104 We can assure you that there is the greatest difficulty attached to the collecting of such things and could you but make the trial you suggest of "One Week in London" or a much longer trial than this, we feel sure you would find the result to be something more like despair than gratification. There is one very strong reason for these journals being scarce. Most of such things are failures (scarcely any can boast of much success) and are looked upon by the greater portion of the book trade as waste, and treated as such, with most of the trade in London. If any fall into their hands in the ordinary course of trade, they are destroyed as packing paper, or consigned to some waste paper dealer, the demand being so limited that they would never pay for keeping. On a similar occasion Gustave Bossange, Paris, retorted to Billings: ". . . there is nothing so difficult & which requires more search & inquiry than to obtain odd numbers of periodicals and it is a work which can only be carried out successfully with time and patience."105 Because his agents could not obtain journals from some countries, or ob- tained journals too slowly or at too high a price, Billings asked United States consuls to aid him. In June 1872 he sent, through the State Department, the following letter to consuls James Partridge, Rio de Janeiro, and Thomas Pearne, Kingston, Jamaica:106 To complete the files of American medical journals in the Library of the Office, the Surgeon General U.S. Army is very desirous of obtaining the medical journal 60 THE GREAT JOURNAL HUNT mentioned in the enclosed memorandum, or any other medical periodicals which may have been published in Brazil [Jamaica]. He is willing to purchase the journal, or to exchange the publications of this Office for the same. Any expense incurred by you in processing the said journal will be refunded either through the State Department, or otherwise as you may direct. Four months, later he received word from Partridge that the Brazilian jour- nals could not be found.107 Pearne, however, managed to obtain several issues of West India Quarterly Magazine from the editor. This led Billings to ask Pearne to compile and send bibliographic information on any medical journal ever published in Jamaica.108 After this time Billings wrote to consuls in Cuba, Mexico, Spain, Portugal, India, Australia, Hawaii, Japan, Russia, Venezuela, Peru and other countries, with varying results.109 Consuls attempted to fill Billings' requests through book dealers and editors, or by other means. Consul J. J. Cooper visited 12 book stores in Cadiz and sent Billings a list of 248 books and 60 periodicals that he saw on the shelves.110 Henry Hall, consul in Havana, could not find back issues of a Cuban periodical but obtained the donation of an old medical treatise.111 Julius A. Skilton, Mexico City, subscribed to a Mexican journal for the Library and located rare journals and old books.112 A lesser librarian would have been discouraged by the difficulties in ob- taining journals from countries which did not have channels in the book trade, but some measure of Billings' tenacity and ingenuity in pursuing publications may be judged from his use of consuls as book scouts. Through them he procured periodicals, books and pamphlets that the Library otherwise might not have obtained. When Billings began he did not know much about American medical jour- nalism; the dates when certain journals had started and stopped, the changes that some journals had undergone in title, the names of past and present editors, and even the existence of a number of extinct and living periodicals. This hindered him, and he resolved to compile a bibliography of journals. By the spring of 1872 he had sufficient data to put together a preliminary bibliography, which would also serve the purpose of a want-list, and in April he published it as a 26-page pamphlet, Library of the Surgeon General's Office, United States Army. Supplement to Catalogue. No. 1. List of American Medical Jour- nals.113 He did not publish a final, separate bibliography but interspersed his detailed bibliographical information through the multivolume Index-Catalogue of the Library of the Surgeon-General's Office which he started in 1880, and in volume 1 of which he placed an alphabetical list of journals.114 During the journal hunt Billings accumulated historical information that he wove into writings that helped establish his reputation as a bibliographer.115 An illustration of the otherwise unobtainable information that came his way, and which he did not use in an article, is the story about the New York Medical 61 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE and Surgical Reporter sent by its founder Clarkson T. Collins of Great Bar- rington, Massachusetts:116 The only reason for my discontinuing the work was my own feeble health. I am a native of N.Y. and had intended to spend my days in the city, but I became consumptive, was compelled to go abroad, and on my return I came here among the Berkshire hills where I have been living for 20 years. I sold the Reporter to a rascal by the name of William R. Wagstaff, M. D. who collected all he could of the subscribers and went to London, Eng. ... I paid back to his subscribers all they paid him because I had recommended him to them. During the height of the hunt Billings considered publishing a historical sketch of American medical journalism into which, presumably, he would have poured all of his accumulated notes.117 It is unfortunate that he did not do so; if he had we would now know much more than we do about earlier publishers, editors, and periodicals. Billings accumulated journals with speed unparalleled in the development of any other American medical library, perhaps any other medical library in the world. Five years after he began his journal hunt the Library had obtained partial or complete sets of 714 of the estimated 1,147 medical journals that had come into existence since the first one had appeared in 1679. The Library possessed 8,214 volumes of the estimated 10,736 volumes that had been pub- lished.118 Thereafter Billings concentrated on filling gaps among his American and foreign journals, and on obtaining every medical journal of value published in every country. Notes 1 Publication number 10,001 was acces- sioned in the Register on Jan. 2, 1871. Number 13,761 was accessioned at the end of the year. Billings' previous most active year was 1869 when, according to the Register, he acquired 1,252 items. 2 Letter, Billings to Toner, Jan. 4, 1872: LC. 3 The list of journals in medicine and the cognate sciences copied from the Annual is in Billings' correspondence, 1872: MS/C/81. 4 For example, G. Bossange, Paris, sent a list of French scientific and medical periodicals as requested by Billings; letter, Bossange to Billings, Dec. 12, 1871: NLM. 5 "The important part of a medical library, that which will give it character and value, and for deficiency in which nothing can compensate, is its file of medical journals and transactions": Billings, "Medical Libraries in the United States," p. 178 in Bureau of Education special report, Public Libraries in the United States . . . , part 1, 1876. 6 Letter, Asst. Surg. C. Smart to Billings, Jan. 30, 1872: MS/C/81. 7 Letter, Billings to "Dear Doctor," Jan. 23, 1872: MS/C/81. Billings, on occasion, drew up a letter to serve as a form letter for his clerks to copy in writing to persons about books and journals. The above letter was marked "sample"' and probably was copied and sent to other med- ical officers in addition to those mentioned above. 8 Letter, Billings to Webster and Abadie, Jan. 17, 1872: MS/C/81. 9 For example; a handwritten want-list of journals is attached to letter, Surg. Weeds to Billings, March 18, 1872: MS/C/81. 10 In HMD, NLM, are several of the printed lists: List of Medical Journals, Transactions, and Reports, Wanted to complete Files in the Li- brary of the Surgeon General's Office, Wash- ington, D.C., 30 pp.; List of Medical J our nab, Transactions, and Reports . . . , 15 pp.; List of Medical Journals, Transactions, and Reports . . . , 2 pp.; List of Medical Journals, Trans- actions, and Reports . . . , 11 pp. In the Otis Archives, AFIP, is a scrapbook containing other lists: List of American Homeopathic Periodicals Wanted . . . , 3 pp., of which 40 copies were 62 THE GREAT JOURNAL HUNT printed; List of Medical Journals Wanted . . . , 4 pp., of which 75 copies were printed; List of Medical Journals Wanted . . . , 3 pp.; Supple- mental List of American Medical Journals of some of which specimens are in the Library . . . , Aug. 26, 1872, 4 pp., 75 copies printed; List of Medical Journals of which no copies are in the Library . . . , long, narrow broadside, 250 cop- ies printed. 11 Letter, Smart to Billings, Jan. 30, 1872: MS/C/81. 12 Letter, Smart to Billings, Jan. 30; also let- ter, Smart to Billings, Feb. 3, 1872: MS/C/81. 13 Letter, Smart to Billings, Feb. 15, 1872: MS/C/81. Purple gave his library to the New York Academy of Medicine, which he helped to create. 14 Letters, Webster to Billings, Jan. 31, Mar. 13, Apr. 16, 20, 1872: MS/C/81. 15 Letters, Smith to Billings, Jan. 26, Mar. 9, June 19, 1872: MS/C/81. 16 Letters, Randolph to Billings, Mar. 20, Jan. 26, 1872: MS/C/81. 17 Letters, Bentley to Billings, Oct. 19, 1872, Feb. 6, Mar. 31, 1873: MS/C/81. 18 Letters, Alden to Billings, Aug. 25, 30, Sept. 5, Oct. 8, 1872; Jan. 26, Mar. 13, 1873: MS/C/81. 19 Letters, Town to Billings, Apr. 8, May 20, Aug, 6, 1872: MS/C/81. 20 Letters, Bibber to Billings, June 19, July 20; Billings to Bibber, June 21; Billings to Bos- ton Med. Surg. J. July 6, 1872: MS/C/81. 21 Letters, Beall to Billings, Jan. 26, Feb. 1, Mar. 18, 28, Sept. 23, Nov. 2, 1872; J. P. Ches- ney to Beall, Feb. 2, 1872; Billings to Beall, Feb. 3, 1872: MS/C/81. 22 Letters, Weeds to Billings, Feb. 1, Mar. 11, 18, 25, Apr. 17, June 9, Sept. 20, Oct. 18,' Nov. 3, 1872: MS/C/81. 23 Letters, James to Billings, Mar. 10, 14, 19, 23, 30, Apr. 18, June 25, Sept. 21, Nov. 2, 1872: MS/C/81. 24 Letters, McClellan to Billings, July 28, Aug. 14, 1872, Jan. 14, 15, 1873: MS/C/81. 25 Letter, Randall to Billings, July 18, 1872: MS/C/81. 26 Letters, Billings to Sloan, Jan. 23, 1872; Sloan to Billings, Jan. 26, May 21, 1872; Billings to Griffiths, May 13, 1872; Samuel L. S. Smith to Billings, July 1, Sept. 11, 1872: MS/C/81. 27 Brown's report was published as Senate Executive Doc. 9, parts 1 and 2, 42 Cong., 3 Sess., 1872, and as a book, Report on Quar- antine on the Southern and Gulf Coasts of the United States (New York, 1873). 28 Letter, Brown to Billings, June 24, 1872: MS/C/81. 20 Letter, Brown to Billings, June 30, 1872: MS/C/81. 30 Letter, Brown to Billings, July 8, 1872: MS/C/81. 31 Letters, Brown to Billings, July 25, Aug. 26, 1872: MS/C/81. 32 Letter, Simpson to Billings, Jan. 13, Feb. 20, 1872: MS/C/81. 33 Letter, Knickerbocker to Billings, Jan. 27; Billings to Knickerbocker, Feb. 16, 1872: MS/ C/81. 34 Letter, Frantz to Billings, Mar. 28, 1872: MS/C/81. 35 Letter, Horton to Billings, Apr. 19, 1872: MS/C/81. 36 Letter, Hammond to Billings, May 27, 1872: MS/C/81. 37 Letters, Billings to Hammond, Oct. 30; Hammond to Billings, Nov. 14, 1874: MS/C/81. 38 Letter, Perrin to Billings, June 8, 1872: MS/C/81. 39 Letters, Sutherland to Billings, Nov. 21, 1872; May 10, 1873: MS/C/81. 40 Letter, Barker to Hassan, Mar. 13, 1872: MS/C/81. 41 Letters, Middleton to Billings, June 10; Reynolds to Billings, June 22, July 6; Murray to Billings, Sept. 28, Nov. 21; Taylor to Billings, Dec. 2, 1872: MS/C/81. 42 Letter, Porcher to (Billings?), Apr. 28, 1873: MS/C/81. 43 Letters, J. W. Freer, Chicago, to Billings, May 4, 1872; T. C. Duncan, Chicago, to Bill- ings, Apr. 9, 1872, June 25, 1873; P. O. Tessier to Billings, May, 1872; G. Dowell to Edwards, Mar. 15, 1872: MS/C/81. 44 "The wife of a physn deceased some years ago tells me that she sent this spring barrels of old med journals to the paper mill"; letter, A. Jewett to Billings, June 3,1872: MS/C/81. Other letters in Billings' correspondence mention pa- per mills as the fate of physicians' books and journals. 45 Letter, Billings -o Flint, Jan. 13, 1872: MS/C/81. Billings, at this time, was far from being the expert on medical publications that he would become later. One of several indica- tions of this is the above letter where he did not know that New York Monthly Review of Medical and Surgical Science was New York Monthly Review of Medical and Surgical Science, and Buffalo Medical Journal, actually volume 15 of Buffalo Medical Journal. 46 Letter, Smart to Billings, Jan. 29, 1872: MS/C/81. 47 Letter, Billings to Eve, Mar. 12, 1872: MS/C/81. Eve had been an editor and associate editor of Southern journal, 1845 to 1849; of Nashville journal, 1852 to 1857 and 1866 to 1867. 63 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 48 Letters, Eve to Billings, Mar. 22, Apr. 6, 1872: MS/C/81. 49 Letter, Billings to Dowler, May 22, 1872: MS/C/81. 50 Letters, Dowler to Surg. Randolph, July 15, 1872; to Surg. Gen. Barnes, Aug. 7, 1872: MS/C/81. 51 Letter, Wormley to Billings, May 14, 1872: MS/C/81. 52 Letters, Billings to Tessier, May 4; Tessier to Billings, May (no date) 1872: MS/C/81. The periodical was bilingual, also titled The Quebec Medical Journal. Billings sent circulars 3 and 4 as a good will gesture. 53 Paper covers, bound in volume 1, bear the name of Dr. Cook. The volumes were acces- sioned in 1890. 54 Letters, Fenwick to Billings, Dec. 12, 1871, Apr. 29, 1872: MS/C/81. Fenwick accepted pub- lications of the Surgeon General's office in ex- change for volumes he sent Billings. 55 Letter, Billings to Lea, Jan. 29, 1872: MS/ C/81. American Medical Intelligencer died with volume 4 in 1841. The publisher was A. Waldie. The firm of Lea & Blanchard (succeeded by Henry C. Lea in 1865) took over the stock of Waldie and started a new journal, Medical News and Library (later, Medical News) in 1843. Bill- ings needed back issues. 56 Letters, White to Billings, Jan. 31; Bill- ings to White, Feb. 1, 1872: MS/C/81. 57 Smart, poking around New York to find journals for Billings, learned of Collins' address, otherwise Billings may never have obtained Collins' rare journal. Letters, Smart to Billings, Jan. 30; Billings to Collins, Feb. 5; Collins to Billings, Feb. 20, 1872: MS/C/81. The volume in NLM bears the inscription in Collins' hand: "Presented by Dr. C. T. Collins to the library of the SCO. 1872." 58 Letter, Butler to Billings, Mar. 14, 1872: MS/C/81. 59 Letter, Billings to Ziegler, Apr. 8, 1872: MS/C/81. 80 Letter, Billings to Clark and Garrison, Apr. 8, 1872: MS/C/81. 61 Letters, Billings to Tilden, Apr. 8, 26; Tilden to Billings, Apr. 22, 27, 1872: MS/C/81. 62 Letters, Billings to Fulton, printed in Canada Lancet 4: 442-443 (May 1872); Fulton to Billings, Mar. 11, 1872, bound in front of Canada Lancet, vol. 3: NLM. 63 Letter, Billings to Johnson & Lund, June 11, 1872: MS/C/81. 64 Letter, Judd to Billings, June 13, 1872: MS/C/81. 65 Letter, Chaille to Billings, Nov. 29, 1872: MS/C/81. Chaille was an editor 1857-1861, 1867. His signature is in volumes 3 and 19, NLM; it may have been in others and been cut off during rebinding. In his letter Chaille listed several journals he was willing to part with, and named persons to whom Billings should write. 66 Letter, Billings to Talbot, Apr. 8, 1872: MS/C/81. 67 Postal card, Brown to Billings, July 18, 1873: MS/C/81. Brown offered journals from his own collection. 68 Letter, Campbell to Billings, July 18, 1872; bound in Canada Health Journal: NLM. Camp- bell sent the complete five issues, all that were published, of his periodical, and information about its fate. 69 Letters, Billings to Gross, Sept. 23, Oct. 8, 1872: MS/C/81. 70 Billings' letter, with remarks and an offer by Fulton to forward publications to Washing- ton, is in Canada Lancet 4: 442-3 (May, 1872). 71 Letters, Fitzpatrick to Billings, May, June 1, June 22, 1872; Feb. 22, 1873: MS/C/81. Bill- ings offered $3 cash or volumes of Scientific American in exchange for Fitzpatrick's journals. 72 Letter, Saunders to Billings, May 14, 1872: MS/C/81. 73 Letter, Robertson to Billings, May 14, 1872: MS/C/81. 74 Letters, Mcintosh to Billings, Aug, 12, 31, Sept. 19, 1872: MS/C/81. 75 Letter, Jones to Billings, Oct. 23, 1872: MS/C/81. 76 Letter, Fulton to Billings, May 7, 1873, sending bill for the ad. The advertisement is missing in the NLM copy of Canada Lancet. 77 Letters, Clark to Billings, June 6, 23, 1873: MS/C/81. 78 Letter, Hawkins to Billings, Sept. 8, 1873: MS/C/81. 79 Letters, Duncan to Billings, Apr. 9, 1872; June 25, 1873: MS/C/81. 80 Letter, Butler to Billings, May 14, 1872: MS/C/81. 81 Letter, Billings to Postmaster, Keokuk, Mar. 8, 1872: MS/C/81. 82 Letter, Armor to Billings, Apr. 13, 1872: MS/C/81. 83 A list of post offices to which the clerk wrote is attached to the letter to Keokuk, above. 84 Letter, Dowell to Edwards, Mar. 15, 1872: MS/C/81. 85 Letter, E. S. Fletcher, clerk, Galveston P.O. to Billings, Mar. 21, 1872: MS/C/81. 86 Letter, Affleck to Billings, May 14, 1872: MS/C/81. Billings, according to pencilled note on the letter, sent circulars and the Library's catalog. The first volume of the Transactions at NLM has Affleck's signature inside the cover and on the title page. 64 THE GREAT JOURNAL HUNT 87 Letter, Postmaster, Hartford, to Billings, Apr. 13, 1872: MS/C/81. 88 Letter, Van de Warker to Billings, June 27, 1872: MS/C/81. The Library, unfortunately, never completed its set of this periodical. Ec- lectic Medical and Surgical Journal underwent changes in its title and ended as Union Journal of Medicine. Billings had not yet become an expert on medical literature, and he thought that the two were different journals. 89 Letter, Hollifield to Billings, Mar. 22, 1872: MS/C/81. 90 Letter, Billings to James, Cincinnati, Feb. 19, 1872: MS/C/81. Italics supplied. 91 Letter, James to Billings, May 2, 1872: MS/C/81. 92 Letter, Woodward to Billings, April 26, 1872: MS/C/81. 93 Letters, Surg. John Moore to Billings, Mar. 25, 1872: Billings to Newton, Apr. 27, 1872: MS/ C/81. 94 Letter, Newton to Billings, Apr. 30, 1872: MS/C/81. Newton's subsequent letters show his continued helpfulness to the Library. 95 Letters, Thomas to Billings, Apr. 23, 30, June 13, 1872: R. D. McClatchey, American Institute of Homeopathy, to Billings, June 13, 20, 1872: Buckman to Billings, June 27, 1872: MS/C/81. Buckman gave Billings bibliographic data about his journal. 96 Letters, Comings to Billings, May 2, 15, June 11, 1872: MS/C/81. 97 Letter, Lodge to Billings, Apr. 25, 1872: MS/C/81. 98 Letter, Lodge to Billings, June [no date], 1872; list of volumes purchased from Lodge, July 6, 1872: MS/C/81. Covers of Medical In- vestigator, Vol. 4, 1866, Nos. 3 and 5 in NLM carry Lodge's signature. 99 Letter, James to Billings, Oct. 29, 1872: MS/C/81. 100 Letter, Alden to Billings, Dec. 19, 1872: MS/C/81. 101 Letter, Billings to Flugel, Nov. 11, 1871: NLM. 102 Italian book scouts who supplied journals to L. W. Schmidt of New York issued and cir- culated an Italian translation of Billings' want- lists. 103 por example, Billings' instructions to Bossange to advertise in Bibliographic de la France and local medical journals, in letter, April 11, 1874: MS/C/81. 104 Letter, Triibner & Co., to Billings, Mar. 20, 1875: NLM. 105 Letter, Bossange to Billings, May 8, 1877: NLM. 106 Letters, Billings to Partridge and Pearne, June 7, 1872: MS/C/81. From the endorsement on the back of the letter to Pearne, I would assume this was a form letter, copied by Billings' clerk and sent to other consuls. 107 Letter, Partridge to Billings, Oct. 25, 1872: MS/C/81. 108 Letters, Pearne to Billings, Aug. 27; Bill- ings to Pearne, Oct. 18, 1872: MS/C/81. 109 For example, letter, Billings to William Hunter, Assistant Secretary of State, Sept. 2, 1873: MS/C/81. Billings asked for names of con- suls in Madrid, Barcelona, Cadiz, Saville, Lis- bon, Calcutta, Bombay, and Melbourne to help him procure journals the Library had been un- able to obtain. There are letters to consuls in other cities in Billings' correspondence. 110 Letters, Cooper to Billings, Oct. 2, 1874; (no date) 1875: MS/C/81. 111 Letter, Hall to Billings, Aug. 7, 1873: MS/ C/81. 112 Letters, Skilton to Billings, Jan. 27, 1873; Nov. 14, 17, 1874; Jan. 26, April 22, 1875; Feb. 25, 1877: MS/C/81. 113 Published by Government Printing Of- fice, Washington. The list contained informa- tion on almost 300 journals, Canadian as well as United States. 114 Index-Catalogue, v. 1, pp. 2-126. New lists or additions to the lists were published in front of each succeeding volume of Index-Cat- alogue . us '"rne Medical Journals of the United States," Boston Med. Surg. J. 100: 1-14 (Jan. 2, 1879), and "A Century of American Medicine 1776-1876, "Amer.J. Med. Set. 72:439-80(1876), to mention two of Billings' most notable articles. 116 Letter, Collins to Billings, Feb. 20, 1872: MS/C/81. For other examples of bibliographical information sent to Billings see letters, Fenwick to Billings, Dec. 12, 1871; Eve to Billings, Apr. 6, 1872; Chaille to Billings, Nov. 29, 1872: MS/ C/81. 117 Letter, Billings to C. T. Collins, Feb. 21, 1872: MS/C/81. 118 Statistics given by Billings on p. 177 of his chapter, "Medical libraries in the United States," in Bureau of Education, Special Report, Public Libraries in the United States . . . , Part 1, 1876. Titles of the journals purchased by the Li- brary, 1869-1872, 1874-1909, are in manuscript volumes in NLM. 65 ¥ Gathering Books and Other Literature for the National Medical Library Acquiring Books BILLINGS' appetite for books was always greater than his means, and he tried in every way possible to obtain the most for his money. He purchased European imprints from or through Continental book agents because their prices were cheaper than American dealers charged.1 He did not buy second or later editions of recent works unless there was an imperative reason for doing so.2 He bawled booksellers out when, in his opinion, they asked higher prices than he thought publications were worth. On one occasion he wrote to bookseller L. W. Schmidt, New York: "I must remark that I think your prices a little high. From most booksellers I get a discount. ... If you continue to invoice me at full retail price I shall have to purchase elsewhere."3 At times he offered less than catalog prices, hoping that if publications were not sold to other buyers the bookseller would be willing to accept Billings' terms.4 Billings also bought volumes from physicians, advertising in journals for works that were difficult to obtain.5 Having a fairly accurate idea of the current market value of secondhand medical works, owing to his constant perusal of catalogs, he sometimes disappointed sellers by low offers. Richard J. Dunglison refused Billings' offer of $135 for 165 volumes of dictionaries from the estate of his father, Robley, and auctioned them in Philadelphia.6 F. Peyre Porcher, Charleston, South Carolina, offered to sell eleven 16th century books (Galen, Celsus, Hippocrates, etc.) that he had bought in Florence, Italy, many years earlier for $250. He sent them to Washington for Billings to examine. Billings replied with a check for $175, telling Porcher to accept or return the check. Porcher, needing money "in these times of hardship" agreed "with a pang of regret."7 Billings browsed through bookstores when he visited Philadelphia, Balti- more, New York, Boston, and other cities on official business or to attend meetings of medical societies. While in Philadelphia in early 1871 he stopped at Peter Doyle's shop and purchased a volume which, unknown to him, was wanted by Samuel Gross, a noted surgeon and biographer. When Gross learned 67 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE that Billings had beat him to the book his grief was so great that sympathetic Doyle wrote Billings:8 Your venerable friend Dr. Gross is in great tribulation about one of the books you bought on Saturday. The book 'Schroder's Dispensatory' he had inquired for some time since. Upon receiving it about two weeks ago, I immediately wrote to the doctor mentioning the fact and the price. Not having heard from him I inferred that he did not want the book, or did not care to pay my price for it. On Monday Dr. Gross called and was very much disappointed to find the book sold. This afternoon the doctor called again, and so lamented the loss of that treasure of Med'l Science that I promised to write and state the facts of the case to you, though I did not think that he could fairly claim the book. Billings felt so sorry for Gross that he surrendered the folio; at least there is no evidence in the Library's invoices and register that it received a copy at this time. A year later Billings managed to obtain another copy of "The Dis- pensatory of that most famous, &c, chemist, J. Schroder" for $20, and it now rests in the History of Medicine Division.9 Billings wrote interesting, readable, sincere letters, and through his cor- respondence he became friendly with physicians who lived states away and who never met him. He encouraged them to donate publications to, or exchange with, the National Medical Library by appealing to their patriotism and pride in their profession. One physician who became infected with Billings' love for the Library was Adams Jewett of Dayton, Ohio, who began scouting for books in 1872. Jewett searched through the libraries of dozens of physicians in Dayton and other towns, sent Billings lists of desirable works they owned, and brought about donations and exchanges. He talked with widows of physicians and ar- ranged sales of their books to the Library. Sometimes the widows had already disposed of the books, as Jewett reported:10 Dr. Blodgett a very respectable practitioner died a good many years ago having a large number of med. books wh came into the hands of a daughter who kept them for years out of regd to her father, & doubtless dusted them regularly twice a year at housecleaning time, but finding them at last too much in the way she sent them to the papermill this season. I went in pursuit hop'g to find something for you, but too late. Embarking on a steamboat trip on the Ohio and Mississippi rivers with his wife, Jewett carried along Billings' want-lists and went to book stores when the vessel tied up at St. Louis, Davenport, and Denmark. Traveling to Troy, Ohio, to attend a funeral he also hunted books and he talked with physicians whose names he sent to Billings as potential donors or exchangers. On a visit to Davenport, Iowa, he looked over libraries of physicians, and sent donated pamphlets and lists of the libraries' contents to Billings. He continued to assist until he died in 1874. A compilation of those persons from whom Billings received books reads like a Whos Who in American Medicine.11 Among them were: Edmund Andrews, a founder of Chicago Academy of Sciences and North- western University Medical School 68 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. James Armsby, a founder of Albany Medical College Richard Arnold, president of Georgia State Medical Association John Ashhurst, Jr., president of College of Physicians, Philadelphia Robert Battey, president of American Gynecological Society Agrippa Bell, editor and leader in the American public health movement Henry I. Bowditch, a founder of Boston Medical Library Association and chair- man of the Massachusetts Board of Health William Brodie, editor and president of American Medical Association Francis Brown, compiler of medical directories of New England Charles Brown-Sequard, international physiologist then living in New York City Gurdon Buck, president of New York Pathological Society Charles Burnett, president of American Otological Society Swan Burnett, president of Medical Society of the District of Columbia James Chadwick, a founder of American Gynecological Society and Boston Medical Library Surgeon General's Office * el o c) n J3 / fi ■* ,<8 ?. » w w X a •i no 0 *• & S3 ft S & *- * = /* V tt « # - t X ffi BS 9 =* * " 9- J Hi ! * = rt 89 a £ * ffi - Si * * * -» V = ; s 2 a ».. Jit * ■t X « ■C' * f *5 » / $ m. iS = a n * 3 n % IS ■» ffi «s< t » * en 8 * » ^ «■ 4. fi sM IS M (d K ■i ^ isi S a 41 n » <■ * ft / ^ » i >M W ' •- ■ a * * 3. * •/ 9 Bt - /* JO <* * % ty * '; —_ xsr." —*-• First page of Kinsei isetsu (Modern Medicine News), started by Stuart El- dridge in Japan, 1874. Eldridge sent this copy, with his handwritten title page, to Billings. their influence when it was needed, included a large proportion of leaders in American medicine. In addition to attracting gifts from physicians of national prominence, the Library over the years received donations from or made exchanges with phy- sicians of whom we know scarcely more than their names because they pub- lished little or nothing and were not active in societies. The Library also re- ceived gifts from physicians of other countries, the most generous of whom may have been Thomas Windsor of Manchester, England, who began pre- senting books in 1874, and continued to do so all his life.14 In an effort to obtain publications from countries that did not have a well- developed book trade, Billings sought help from travelers, emigrant physicians, anyone who could serve his purpose. Receiving a request from Reverend Till- man C. Trowbridge, an American missionary, for Medical Department pub- lications to be sent to Central Turkey College, Billings took the opportunity to ask Trowbridge to keep an eye open for Arabic and Turkish works for the Library.15 Learning of the existence of the American Baptist Mission Press in Rangoon, Burma, Billings asked F. D. Phinney, the superintendent, to obtain native medical writings.16 When Stuart Eldridge, a former Civil War officer, librarian of the Department of Agriculture, and teacher of anatomy at George- town, settled in Japan where he helped establish medical schools, hospitals, a J S3? a 35 & •st 9 ■* u * ® iS V V rt * fi m 9. * *« a = - & » 9 * s . "^ *r n s> Q -IS) m $ # ■h z n ■)/ % 1 ^U <)Lu> din< HuoUctt/ W.. JiidXxU. U YlidAjJlXuttA lrVK<.ul»mtmmt Oc*yrttrI) Ai^moL / o/ < ■ ■ j" Sir, I am instructed by the Librarian of the Surgeon-General's Office, U. S. Army, Washington, D.C., to furnish that Library with as nearly complete sets as I can obtain of the Reports, Cata- logues, Announcements, and other Publications of the Medical and Sanitary Societies and Institutions of Great Britain. The Library of the Surgeon-General's Office, comprising nearly 50,000 volumes, is the largest Medical Library in the United States, and as a Government Institution forms a suitable depository for the permanent preservation of such documents as are now ashed for. If you will be so good as to send me any of your publications that you can spare, I shall be happy to forward them to the Library, and due acknowledgment will be sent to you from Washington. If the Library can, from its duplicates, or other- wise, furnish any vacancies in your collection in exchange for your publications, I shall be glad to hear from you on the subject. I am, Sir, Your obedient Servant, B. F. Stevens, To the Secretary of the B. F. Stevens sent 350 copies of this letter to medical institutions in Britain. GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. Obtaining reports of European health agencies was equally difficult. Billings did not yet know European physicians (he would know many later) and he did not have any regular correspondents other than his few book agents. He re- quested his agents to obtain reports from local institutions, and to advdertise for reports issued in other areas. Accordingly Gustave Bossange asked Parisian authorities for reports, and had a circular printed and distributed throughout French provinces.22 Triibner & Company and B. F. Stevens mailed form let- ters to institutions in Great Britain.23 Another means by which Billings sought to obtain reports issued in foreign countries was through the assistance of United States consular officials. He first attempted to employ a consul as a book scout in March 1871 when he sent Medical Department publications to William Thomson, consul in Southampton, England, and took the opportunity to ask Thomson for assistance:24 We desire to obtain for the library of this Office, all pamphlets or reports relating to Insane, Asylums for Blind, Deaf & Dumb, Idiots &c, Quarantine Officers, Board of Health, and reports on Prisons, and of Prison Inspectors, and find some difficulty in procuring such from England as they are not sold and do not come in the way of Book sellers. Any assistance which you may be able to render in this respect will be gladly received and fully appreciated by this office. Billings did not call on consuls often at first, but later he came to depend on them for assistance in countries, among them Spain, Mexico, Russia, and Venezuela, from which he had difficulty obtaining publications. He also asked consuls to obtain and deliver exchanges, provide information on publishers and publications, and help him find reliable foreign booksellers. The collecting of pamphlets gained momentum rapidly. Within a few years the existence of the Library was known to most of the medical profession in the United States, Canada, and even Europe, and Billings began to receive reports voluntarily. But during his term in the Library he never stopped prod- ding officials in charge of health agencies, hospitals, and institutions to send their publications. Dissertations Among the nonmonographic, nonperiodical literature that came to Billings, like flotsam and jetsam on the current of books and journals, were health laws and ordinances, hospital plans, diplomas, newspaper clippings, almanacs, and blank forms issued by health departments and other government agencies. Billings accumulated but did not purchase these unless there was need for a specific item. One unusual publication that he did seek was the student dis- sertation or thesis required of candidates for the medical degree. Billings felt that dissertations had four uses: they were sources for history of medicine, particularly for the light they shone on schools and teachers; they contained accounts of cases or investigations; they were useful in biography, especially German theses which often contained an account of the student; and 75 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the early programs for theses often contained an introduction, in the nature of an article, by a professor.25 It is doubtful that many librarians agreed with Billings' high estimate of the usefulness of dissertations. Billings said that their value was "usually under- estimated," which was another way of stating that other librarians and physicians considered them "for the greatest part not very important publications."2 Acquiring a complete collection of dissertations was difficult because tens of thousands had already been published, hundreds were printed every year in Europe, only a small edition of each was printed, they were not intended for the book-trade market, and secondhand booksellers generally ignored them. Billings began to accumulate dissertations at least as early as 1868 when he asked Gustave Bossange to try to obtain for him a large number of volumes of theses of the Medical Faculty of Paris.27 Thereafter he obtained American and European dissertations by gift, exchange, purchase, and deposit from Library of Congress28 and Smithsonian Institution—the latter on one occasion deposited 3,000 dissertations it had received through its book agents in Europe and probably was relieved to be rid of them. Billings accelerated his buying of dissertations in 1872. L. W. Schmidt, a New York bookdealer with transatlantic connections, located several large lots in Europe. He offered one group of 450 dissertations for $100, or 300 each if bought individually; additional groups of 3,600 and 1,000; and a gigantic group of 48,113 at 50 each if all were taken.29 By mid-1873 Billings had many American theses, all the Paris theses, a large proportion from the schools of Strassburg, Montpellier, and Berlin, and smaller holdings from other European universities.30 He urged his European agents to search for them. In May 1873 he told Felix Fliigel, "from this date on I wish arrangements to be made to secure for this library one copy of each medical dissertation of all the German universities."31 A short time later he reiterated to Fliigel, "I want to get all that appear in [the] future, for I mean to make this library as complete as I can."32 On Billings' instructions Fliigel corresponded with German universities to try to obtain a copy of every dissertation, but he was unsuccessful because students paid for the printing of their dissertations and therefore owned them. An official of the University of Berlin informed him: "a regular donation of one copy of each medical dissertation can neither be ordered by the faculty nor by the academical senate."33 Billings even tried to persuade a janitor at the Uni- versity of Berlin to act as his agent in collecting theses for the Library for the sum of 20 marks a year, but the arrangement failed.34 Billings was moderately successful in obtaining dissertations through ex- change, including 202 from University of Zurich,35 110 from University of Groningen,36 79 from University of Greifswald,37 917 from University of Mun- ich,38 124 from University of Wiirzburg,39 and copies from the universities of Rostock, Freiburg, and Halle.40 Despite his efforts Billings was not able to obtain all the medical dissertations 76 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. LIST O.F1 Jqumals, Transactions, aid Books WANTED TO COMPLETE THE FILES OF THE NATIONAL MEDICAL LIBRARY, UNDER THK DIRECTION OF TUK SURGEON-GENERAL, U. S. ARMY, WASHINGTON, D. C, For which a fair price will be paid, or valuable exchanges furnished. JOUENALS. JOURNALS. i British-American Medical and Physical Jour- American Lancet. By Beattie. Phila. Want nal. Montreal. Want No. 10, vol. vi. j ! Nos. 5,6, and all after No. 7, rol. i. (1833.) No. 10, vol. vii. (1850-52 ) ! „, .. ,,..„.., . 0 ... Philadelphia Medical and Surgical Journal. Canada Lancet. Montreal. (1863-65) Want By Bryan. Want vols, i., ii. (1852-53); Nos. 11, 53, and all after No. S3 of toI. i. No. 3, vol. iii. ; No. 8, vol. v. Monthly Journal of Medicine. Ilartford, Carolina Journal of Medicine, Surgery, and Conn. Want vols. v. and vi. (1825.) Agriculture. Charleston, 1825. Want all Southern Medical and Surgieal Journal. 7 P • Augusta, Ga. Want vol. iii. (1838-39) ; ! No. 1, vol. Hi., new series (1847) ; No?. 1, I iTOAVQir«PTnVR r»TP 2. 3. 4, vol. vi. ; No. 1, vol. viii.; Nos. 11 1HAHSAC1IOHS O* and 12, vol. xvii.; vol. xviii. Medical Association of the State of Alabama. Western Medico-Chirurgical Journal. Keo- > Want 1st (1847?), 2d, 3d, 9th, and all sub- kuk, Iowa. Want No. 1, vol. i. (1850-51) ; i sequent to reorganisation in 1868 and year Nos. 7 and 8, vol. ii. j 1872. New Orleans Monthly Medical Register. By Connecticut State Medical Society, Proeeed- Axson. Want Nos. 2, 4, 5, 6, 8, 12, vol. i. ing» of. Want all prior to 1818, 27th see- (1851-52) ; Nos. 2, 5, 7, 8, 10, vol. ii. «<»; 1820-23; 1825-29. Union Medicale de la Louisiane. New Or- Medical Society of the State of Georgia, leans. Want Nos. 2, 4, 5, 8, 10, 11, vol. i. Want 1st (meeting 1850), 1855, and all sub- (1852 ) sequent to the 19th (1868), inclusive. Medical Bulletin. Baltimore. Want No. Illinois Stat* Medical Society. Want 1st 24, vol. i. (1869) ; Nos. 21, 22, 23. and 2!, (1851), 1853, 1851, 1865-1866, 1874, and vol. ii. 1875. Vaccine Inquirer. Baltimore. Want N« State Medical Society of Indiana. Want 2, 3, 6, 7. -5'.)j ; elusive, and 1872 to date. No.-. I. :'.,«, vol. ii. ; and all after No. •". M(.,lif..tl Society of State of Kansas. Want vol m. (Jan. l«ol). ,.t and 2,1 (1865-66?). 4tL (Im1\, and Paint I.....n M< lical and Surgical Journal. subsequent. Want N... 10. vol. t. (Jan I8»4): vol. ii. K,n,„..kv Stilte Medioa! Soriet.v. Want 2.1 .1844-1.); N-. 8, vol. vi. ls.'>2 3, 4th (H5ti,3;th ,ls57'] Saint Louis Probe. Waul Nos. 1, 5, 6, 9, 10, u> 12th. vol. i. (I*j0.) M-di.v.1 Society of the Plate of Missouri. NV«- Wk l.w.t. By Houston. Want-W. W;i|it ,,•;;.,„,, a„ gub,e,inent t0 is,;,;, i„. 2. :t. 4. of vol in. No 1 vol ii Vo *N,mv I,:""r""r,! Medical Society. Want all 1,'vo3 Hi.'; vol. xii. " ' ' prior to is.VI, also I860. (70th se„.ion ) Ohio M-I>al I'rpnsitory. By Mason. Want Medi.-al Society of the State of N.-i ih Cap No. I, I «, 7, vol. i. ,18.3-j, and all after J inn. Want'2.1 (Ib'/h, 5th (1854), 12th No. 7. if any. US<>1 ')• il Richard J. Dunglison of Philadelphia assisted Billings by placing this two-page advertisement free in Dunglison s Ready Reference List for Physicians (1876). Note that Billings called the collection the "National Medical Library." 77 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE TRANSACTIONS OP South Carolina Medical Association. Want 1851-52-53, and 1857-58-59. Tennessee State Medieal Society. Want 1831 (2d), 1833-34-36-37-39, 1841, 1845- 47-49, 1852-54-55-57, and all subsequent, exoepting 1869. Medical Society of Virginia, Proceedings of. Want lst-28th (1851), 31st (1854), and all subsequent to time of reorganization in 1870. Medical and Chirurgical Faculty of the State of Maryland. Want all prior to 1854 ; 1855, 1857, 1858, 1860 to 1872, inclusive. THESIS OP Agnew, James. On Perspiration. 1800. Baldwin, William. Dis. of Amer. Seamen at Wampoa. 1807. Ball, Thomas. Causes and Effects of Sleep. 1796. Ballard, B. Phthisis Pulmonalis. 1811. Barton, William P. On Nitrons Oxide Gas. 1808. Blundell, James. On Dysentery. 1791. Butts, E. de. On the Eye, and Vision. 1805. Carter, Robert. On Opium. 1803. Chisolm, Robert On Hydrocephalus Inter- nus. 1796. Clark, Mioajah. On Lithotomy. 1811. Colesbury, H. De Epilepsia. 1792. Condict, L. On Effects of Contagion, etc. 1794. Cnnover, 8. F. On Sleep, Dreams, etc. 1791. Dorsey, J. S. Gastric Liquor. 1802. Drayton, Charles. De Inversione Uteri, etc. 1809. Drysdale, Thomas. Varia da Hepate Pro ferena. 1794. Duval, Grafton. On Melia Asedaraeh of Linnaeus. 1802. Foissln, Peter. De Stimulorum. 1802. Fort, Tomlinson. On Practice of Medicine. 1849 or 1850? Foushee, John H. On Stricture in Urethra. 1799. Gibbons, William. On Hypochondriasis. 1805. Gray, H. M. On Cynanohe Traeh. (Croup). 1805. THESIS OP Handy, H. On Opium. 1791. Huger, Francis K. Gangrene and Mort. 1797 Jones, Edward. On Pneumonia. 1796. Laws, John. On Opium. I7<<7. McDonald, Thompson. On Cynanehe Trecb- •alis (Croup). 1602. Madison, J. C. On Med. Prop, of Iron. Isu5 Magruder, N. On Smallpox. 1792. Meredith. C. On Phthisis Pulin. 1802. Mifflin, Charles. On Injuries of Head. 1826. Moore, David, On Ophthalmia. 1807. Otto, John. De Epilepsia. 1797. Parrish, Joseph. Influence of Passions, etc. 1805. Pendergast, G. E. Top. Sketch of Miss., La., and W. Fla. 1803. Perkins, E. On Universal Dropsy. 1791. Pfeiffer, G. On Gout. 1791. Proudfit, Jac. De Pleuritide Vent. 1790. Ribb, W. W. On Lymphatics. 1811. Rogers, R. K. Oa Liriodendron Tolipifera (Poplar Tree). 1802. Rose, Henry. Oa Effects of Passions. 1794. Rome!, A. J. de. Do Febribus Intermit. 1790. Rowan, Thomas. On Hydro. State of Fever 1802. Rush, James. Oa Use of Omentum. 1809. Sawyer, M. E. Causes of Animal Life. 1793. Stevens, A. H. Oa Inflammations. 1811. Stock, J. E. On Effects of Cold. 1797. Stokes, W. Quaedam de Asphyxia, etc. 1793. Thomas, G. G. On Kalmia La ti folia. 1802. Thompson, Hodge. Oa Spigelia Marilandica. 1802. Thornton, Geo. A. On State of Med. Science, etc. 1807. Tripiett, Thomas On Apoplexy. 1798. Wallace, J. W. On Catamenia. 1793. Washington, Wm. On Diabetes. 1802. Cases and Observations by the Medical Society of New Haven Co., State of Connecticut. 8vo. New Haven. 1788. Address, Dr. J. S. BILLINGS, U. S. A., Librarian Shroeox-Gf.xeuai.'s Ot-nm, WASHINGTON, I). C. 45 78 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. that had been published in America and Europe before he began collecting, or those that were published each year thereafter. Nevertheless, during his long tenure as Librarian he accumulated a vast number, increasing from ap- proximately 40,000 theses in 1875, to 40,524 plus 1,385 volumes each containing many theses in 1885, to 57,187 plus 1,762 volumes in 1895. This was the largest such specialized collection of any library in the United States, perhaps in the world.41 Mutual Aid Through Exchanges To conserve funds for purchases Billings did his best to obtain books, pam- phlets and journals by exchange with organizations and individuals. At first he did not have many commercial publications to exchange (later the storage areas would overflow with duplicates and triplicates) but he did have Medical De- partment publications. From 1870 onward there were copies of the monu- mental, multivolume Medical and Surgical History of the War of the Rebellion, eagerly sought by medical libraries here and abroad, and by thousands of regular army, volunteer, and contract Civil War physicians. There was a supply of authoritative, highly regarded "circulars" or monographs on aspects of military medicine written by Woodward, Otis, Billings, and other officers, among them A Report on Amputations at the Hip-joint in Military Surgery, Report on Epidemic Cholera in the Army of the United States During the Year 1866, Plan for a Post Hospital of Twenty-four Beds, Report on Barracks and Hospitals with Descriptions of Military Posts, and Report of Surgical Cases Treated in the Army of the United States from 1865 to 1871. There were copies of research pamphlets and articles written by scientists in the museum—in 1872 museum workers published at least 20 pamphlets and articles. He had reproductions of photographs and photomicrographs taken in the museum. After 1872 there was the Catalogue of the Library of the Surgeon General's Office, and after 1873- 74 a three-volume catalog, the largest American medical catalog of its time, greatly desired by American and foreign medical libraries, medical schools, and university libraries. In proposing an exchange Billings customarily made a favorable impression by offering a gift of the Library's latest catalog and perhaps another recent Medical Department publication. Illustrative of his approach is the letter he sent to Alfred Purdy, president of a medical group named the New York Journal Association:42 I send you this day for the Library of the Journal Association a copy of the catalogue of our Library and a paper on cancer. The Library now contains nearly or quite 18,000 vols and may be considered as a good foundation for a National Medical Library. This being the case we are specially desirous of making it complete in American medical literature, and I call your attention to it in the hope that you will assist us to carry out this purpose, the importance of which I need not enlarge upon. What we especially desire is to get old medical pam- phlets, addresses, theses, medical college announcements &c and to complete our files of American medical journals. I send a list of Journals showing what 79 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE we have. I presume the journal association must have many duplicates, as we have, and hope that an exchange can be arranged with mutual benefit. Any package may be sent to the Chief Med'l Purveyor 126 Wooster St, or to Wm Wood & Co to be sent to us. All duplicates will be returned and proper returns made as soon as the nature of your wants are known. The demand for the Medical and Surgical History and the large catalogs far exceeded the supply, and Billings doled them out in a miserly fashion. To a request from T. Apoleon Cheney for the History, Billings replied: "... the work will be issued from this office only in exchange for other works for the Lib, and to those who can furnish most of such jours &c required will the most liberal exchanges be made."43 When Sewell Green asked for a copy of the 1872 catalog, Billings drew up a form letter to be used thereafter in answering all such requests:44 Yours of________reed. In reply I have to say that but a limited edition of the C. has been printed & that it is designed only for working purposes, & to procure exchanges from Libs etc, and that none can be spared to individuals unless for the purpose of procuring donations of rare books etc. It is probable that Billings wrote to every medical and large public, state, and society library in the country in search of exchanges. The remains of his correspondence show he communicated with the libraries of New York Hos- pital, College of Physicians of Philadelphia, Pennsylvania Hospital, Medical College of Ohio, Starling Medical College, Johns Hopkins, Massachusetts Medical Society, Hahnemann Medical College, Medical and Chirurgical Faculty of Maryland, American Antiquarian Society, Boston Athenaeum, Boston Public Library, Boston Medical Library, Buffalo's Grosvenor Library, Massachusetts Historical Society, New York Historical Society, Harvard University, Brown University, and the state libraries of New York, Wisconsin, South Carolina, Michigan, and New Hampshire.45 Billings arranged exchanges with European organizations, libraries, and persons through correspondence and during his trips abroad. His procedure was to ship a crate of publications, along with a list of names of recipients and packet of letters addressed to the recipients, to one of his agents, who distrib- uted the volumes and letters. Upon sending a case of catalogs and other pub- lications to Gustav Bossange, Paris, Billings instructed him:46 The catalogues and pamphlets are put up in packages, addressed, and accom- panied by letters to parties for whom they are intended. The letters should be sealed by you after having read them. You will observe from the letters referred to that it is my object and desire to procure for the Library such old pamphlets, reports, lectures, etc, as cannot be obtained in any other way, and especially to complete our files of medical journals published in France, Belgium, etc. I have requested that anything of the kind to be forwarded in pursuance to the letter may be sent through you, and in this connection I ask that you will urge the matter and endeavor to procure from the parties addressed everything that you know will be of value to such a Library as this is designed to be. 80 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. Sending a case of books to Felix Fliigel, Leipzig, Billings admonished him thus:47 The Medical and Surgical History of the War of which I have sent you 24 copies for distribution is an expensive book and the number printed being limited I shall be able to send you but few copies. ... I wish them so employed as to produce the best exchanges for our Library which is now the largest medical collection in this country and which I am trying to make as complete as possible. Among the medical societies to which Billings sent publications, and which reciprocated, were those of Edinburgh, London, Marseilles, Aachen, Lille, Bologna, Modena, Berlin, Frankfurt am Main, Cologne, and Cracow.48 Billings considered exchanges as a means of assisting other libraries. Ar- ranging a trade with Achille Chereau, librarian of the Faculty of Medicine, Paris, Billings wrote: "This office will be most happy not only to forward its own publications but to render assistance in making the Library of the Faculty complete in American medical literature. . . . personally I shall be glad to be of service to you by collecting and forwarding American medical books and periodicals."49 Among the libraries that Billings aided were Parkes Hygiene Museum, University College, London, which requested American reports on hygienic subjects;50 the Philadelphia College of Pharmacy and Science, whch wanted to fill gaps in its file of journals;51 the Medico-Legal Society of the City of New York;52 and the German department of health, which desired reports of U.S. state boards of health.53 Not having all the publications desired by the library of the Faculty of Physicians and Surgeons, University of Glasgow, Bill- ings wrote to the Boston Medical Library to see if it had the works among its duplicates.54 Billings also helped by giving advice on bibliography, classification,55 book- sellers,56 design of libraries,57 and the content of libraries.58 To Norman Bridge, librarian of the recently formed Chicago Medical Press Association, he sent instructions for indexing, samples of index cards, names of suppliers of storage boxes for pamphlets, and a list of journals.59 To the librarian of Worcester, Massachusetts, Medical Society, which had 500 volumes and $700, Billings suggested additions to the library.60 To the Waterbury, Connecticut, Medical Association, ready to spend approximately $1,000 to add a medical section to the local public library, he gave advice.61 To the Massachusetts Medical-Legal Society, which asked what journals it should subscribe to, Billings sent a list.62 Exchanges helped Billings develop every area of the Library's holdings. He received transactions, proceedings, journals, dissertations, books, and reports from American and foreign libraries. He obtained many of the rare 17th century and early 18th century medical pamphlets and theses now in the Library. But he was not always successful; although he obtained 56 pamphlets, 1771-1832, and medical theses of University of Pennsylvania graduates, 1792-1807, plus 9 books, 1773-1838, from Pennsylvania Hospital, he failed to pry loose the hospital's only copy of James Tilton's Economical Observations of Military Hospitals, Wilmington, Delaware, 1813, from the cagey trustees.63 81 a history of the national library of medicine Beginmnc the Portrait Collection It is not known when the Library acquired its first engraving, etching, lithograph, caricature, drawing, painting, or photograph of a medical subject, but Billings was collecting portraits routinely by the early 1870's.64 "I am en- deavoring to make this library as complete as possible," he wrote Henry March in 1874, "I also wish to collect portraits . . . of American physicians. "&5 Billings obtained photos of many of the prominent physicians of his time by asking for them, sometimes sending his own photograph in exchange.66 Occasionally the Library received portraits as a gift; Alfred E. M. Purdy, editor of The Medical Register of New York and Its Vicinity, contributed a bundle of portraits in 1874.67 But generally Billings purchased portraits from collectors and booksellers in small or large lots at prices of 10, 15, or 20 cents each. G. W. Foster, Sing Sing, New York, apparently a collector for at least a portion of his career, offered to sell or exchange for duplicate publications a lot of between 800 and 900 portraits.68 J. H. Pooley, Columbus, Ohio, sent 160 portraits, for whatever price Billings was willing to pay, apparently 200 apiece.69 The largest collection that Billings bought was that of Cornelius Wilhelm Hendrik van Kaathoven, auctioned in Amsterdam on December 1 and 2, 1879. Billings obtained approximately 6,000 of Kaathoven's portraits for about 150 each. But in his eagerness to acquire this splendid collection Billings momen- tarily forgot that it would wipe out about one-tenth of his year's funds. "This purchase ... so crippled me in the purchase of books," he recalled, "that I made up my mind I would not spend any more of the library funds in that direction except in a very small way."70 But in 1885 the magnificent collection of 12,000 portraits, mainly of phy- sicians and naturalists, gathered by Heinrich Wolff of Bonn, Germany, was placed on the market and Billings forgot his resolution. He sought desperately to acquire the collection. He considered advancing $1,000 out of his own pocket toward the purchase.71 He tried, through S. Weir Mitchell, to persuade the College of Physicians in Philadelphia to agree to buy at 250 each the 3,000 duplicate portraits the Library would own if it acquired Wolffs collection, thus replenishing part of the Library's expenditure.72 He attempted to buy only a portion of the collection.73 But other persons were interested in these portraits, whose artists included Diirer, Holbein, and Rembrandt, and the collection was acquired by the Leavenworth family of Syracuse, New York, by whom it was presented to Syracuse University, in whose Rare Book Collection it now reposes.74 A few years later Billings was offered 1,120 portraits of physicians, ancient and modern, American and European, by the firm of G. E. Stechert for $400, or about 350 apiece, but again the Library could not afford it.75 "It is my purpose to make this collection as complete as the means which are at my disposal will permit,"76 wrote Billings in 1886 referring to the Library's portraits, but his means were never sufficient. 82 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. The first photograph believed to have been presented to the Li- brary, 1867. Sir William Fergus- son, 1808-1877. Allied to portraits and pictures on paper were medical scenes and likenesses of physicians on medals. The Library acquired its first medals as gifts. In 1886 when Billings requested permission to buy medals at an auction, the Secretary of War wanted to know why medals should be in a library and asked what appropriation would be used to pay for them. Billings defended medals by pointing out their relationship to medical history, but apparently he decided to forestall any further criticism by transferring the medal collection to the museum.77 Manuscripts and Letters Although there is no evidence that Billings was interested in history of medicine during his early years, either he had a latent feeling for the subject or he acquired a taste for it. One of his initial decisions was to collect source materials of history: "Mss and letters bearing on the history of American med- icine and physicians are of course valuable and there is no more appropriate place to file them," he wrote to A. W. Woodhull, a prospective donor in 1872.78 Letters of prominent physicians and manuscripts of medical interest, in- cluding student lecture notes, texts, speeches, and collections of recipes, did not come Billings' way very often, but he obtained what he could. His friend William Lee of Washington presented manuscript lectures and speeches on medical subjects delivered by Joseph Roby at Dartmouth and University of 83 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE fLae*^,*^ f sT^L*— w X^^^av'>i^»K^x*a7a __ S^&a. sz 3^*-c a~ ^*."Ztt^.«^». a-a-Ql, /7(ftLc #xXfT3^£ ja^svZ^* *\gexcjfey* gt to . " 84 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. Letter in the History of Medicine Collection. Addressed to "The Honorable Joseph Jones, Esq. of Congress at Philadelphia," the letter reads: Head Quarters Sep. 9th, 1780 Dear Sir: 1 have heard that a new arrangement is about to take place in the Medical Department, and that it is likely, it will be a good deal curtailed with respect to its present appointments. Who will be the persons generally employed I am not informed, nor do I wish to know; however I will mention to you, that I think Doctors Craik and Cochran from their services, abilities and experience, and their close attention, have the strictest claims to their country's notice, and to be among the first officers in the estab- lishment . There are many other deserving characters in the medical line of the army, but the reasons for my men- tioning the above gentlemen are, that I have the highest opinion of them, and have had it hinted to me that the new arrangement might possibly be influenced by a spirit of party out of doors [i.e. partisan politics], which would not operate in their favor. I will add no more than that I am With the most perfect respect Dear Sir Your most obedient servant G. Washington Maryland medical schools, 1840 to 1856.79 The Library received from friends other manuscripts, among them an account of the yellow fever epidemic at Wilmington, North Carolina, 1862, and case-books containing the medical pa- pers of Frank H. Hamilton.80 On one occasion Billings tried to obtain some correspondence of John Mor- gan founder of the University of Pennsylvania's medical school in 1765, the first medical school in British North America, but he was unsuccessful.81 Never- theless Billings picked up what he could, as he mentioned to Leon de Fort of Paris: "From time to time as I have met with them, I have secured and placed in this L[ibrary] autograph letters of distinguished physicians and surgeons."82 Eighteen seventy-one and seventy-two were exciting years in the Library's childhood. During that brief period Billings developed every method that he and his successors would use for obtaining books, journals, reports, disserta- tions, and other literary materials. Publications arrived at a rapid rate, and on 85 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE one of the days in the early 1870's the Library slipped into first place as the largest medical library in America. The cataloging of publications in 1874 re- quired three large volumes; a decade earlier it had been done in a small pamphlet. The Library had accumulated so many of the ordinary Ameican medical books that Billings was finding it difficult to obtain those he did not have.83 By 1875 the Library contained approximately 75 percent of all the periodical literature that had ever been published, it possessed by far the most voluminous collection of pamphlets, about 40,000, and was twice the size of the second largest medical library, that of the College of Physicians, Philadel- phia.84 "Nothing is so remarkable in the development of medical libraries as the extraordinarily rapid growth of the Library of the Surgeon General's office," remarked an observer, "like Jonah's gourd it came up in a night."85 Notes 1 Letter, Billings to Adams Jewett, July 15, 1872; "I prefer as a rule not to purchase foreign books in this country, because I can get them easily and much more cheaply abroad': MS/C/ 81. Invoices sent by Billings' agents listed the author, short title, price, and sometimes other information about publications he purchased. The Medical Department's monthly abstracts of disbursements also contained this information. The invoices and abstracts are in NLM. A few examples of his purchases in the 1870's are: Par- acelsus, De Cleyne Chirurgie, 1568, $7.20; Hip- pocrates, Prolegomena, 1597, $1.95; Antonius Busennius, In Cl. Galeni Pergameni Librum De Inequali Intemperie Commentarii, 1553, $9.30; Boyle, Apparatus ad Historiam Naturalem, 600; Thomas Sydenham, Opera Medica, 1735, $1.15; Thomas Bartholin, Twee Hondert Getal, 1657, $1.50; Johannes Mesue, Opera Medicinalia, 1471, $31.40. 2 Letter, Billings to Jewett, June 28, 1872; "as I must get all the new books + take all the M.J.'s [medical journals] I do not have a great amt. to sp. for exa editions": MS/C/81. 3 Letter, Billings to Schmidt, Dec. 15, 1871: MS/C/81. Angry at Mackay Brothers, New York, Bill- ings wrote: "I regret that it should not have been thought proper to ask a reasonable price for the pampfhlets] as probably 200 of them are not in this library and it would have saved me some trouble in procuring them. I have no doubt how- ever that I shall be able to procure all of them that I want at not to exceed 25 cents each": letter, Billings to Mackay Bros., Feb. 15, 1872: MS/C/81. For another example see letter, Bill- ings to E. P. Boon, Roxbury, Mass., June 23, 1884: MS/C81. 4 Letter, Billings to Bailliere, Aug. 14, 1882: MS/C/81. 5 Among the periodicals in which he adver- tised was New York Medical Record, 1872, Can- ada Lancet 1873, and American Practitioner 1873. Unfortunately advertisements were discarded when old journals were bound in NLM and most other medical libraries, and copies of Billings' ads are difficult to locate. No records were kept of responses to the ads and there is no way of knowing how many publications they brought in, but at least they alterted readers to the ex- istence and needs of the infant library and may have led persons to contribute. 6 Letters, Dunglison to Billings, Sept. 23, Oct. 3, 1872: MS/C/81. 7 Letters, Porcher to Billings, July 15, 21, Sept. 27, Oct. 5, 9, 12; Billings to Porcher, July 23, 1872: MS/C/81. Another example of Billings' offer of low prices was his dealing with H. A. Ford of Leonardtown, Md.; letters, Ford to Billings, July 10, Aug. 2, 13, 14, Sept. 19, Oct. 5; Billings to Ford, Aug. 7, 1872: MS/C/81. 8 Letter, Doyle to Billings, Jan. 3, 1871: MS/ C/81. 9 Johann Schroder, Complete Chymical Dispensatory . . . London, 1669. The title in the text above is copied from the invoice. The book was accessioned as no. 14,845, sometime after Feb. 15, 1872 (most volumes listed in the old registers do not have a date of acquisition). Voucher no. 10, abstract of disbursements, mu- seum and Library appropriation, shows that the book was sold to the Library on Mar. 25, 1872. 10 Quote is from letter, Jewett to Billings, July 20, 1872. This and many other letters Jew- ett wrote to Billings between 1872 and 1874 are in MS/C/81. Dorothy M. Schullian, "Adams Jewett and 86 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. John Shaw Billings, Partners in Acquisition," Bull. Med. Lib. Assoc. 49: 443-9 (1961). 11 Partial lists of donors and exchangers re- siding in the United States and other countries are in Index-Catalogue, 1 series, vol. 16, 1895, pp. iv-ix; and Catalogue of the Library vol. 3, 1874, pp. [iii]—vi. Names of other donors may be found in Billings' correspondence. 12 Yarrow, Military Surgeon 60: 172 (1927). 13 Garrison, Billings, 217-8. 14 Dorothy M. Schullian, "Thomas Windsor, Benefactor of the Army Medical Library," Bull. Med. Lib. Assoc. 38: 135-144 (1950). 15 Letters, Trowbridge to the Surgeon Gen- eral, June 23, 28, 1875; Trowbridge to Billings, June 23, 28, 30, July 6, 1875, Jan. 29, 1877; Billings to Trowbridge, July 2. 1875: MS/C/81. 16 Letter, Phinnev to Billings, Nov. 28, 1884: MS/C/81. 17 Correspondence of Eldridge from 1871 to 1893 is in MS/C/81. 18 Letters, Green to Woodward, May 20, 1873, with attached reply by Billings; Green to Billings, Sept. 16, 1875, Feb. 3, July 23, 1879: MS/C/81. 19 Letter, Billings to Wood, Jan. 20, 1871: MS/C/81. This is the earliest letter in Billings' correspondence asking for help obtaining re- ports. Wood obtained several reports, according to letter, Wood to Billings, Jan. 30: MS/C/81. 20 Letters, Van Deusen to Billings, Mar. 1, 1871; Snow to Billings, Mar. 7, 1871: MS/C/81. 21 Letters, Simpson to Billings, Feb. 9, Mar. 28; Asch to Billings, Feb. 21; Irwin to Billings, Feb. 26; Semple to Billings, Mar. 18, June 13; Randolph to Billings, Mar. 11, 1871: MS/C/81. 22 Letters, Bossange to Billings, Oct. 31, Dec. 12, 1871: NLM. 23 Letters, Billings to Triibner & Co., Sept. 1; Triibner to Billings, Sept. 23, Oct. 5 (with list of institutions circularized), Oct. 9 (with copy of form letter), 1871: NLM. Letter, B. F. Ste- vens to Billings, Sept. 24, 1878, with form letter attached: MS/C/81. 24 Letter, Billings to Thomson, Mar. 3, 1871: MS/C/81. 25 Billings' opinions on dissertations are given in his chapter, "Medical Libraries in the United States," in the Bureau of Education special re- port, Public Libraries in the United States of America, part 1, 1876. 26 The latter quotation was the opinion of physician, philologist, bookseller Felix Fliigel; letter, Fliigel to Billings, June 22, 1873: NLM. 27 Letter, Billings to Bossange, April 16, 1868: NA. 28 The Library received hundreds, or per- haps a few thousand, from Library of Congress, but it is not possible to ascertain the number because pamphlets and dissertations were to- taled together. Letters, T. Gill to Billings, Mar. (n.d.); Billings to Gill, Mar. 12, 1872: MS/C/81. In the Catalogue of 1872, pamphlets and dis- sertations from Library of Congress may be identified by the letter C. 28 Letters, Schmidt to Billings, Mar. 31, Apr. 7, May 8, June 30, Sept. 20, 27, Oct. 9; Billings to Schmidt, Sept. 19, 1872: MS/C/81. 30 At the time Billings published the Cata- logue of 1872, the Library had 700 bound vol- umes of Paris, Montpellier, and Strasburg dis- sertations. 31 Letter, Billings to Fliigel, May 2, 1873: NLM. 32 Letter, Billings to Flugel, July 10, 1873: NLM. A. Treichel, a philatelist of Berlin, Ger- many, heard of Billings' wants and sent him dissertations and pamphlets, requesting U.S. stamps in return: letters, Treichel to Billings July 29, 1874; June 12, Dec. 28, 1875: MS/C/ 81. 33 Letter, Flugel to Billings, transmitting letter from University of Berlin, Oct. 18, 1873, accompanied by translation made in SGO: NLM. 34 Letters, Billings to Flugel, June 15, 1878, June 29, Aug. 2, 31, 1882: NLM. Billings also asked Flugel to have copied from records of principal German universities, at the Library's expense, lists of names of medical graduates so that he would know of gaps in his collection, and be able to arrange and bind his copies. Let- ters, Billings to Flugel, May 2, July 10, 1873: NLM. 35 Letter, Billings to librarian, University of Zurich, Oct. 27, 1874: MS/C/81. 36 Letter, University of Groningen to Bill- ings, Nov. 30, 1874: MS/C/81. 37 Letter, University of Greifswald to Bill- ings, Jan. 25, 1874: MS/C/81. 38 Letter, librarian, University of Munich to Billings, June 20, 1876: MS/C/81. 39 Letter, Univesity of Wiirzburg to Bill- ings, Dec. 1, 1877: MS/C/81. 40 Letters, University of Rostock to Billings, Oct. 3, 1874; University of Freiburg to Billings, Sept. 30, 1876; University of Halle to Billings, Dec. 31, 1874: MS/C/81. 41 Figures are from the Billings chapter, "Medical libraries in the United States," pub- lished in 1876, and the annual reports of the Surgeon General for 1885 and 1895. 42 Letter, Billings to Purdy, May 16, 1872: MS/C/81. 43 Letter, Billings to Cheney, Apr. 26, 1872: MS/C/81. 44 Letter, Billings to Green, May 16, 1872: MS/C/81. On this letter Billings wrote: "In ans to all letters (official and other)." 87 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 45 Names of some of the societies, univer- sities, libraries, and organizations which con- tributed to the Library by exchanges of gifts are in Catalogue of the Library, vol. 3, 1873, pp. vi-x, and Index-Catalogue, first series, vol. 16, 1895, pp. ix-xiv. Joseph E. Garland, The Cen- tennial History of the Boston Medical Library, 1875 to 1975, pp. 30-32. 46 Letter, Billings to Bossange, Apr. 11, 1.874; NLM. 47 Letter, Billings to Flugel, May 2, 1873: NLM. Lists of recipients of catalogues, histo- ries, and other publications are in the corre- spondence of Billings and Flugel, NLM. A careful record was kept of recipients of volumes of the Index-Catalogue, 1880 onward. 48 Some letters of acknowledgment from so- cieties are in Billings' correspondence, MS/C/ 81. 49 Letter, Billings to Chereau, May 24, 1884: MS/C/81. See also letter, Billings to Hahn of the Paris faculty, April 8, 1885. 50 Letters, G. V. Poore to Billings, Mar. 27, Apr. 27, 1877: MS/C/81. 51 Letter, Librarian PCP to Billings, June 1, 1875: MS/C/81. 52 Letters, M. Eller to Billings, Feb. 24, Mar. 29, 1877: MS/C/81. 53 Letter, Struck to Billings, Feb. 3, 1882: MS/C/81. 54 Letters, Librarian, Faculty of Physicians, to Billings, Aug. 2, 1882; Billings to Bowditch, Boston Medical Library Association, Sept. 9: MS/C/81. 55 Letters, Brigham to Billings, July 7, 19, Nov. 14, 18, 1882: MS/C/81. John W. Farlow, History of the Boston Medical Library, pp. 204- 205. 56 Letter, D. W. Cathell to Billings, Oct. 6, 1887: MS/C/81. 57 Letter, J. H. Larned, Young Men's Li- brary, Buffalo, to Billings, Feb. 4, 1884: MS/C/ 81. 58 Letters, Billings to Melvil Dewey, Co- lumbia University, Nov. 13, 1886; Dewey to Billings, Nov. 10: MS/C/81. 59 Letters, Bridge to Billings, May 5, June 12, July 3, 23, Sept. 29, 1877: MS/C/81. 60 Letters, L. Wheeler to Billings, Feb. 3, 17, 24, 1880: MS/C/81. 61 Letter, A. North and E. McDonald to Billings, Mar. 19, 1880: MS/C/81. 62 Letter, F. W. Draper to Billings, Oct. 17, 1883: MS/C/273. 63 Letters, J. Turnpenny to Billings, Apr. 3, 7, 10, 15; Billings to Turnpenny, Apr. 4, 11, 1872: MS/C/81. 64 Alex. Williamson presented a photo of Sir William Fergusson in 1867 (letter, Billings to Williamson, Nov. 6, 1867: NA), but there seems to be no way of ascertaining whether or not this was the first. 65 Letter, Billings to March, Oct. 10, 1874: MS/C/81. 66 For example, photos were sent by Baron Felix-Hippolyte Larrey, Paris (letter, to Bill- ings, Dec. 28, 1874: NLM), T. Lauder Brunton, London (letter, to Billings, Jan. 25, 1877: NLM) and C. Muller, Budapest (letter, to Billings, Nov. 3, 1894: NYPL). Billings sent a group of photos of himself to Felix Flugel, his agent in Leipzig, for distribution in 1877 (letter, to Flugel, Feb. 24, 1877: NLM). 67 Letter, Purdy to Billings, Sept. 8, 1874: MS/C/81. 68 Letter, Foster to Billings, Nov. 4, 1881: MS/C/81. 69 Letters, Pooley to Billings, Nov. 4, 24, 1881; Billings to Pooley, Nov. 22, 1881: MS/C/ 81. 70 Letter, Billings to J. H. Pooley, Nov. 22, 1881: MS/C/81. 71 Letters, Billings to E. Wolff, Germany, Nov. 13, Dec. 27, 1886: MS/C/81. 72 Letter, Billings to Mitchell, Jan. 13, 1887: MS/C/81. 73 Letter, Billings to E. W. Leavenworth, Dec. 10, 1886: MS/C/81. 74 Lyttl. Gardner, L. G. Wells, "TheWolff- Leavenworth Collection of Engraved Portraits at Syracuse University," Bull. Hist. Med. 35: 175-7 (1961). 75 Letters, Stechert to Billings, Aug. 18, 1894; Fletcher to Stechert, Aug. 20, 1894: MS/C/81. 76 Letter, Billings to E. W. Leavenworth, Dec. 10, 1886: MS/C/81. 77 Letter, Billings to Surgeon General Mur- ray, Feb. 13, 1886, with endorsement by Sec- retary of War; letter, Billings to Surgeon Gen- eral, Feb. 26: MS/C/81. It is noteworthy that the military establishment was so small in 1886 that the Secretary of War became involved in such matters. Correspondence between Billings and two of his advisors on medals, William Lee and Horatio Storer, is in MS/C/81. A. Allemann, "The Collection of Medical Medals in the Army Medical Museum," Bull. Med. Lib. Assoc. 7: 5-7 (1917-18). 78 Letter, Billings to Woodhull, May 13, 1872: MS/C/81. 79 Letter, Lee to Billings, Dec. 5, 1889: MS/ C/81. * Letters, Harvey E. Brown to Billings, June 30, July 25, 1872: MS/C/81. The manuscript on yellow fever is MS/fB/30. Letter, D. A. Davis to John B. Hamilton, with endorsements and reply of Billings to J. B. 88 GATHERING BOOKS AND OTHER LITERATURE FOR THE N.M.L. Hamilton, Apr. 1, 1888: MS/C/81. Hamilton's notes, case reports, correspondence, memo- randa, and other documents are filed under MS/ B/184. 81 Letters, Surg. John Campbell to E. Spra- gue, filed under date Aug. 17, 1877: MS/C/81. 82 Letter, Billings to de Fort, Apr. 4, 1893: MS/C/81. 83 Letter, Billings to H. A. Ford, Aug. 7, 1874: MS/C/81. 84 Table of principal medical libraries on p. 182 of Billings' chapter, "Medical libraries in the United States," in Bureau of Education Spe- cial Report, Public Libraries in the United States . . . , Part 1, 1876. 85 Archibald Malloch, in Celebration of the Centennial of the Library of the Medical and Chirurgical Faculty of the State of Maryland, 1830-1930 (1931), p. 8. 89 VI The Operation and Services of the Library The Library in Operation WHILE Billings was gathering books, journals, reports, dissertations, and other literature, the Library had to be managed, publications had to be registered, classified, cataloged, and shelved, readers had to be assisted, and Congress had to be approached annually for funds. For the first few years the shelves in Ford's were probably wood, constantly extended as Billings acquired more and more volumes. In 1871, around the time the decision was made to develop a national library, Billings began to order iron stacks.1 Eventually the only space for expansion was upward, toward the high ceiling. A second level of stacks was erected atop the stacks against the walls, with an iron balcony reached by an iron stairway allowing access to the upper level.2 Finally books had to be double shelved. A tall metal bookcase with glass doors for display and protection of rare books and incunabula was placed against the front wall between the windows.3 In the 1860's the clientele of the Library was exclusively military. In the seventies, when it was opened to the entire medical profession, civilians grad- ually outnumbered medical officers.4 A visualization of the interior of the Li- brary and the number of readers may be obtained from the furnishings in 1887: 5( chairs, 10 desks, 9 tables, 9 stools, 8 spittoons, 7 book and file cases, 5 ladders, 2 library tables, 2 manuscript cabinets, 2 water coolers, 1 case of book drawers, 1 card case, 1 negative case, 1 map chest, 1 umbrella stand, 1 marble top table, 1 washstand, 1 wash bowl and pitcher, and 1 clock.5 Electric fans and air-conditioning were in the future, and during the hot Washington sum- mers the only relief came from open windows and awnings. Billings' office was in Riggs. Here publications were received, unpacked, and examined by clerks to make certain that no pages or plates were missing. The short title, author's name, size, date and place of publication were written in the Register.6 The books were classified according to subject, as anatomy, surgery, and so on. The registration number and classification were written on a book plate pasted inside the front cover. They were then sent to Ford's and shelved. In 1883 on being appointed head of the newly created Museum and Library 91 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Division, Billings moved his office to a room in the house attached to Ford s. His office had a rug on the floor and awnings on the windows, contained 2 sofas, 2 desks, 2 tables, 1 small table, 12 chairs, 1 stool, 3 revolving book towers, 1 cabinet for engravings, 1 cabinet for letters, 17 book and file cases, 1 card case, 1 map holder, 1 fireproof safe, 1 typewriter, 2 clocks, 1 drop light, 2 mirrors, 1 wardrobe, 1 water cooler, 1 washstand, 2 marble top tables, 1 wash bowl and pitcher, and 2 spittoons. A newspaper reporter who interviewed Billings in 1883 described his office thus: "At desks on each side of the librarian were two clerks, and in the opposite corner was Dr. Robert Fletcher, a colaborer with Dr. Billings in library work. Little heaps of pamphlets, periodicals and manuscripts covered the desks, while here and there were piles of books which were at intervals removed by mes- sengers and their places supplied by others."7 The earliest arrangement of books on the shelves is not known. Presumably it was the same as in the catalog of 1865, and later of 1868; that is, there were about 10 classes, and in each class books were arranged alphabetically by author. From about 1871 to the late seventies books were classified and arranged as were the medical publications in the Library of Congress. Billings then de- veloped a classification based on that of the Royal College of Physicians, Lon- don.8 Within each class books were shelved alphabetically by author. Unbound journals were shelved according to size, as folio and quarto, in order to use all available space. Within each size they were arranged alpha- betically. Bound volumes of journals were arranged by country, then alpha- betically within each country.9 Unbound pamphlets were first arranged in one alphabet in a series of boxes ("Woodruffs Patent File Boxes"). Because of the constant insertion of incoming pamphlets and of new boxes at various points in the series, this system took too much time. It was stopped, and thereafter incoming pamphlets were laid in a box until the box was full, the box was replaced by an empty box, the pamphlets of the full box were alphabetized, and the box placed on the shelf. Each box was numbered, and the number was placed beside the title of each pamphlet in the catalog. Volumes of bound pamphlets were shelved chrono- logically. Some of the early binding of pamphlets, journals, and reports was done at the Government Printing Office and some by private bookbinders.10 In 1872 Billings decided to try a variety of bindings and adopt one for the Library. He sent 150 volumes to Charles Sutherland, medical purveyor, New York, and asked him to have them bound, most in half turkey dark red, some in full calf, a few in half calf. "The style of binding desired is plain, neat, and strong, without fancy gilt tooling, edges of books speckled," he wrote, "I send this as an experimental lot to learn about styles and prices. "u Billings chose half turkey, and some of the volumes of that time still bear that binding somewhat the worse for wear.12 Billings continued to send journals, pamphlets, and books in need of repair 92 THE OPERATION AND SERVICES OF THE LIBRARY to the Government Printing Office and to private firms until laws were passed requiring that all Federal agencies have their publications bound at the printing office. Unfortunately the latter did not have sufficient employees and storage space to accept, bind, and return publications rapidly. Volumes from the Li- brary sat at the GPO for 6 months or longer before being returned. In Billings' opinion the most unsatisfactory aspect of library operations was the unavaila- bility of works waiting to be bound.13 He would have preferred that the or- ganization control its own binding, but that did not come to pass for many years. Billings had two immediate assistants, Edward Shaw, who was with him from 1867 onward, and Andrew Bischoff up to 1880, succeeded by Frederick W. Stone. Shaw, who was Billings' secretary much of the time, held a bachelor's degree from Yale and was the only college graduate in the Library, other than Billings.14 The Library was presided over by Acting Assistant Surgeon Thomas Wash- ington Wise. Wise had begun to work for the Medical Department as a nurse and clerk at Armory Square Hospital in Washington when he was 16 years old during the Civil War. He studied medicine at Georgetown and received his M.D. degree after the war. He practiced in Kentucky for a few years then returned to Washington to work under contract for the department from July 1, 1874 onward. Officially he was to assist in the preparation of the Medical and Surgical History of the War. Billings construed this most broadly and placed him in immediate charge of the Library.. Apparently he lived an un- ambitious, placid life for there is no record of his writing articles or engaging in other activities that would have perpetuated his name. But he was appre- ciated by Library users, one of whom wrote: "His genial and courtly manner made his acquaintance a pleasure, while his prompt and cheerful offers to render aid made a visit to these halls a double pleasure. His kindness and gentleness, mingled with true manliness, impressed themselves upon all who came in contact with him."15 Wise was assisted by clerks (most of the civilian employees of the Library in those days were designated as "clerks"), ex-soldiers who had come to work for the department after the Civil War and been assigned to the Library. They were a rough, uneducated group of men who knew nothing about medicine except what they had picked up from being among Army surgeons, but they were conscientious, and they learned what they needed to know to operate the institution and assist readers.16 The Library was open every day except Sunday from 10 a.m. until 3 p.m.17 Readers included museum workers, compilers of the Medical and Surgical History, and military and civilian physicians of Washington. Books were not loaned ordinarily, and some publications (as reference works and current jour- nals) never. The early readers were aided by the interleaved catalog of 1865, the catalog of 1868, the first large catalog of 187218 and the List of American Journals also 93 • HISTORY OF THE NATIONAL LIBRARY OF MEDICINE OF THE LIBRARY OF THE SURGEON GENERAL'S 0EF1C1 i I' I. The Library is intended to be a " Reference," and not a " Lending " Library. vi II. The Library is open to any one desiring to consult it each day excepting Snn- nx, days, from ten A. M. to three P. M. vl III. Books will be loaned only to persons having a written permit from the Snr- ;, goon General or Assistant Surgeon General. , | IV. Volumes of Engravings or Plates, Encyclopaedias, Dictionaries or period- ; j icals cannot be taken from the Library by any one. ( By order of the Scr<;eon General: Asst. Surgeon (icmcal. ('. S. . I is- ~3' * \ - ^'~Z --~l'Z --" The earliest known rules, printed in the 1870's, governing the use of the Library. issued in 1872. During the latter year the flood of books, reports, theses, and journals forced Billings to start an expandable card catalog for his own, his clerks', and his readers' use.19 The "cards" were actually rectangles of thick white paper, about 5x7 inches in size, lined on one side.20 On the top line clerks copied the author's name, followed below by the title, collation, size, place of publication, publisher, and date of publication of each book, thesis, and pamphlet. These cards were filed alphabetically in wooden drawers. Cards on anonymous works, periodicals, transactions, and reports were filed in sep- arate drawers. Billings sent these cards to the printer for use in preparing a three-volume catalog published in 1873-1874.21 When the cards were returned Billings added subject headings and clerks filed the cards alphabetically by subject. Author cards were made for publications that arrived after the original cards had gone to the printer. The Library now had a printed author catalog, a supplementary card author catalog, and the nucleus of a card subject catalog.22 In the 1870's the stacks were open. After a reader had consulted Wise or 94 THE OPERATION AND SERVICES OF THE LIBRARY the catalog or card index, he selected the publications he wished to peruse and carried them to a table or desk. "The books are all out in full view," remarked a writer, "to be inspected and handled at your pleasure, and there is no envious looking through glass panes or wire screens at what you cannot reach without the aid of an assistant."23 But readers misshelved books and disorganized the Library's operations in other ways, and slowly Billings lost his patience. He closed the stacks and required readers to apply to Wise or a clerk for publi- cations. "We cannot let visitors rummage the shelves," he told a patron, "be- cause the books must be kept in a certain order, and it wont do to let visitors out of sight. But Dr. Wise will go with you and take down as many books as you like and give you every facility to examine them in the reading room and will then replace them himself. ... It wont do to make any exceptions to these rules as I have found by sad experience, for what I grant to one I must to all."24 For the convenience of physicians in Baltimore, Philadelphia, and other places who planned to visit Washington to research in the Library, Wise or the clerks would pull publications from the shelves and have them on a desk for the visitor when he arrived if the visitor would send a list of publications in advance. Billings' pride in the Library led him to arrange exhibits of its treasures. A visitor in 1878 mentioned one of the displays:25 Going into the library of the surgeon-general's office, the other day, to look up some works of reference, we could not help being struck with the thoroughness of the administration of that library, seeing spread out on the table before him, as an example, the whole of the collection of pamphlets, in bound volumes, which belonged to Claude Bernard. Here, then, was the material utilized by that distinguished physiologist to aid him in those researches which have done so much for medicine, and with which the whole medical world is so familiar. Wise and his assistants serviced the readers promptly and well, so much so that is difficult to find a complaint about the Library in corespondence, editorials, or articles. Readers may have been disappointed occasionally by not finding information they sought but never by lack of cooperation from the staff. The following impression of the Library by a writer may be regarded as typical: "The situation of the library is peculiarly interesting in its associations, the readiness of access to the books, and the politeness of the attendants in charge. . . . The room is warm and comfortable, with every convenience for the visitor who wishes to make extensive notes, and the quiet which pervades shows a due regard for mental abstraction."26 APPROPRIATIONS FOR LITERATURE One of Billings' periodic concerns was the amount of money that the Library would receive from Congress. The first appropriation had been granted in 1867, $10,000 for the fiscal year ending June 30, 1868. Much of this had been spent to furnish the second floor of Ford's for library use. The next year and thereafter 95 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the appropriations had been reduced to a sum just sufficient to purchase pub- lications: Fiscal Year Library and Ending June 30 Library Museum Museum combined 1868 10,000 10,000 1869 2,000 5,000 1870 2,000 5,000 1871 3,000 5,000 1872 7,000 1873 10,000 1874 10,000 Two or three thousand dollars may seem insignificant to a major library in today's economy, but during the 1870's it possessed considerable purchasing power. In 1874 ripples from the Panic of 1873, one of the worst business depressions in American history, reached the Library. Some congressmen proposed to reduce the Library-museum appropriation from $10,000 to $3,000. "This would be barely sufficient to care for the Museum . . . and would entirely stop the increase of the Library, and especially the completing of the files of serials, which is of the greatest importance," Billings noted. He sought help from editors and influential physicians, telling them:27 I think it is unnecessary to explain to you in detail how desirable it is that this work should not be interrupted. Every year adds to the difficulty of procuring books and journals not of recent date, and if we are ever to have a medical collection in this country which shall approach in completeness and value those formed by European governments, and thus furnish our writers and teachers with the same facilities as those of the Old World, the small appropriation heretofore made should not be at all diminished. Congress in judging of the advisability of this expenditure must be guided by the expressed opinion of the medical profession as to the utility of the work, hence I venture to express the hope that you will take steps to have such opinion expressed to the Members and Senators of your State in the shape of resolutions by a Medical Society and by personal letters, to the effect that you are interested in the progress and completion of the Museum and Library, and begging that the appropriation be not reduced, but if possible increased. When the spring of 1874 rolled around Congress appropriated $10,000. Whether or not it had been influenced by letters, petitions, and memorials from Billings' correspondents is not known, but Billings had learned that this manner of lobbying was effective, and he was to seek aid from the medical profession again and again in the future. Evolution of the Loan System It is not known when medical officers were first given the privilege of borrowing books and journals from the Surgeon General's office, but within a few years of the Civil War's end the practice was well established. For example, 96 THE OPERATION AND SERVICES OF THE LIBRARY in 1868 Surgeon Andrew K. Smith, Atlanta, Georgia, complained to Billings: "I don't get any medical or chemical journals here. I don't care about the trifling Philadelphia Surgical and Medical Reporter, but the Lancet, Chemical News, American Journal, and the semiannual I wish exceedingly. Will you please see that they are sent to me." Billings passed this letter to his clerk with a penciled note, "The journals are to be sent to Dr. Smith."28 The lending of publications to civilian physicians was not begun until the 1870's. Then books could not be borrowed except by written permission of the Surgeon General or Assistant Surgeon General, and certain types of publications (journals, encyclopedias, dictionaries, volumes of plates) were not loaned under any circumstances. Rules were first drawn up by Billings in the spring of 1872 at the urging of Woodward, the custodian of Ford's, and were printed and placed in prominent places in the Library.29 Neither the hours of service, 10 a.m. to 3 p.m., nor the rule against bor- rowing were entirely satisfactory to private physicians. A Washington corre- spondent of the Boston Medical and Surgical Journal pointed out that most physicians were busiest in their offices during these hours and therefore had little chance of visiting the Library, and that the no-lending rule prevented physicians from studying books at home. "It is true," wrote the correspondent, "that the gentleman in charge, Dr. Billings, is remarkably courteous in relaxing the rules and giving every aid possible under suitable circumstances; but this is a personal favor and . . . one cannot help questioning what would be the effect of a change in the ordinary routine of army duty; perhaps the new librarian would not be so favorably disposed."30 Furthermore as time passed and the Library became ever larger, more publicized and better known, Billings began to receive requests from physicians living in other towns to borrow publications.31 This placed him in an awkward position. On one hand he was urging physicians to give journals, books, reports, theses, and other publications to the Library, while on the other hand he was refusing to lend materials to those who needed them. Physicians who lived where there were no or poor medical libraries and who needed information for research or cases had to ride the train to or hire a copyist in Washington. Persons came from Baltimore, Philadelphia, and even as far as Chicago.32 By 1874 Billings had relaxed his no-loan policy somewhat. When Richard Dunglison, a teacher, editor, author, and compiler of a standard medical dic- tionary living in Philadelphia, asked to borrow a medical almanac, Billings told his clerk to let him have it.33 It appears that Billings began to develop his loan policy during 1874.M Perhaps he was encouraged to lend books because the small American Medical Association library, then housed in Washington, and the Smithsonian Insti- tution both sent books on loan to physicians outside the town.35 By 1875 Billings was lending books and journals to Horatio C. Wood and William Pepper by sending them to College of Physicians, Philadelphia.36 Then, responding to a request for books from William W. Keen, Philadelphia, Billings wrote out the 97 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE ^ COLLEGE OF PHYSICIANS, * N K cor Thikti-kntii and Locust streets, Philadelphia, &)jtpJ- /*' i$f3 To tmi' Librarian of the College of Physicians: Sir: I desire to obtain from the Library of the Surgeon- General's Office, Washington, for consultation, in accordance with the Rules of the College, the following book :— UL CX-JTvuaLo-vu knkrai's Office. Washington. D. C. U Librarian of the Surgeon-General's Office, Washington, D. C Dear Sir: Will you please loan to the College of Physi- cians of Philadelphia,, for the use o£_ I)r. V£&4^. xs>Y. <&Z^444*€><&ZZy' / the above-named book. Form employed by the College of Physicians, Philadelphia, for interlibrary 98 THE OPERATION AND SERVICES OF THE LIBRARY conditions given below and sent them to Robert Bridges, librarian of College of Physicians:37 As things now are you are personally responsible for the books. This is not what is desired by this office. We only wish to loan books to a chartered, incorporated and responsible medical society. For this purpose it is desirable that the College should pass a resolution requesting the Surgeon General to loan it books from time to time as may be requested by the librarian, and declaring that it will be responsible for all books so loaned. The College of Physicians was not willing to assume this responsibility, and for 2 years Billings would not lend books to Philadelphians.38 Finally the two organizations reached an amicable agreement, and the Library resumed its loan privileges.39 In the meantime Billings extended the loan system to Boston Medical Library Association, New York Hospital Library, Johns Hopkins University, and other libraries.40 By 1880, with experience to guide him, Billings had made the conditions for borrowing more specific. Replying to a request from the College of Phar- macy, New York, he agreed to send volumes if the authorities would assent to the following propositions:41 I. That the College formally authorize some one person to make requests for the books and agrees to be responsible for the safe return of all books sent in accordance with requests made by this office. II. That books be sent and returned by express free of expense to this office. / ■ • Cleveland, Q.^U^f-'.+^t........S&f<& 3 ,a3£r. S.hzs. &rr, 6zse $!ce/(, Siiy. gihrzriiq of Quyah^oiz So. "f^edical Society: plleaze secure if possible, the following hoo/fs /rem. ike library of tfe ^urfeoq General's office. -<-e -/ boor .^ /l£^/^i/ tf y%^^^^ ^^^^^ \%?u!fhcr J^7~ j^^ia^^^c^^e-^L'.. Chairman Library Committee. ^rW^a^^<— Form used by the Cuyahoga County Medical Society, Cleveland, Ohio, to borrow publications from the Library. Henry Ebenezer Handerson, who re- quested the book, was a well-known historian of medicine. 99 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE III. That all books sent be kept in the Library rooms of the College until their return. IV. That all books loaned be returned in two weeks unless special permission to retain them longer be obtained from this office. As a rule this library does not loan unbound numbers of current periodicals. As the 1880's moved along and the Library's liberal loan policy became widely known through editorials, word-of-mouth, and Billings' publications and speeches,42 the number of requests for loans increased greatly. Some librarians of medical societies received so many requests from members to borrow books from Washington that they had forms printed for the purpose. Occasionally an urgent request, perhaps resulting from an emergency, came by telegraph.43 Requests even came from Canada and from Europe.44 In the meantime Billings had received requests for loans from physicians living in towns where there were no medical, public, or collegiate libraries— and in the 1870's libraries were not nearly as numerous as today. He was also approached by physicians residing in Washington for permission to borrow books. His answer was no. He told A. Ostertag, Okawville, Illinois, who asked to borrow two books, "Regret cannot comply with request as this is a reference not a lending library. "45 And when Jacob J. Delamater, a physician then working for the Pension Office in Washington, wished to borrow a printed introductory lecture written by himself, Billings told him to come and copy it, for "this is exclusively a reference and not a lending library."46 Some physicians who wrote were friends of Billings and had donated pub- lications. Billings did not have the heart to refuse their requests, but he asked them not to publicize his loans. "... Please do not let anyone know that I have sent them to you," he told Theophilus Parvin of Indianapolis, "as it is contrary to rules to lend books to individuals."47 Within a few years Billings changed his policy and began to lend books to individuals if the person would deposit a sum of money with the Library sufficient to replace books if they were lost. After the borrower returned the books the Library returned his deposit. By 1885 the Library's loan policy was so widely known and utilized that borrowers outnumbered visiting readers. "While there are always some phy- sicians reading & making notes in the L. & many come here from a distance for that purpose," reported Billings, "yet the library is most used by physicians in other cities who borrow books on the deposit of a sum of money sufficient to replace them."48 Billings bent the rules when he felt there was good reason to do so. Asked by John Stockton-Hough, a collector and student of medical incunabula, for a loan of 15th-century printings, Billings assisted him with his studies by sending some, not all, of the Library's holdings. "Am willing to lend you books for yr. purpose wh. I would not lend to anyone else," he wrote Stockton-Hough. This was very liberal: incunabula were not as expensive then as they are today, but it is doubtful that any other library would have sent them beyond its walls. 100 THE OPERATION AND SERVICES OF THE LIBRARY '..-*.%.* >."• - > v., ■ „ ■. T . .-^ w ■. . '< ' ■. WvCXCCt\CC*\ 03X3"v. t v"\ ^a V.. v—-7__— », Vi^ 7 7-*2-/tr// /farz^cas ^U^c^ct^t, '£>& Form used by the Library in returning deposits to individual borrowers. This borrower was Theodore W. Richards, a noted Harvard chemist who received a Nobel Prize in 1914 for his determinations of atomic weights. Billings apologized somewhat to Stockton-Hough for not lending every work in the Library, but explained the unreasonableness of some requests:49 It is true that the Liby is not as useful to individuals as if I loaned books freely. I have had that urged upon me by men in Arkansas and in Minnesota— one of whom wanted me to send him every book ptd. in Venice prior to the 18th cent., but I tk. my regulations are quite as liberal as it is safe to make them—and more liberal than those of most libraries. . . . Send another list & I will do the best I can for you. Physicians generally were careful with borrowed books and journals, and conscientious about returning them within the prescribed period of 2 weeks. If they needed the volumes longer they requested additional time and it was 101 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE |ibrar5 of tk lurgeon ftencrat's $f)H §.|». J^., Sir : By direction of the Surgeon General of the Army I forward to your address, by e.vpress, the boohs re- quested in your letter of fl^OLA-'G-^X. VP # ~, Please note the conditions under which books are lent from the library at this office. Very respectfully, Your obedient servant, Jt&n 'JUL^A 7 Surgeon, V. S. A, and Librarian, S. O. O. COKQjjXJONS OF LOAN. / Books will I* lent upon request of the librarian of a public library or university, that officer tieing held responsible for the safe return of the volumes within two necks from the day of their receipt. Packages must be sent and returned by tjepre**. can-fully packed, and the charges, both ways, must be pnid by the borrower. Where there is no public library through which the application can be made, lxx>ks will be lent directly to the individual upon his remitting to the librariau of this library a sum of money sufficient to cover their value in case of loss or injury. Certain valuable or rare books will not Im? permitted to leave the library. I>irect packages: "Librariau, Surgeon General's Office. U. S. Army. Washing- ton, D. C." Form sent by the Library to borrowers of publications. 102 THE OPERATION AND SERVICES OF THE LIBRARY usually granted. Once in a while a mail handler, expressman, or physician damaged a binding, and then the borrower apologized and paid the cost of repair. Infrequently a patron lost a volume and then Billings adamantly charged him for it. William Osier, a frequent borrower, jokingly sent the following note to Billings after one of the Library's works disappeared somehow from his possession: "Bring a club with you in your next visit and pummel me well. What an aggravating devil I am! Yes do order the book and make me pay double for it, if possible."50 Reference Service Billings encouraged the use of the Library by researchers. "It is the inten- tion," he told Adams Jewett in 1872, "to make this an universal library of reference."51 He wrote to another friend, L. A. James, that the Library would be "one place in the country where a physician desirous of consulting files of jour's can be sure of finding what he wants."52 And as it became known through the American medical profession in the early 1870's that the Surgeon General's was the largest medical library in the country, was open to the public, and was a reference library, Billings began to receive requests for information from physicians residing outside of Washington. The earliest inquiries of which records survive arrived in 1874. Slowly at first but with increasing frequency in 1875 and '76, Billings received letters asking for references, abstracts, extracts, transcriptions, and translations. In 1882, less than a decade after the initial requests were received, the Library received more than 300 pleas for information, necessitating the sending of a thousand letters.53 Physicians sought information on diseases, operations, cases, remedies, and history of medicine; medical writers and editors on biographies, bibliographies, references, and illustrations; architects on planning, construction, and arrange- ment of hospitals; insurance companies on statistics; lawyers on matters relating to public health; and librarians on names of book sellers, classification, arrange- ment, and library furnishings. Letters came from every section of the United States, from Canada, France, England, Scotland, Russia, and other countries.54 Billings, Thomas Wise, or library clerks answered the requests if the copying or researching could be done within a reasonable length of time, but if a correspondent wanted too much Billings suggested that he come or send some- one to the Library or commission a Washingtonian to do the work.55 A number of persons served as copyists, abstractors, researchers, and trans- lators for out-of-town patrons. Several of the Library's staff, among them Fred- erick W. Stone, C. P. Clark, C. J. Myers, and Beruch Israeli, did this in the evenings or on Sundays when they were off duty. Their rates for transcribing and abstracting are not known, but they charged 20 per card for copying references from the Library's subject and author index cards.56 Israeli provided translations from Russian, German, and other languages at a cost of $1.50 an hour.57 103 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE l^atiopat Bureau of /T\cdieal Bibliography. Bibliographical Researches ^SiSttflES iSl Abstracts and Translations Made. aSKm SSSOI Furn.shed. of rici: 1210 T ST., N. W. ■ <('> *' . 3/rr« 1^: #UL-*~.&tf... @d- ■&-................M? CL4 . '*■•" v*" 3?^w.v^»* y-^3- 333-333 Letter from Ethylwyn B. Hall, one of several persons who carried out library research for physicians living outside the Washington area. The work mentioned in the letter was done for Rudolph Matas of New Orleans. A few physicians of Washington, perhaps those building their practices and thus having free time, acted as researchers, translators, and copyists, as did some persons who apparently were professional clerks or literary researchers. A Miss Morrill carried out research for Timothy F. Allen of New York City, editor of Encyclopedia of Pure Materia Medica.58 William Lee, a physician and for a time librarian of the American Medical Association library; Kate H. Duvall of 2133 F Street, who offered to copy in her spare time; Dr. R. R. Gurley, who sent out circulars advertising his availability for library jobs; Dr. R. Lorini, who charged $1 an hour for preparing abstracts and doing other library work; and Dr. Henry Liddell, who translated (except from German and Russian), provided services.59 Transcribing, abstracting, excerpting, copying, and other services decreased as more and more medical and public libraries came into existence, and knowl- edge of the Surgeon General's library's willingness to lend publications spread through the medical profession. It was much more satisfactory for physicians to borrow and read original works than to depend on copies, abstracts, or excerpts. And the interlibrary loans may have been just as fast or faster in providing information. 104 THE OPERATION AND SERVICES OF THE LIBRARY Billings and the Library Develop Each Other Billings' development of the Library during the early 1870's was all the more remarkable because he could not devote full time to it. From 1870 to 1877 he was in charge of the Disbursing Division and had the responsibility for overseeing the expenditure of funds for the museum, the Medical and Surgical History, trusses and artificial limbs for veterans, and other accounts.60 For a period in 1874 he was acting medical storekeeper. He had to serve on various boards, including those for examining candidates for admission into the Medical Department, for recommending changes in the plans of post hospitals, for examining applicants for the jobs of superintendents of national cemeteries, for examining "Howes Patten Spring Pad Belt Truss," and reporting on a new "field packet case" devised by a medical officer.61 He was sent to Fort Wash- ington on the Potomac River in 1872 to select the site for a temporary hospital,62 and in 1873 was told to plan Barnes Hospital at the Soldiers' Home in Wash- ington.63 In 1875 he edited the 567-page Report on the Hygiene of the United States Army issued by the Surgeon General's office. Off duty he had all the responsibilities, worries, and problems of a bread- winner and father. He and his wife, Katherine, were the parents of five children born between 1863 and 1872. They owned a home in the Georgetown section of the District of Columbia. His mother and father were living in Ohio, and he corresponded with and visited them. In 1872 he considered resigning from the Army. His reasons are not known, but he may have thought of going into private practice to increase his income for his young family, or he may have been faced with a possible transfer to a frontier post and separation from his family.M Billings' vigorous development of the Library brought opportunities for Billings to develop himself. In 1870 he was scarcely known outside of the Medical Department, but his outpouring of letters in 1871, '72 and '73 plus favorable editorials regarding the Library placed his name before the leaders of the profession and led to friendships that were advantageous to Billings and the Library. He was publicizing the Library, and in a way the Library was publicizing him. Invitations to speak, requests for articles, and medical society recognition began to come his way. He was offered chairmanships in the American Medical Association and the American Public Health Association. He was in- vited into the American Library Association and for a time was an associate editor of The American Library Journal, started in 1876. In March 1875 the trustees of Johns Hopkins University asked Billings and four other physicians to submit plans for the proposed university hospital. Billings knew much about the advantages and disadvantages of hospitals of various designs, having worked in and administered hospitals during the war, planned military hospitals in the 1870's, edited Medical Department circulars on the subject, and investigated marine hospitals of the Treasury Department. The trustees selected Billings' conception as being the best and passed it 105 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The first printed catalog indicates the small size of the collection in 1864. A comparison with the large three- volume catalog, published in 1873-1874, shows the as- tronomical growth of the Library in a decade. to an architect for fulfillment.65 In June 1876 the trustees requested Billings to be their advisor in medical affairs. Billings thought it over, obtained per- mission from Surgeon General Barnes to act as a consultant, and on September 18 he accepted. For years he had been accumulating reports on American and foreign hos- pitals,66 until by this time the Library had probably the country's largest col- lection of literature upon that subject. But now he had reason to inspect the best and most modern European hospitals. Obtaining permission from the Surgeon General, he sailed for Europe in October to visit libraries and book agents, but "mainly to examine hospitals & medical schools."67 He toured Great Britain, France, Germany, Austria, and Italy, and returned in December.68 Thenceforth with Billings as one of the guides the construction of Johns Hopkins Hospital proceeded slowly, funds being scarce, until the building opened many years later.69 Thus within a decade Billings had raised the Surgeon General's Library to the first rank in the United States and the world, and in doing so had been 106 THE OPERATION AND SERVICES OF THE LIBRARY given and seized the opportunity to raise himself to prominence in his profes- sion. Notes 1 Correspondence of Billings with firms who furnished the stacks and metal bookcase include letters, Billings to Bartlett, Robins & Co., Mar. 17, 29, Aug. 26, 31, 1871; to F. & A. Schneider, Aug. 31, 1871: NA. Woodward to Billings, July 18, 1872; Bartlett, Robins & Co., to Billings, Aug. 1, 1872; Billings to Bartlett, Robins & Co., Aug. 2, 1872: MS/C/81. Medical Department, vouchers and abstracts of disbursements, Oct. 1875: NLM. 2 The iron book stack along the wall may be seen in a photo of the interior of Ford's, taken in 1893, p. 76 of Olszewski, Restoration of Ford's Theatre. 3 Garrison gave the impression that rare books were not protected until around the turn of the century. The letters cited in footnote 1, above, show that Billings protected books while dis- playing them at least as early as 1872. A note on the margin of p. 49, vol. 3 of the Catalogue of 1873-74, shows that Incipit Perutilis Trac- tates de Pestilentia, Augsburg, ca. 1475, was in the "rare case." 4 In 1892 the 52d Congress passed Joint Res- olution 8 stating that all government libraries would be open to the public (joint resolution to encourage the establishment and endowment of institutions of learning at the national capital by defining the policy of the government with ref- erence to the use of its literary and scientific collections by students: April 12, 1892). In 1901 Congress reiterated the right of the public to use Federal libraries (31 Stat. 1039, March 3, 1901). This is mentioned here as a matter of interest, for the Surgeon General's Library had been opened to the public in the early 1870's. 5 Inventory of property in Museum and Li- brary Division at Army Medical Museum, Tenth Street, June 30, 1887: MS/C/307. 6 These registers are in NLM. 7 Washington Evening Star, May 5, 1883. 8 He developed this classification for Index Medicus, discussed later. 9 Letter, R. Fletcher to C. Fisher, librarian, College of Physicians, Phila., Oct. 18, 1907: MS/ C/116. Fletcher stated that unbound and bound journals had been arranged thus for perhaps 30 years. 10 Letter, J. H. Roberts, GPO, to Billings, Dec. 28, 1867: MS/C/81. Medical Department vouchers to W. C. Lycett for binding, 1870: NLM. 11 Letter, Billings to Sutherland, Jan. 18,1872: MS/C/81. 12 In a half turkey binding the corners and back are bound in Turkey leather, a kind of oil- tawed leather stained a distinctive shade of red, 13 Rogers, Selected Papers of John Shaw Billings, pp. 230-231. M Shaw, B.A. Yale 1847, entered the SGO as a hospital steward, Oct. 22, 1867, and was assigned to Billings. In 1870 he was designated a clerk. Letters, C. H. Crane to Shaw, Oct. 22, 1867; J. Barnes to Secretary of War, May 28, 1878: NA. 15 National Med. Rev.h 7-8 (1892-3). Wise was born in Washington, Feb. 22, 1846. His salary when he became a contract surgeon in 1874 was $125 a month plus rations. He died Feb. 17, 1891. Brief sketches of Wise are in History of the Medical Society of the District of Columbia, 1817-1909, p. 279, port, facing p. 88; W. Thornton Parker, Records of the Asso- ciation of Acting Assistant Surgeons of the United States Army, p. 103. See also letter, Surg. Gen. Barnes to Secretary of War, Feb. 6, 1878: NA. 16 Many of these ex-soldiers continued to work in the Library for 30 or 40 years, until they died or old age forced them to retire. The names of some of them will be found later in the text or footnotes. One of them, James W. Allison, was also an early professional baseball player. Alli- son died Dec. 30, 1911, still employed at the Library. 17 This was in the early 1870's. Later, hours were extended to 4 p.m., and then to 4:30. 18 The catalog of 1872 contained 454 pages. The first 431 pages comprised an alphabetical list of authors and, where appropriate, of titles. The pages from 433 to 454 listed the subjects. There were about 13,300 volumes. It was com- piled and printed in 1871, and published in 1872. After the catalog was placed in the Library, it was kept up to date, to some degree, by writing titles on interleaves. A copy in NLM is inte- leaved and contains some corrections and lo- cation symbols written on the margins by at- tendants. 19 Archibald Malloch, New York Academy of Medicine, said this about cards: "I cannot tell you when such cards were used for the first time in medical libraries, but at the Surgeon Gen- eral's Library about 1865, they were employed in the author catalogue, the subject catalogue 107 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE being added just before 1880. Both were started at the Boston Medical Library in 1875. At the New York Academy of Medicine Mr. John S. Brownne made an author card catalogue in 1880, but the subject catalogue was not begun until 1901" (Celebration of the Centennial of the Li- brary of the Medical and Chirurgical Faculty of the State of Maryland, 1830-1930 p. 6). I have not seen any evidence that a card catalog existed in the Library in 1865. There were so few books that the preparation and maintenance of a card catalog would have been a waste of time. Furthermore the Library had printed cat- alogs. I imagine that Malloch guessed the date "about 1865." 20 Index cards of this period attached to a War Dept., SGO Record and Pension letter, July 9, 1875, and to a letter, Billings to Bridges, Dec. 1, 1875, measure 4% by 67/sinches: MS/ C/81. Billings mentioned the card catalog on p. 176 of his chapter, "Medical Libraries in the United States," in Public Libraries in the United States. ... He stated here that the card catalog was used in printing the 3-volume catalog of 1873-74. The card catalog may have been started earlier, but I have not seen any reference that would place it before 1872. 21 The letter of transmittal in volume 1 of the 1873-74 catalog was dated Aug. 15, 1873. Vol- umes 1 and 2 listed authors alphabetically. Vol- ume 3 contained a list of anonymous works, one of transactions, one of reports, and one of pe- riodicals. The Library at the date of transmittal contained about 25,000 volumes and 15,000 pamphlets (theses, reports, etc.). About 700 of the volumes contained collections of theses, and about 700 other volumes held groups of pam- phlets. The catalog listed about 50,000 titles, exclusive of cross references. In the transmittal letter and at the beginning of volume 3 are lists of donors of publications. In NLM are copies of these catalogs, some volumes of which are in- terleaved and contain marginal additions and corrections. 22 Printed library catalogs were considered superior to card catalogs at that time. Indeed, card catalogs had a long way to go before they would become as standardized and as universal in libraries as they are today. See, for example, the section "Printed or Manuscript," pp. 552- 560; the answers to questionnaires on the de- sirability of printing catalogs, pp. 567-573; and the list of printed catalogs, pp. 576-622, in C. A. Cutter's chapter, "Library Catalogues," in Pub- lic Libraries in the United States of America, their History, Condition, and Management, U.S. Dept. of Interior, Bureau of Education, Part 1, Washington, 1876. 23 W. L. [William Lee], "Letter from Wash- ington," Boston Med. Surg.]., 99: 709 (1878). 24 Letter, Billings to Mrs. Celeste Willard, Oct. 25, 1885: MS/C/81. See also memo by Bill- ings, May 2, 1890: MS/C/81. 25 Boston Med. Surg. J. 99: 707-8 (1878). 26 Boston Med. Surg. J. 99: 709 (1878). 27 Letter, Billings to "Dear Doctor," Jan. 10, 1874: MS/C/81. This was a form letter that clerks copied and sent to editors and physicians. For examples of responses see letters, J. C. Peters to Billings, no date, Jan. 15, 1874: NYPL. Ed- itorial, Buffalo Med. Surg. J. Feb., 1874. 28 Letter, Smith to Billings, July 29, 1868, with note by Billings: MS/C/81. 29 Letter, Woodward to Billings, April 26, 1872: MS/C/81. 30 Boston Med. Surg. J. 94: 138-142 (1876). 31 For example H. C. Wood, Philadelphia, Sept. 26, 1871, asked if the Library had a certain German publication he was "very desirous" to see. E. Andrews, Chicago, Nov. 21, Dec. 19, 1871, asked if the Library had reports of Eu- ropean hospitals and if he could send someone to examine reports. William Pepper, Philadel- phia, Feb. 17, 1874, asked if books were sent to reliable persons. MS/C/81. 32 "Prior to this time [1883] no large collec- tion of books and periodicals was freely available to the doctor [in Chicago] except in university medical schools . . . Dr. Bayard Holmes re- called that many were forced to make a journey to Washington to complete a subject under in- vestigation." Thomas N. Bonner, Medicine in Chicago: 1850-1950, p. 82. 33 Letter, Dunglison to Billings, Sept. 28, 1874: MS/C/81. 34 Letter, William Pepper to Billings, Feb. 20, 1874: MS/C/81. 35 The AMA librarian reported in 1873 that he made loans to members by mail or express, while the Surgeon General's library was "strictly for reference within its proper precincts": Trans. AMA. 24: 99-109 (1873). As far as I have been able to ascertain the librarian loaned books only to members of the AMA. A brief account of this library may be found in: M. H. Moore, "The Library of the American Medical Association," in M. Fishbein, ed., History of the American Medical Association, 1847 to 1947, pp. 1071- 84. See also W. J. Wilson, "Early Plans for a National Medical Library," Bull. Med. Lib. As- soc. 42: 426-34 (1954). Letter, M. Michel, Charleston S.C., to Bill- ings, July 22, 1876, "The Smithsonian Institute has occasionally forwarded [books to] me by express & I have returned [them] immediately . . ."; Billings to Michel, July 28: MS/C/81. 108 THE OPERATION AND SERVICES OF THE LIBRARY 36 Letters, Wood to Billings, Mar. 16, Mar. 21, 1875; Billings to Wood, Mar. 18; Pepper to Billings, July 2: MS/C/81. 37 Letters, Billings to W. W. Keen, Oct. 2, 1875; Billings to Bridges, Dec. 1, 1875: MS/C/ 81. 38 Letters, L. A. Duhring to Billings, Mar. 2, 19, 1877; H. Allen to Billings, Apr. 9, 1877: MS/C/81. 39 Letter, Billings to H. C. Wood, Oct. 11, 1878, sending books to College of Physicians for Wood: NLM. 40 Letters, Billings to J. R. Chadwick, li- brarian, Oct. 30, 1876, sending 12 publications; E. H. Brigham, asst. librarian, to Billings, Nov. 4, returning volumes; E. H. Bradford to Bill- ings, Mar. 25, 1877, requesting loan of books to N.Y. Hospital Library; A. W. Tyler, librar- ian, Johns Hopkins, Oct. 12, 1877, returning 22 volumes: MS/C/81. The letter from Tyler shows that the SG library kept a list of accession num- bers as well as titles of books it loaned. 41 Letters, C. R. Rice to Billings, Dec. 20, 1880; Billings to Rice, Dec. 22: MS/C/81. Bill- ings forgot to add one rule to the letter, "For most part dissertations] not permitted to be taken out"; letter, L. Hektoen, Chicago, to Bill- ings, May 29, 1889, with Billings' endorsement: MS/C/81. 42 For example, editorial, "Library of the Surgeon General's Office," St. Louis Courier Med. 9: 43-45 (Jan. 1883); Billings' letter stating conditions for loan in Med. News 43: 140 (Aug. 4, 1883); remarks by Alexander Hutchins, Trans. Med. Soc. State N.Y., 1884, p. 11. 43 Example: telegram, R. F. Weir to Bill- ings, April 19, 1893; "Kindly send immediately [Gustav] Schneider [Ueber] traumatische gan- gran inaugural dissertation Freiburg 1892 to New York Hospital librarian important legally": MS/C/81. 44 Letter, J. T. W. Ross, librarian, Ontario Medical Library Association, Toronto, to Bill- ings, June 29, 1893, sending check for $100 which Billings made the association deposit as secu- rity. Letter, librarian, Pathological Anatomical Institute, Basel, Switzerland, to Billings, Sept. 22, 1886, requesting four U.S. and British pub- lications. MS/C/81. 45 Letter, Ostertag to Billings, Sept. 1, 1876, with Billings' endorsement: MS/C/81. 46 Letter, Delamater to Billings, Sept. 13, 1876; Billings to Delamater, Sept. 15, in Bill- ings' abbreviated style which I expanded into the quote: MS/C/81. 47 Letter, Billings to Parvin, Apr. 17, 1878: MS/C/81. I have deciphered Billings' scrawl into the quote. 48 Letter, Billings to L. H. Petit, Paris, April 8, 1885: MS/C/81. 49 Letters, Stockton-Hough to Billings, Aug. 29, 1889; Billings to Stockton-Hough, Aug. 30, 1889: MS/C/81. 50 Letter, Osier to Billings, Feb. 18, 1890, with Billings' endorsement that a replacement copy of the book had been ordered from Triib- ner, the Library's agent in Germany: MS/C/81. 51 Letter, Billings to Jewett, May 13, 1872: MS/C/81. 52 Letter, Billings to James, Feb. 19, 1872: MS/C/81. 53 Annual Report of the Surgeon General, 1882, pp. 16-17. Unfortunately, this seems to be the only year for which such statistics were kept. 54 Examples. A. Duceau, Academie de Medecine, Paris, asked for information on three American physicians; letter, Duceau to Billings, Dec. 6, 1882. The Medical Board of New South Wales, Australia, requested information on the American Eclectic College of Ohio; letter, to Billings, Dec. 7, 1882, with answer, Feb. 3, 1883: MS/C/81. 55 After the Index-Catalogue began to be published, if a physician requested references to a subject covered in a volume of Index-Cat- alogue being readied for publication Billings loaned the correspondent page proofs from the Index. Examples: letters, J. O. Roe to Billings, July 13, 1888; S. T. Armstrong to Billings, Feb. 19, Mar. 3, 1892; L. Hektoen to Billings, Mar. 7, 1892; J. P. Tuttle to Billings, Mar. 10, 1892; all asking or thanking for proof sheets: MS/C/ 81. 56 Letters, E. A. Brigham, Boston, to Bill- ings, April 4, 9, 1878, re an unnamed clerk who charged $2.75 for copying 75 index cards (higher than the usual charge) under the heading "Women as physicians"; E. T. Reichert, Uni- versity of Pennsylvania, to Stone, Sept. 30, 1878, requesting translations and Billings to Reichert, Oct. 5, 9, explaining that clerks were not med- ical men and could not read foreign languages; Austin Flint, Jr., to Billings, July 6, 1880, re- questing a copy of an article, and July 15, send- ing $6 to Stone for making the copy; Billings to R. F. Fletcher, Rochester, N.Y., Sept. 27, 1881, and to J. B. Fuller, Pawtucket, R.I., Dec. 22, 1881 stating that clerks charged $2 per 100 cards for copying references; E. H. Brigham to Bill- ings, Oct. 15, 1885, requesting all titles on "iron" be copied at usual rates, with attached note stat- ing that Clark copied 190 cards for $3.80; W. W. Keen, Phila., to Billings, May 28, 1886, asking for refs on "stumps," with note that 150 had been provided for $3; Billings to Brigham, Dec. 109 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 24, 1886, naming Mvers as an abstractor: MS/ C/81. 57 Memo, E. B. Fullerton to B. Israeli, Feb. 10, 1893, paying $4.00 for translating: MS/C/81. * Letter, Allen to Billings, Nov. 19, 1875, presenting a volume of his Encyclopedia and thanking Billings for courtesy to Miss Morrill: MS/C/81. 59 Letter, J. J. Putnam, Boston, to Billings, May 18, 26, 1876, regarding a literature search by Lee for Putnam on cases of poisoning from medicinal doses; Duvall to Billings, Sept. 18, 1883; E. H. Brigham, Boston, to Billings, Nov. 19, 1886, Billings to Brigham, Nov. 23, and L. A. Stimson, New York, to Billings, Dec. 13, re Gurley; Billings to E. J. Beall, Mar. 25, 1887, memo on P. C. Knapp, Boston, Jan. 21, Feb. 8, 1889, and Brigham to Billings, Feb. 8, 1893, regarding Lorini; E. B. Fullerton, Columbus, Ohio, to Billings, Feb. 1, 6, 1893, S. Loving to H. Liddell, April 10, 1893 sending $25 for trans- lations, and Liddell to Billings, April 11, 1893: MS/C/81. The Library provided patrons with the names of translators until the 1960s. Handcopying of articles ceased after World War I when the museum obtained equipment and personnel to provide photographs and photostats. 60 The monthly accounts, vouchers, and other financial records that Billings kept as disbursing officer, 1870-1877, are in NLM. Full title of the Disbursing Division was Library and Disburs- ing Division. 61 Orders to Billings are in SGO records, NA. Copies of some orders are in MS/C/273. 62 Letter, Asst. Surg. Gen. Crane to Billings, July 10, 1872: NA. 63 Plans of Barnes Hospital and Billings' comments thereon are in: War Dept., Surgeon- General's Office, Circular No. 8, A Report on the Hygiene of the United States Army, with Descriptions of Military Posts, edited by Bill- ings, Washington, G.P.O., 1875, pp. liv-lvi. This circular was reprinted with introduction by Col. Herbert M. Hart, NY., 1974. 54 Letter, W. Wesley to Billings, June 18, 1872; "I am very much pleased to hear that the resignation does not take place": NLM. 65 The plans submitted by Billings and the other physicians were published under the title: Hospital Plans. Five Essays Relating to the Con- struction, Organization, I? Management of Hos- pitals, Contributed by their Authors for the use of Johns Hopkins Hospital Baltimore (New York, 1875). 66 Example: letter, Billings to F. Flugel, bookseller, April 17, 1875, asking Flugel to procure working drawings of Saint Joseph Hos- pital, Leipzig. Flugel sent them; letter, Flugel to Billings, Feb. 23, 1876: NLM. 67 Letter, Billings to L. W. Schmidt, book- seller, Sept. 26, 1876: MS/C/81. 68 Garrison, Billings, pp. 191-196, reprints portions of Billings' letters from Europe to his wife. 69 Billings was asked on a number of occa- sions to plan, or give his opinion of the plans for, hospitals. In 1877-78 he drew up plans for the central, or administrative, building and east wing of Children's Hospital. The buildings were erected under contract. See 69 Cong., 2 Sess., Senate Doc. 207, Charitable and Reformatory Institutions in the District of Columbia, by George M. Kober. In 1878 Billings advised James R. Chadwick, librarian of the Boston Medical Library Asso- ciation, about the ventilating and heating sys- tem of the new Boston Medical Library. See Joseph E. Garland, The Centennial History of the Boston Medical Library, 1875 to 1975, p. 40. 110 VI The Beginning of Indexing in the Library Billings Starts to Index Journals BY 1873 the Library had an author catalog in book form, a supplementary author catalog on index cards, and the nucleus of a subject catalog on cards. Those finding aids helped readers locate information in the tens of thousands of books, pamphlets, theses, and reports in the Library, but not in articles in the myriads of issues of journals. Billings now turned to the indexing of periodicals. This would be a monumental task, and presumably he thought about it long and hard before going ahead. He had to consider the length of time it would take, and the number of assistants that would be available. Undoubtedly he considered the alternative of directing readers to the annual indexes provided by many journal publishers. But having concluded that an index should be prepared, he had to consider the alternatives of author and/ or subject and/or title indexes, and of printed or card catalogs. In considering the indexing of journals Billings was not exploring new ter- ritory. In 1867 the Royal Society of London had begun to publish its Catalogue of Scientific Papers, a multivolume bibliography of articles that had appeared in American and European journals from 1800 to 1863, arranged alphabetically by author. The Library had obtained the first three volumes of the set in 1870, and it appears that the catalogue may have provided Billings with a model and perhaps stimulation.1 Billings, however, felt that a subject index would be preferable to an author index (the Royal Society had considered compiling a subject index but had abandoned the idea because it would have been too expensive).2 Billings' preference for a subject index may have had roots in a time-con- suming, disappointing literature search he had undertaken back in 1859 and '60 while preparing his thesis on the surgical treatment of epilepsy. He had discovered that it required "a vast amount of time and labour to search through a thousand volumes of medical books and journals for items on a particular subject. . . ."It was the memory of this experience that, according to Billings, led him to prepare "a comprehensive catalogue and index which should spare medical teachers and writers the drudgery of consulting ten thousand or more 111 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Billings working in his home in the Georgetown section of Washington. The caption was written by one of his children. Number 84 Gay Street later became 3027 N Street. different indexes, or of turning over the leaves of as many volumes to find the dozen or so references of which they might be in search. "3 Billings started to prepare the index on New Year's Day, 1874.4 One would assume that at the beginning he indexed several volumes to obtain an estimate of the time that it would take to index every volume of every journal. Probably during the indexing he made the decision to include original articles only, not reprinted articles, editorials, news of medical events, book reviews, letters to the editor, and other material (occasionally in the future Billings was to violate this rule and select editorials and items of interest to him). He decided to follow this method; he would scan journals and check, in pencil, the title of each article he wanted indexed. His clerks would copy on a card a complete reference to each article checked, leaving the top line of the card blank for Billings to add a subject heading.5 Recent journals would be indexed before old journals; current journals would be indexed within 24 hours of arrival.6 Once started, Billings scanned journals in his office and at home. "Almost 112 THE BEGINNING OF INDEXING IN THE LIBRARY every day," said his future associate, Fielding Garrison, "a government van would leave a wagon load of bound periodicals at his residence in Georgetown and the next morning would find their principal articles, cases, and essays carefully checked, by lead-pencil markings, for the copyists in the office. This night work continued until the gigantic task of indexing all the bound periodicals was accomplished, but even in the later days, when he had only the current unbound periodicals to deal with, Billings still continued to take some of these home in his overcoat pocket, or to have them sent up in baskets, for checking."7 A visitor recalled seeing Billings " 'resting' in the evening after a long and arduous official day. He was lying on a couch, almost hidden by two mountains of medical periodicals in every language, one on either side of him. He was slowly, but without pause, steadily working through the mountain on his right, marking the items to be indexed, and transferring each journal, as finished, to the mountain on his left."8 The division of labor between Billings, medically trained, and his copyists, most of whom had no more than an elementary school education, worked well and continued into the future. The assistants learned to copy references care- fully and legibly, leaving Billings free to concentrate on choosing subject head- ings. Joseph Toner had been preparing an index to American medical journals, and Billings, seeing no reason to duplicate Toner's work, at first planned to index foreign journals only.9 Then Billings learned that Toner's method was different in that he included reprinted articles (Billings limited his index to original articles) and he abbreviated titles of articles (Billings used complete titles). Billings thereupon decided to index American journals as well as for- eign.10 The trial indexing of several volumes at the start would have shown Billings that he needed more copyists if he hoped to prepare an index within a reasonable length of time. So Billings did again as he had done before when he needed assistance: he turned to his brother officers, who had garnered so many pub- lications for the Library, and some of whom were still scouting for periodicals on Billings' want-lists. He wrote letters to Surgeon Blencowe Fryer, Fort Wood, New York Harbor; Surgeon Bernard Irwin and Assistant Surgeon Alfred C. Girard, West Point; Assistant Surgeon Robert H. White, Fort Porter, Buffalo; Surgeon Joseph Smith, Fort Wayne, Detroit; Surgeon William Spencer, Chi- cago; Surgeon Dallas Bache, Fort McHenry, and others, explaining his plan and asking for help.11 Apparently he first asked his helpers to index the periodicals at their hos- pitals—some Army hospitals had runs of journals that extended back several years. When these were completed, he mailed volumes from Washington. To officers at posts sufficiently large to have hospital stewards, he suggested that the stewards be pressed into service as copyists. He sent instructions, index cards, and specimen cards; and officers replied, asking questions to clarify his guidelines. 113 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Billings does not seem to have asked help from surgeons on the frontier, perhaps because of the uncertain communications, primitive conditions, and hard life. But Charles Smart, now at Fort Bridger, Wyoming Territory, learned of the undertaking and volunteered to assist. He told Billings:12 I have just looked over the files of Phila. Med. Times to ascertain complete- ness & find one or two numbers of 1st vol missing, but will index in manner you mention all I have, and notify you of absentees when I send on the finished packet. If you send me cards I shall have all finished in scroll by time they arrive and can return them with no delay but that of copying. I could have cards ruled & cut of size of samples but have not such nice paper as the S.G.O. makes use of. Starting his index, Smart found himself puzzled and he wrote to Billings for instructions:13 I am getting along with your Phila Med Times, and expect packet of tickets or cards in a day or two from you. In making out scroll while waiting for cards I have taken note of all cases reported in hospital service or clinics, although many of these cases present nothing unusual, being in fact brought before the class to illustrate the characteristic type or usual operation. I have put them down as I am indexing the original articles & cases in the paper. I have also taken note of the cases, specimens & discussions in Trans. Path. Soc. Phila. but I am doubtful whether you want these or no. I am under the impression that the Society publishes its Trans in book form & if so it would remove these items from the indexing. Please let me know if you want them indexed. All these included will make about 1500 cards. If you send me a slip of paper with a hint as to method of classification of subjects I would arrange them more satisfactorily to myself and might save you much trouble in changing the penciled headings. The two model cards you sent me gave me no clue as in one the subject runs "Kidney" and the other "Hernia," the one arranging by regions or organs and the other by the lesion. A few days later Smart wrote again:14 Yours of 30 ult reed together with cards for Am. Journal of Medl Sciences. The files at this fort run from July 1863 (including it) to date. One number is missing however viz, that for Octr 1866. I shall fill the cards with great pleasure, regretting only that I cannot begin farther back. Anything else you may think of which I can do I will take pleasure in doing in the plenty of spare time I have here. There is no other record of the titles and quantities of journals handled by Smart, but he cooperated with Billings on several occasions during his life in the Army, and he probably continued to index in the wilderness of Wyoming until Billings had no more periodicals to send. Assistant Surgeon William R. Steinmetz began to index Medicinische An- nalen while stationed at Fort McHenry, Baltimore. He took 13 volumes of the periodical along with him when he was transferred to the Cheyenne and Ar- apahoe Agency, Indian Territory. He wrote Billings:15 We are right amongst the Cheyennes & Arapahoes. The first tribe was very troublesome last year and this spring, giving our troops a skirmish about a mile 114 THE BEGINNING OF INDEXING IN THE LIBRARY from our camp on the 6th of April—they are quiet at present, but we can expect them to break out again at any moment on the slighest occasion. Our command consists of three Cos. of Calvary and two of Infantry; all in tents on the south bank of the north fork of the Canadian river. When Steinmetz completed the Annalen, he returned the journal and cards to Billings, along with the following letter:16 I return to you today per express the thirteen books, you sent me sometime ago, and hope that the indexing is done to your satisfaction. If there is anything you like to have done differently please let me know, so that I may avoid the error in the next lot. I got through with the indexing some two weeks ago, but hesitated to send the box off, as long as the rivers were as high as they have been between here and the nearest rail-road station, Wichita Kas, (distant 160 miles) for some time past. During the last six weeks, our mail which together with the express, is brought to our post by the Stage Co., frequently arrived here in a fearful condition, & thoroughly soaked owing to the high water and heavy rains, and I was under apprehension, that the books might share the same fate. One of the severest thunder showers & storms, I ever witnessed, passed over this section of the country last Monday night, the 9th inst. The wind was so strong, that within a few minutes, all the hospital tents and large Q. M.'s & Commissary tents, which were not framed, were blown down or torn to pieces. Several of my patients, sick in hospital with malarial fever, as also a large portion of my hospital property, were suddenly deprived of their shelter and exposed to a heavy rain and hail shower. No tents can withstand such fearful winds, as (%**«*,/&#. 9.J y A file card prepared for the Index-Catalogue. The citation was copied by a clerk, the heading was added by Robert Fletcher or Fielding Garrison. The citation was listed under Raynaud's Disease in Index-Catalogue, 2 series, vol- ume 14, 1904, p. 317. 115 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE frequently prevail in this country, unless they are well framed and otherwise secured. Although this camp has been in existence for more than a year, the most of the hospital tents are not floored, although several applications for the necessary lumber have been forwarded to Hd Qrs. of the Dept. During last winter, in order to keep from freezing to death, this Command dug holes in the bank of the river, and I suppose, we will have to do the same thing, unless something is done before the cold season sets in. During the early months of indexing, with thousands of cards being pro- duced by his clerks and friends, Billings had to develop his system of classi- fication in detail. Writing to Irwin at West Point in the summer of 1874 he explained it rather fully:17 I forward this day a box by express containing the journals & transactions shown on the enclosed list, also some more blank cards. Of these I would like the transactions of the Society of Biology indexed first, and returned separate. From a hasty examination of the cards made by yourself and Dr. Girard, I think they are nearly right. It is very rarely desirable to make two cards for one article for the reason that it would make the work so immense that it never could be completed. I have about 8000 volumes of journals and transactions to index which will average at least 50 cards per volume. You will readily see that I must abbreviate labor and space as much as possible. The classification for diseases which I shall use is mainly Anatomical. For instance,— Brain, Anatomy of:— Physiology of:— Inflammation of:—Abscess of:— Cancer of:— Hydatids in:— Tumours in, etc. Uterus,— Polypus of:— Cancer of: Prolapsus of: &c. Then under the head of Polypus,— I shall give a general reference "See"— Larynx, Heart, Intestine, rectum, Uterus, bladder, etc. Polypus of:—. The exceptions to this rule are as follows, Addison's disease, Bright's disease, Phthisis, fractures & dislocations. Cancer of a single organ is put under that organ, if of several organs, is put under Cancer. The majority of tumours are put under Tumours,— exceptions, Brain, Ovary, Uterus, tumours of. I use the English name of the disease, e.g. Pleurisy, Mumps, Scarlet Fever, Hooping Cough. An article on the effect of a certain remedy in a certain disease, goes under the disease, e.g. On the use of Perchloride of Iron in post-partum hae- morrhage, is indexed, Haemorrhage, post-partum, Perchloride of Iron in. Obit- uary notices which contain anything of a sketch of the life of a physician—who has ever written anything Medical—should be carded thus; Smith, John. Obit- uary of, or, Sketch of life of. An article on complications or sequelae of a disease should be indexed under that disease thus;— Fever Typhoid, Sequelae of, or, complicated. Labour— difficult, from tumour from contracted pelvis; from mal- position, &c. Cases of poisoning are indexed under the head of the Poison, e.g. Arsenic Poisoning. When it is probable that an article must come under two headings, it should be put under the first one in alphabetical order thus: Ex- periments on the effects of Salts of Soda & Potash, should go under Potassium- Salts of. When I come to print it will then be easy for me to transfer the same card forward to soda. When there are two authors it is not necessary to make two cards—The title of the journal must be given a little more fully than you have done, thus; instead of U. M. it should be Un. Med. Tell Dr. Girard that it is not necessary to give the weekly number,—the number of the volume and year is [all] that is desired. I shall go over the cards made by yourself and Dr. Girard carefully within the next two or three days and may then write again. These cards will be sent to the printer, hence, they must be written plainly 116 THE BEGINNING OF INDEXING IN THE LIBRARY enough for him to decipher them. Would Dr. Girard like to have the Annales d'hygiene sent to him for indexing? Medical officers assisted Billings for at least 2 years, 1874 and 1875. There is no record of the number of articles and journals they indexed, but judging from existing letters they contributed much. On occasions Irwin asked for 2,000 or 3,000 index cards, Assistant Surgeon Frank Meacham, Fortress Monroe, 300, and Smart 750. Irwin and Girard indexed all or parts of Berliner Klinische Wochenschrift and Univers Medicale; Assistant Surgeon Alfred A. Woodhull, McPherson Barracks, Atlanta, Atlanta Medical and Surgical Journal and Phil- adelphia Medical Times; White, New York Medical Record; Charles Smart, Philadelphia Medical Times and American Journal of the Medical Sciences; Fryer, Edinburgh Medical Journal and Medical Gazette; Surgeon William C. Spencer, Chicago, Edinburgh Medical Journal; assistant surgeon Daniel Wei- sel, Fort Johnston, North Carolina, American Medical Recorder, Western Lan- cet and the Philadelphia Medical and Surgical Reporter.18 Over the span of succeeding years Billings had other assistants, volunteers and paid. We know little about those outside the Library with the exception of one whom Billings treated kindly and helped pass the tedious, boring hours of invalidism. "I recall," wrote Fielding Garrison, "an old Confederate general who had to live supine in bed for years from spinal paralysis, a sequel of heat- stroke on service with Gordon in the Soudan, and to whom Billings charitably sent basket fulls of library work daily, which came back next day with never a blunder."19 The Library's First Major Bibliography, on Cholera The first major test of the utility of Billings' subject index came in 1875 when he was asked to prepare a bibliography on cholera. Cholera was one of the most feared epidemic diseases in 19th century America. It killed, within a short time, a sizable proportion of persons whom it infected. Major epidemics had occurred in the United States during the periods from 1832 to 1834, 1848 to 1849, and 1865 to 1866; and minor outbreaks had happened in 1850, '51, '52, '53, '54 and perhaps other years. The disease was not native to America, but came across the Atlantic from Europe after traveling all the way from India, where it smoldered perpetually. Presumably quarantine could have prevented cholera from entering the United States, but the country did not have a national quarantine system. Instead, a tug-of-war between States Rights and Federal Rights had caused quarantine to be left under the control of state and municipal governments. As a result the Atlantic, gulf, and Pacific coasts were dotted with quarantines controlled by local officials concerned only with the welfare of their own ports, not the welfare of the Nation. In the spring of 1874, following a year in which cholera invaded at least 18 states, Congress resolved that the recent epidemic be studied by an Army 117 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE medical officer and the Supervising Surgeon General of the Marine Hospital Service (the agency which developed into the Public Health Service).20 Officials hoped that this study would provide information for local, state, and national officials to use in preventing or containing future outbreaks. Surgeon General Joseph K. Barnes detailed Assistant Surgeon Ely Mc- Clellan to prepare the Army's report. Starting in May 1874 McClellan traveled through 14 states and 2 territories, visiting localities where cholera had been and talking with survivors, laymen, and physicians. Unable to visit every cholera site during the 9-month period allowed for the study, he sent blank forms to physicians in the neighborhood of known cholera cases, asking for detailed information. He had his voluminous report ready for the Surgeon General on January 1, 1875. Within the Surgeon General's office a decision was made that a history of cholera epidemics and a bibliography of writings on the disease would be added to McClellan's report. McClellan collaborated with John C. Peters, a physician of New York City who had studied cholera, in writing the history and he asked Billings to provide a list of books, pamphlets, and articles on the disease. McClellan's investigation of cholera was made during the period when medical officers at Army posts throughout the country were assisting Billings prepare a subject index of articles in medical journals. Billings wrote to his helpers, asking them to send index cards on cholera.21 At the Library he and his clerks wrote out cards for every book, report, thesis, and article dealing with the disease. At this time there were many gaps in the Library's collection of periodicals, and Billings was unable to check cholera articles that he learned existed in at least one missing journal, Gazette Medicale de Paris; but John _L. Vandervoort, New York Hospital library, offered to lend the hospital's set for indexing, and Fred B. Perkins, Boston Public Library, offered to prepare index cards for Billings from his set.22 Presumably the absence of certain journals required in compiling the bibliography of a disease underlined the need for a complete collection of periodicals, and reinforced Billings' determination to make the Library's holdings as full as possible. All the reports were brought together and published during the summer of 1875 under the general title, The Cholera Epidemic of 1873 in the United States.23 Billings' bibliography required 316 pages of the 1,025-page Medical Department report, and included more than 18,000 titles. It was the most voluminous bibliography on cholera produced up to that time and, to the best of my knowledge, the longest bibliography on a single disease made in the country up to that time. If any physician who had heard or read of the Library had doubts of its usefulness, this bibliography would have dispelled them. And the bibliography must certainly have convinced influential physicians that the Library was worth supporting—an extremely important consideration as pe- riodic economy drives in Congress threatened the institution's appropriations and existence. 118 THE BEGINNING OF INDEXING IN THE LIBRARY The Specimen Fasciculus, Billings' model of his proposed bibliography of medicine. At this time he was referring to the collection as the "National Medical Library," but when the Index-Catalogue appeared in 1880 the title page bore the name the collection carried for the next three- fourths of a century, "Surgeon General's Library. "Behind the Specimen are early volumes of the Index-Catalogue, which continued to be pub- lished until 1961. Specimen of the Index-Catalogue By the summer of 1875 Billings had accumulated tens of thousands of index cards. He estimated that the references, when printed, would fill at least five volumes each of 1,000 pages.24 Billings wondered how he and Surgeon General Barnes could persuade Congress to provide funds for printing and binding the catalog. He decided to publish a sample showing how the index would look in print and mail copies to librarians, editors, and influential physicians. He would use the testimonials, which he expected would be favorable, to impress leg- islators and persuade them to appropriate funds for publication of the entire work. During the summer and autumn of 1875 he alphabetized his cards and sent to the Public Printer those beginning with the subject Aabec and ending with Air. He lured a first-rate printer, Harry O. Hall, from the Government Printing Office to aid him in preparing and proofreading the work.25 The product was a book which Billings titled, Specimen Fasciculus of a Catalogue of the National Medical Library, containing 72 pages of text and listing more than 4,000 references. Twelve hundred copies were printed, fifty of which Billings 119 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE had bound in half turkey for special presentation, the remainder in paper covers.26 Billings began sending out copies of the Specimen Fasciculus in March 1876, reminding the recipients that the Library needed its customary $10,000 appropriation from Congress as well as authorization to print the Index-Cata- logue.27 Among the persons who received volumes were Henry C. Lea, medical publisher; Abraham Jacobi of the College of Physicians and Surgeons, New York, and Mary Jacobi; Robert S. Newton, Eclectic Medical College, New York; Ezra M. Hunt, former president, New Jersey Medical Society; Hunter McGuire, Medical College of Virginia; Henry I. Bowditch, Harvard University; Henry Baker, Michigan Board of Health; Jerome Cochran, Medical College of Ala- bama; Jacob M. Da Costa, Jefferson Medical College; D. B. St. John Roosa, medical department of New York University; Galusha B. Balch, St. John's Riverside Hospital, New York; Francis H. Brown, former editor of Boston Medical and Surgical Journal; William H. Mussey, Miami Medical College; and Oliver Wendell Holmes.28 Readers praised Billings' Specimen Fasciculus wholeheartedly. A few noted errors of one kind or another or suggested slight changes, but the response was overwhelmingly in favor of publication of the entire work. Oliver Wendell Holmes told Billings he was "helping to raise the whole standard of American scholarship by providing it with implements and a model."29 Editorials applauding the proposed catalog soon appeared in periodicals. The Boston Medical and Surgical Journal reported:30 A sample of the proposed work, entitled a Specimen Fasciculus of a Catalogue of the National Medical Library, under the direction of the Surgeon General U.S.A., at Washington, D.C., is now before us. It is but a specimen of what has already been done in manuscript, and which only awaits the proper appro- priations to be put in print and placed in the hands of the medical men of the country. Medical bibliography, we fear, can hardly be said to have made such gigantic strides in the past century as have been witnessed in the other branches of science and literature; but we have evidences all around us, in Germany, in England, and in our own country that it is taking a more important and honorable stand; and that writers and earnest, thorough students of medical lore are every year becoming more numerous and more persevering. Such men, and all who seek the true advance of medicine, must welcome the publication of a work which will lay open the field of medicine and the investigations which have already been made. It now becomes the duty of all medical men, the country over, to strengthen the hands of the surgeon-general and the librarian by assuring members of Congress, who will shortly be called on to make the appropriations, of the great value of the work which has already been done, and of the great advantage of opening more freely to the medical profession the stores of wealth which so important a collection as the National Medical Library offers. The Medical Record of New York told its readers:31 With a laudable desire for receiving suggestions in regard to the arrangement of this prospective catalogue, Dr. Billings has issued the fasiculus in question. 120 THE BEGINNING OF INDEXING IN THE LIBRARY . . . We have said enough of the value of this great library to make it unnecessary to urge upon our medical brethren every effort to increase its usefulness and perpetuate its aims. The publication of the catalogue being one of the means to that end, it behooves the profession of the country to give its hearty endorsement to the project, and to use its influence, individually and collectively, to secure the necessary sanction from Congress for its publication. Horatio C. Wood, Jr. was so pleased that he persuaded the American Medical Association to appoint a committee to petition Congress to appropriate funds to print the work.32 Billings sent several copies of the Specimen Fasciculus to the Conference of Librarians held in Philadelphia as part of the 1876 Centennial Celebration. Unable to be there because he was obligated to attend a concurrent meeting of the American Public Health Association, Billings asked John Ashhurst, Jr., to take his place and answer all questions, particularly about medical subject headings. If there was any criticism it was not recorded. Charles A. Cutter placed his stamp of approval on the venture, telling his colleagues:33 The physicians are the proper judges of this question [a single catalog vs. separate author and subject catalogs] those, that is, who are in the habit of consulting bibliographical works. There must be some such, although they have not had many medical catalogues to consult. It would be interesting to hear their experience. . . . As to the nomenclature, I am sure every cataloguer will welcome with delight the prospect of having his choice of subject headings made for him by one who is thoroughly competent. Nothing is so puzzling in our work as this choice; in that matter at least I shall be gald to resign the right of private judgment, and pay the most abject deference to authority. Justin Winsor of the great Boston Public Library told the meeting that he thought that Billings' work was "the most satisfactory effort at indexing medical knowledge which has yet been attempted, and quite worthy of the largest medical library in the country."34 James L. Whitney, also of Boston Public, declared he was:35 impressed with the excellence of its method, and with the important aid which it will render to the medical profession and to librarians ... it is difficult to estimate the treasures it will unlock to the student of medicine. The cataloguer who, in books of all ages and languages, has wrestled with the nomenclature of diseases, will find a great burden lifted from his shoulders in being able to fall back upon work so thoroughly done by specialists. Meanwhile in Boston Billings was persuading the American Public Health Association to appoint a committee to send a memorial to Congress requesting publication of the Catalogue.36 The College of Physicians, Philadelphia, also sent a resolution on the subject to Representative Samuel Randall.37 Another sponsorship that Billings sought was that of the International Med- ical Congress, meeting in Philadelphia as part of the Centennial. He explained to Samuel Gross, president of the congress, that the Catalogue would be useful to physicians everywhere:38 121 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE While the object in view in forming this Library has been to make a collection of sufficient extent and completeness to meet the wants of the physicians of the United States, an attempt is being made to prepare a catalogue and index of its contents whose practical usefulness shall not be confined to this country but shall be, so far as the material available will permit, international and cosmo- politan. The manuscript of the entire work is so nearly completed that the printing can be commenced next Spring, if Congress shall see fit to give the necessary authority. After examining the copy that Gross showed them, the members of the Congress passed and sent to the President of the United States the following resolutions:39 That the members of this International Congress regard with great interest the contribution of a national medical library, in the city of Washington, and respectfully petition the Congress of the United States to provide for additions to the number of volumes and periodical publications, until the library is made as complete as possible. That in veiw of the necessity of what is known as a catalogue raissone in order to render the library properly available for reference, this International Medical Congress urge the importance of an early completion and publication of such a catalogue. That the Specimen Fasciculus of the catalogue, which is stated to be nearly ready for the press, affords evidence of great labor and care, and the arrange- ments for convenience of reference is believed will prove in all respects satis- factory. That those of the delegates of this International Medical Congress who are citizens of the United States, and other members of the medical profession in this country, are urged individually to exert their influence to secure the en- largement of the library and the speedy publication of the catalogue. Robert Fletcher Joins the Staff During the period in 1875 and '76 when the Specimen Fasciculus was being printed and distributed, Billings continued to check journals, develop his sys- tem of classification, and insert headings on cards produced by his helpers. Cards were filed in trays kept in his crowded office. He permitted scholars to refer to cards, but only for brief periods of time so as not to interfere with his work.40 He told Stanford Chaille, a prominent New Orleans physician, "I average 14 hours work a day over books."41 Billings requested Assistant Surgeon General Crane to provide him with a helper. Crane asked Acting Assistant Surgeon Henry Crecy Yarrow if he would like to work in the Library. Yarrow went to Billings' office and inquired what his duties would be. Billings replied: "First of all you must move to Georgetown so as to be as near as possible. You must be willing to work week-ends and Sundays and even late into the night if it becomes necessary."42 Yarrow was a conscientious officer but this was too much. He went back and told Crane he preferred a different post. Crane had a good laugh and assigned him elsewhere. Another person to whom Billings offered the job was George M. Kober, a 122 the beginning of indexing in the library young German immigrant medical student who would later become dean of Georgetown University School of Medicine. Hired as a hospital steward in 1870, Kober worked in the Surgeon General's office for 4 years. During most of this time he indexed the department's old manuscript letterbooks, which earned him the nickname "Index" from the clerks. Other times he copied titles of articles in German journals for Billings. After graduating from Georgetown, Kober stepped up to the rank of Acting Assistant Surgeon and was given the choice of helping Billings or going into the field. Apparently what he had seen of Billings' labors convinced him that service in the western wilderness was preferable and off he went.43 Eventually there came to Billings a first-class aide. On September 1, 1876, Crane sent Acting Assistant Surgeon Robert Fletcher who accepted the job— although he did not move to Georgetown.44 Fletcher, a tall, slender, well- groomed courtly man whose dignified appearance belied his friendliness, had emigrated from Great Britain to the United States in 1847 and settled in Ohio. When the Civil War began he joined the Ohio Volunteers as a surgeon. Sub- sequently he managed an Army hospital, was a medical purveyor, and per- formed other duties. Billings made Fletcher his assistant in checking articles, classifying subject index cards,45 and managing the Library. Fletcher was perfect for these tasks. He was scholarly and conscientious, he worked long hours, and he got along well with Billings, his other associates, and with readers. William Osier never forgot his first visit to the Library and his reception by Fletcher, "an elderly gentleman, who very quickly put at my disposal the resources of the library, and for two days did everything in his power to further my wishes." The assignment of Fletcher to the Library was one of the most fortunate events that happened to Billings. Without Fletcher, or an associate of similar ability, personality, and character, Billings would have had to spend much more of his time on library affairs and not have been free to engage in the many other activities that helped bring him fame. The Department Requests Funds to Publish the Index-Catalogue During the absence of Billings in Europe in 1876 clerks continued to prepare subject cards for books and articles, and Fletcher continued to classify and file the cards.46 After Billings returned the two men labored over the index. By mid-January 1877 so many cards had been inserted into the files that the estimated number of volumes required to print the entire catalog had increased from five to eight.47 Surgeon General Barnes asked Senator Henry B. Anthony of the Committee on Printing to use his influence in persuading Congress to appropriate funds for publication. Barnes and Billings first hoped that Congress would authorize an edition of 5,000 copies of each volume, sufficient to supply every library and physician here and abroad who might desire a copy. But when the Government Printing Office estimated the cost to be $6 a volume, or $30,000 for an edition of 5,000 copies, they quickly lowered their request 123 A history of the national library of medicine to 3,000 copies, suggesting that the books be stereotyped so that additional volumes could be printed if required. The printing of the eight volumes would take 4 years, since only two volumes could be produced each year, the bottle- neck being the slow, careful proofreading that would be necessary for maximum accuracy.48 On January 22 Representative Morton Sayler (a graduate of Miami Uni- versity, Billings' alma mater) introduced into the House a joint resolution authorizing the printing of the catalog of the "National Medical Library."49 A few days later Senator Anthony introduced a bill for the same purpose.50 These pieces of legislation had practically no chance of being considered, for Congress was close to adjournment and more important bills were waiting to be debated. On February 23 Representative Henry Pierce sought to enact legislation by means of a parliamentary maneuver: he offered an amendment to the Civil Appropriation Bill to provide funds for the catalog. Another Representative protested that the amendment was out of order because there was no law authorizing the catalog, and after a brief argument the Speaker agreed.51 Bill- ings' opportunity for obtaining an appropriation during this Congress expired and he had to wait until the next Congress convened in December 1877. In the meantime he expressed his feelings about the debate in this statement:52 The question for Congress to decide is whether the result would be worth the expenditure. . . . What is the value of such an index to the people of the United States as compared with an expedition to the North Pole, five miles of subsidized railroad, one company of cavalry, or a small post-office building? Notes 1 The accession numbers 9726, 9727, 9728, 3 Billings, "The Medical College of Ohio of volumes 1, 2, 3, of the Royal Society's catalog before the War. Address to the Society of Al- show that they were received during 1870. umni of the Ohio Medical College . . .." Cin- Vocher No. 17, abstracts of disbursements, cinnati Lancet-Clinic 20: 297-305 (1888). Medical and Hospital Appropriation SGO, show 4 Billings, "Medical Libraries in the United they arrived in September 1870. States," p. 176. Letter, Billings to John Ash- Billings said of his partly completed catalog hurst, Jr., Mar. 11, 1874: CPP. in 1875: "This mode of indexing is on the plan 5 These cards were slips of tough, white pa- pursued in the Catalogue of Scientific Papers per, approximately 5" X 7", the same, appar- ... by the Royal Society of London": Billings, ently, as were used for the catalog of 1873-74 "Medical Libraries in the United States" in Pub- (see chap. 6). lie Libraries in the United States . . ., p. 177. 6 Letter, Billings to J. Ashhurst, Jr., Mar. 2 The value of subject catalogs was apparent 11, 1874: CPP. to anyone who had undertaken scholarly re- 7 Garrison, Billings, p. 221. search. Bookseller James Campbell of Boston, 8 J. Y. W. MacAlister, Royal Soc. Med., one of the Library's suppliers, wrote to Billings quoted by Garrison, Billings, p. 334. on Aug. 22, 1872; "[I] would suggest that at the 9 Letter, Billings to John Ashhurst, Jr., Mar. time when you print your new catalogue that 11, 1874: CPP. some arrangement be adopted to make a clas- 10 Billings, "Medical Libraries in the United sified Index which would make it exceeding val- States," p. 177. There may have been other uable to the medical profession as a ready book reasons why Billings decided to parallel Toner's of reference to find authorities of special sub- index. Perhaps Toner's index, being private, jects." Letter, Campbell to Billings: MS/C/81. might not have been as accessible to readers as 124 THE BEGINNING OF INDEXING IN THE LIBRARY the Library's. Perhaps Toner was not looking forward to publishing his index, whereas Bill- ings apparently was. 11 Letters, Fryer to Billings, Jan. 20, 1874: Billings to Girard, June 20, 1874; White to Bill- ings, July 20, 1874: MS/C/81. Billings acknowl- edged the assistance of these officers on p. iv of the foreward to vol. 16 of the Index-Catalogue of the Library of the Surgeon-General's Office, 1895. 12 Letter, Smart to Billings, July 23, 1874: MS/C/81. 13 Letter, Smart to Billings, Aug. 2, 1874: MS/C/81. 14 Letter, Smart to Billings, Aug. 4, 1874: MS/C/81. 15 Letter, Steinmetz to Billings, July 5, 1875: MS/C/81. 16 Letter, Steinmetz to Billings, Aug. 14, 1875: MS/C/81. 17 Letter, Billings to Irwin, Aug. 13, 1874: MS/C/81. 18 The earliest letter referring to indexing in Billings' correspondence is a letter from Surg. Fryer, Fort Wood, Jan. 20, 1874: MS/C/81. Letters, Irwin to Billings, July 8, 14, Aug. 10, Sept. 7, Oct. 26, 1874, Feb.3, 1875; Billings to Irwin, Aug. 13, 1874; Meacham to Billings, June 15, 1875; Smart to Billings, July 23, Aug. 19, 1874; Woodhull to Billings, July 16, Sept. 23, Oct. 3, 1874; White to Billings, July 20, Aug. 17, 1874, Mar. 16, 1875; Fryer to Billings, May 14, July 14, 1874, Mar. 3, July 17, Sept. 1, Nov. 1875; Billings to Weisel, June 30, 1875; Weisel to Billings, Aug. 16, Sept. 11, 1875: MS/C/81. Smart to Billings, Apr. 13, May 9, 1875; Spencer to Billings, Feb. 11, June 22, 1874: NYPL. 19 Letter, Garrison to W. Welch, Aug. 14, 1932: JH. 20 43 Cong., 1st sess., Joint Resolution au- thorizing the Secretary of War to detail a med- ical officer of the Army to inquire into and report upon the epidemic cholera, approved Mar. 25, 1874. 21 Letter, Frver to Billings, Jan. 27, 1875: MS/C/81. 22 Letters, Perkins to Billings, Jan. 25; Van- dervoort to Billings, Jan. 29, 1875: MS/C/81. 23 43 Cong., 2d sess., H.R. Ex.Doc. 95. The Army and Marine Hospital Service reports were printed separately but bound and issued in one volume. Supervising Surgeon General Wood- worth's report covered only 28 pages, whereas the Army report comprised 1,025 pages. Be- cause the M.H.S. report was placed first, and Woodworth's name was on that report's title page, he is often listed in catalogs as the author of the complete volume, whereas he was re- sponsible for only a minuscule portion of the work. 24 Billings estimated five volumes in 1875. As the years went by and he indexed more and more periodicals, his estimates grew larger. 25 Hall was the first person hired by Billings to assist with the Catalogue. He transferred from the GPO on July 1, 1875. "The entire work of preparing the author bibliographies, verification of titles and authors, supplying the dates of birth and death, selection of type, establishing rules and precedents, alphabetical order, etc., was in my charge as a practical printer and proof-reader under the approval and decisions of doctors Billings and Fletcher," he recalled (memo, Hall to Col. C. C. McCulloch, Sept. 2, 1916: MS/C/ 137). He was such a superior assistant that Bill- ings had him promoted to the highest grade, and in 1891 placed him in charge of the reading room. Hall remained with the Library 46 years, retiring in 1921 when he was in his seventies. 26 Letter, Billings to Congressional Printer, Apr. 19, 1876: NA. 27 The United States was still in the depres- sion following the Panic of 1873. Billings feared that the "rage for economy" might cause the House to reduce the Library and museum ap- propriation, and he asked editors and physicians to influence Congress. See letters, Billings to S. Chaille, Dec. 13, 1875; to E. McClellan, Jan. 3, 1876; to L. Waterman, Mar. 24, 1876: MS/C/89. H. C. Lea to Billings, Mar. 15, 1876; MS/C/1. Boston Med. Sur.J. 94: 407, 509 (1876). A disagreement between the Senate and House committees delayed passage of the ap- propriation bill, and for a time Billings could not order books. Letter, Billings to Flugel, July 3, 1876: NLM. 28 Letters, Billings to Lea, Mar. 16, 1876; to Jacobi, Apr. 16; to Newton, Apr. 21; to Mc- Guire, Apr. 21; to Bowditch, Apr. 21; to Baker, Apr. 21; to Cochran, Apr. 25; to Da Costa, May; to Balch, May 12; to Brown, May 17; to Mussey, June 2: MS/C/81. Holmes to Billings, May 12, 1876: MS/C/1. 29 Letter, Holmes to Billings, May 12, 1876: MS/C/1. 30 Boston Med. Surg. J., 94: 547-9 (May 11, 1876). The editorial was probably written by Francis H. Brown, a former editor of the journal and one of Billings' book scouts: see postal card, Brown to Billings, May 13, 1876: MS/C/81. 31 New York Med. Rec, 11: 447-8 Quly 8, 1876). Letter, George H. Shrady, editor Med. Rec, to Billings, June 1876: NYPL. Among other favorable editorials were those in Philadelphia Med. Times, 6: 373-4, 422 (1876), Atlanta Med. 125 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Surg. J., 14: 1S4-5 1876). and Nation. Mav 18, 1876. 32 Trans A MA, 27: 49 (1876); 28: 35 (1877); 30: 41 (1879). The committee comprised Joseph Toner. H. C. Wood, and J. R. Chadwick. ™Amer. Lib. J., 1: 121-2 (1876). Letter, Billings to W'insor, advising W'insor that Ash- hurst would substitute for Billings, Sept. 13, 1876: MS/C/81. 34 Amer.Lib.J.. 1: 122(1876). KAmer. Lib. J.. 1: 122(1876). 38 Public Health Reports and Papers. Amer- ican Public Health Association, 3: 239 (1877) Joseph Toner, Lewis H. Steiner, and J. Foster Jenkins were on the committee. 37 Letter, J. Ashhurst to Billings, Mar. 24. 1876; MS/C/1. * Letter, Billings to Gross, Julv 31, 1876; MS/C/81. 59 Copy of resolutions attached to letter of transmittal from Gross to the President. Dec. 14, 1876; MS/C/81. Clipping from Philadelphia newspaper in scrapbook, International Medical Congress; W'3/ In737/1876: NLM. William W. Keen, Philadelphia, offered to present a resolution at the Congress if Billings would send him a draft; letter. Keen to Billings, Julv 22, 1876: MS/C/81. 4" Letter, T. B. Allen to Billings, Mar. 21, 1876, with replv, Billings to Allen, attached: MS/C/81. 41 Letter, Billings to Chaille. Apr. 3, 1876 MS/C/81. 42 Yarrow, "Personal Recollections of Some Old Medical Officers," Military Surgeon 60: 173 (1927). Later Yarrow accepted an assignment to act as a proofreader for Billings. A biography of Yarrow is in Edgar E. Hume, Ornithologists of the United States Army Medical Corps, pp. 530- 49. 43 Page proof 140, vol. 2, part 13, unpub- lished reminiscences of Kober: MS/C/315. F. A. Tondorf, Anniversary Tribute to George Martin Kober . . . in Celebration of his 70th Birthday . . (Washington, 1920), pp. 6-7; copy in MS/ C/315. 44 Order, Crane to Fletcher, Sept. 1, 1876; NA. Fletcher was at this time a contract surgeon. Later, when Congress abolished the Medical Department's practice of contracting with phy- sicians, he became a civil servant. 45 Billings wrote a brief memorandum of in- structions for indexers. The rule for heading in- dex cards was; "Titles on author cards to be lull. On subject cards brief, but the briefing will be done by Dr. Billings + Dr. Fletcher": undated memo: MS/C/81. 46 Letter, Fletcher to Chadwick, Nov. 14, 1876; MS/C/81. 47 Letter, Surgeon General Barnes to Sen. H. B. Anthony, Jan. 17, 1877: NA. 48 Letter, Barnes to Sen. H. B. Anthony, Jan. 17, 1877: NA. 49 44th Cong., 2d sess., H. R. Joint Reso- lution 185, introduced Jan. 22, 1877 50 44th Cong., 2d sess., Bill S. 1198, intro- duced Jan. 29, 1877. 51 Congressional Record, Feb. 23, 1877, p. 1876. 52 Billings, "National Catalogue of Medical Literature," Lib. J. 3: 107-8 (1878). 126 vm The Index-Catalogue and Index Medicus Congress Appropriates Funds for Index-Catalogue THE estimate of the cost of publishing 3,000 copies of each volume of an eight-volume bibliography at $6 a volume amounted to $144,000, a very large sum of money in 1877. This was probably the cause of the resistance in Congress to publication of the Index-Catalogue. By comparison, Congress would only appropriate $200,000 for construction of the entire Medical Museum- Library building a few years later. Hoping for a lower cost Surgeon General Barnes and Billings sought a more precise estimate from the Public Printer. This turned out to be $25,000 for 3,000 copies of volumes 1 and 2, or about $100,000 for 3,000 copies of all eight volumes.1 This estimate was used during the winter of 1877-78 and the following spring as Billings and his friends continued to exert pressure on Congress. George F. Shrady wrote about the need for an appropriation for the catalog in his Medical Record and urged physicians to influence legislators.2 A committee of the Medical Society of the County of New York sent a memorial to the Senate and House.3 Horatio C. Wood of Philadelphia, chairman of the American Med- ical Association committee on the catalog, took the train to Washington and talked to members of the House Committee on Appropriations.4 But the amount of money involved was still too large. Representative Sayler thought it best to reduce the number of copies to 2,000 and ask at first for funds to print volume one. This he did in a bill in May 1878.5 The reduction did not satisfy all opponents. Within the Committee on Printing there was resistance that kept Sayler's bill from being released to the House. Billings, disappointed, increased his lobbying activities. Among his corre- spondents was Abraham Jacobi, to whom he wrote the following letter:6 Congress has adjourned without authorizing the printing the catalogue. This is not Mr. Eickhoffs fault for he did what he could but he was defeated by Mr. Singleton of Mississippi who made the most exaggerated statements as to its cost. I saw Mr. Hewitt who said that next session he thought it could be done. Now during the summer and fall I want to have the profession talk to the Members and Senators, and then in November have some formal resolutions 127 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE &c sent in, and I think it will go through. 1 shall put in an estimate for $25000 for the first two vols. Will you not consider your committee as still existing and have messrs Hewitt, Eickhoff, and other New York members impressed with the part that their medical constituents really want this thing, and that their request is not merely pro forma to oblige the Surgeon General or myself but is for their own pleasure and profit. I am writing all over the country about this. . . . Billings sent a longer plea for assistance to William T. Briggs of Nashville, editor, teacher, and former vice president of the American Medical Association:7 Congress having adjourned without authorizing the publication of the Index Catalogue of the Library of this Office, it is very desirable that members of the medical profession who desire its publication should do what they can to convince Members and Senators of its utility and of their desire for its publication that they may obtain copies. I believe you are familiar with the character of the collection and of the proposed catalogue, and I will only say that the catalogue will contain about 400,000 titles, that it will make from 7 to 10 volumes and that it will cost for an edition of 2000 copies of each volume less than $11,000 per vol or about $100,000 for the entire work. This estimate may be relied on. The Surgeon General will again apply next winter for the necessary authority to print the catalogue, asking for a sufficient appropriation to print the first two volumes. The entire mss is ready for the press, but not more than two volumes a year can be printed consistent with that accuracy which such a work demands. (The Members from Tennessee will be very powerful in this matter, especially Mr. Atkins and Blount who is chairman of the Committee on Appropriations.) I venture to call your attention to this matter and to suggest that during this summer and fall, steps should be taken by the physicians of Tennessee to get Mr. Atkins and others interested in the matter. It will be a great pity if the authority to print is not given next winter, and it will surely be given if the physicians of the country take hold of the matter in earnest. I am aware that I am suggesting some troublesome work for you, for it will involve correspondence etc., but I hope you will excuse me in con- sideration of the importance of the object, and in view of the fact that my acquaintance with physicians in Tennessee is very limited and I do not know whom to apply to. Presumably Billings sent similar letters to influential physicians in the states of other key congressmen. With the Committee on Printing opposed to any bill favoring the Index- Catalogue, Billings' friends in Congress changed their strategy. Instead of trying to pass a specific bill they decided to include funds for publication in an ap- propriation bill. Billings informed Edward Ely Van de Warker, a prominent physician of Syracuse and a freiend of Representative Frank Hiscock, of the plan:8 The matter of printing the catalogue will not come up as a separate bill, but will be on the estimates before the appropriation committee. The Surg. Gen'l. has estimated for $25,000 to print and bind the first two volumes of the catalogue and to stereotype the same, and will urge this in his annual report. 128 THE INDEX-CATALOGUE AND INDEX MEDICUS The first thing to be tried therefore is to induce the Appropriation Committee of the House to rept this item on one of the appropriations bills. If they do there will be no further trouble in the matter. The principal opposition in the appro- priation committee will probably come from Mr. Singleton of Miss, and Mr. Atkins of Tenn. If the committee will not pass this item, then we want some one to see that our amendment is introduced to put the item on the Appropriation Bill. If this amendment is presented in a five minute speech so as to make the points, it will almost surely pass, and if the yeas and nays are insisted on it will pass beyond doubt. I shall be very glad to give Mr. Hiscock all the information I can about it when he comes here and I have no doubt that he can do much towards obtaining the necessary authority. The strategy worked. In February 1879 appropriation legislation containing many items moved through the House and Senate without any comment about a sum of $20,000 for printing volumes 1 and 2 of the Index-Catalogue.9 The President approved the bill on March 3. The next day Billings thanked Jacobi, who had influenced a key representative:10 The catalogue appropriation has passed and we are authorized to print the first two vols. This is largely due to a letter which you wrote to Mr. Eickhoff— a letter which kept the printing committee from being hostile actively although they would not report favorably—probably on account of homeopathic opposi- tion. The Surgeon General received $5,000 less than was needed and he had to return to Congress later for additional money,11 but Billings was now able to make arrangements with the Government Printing Office for production of the Index-Catalogue. The Appearance and Reception of Index-Catalogue In July 1880 reporters in Washington on their daily quest for news learned that the Index-Catalogue was ready to be issued. Papers mentioned the coming event and the Medical Department began to receive requests for copies.12 When volume 1 appeared it contained 888 pages of text, preceeded by a 6- page preface and a 126-page list of journals indexed by Billings and his helpers. In the text were 9,090 author-titles, representing 8,031 volumes and 6,398 pamphlets; 9,000 subject titles of books and pamphlets, and 34,604 titles of articles. The first entry was "A. (E.E.), Ozonized cod-liver oil . . .," and the final entry was "Berliriski (Marcus), De nascentium morientiumque numero ex lege naturae diversis diei temporibus diverse" Billings' clerks began to mail volumes during the summer, and letters of praise started to reach the Library in September. "It is a monument of useful labor, a time saving directory to medical literature, a delight and a blessing to the medical scholar. May the Lord save Dr. Billings to finish it," wrote George J. Fisher of Sing Sing, New York. "I am filled with admiration at your ability with however much help to bring out so vast a work & I am also filled with dispair that there should be such a mighty mass of medical literature," said Henry D. Noyes, New York. "Such a work, so full of research & of patient 129 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE labor, reflects immortal credit upon the office from which it emanates," stated Samuel Gross, Philadelphia.13 Alfred S. Purdy told Billings: "The profession can never repay you for the exhausting labor you have spent upon the library and catalogue." Austin Flint, Jr., echoed the same thought: "The medical profession at the present and in all future time should feel under great obligation to you." Charles Rice wrote: "I must say that I hardly ever opened and examined a work which is more carefully prepared and more beautifully gotten up than this masterpiece of printing. To bestow words of praise upon the immense labor devoted to making the catalogue, is entirely unnecessary on my part, for it is impossible to do justice to the work by mere words. This work, if no other ever before, will be sought for everywhere, and its publication will put to shame many wealthy and otherwise well-governed libraries abroad, none of which can show anything of equal value and usefulness."14 From his farm Oliver Wendell Holmes sent this message: "You are raising a monument to science . . . more enduring than brass, and a great deal more valuable to mankind than palace or pyramid."10 Reviews in journals in every section of the United States and in Europe were equally flattering. Cincinnati Lancet-Clinic called the catalog "an addi- tional honor to the name of one of the youngest, most industrious and distin- guished medical men in America."16 Billings was a happy person when the medical profession heaped praise on the catalog upon which he had worked for 6 years. "Dr. Billings is in every sense the author of the Index, is very proud of his work, as he has reason to be, and appreciates the approbation and encouragement of the profession," wrote William Lee of Washington, a frequent visitor to the Library.17 The Index-Catalogue made the Surgeon General's Library universally use- ful. Without the giant catalog the huge collection of medical writings would have been consulted almost solely by physicians who lived in and near Wash- ington. With it and through the courtesy of interlibrary loans, books and journals were available to physicians throughout the United States and Canada. Libraries in the Americas and on other continents used it as a subject index to their journals. It stimulated the growth of other medical libraries. A goodly portion of the medical literature of the world was opened to the physician who had access to the catalog. It saved the time of every researcher and directed him to writings he might not have found otherwise. William Osier regarded it as "one of the most stupendous bibliographical works ever under- taken . . . of incalculable value to any one interested in books ... a monument to the Army Medical Department, to the enterprise, energy and care of Dr. Billings, and to the scholarship of his associate, Dr. Robert Fletcher."18 The Selection of Articles for the Catalogue Each year after the Index-Catalogue first appeared another volume came from Billings' assembly line. Each year Billings and Fletcher checked off more and more articles resulting from increasing research in new scientific schools, 130 THE INDEX-CATALOGUE AND INDEX MEDICUS hospitals, research institutions, and government agencies. His original estimate of five volumes proved a very bad guess; it doubled and then tripled. It might have doubled again had Billings not become more selective. He omitted trite public addresses, insignificant, duplicate, repetitious and worthless material, and some clinical cases. He passed by almost all editorials and letters to the editor. He picked all the articles in first-rate journals but only important articles in second-rate journals, and he ignored most of the contents of inferior jour- nals.19 "I do not index everything in med. journals," Billings explained to a researcher, "not even all those wh. come under the head of original commu- nications and are of some length, but I do try to include everything wh. contains either a new fact, a new idea, or a new way of stating old ones."20 On the other hand Billings' desire to appear unbiased in his selection may have resulted occasionally in some trash being included. Fielding Garrison recalled: "In two instances, I knew Dr. Billings and Dr. Fletcher to deliberately collect, card and catalogue full lists of the writings of avowed and bitter enemies, as showing that a private and personal opinion of these men and the specific worth of the products of their brains were different and disparate things, and in neither cases were the 'products' worth very much."21 Thus the Index-Catalogue, con- trary to what most persons believed, became not the index to all the medical literature of the world, but only to the important literature. Perhaps as much was omitted as was included. The Index-Catalogue as a Model of the Printers Art Billings was as particular about the final appearance of his Index-Catalogue as he was about the content. His foresight in bringing printer Hall from the GPO to the Library and placing him in the assembly line resulted in great care being taken with the typography and proofreading. A tradition of error-free printing was started and maintained throughout the long life of the work. This, even though the printing was said to be "the most difficult piece of typography attempted in the United States."22 Billings had the aid of Acting Assistant Surgeon Henry C. Yarrow as a proofreader. Yarrow examined proof sheets carefully from 1879 to 1888, until his eyes could no longer stand the strain of reading fine print.23 Billings was also assisted by two volunteer proofreaders, Charles Rice and James R. Chad- wick. Rice, a pharmaceutical chemist and linguist of New York City, after perusing volume 1, suggested that Billings obtain a new font of Greek type, and offered to read proof in languages except Slavic, Hungarian and English. He was particularly helpful with Greek and some Oriental languages. Although very busy with his own professional affairs, he read galleys for two decades.24 Chadwick, a founder and librarian of the Boston Medical Library, read proof for many years.25 Because of careful work from beginning to end, only occasionally did a reader find an error. Norman E. Harding, a British medical officer, reported that a check of 800 entries revealed only one mistake, the misprint of an r for 131 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE an n.26 William W. Keen sent a glowing testimonial: "The proofreading of both [Index-Catalogue and Index Medicus] is as good as the proof reading of the Bible, and praise could go no further."27 The Influence of the Index-Catalogue on the Development of the Library The Index-Catalogue proved good for medicine, but, in a way, bad for the Library. When Billings started the bibliography, he bequeathed to his followers their major task for generations into the future. Henceforth, the Library became preoccupied with the job of grinding out a volume each year. All operations were geared to the production of the Catalogue. One-third of the clerks worked full time indexing, preparing copy, and proofreading. Others proofread part time, packaged and sent out hundreds of copies, kept records, and handled the miscellany of odd jobs involved in the production of a monumental reference book every year. The usefulness of a person to the Index-Catalogue team became the chief criterion in hiring clerks. The most important qualifications of an employee were, in order of importance: "legibility of handwriting, ac- curacy in copying and in collation of books, rapidity of copying; knowledge of foreign languages, especially of Russian, Polish, Hungarian, Swedish, Dutch, Portuguese, Spanish, Italian, French, and German; knowledge of proofreading and methods of correcting proof; knowledge of medicine and medical terms."28 The Library contributed much to the advancement of medicine by producing the Index-Catalogue (William Welch considered it America's greatest contri- bution to medical knowledge)29 but in so doing, it funneled so much of its resources into the publication that it retarded its development in other areas.30 The Founding of Index Medicus While preparing the Index-Catalogue Billings conceived the idea of a pe- riodical that would list the titles of current medical articles, books, reports, and other literature. He found a publisher, Frederick Leypoldt, willing to take a financial gamble in publishing it, and he persuaded a number of physicians to share the financial burden by subsidizing the journal until it would become self-sustaining. Fletcher suggested the title Index Medicus, a Monthly Clas- sified Record of the Current Medical Literature of the World.31 Billings obtained permission of the Surgeon General to have the Library's Index-Catalogue cards copied to provide the text for Index Medicus.32 Library clerks made duplicate cards when they were off duty in the evenings and on weekends, and were paid by the publisher for their work.33 The clerks' wives and daughters assisted with the copying.34 Billings conceived, planned, and started the journal and then turned the editorship over to Fletcher—the title page carried the names "Dr. John S. Billings, Surgeon U.S. Army, and Dr. Robert Fletcher, M.R.C.S. Eng.," but Fletcher was the active partner and Billings always acknowledged this. The first number appeared in January 1879. Thereafter titles of articles from 132 THE INDEX-CATALOGUE AND INDEX MEDICUS Index Medicus A MOXTHLY CLASSIFIED RECORD • IK TMK Current litebical Citerature of tt)e lllorlb. COMPILED UNDER THE SUPER VIS/OX nr Dr. JOHN S. BILLINGS, Surgeon U. S. Army, AND Dr. ROBERT FLETCHER, M.R.C.S.Eng. Vol. I. January—December, 1879. New York: V. LEYPOLDT, 13 & 15 Park Row. London: TxL'BNtK * Co., 57 Ludgate Hill. Paris: C. Rkimwald et Cic, 15, Rue 4e» Samu Peres. Leipiit{: K. K. Kuiilkk, Puststrassc, 16. AmsUrdam: Fkkdukik Mullkk .V Co., Iln-rentrrat-lit, jjy. St. P*i~r*burg: Kahl Huttgkk, Ncwskij-Fr. N>. 5. 1879. Title page of volume one of Index Medicus. Originally a by-product of the Index-Catalogue, Index Medicus outlasted its parent, and is the longest lived, most widely used medical bibliography that ever existed. 133 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE hundreds of journals were at the fingertips of readers, arranged in a system that Billings derived from the classification used by the Royal College of Phy- sicians of London.35 The classification system was used later for arranging pub- lications in the Library36 and was adopted for the purpose by other medical libraries. James Chadwick and Edwin Brigham remodeled the classification system of Boston Medical Library along the lines of Index Medicus,37 as did the College of Physicians in Philadelphia and the Library of Congress for its schedule R, Medicine.38 Billings requested publishers and authors to send books, pamphlets, and other writings to Washington so that the titles could be listed in Index Medicus. His agreement with Leypoldt provided that all publications sent would, after being indexed, be deposited in the Library.39 "The hope that the contributions to the Library from this source will be large, and thus permit the application of the limited funds provided by the government for its support to the purchase of the many works still required to make it fairly complete, has been my main inducement for undertaking to furnish the necessary data," Billings stated in the prospectus, "Beyond the satisfaction in thus contributing to the convenience of medical writers and teachers, and to the completeness of the Library under my charge, I have no personal or pecuniary interest in the enterprise." Over the years the Library received many publications through this channel, in- cluding duplicates which it used for exchange, and some foreign periodicals, which it would have had to pay for otherwise.40 Although the price of Index Medicus was moderate, $3 a year, and com- petitive with that of other journals, almost all American physicians ignored it. Leypoldt and his sponsors struggled to lure subscribers, but they had little success.41 Leypoldt had to raise the price to $6 in the second year, but he still lost $1,000, and his total deficit for the first 2 years was $5,000, a large sum of money in the 1880's. He might have given up had not a number of subscribers guaranteed to pay part of the deficit. In 1884 he was forced to increase the price to $10. Later that year he died, and Billings and Fletcher thought that the periodical was doomed. But George S. Davis, a medical publisher in De- troit, took over. By that time there were only about 250 subscribers, many of whom took the journal out of friendship for Billings or because they thought the profession needed such a periodical.42 The sale increased slowly; by 1891 there were only 482 subscribers, 90 of whom were medical officers, 224 were U.S. civilian physicians and libraries, and 168 were from other countries.43The inability of the journal to find more than a few hundred physicians (out of the 80,000 to 100,000 in the United States between 1880 and 1890) willing to pay for its services indicates the lack of interest of physicians in research and continuing education at that time.44 Hard times during the Depression of 1893 caused some subscribers to drop off. The publisher's deficit increased further in 1894. By the spring of 1895 Davis felt that he could no longer bear the financial loss and he decided to stop publishing the periodical. Apparently some of Billings' friends suggested they 134 THE INDEX-CATALOGUE AND INDEX MEDICUS were willing to pay $25 a year for the Index Medicus if it could be continued. Billings sent out a circular letter soliciting subscriptions at that price. Editorials in medical journals urged physicians to support the undertaking. More than 200 patrons responded, not an overwhelming number but sufficient to rescue the publication. In the meantime a disagreement caused Davis to withdraw permanently, leaving Billings and Fletcher with the full responsibility of pre- paring, publishing, and selling the journal.45 Index Medicus was a companion to Index-Catalogue. A complete series of the Index-Catalogue took many years to complete, and in the intervals between comparable volumes in each series Index Medicus provided up-to-date refer- ences to the current literature. Through the journal physicians could keep abreast of almost all medical articles in the world within 1 to 3 months of their appearance. If they wished to read an article cited in Index Medicus, they could, if they resided in one of the larger cities, perhaps obtain the journal in their local medical library. Otherwise they could borrow the journal from the Surgeon General's Library through an interlibrary loan or pay a clerk in Wash- ington to write out a manuscript copy. Without the Surgeon General's Library with its never ending stream of journals arriving from American and foreign publishers, and without the Li- brary's indexing operations, Index Medicus could not have existed. No publisher could have afforded to subscribe to the 600 journals received by the library46 or pay the salaries of a group of indexers. Billings' Reward Billings' bibliographic labors established his reputation internationally and brought him many honors. In 1881 he was invited to give the general address before the International Medical Congress, the first time an American was chosen to give this important speech. Thereafter he was frequently asked to give addresses, here and in Europe.47 He was elected to honorary memberships in many organizations, among them the Medical Society of the County of New York (1879), Medical Society of the State of New York (1880), Medical and Chirurgical Faculty of Maryland (1880), Medical Society of London (1881), Clinical Society of London (1881), Society of Medical Officers of Health, London (1881), National Academy of Sciences (1883), College of Physicians of Phila- delphia (1883), and others. He was invited to be a member of the Board of Visitors of Baltimore Medical College.48 He was sought after for testimonials.49 He was offered a professorship at Johns Hopkins50 and invited to lecture at Columbia51 and in Boston.52 He was offered the editorship of Louisville Medical News.53 In 1884 he was presented with the first of eight honorary degrees that he would receive from European and American universities. A few years later 259 physicians of the United States and Great Britain contributed a gift of $10,000 to Billings, to thank him in some measure for his arduous work developing the Library, the Index-Catalogue and Index Medicus. A check for the sum was placed in a silver box and handed to a surprised Billings 135 A history of the national library of medicine John Shaw Billings, Librarian from 1865 to 1895. This photo was taken, it is believed, in the 1870's when Billings was founding Index-Cat- alogue and Index Medicus. during a banquet held in his honor at the Bellevue Hotel in Philadelphia. The physicians also commissioned artist Cecilia Beaux to paint a full-length portrait of Billings. This colorful painting showing Billings in his uniform and academic gown hangs in the reading room of the Library.54 In the eyes of his contemporaries Billings was one of the world's great bibliographers, and it is chiefly as this that his reputation has lasted. His few attempts at investigation of fungi and crania did not produce significant results. The course into which he steered the National Board of Health may have helped wreck that agency. His work on vital statistics, and on the design of libraries, Johns Hopkins Hospital and other hospitals were noteworthy but did not have the universal importance of the Index-Catalogue or Index Medicus. "Years after the iniquity of oblivion has covered Dr. Billings' work in the army, as an organizer in connection with hospitals, and even his relation to the great Li- brary," said Osier, "the great Index will remain an enduring monument to his fame."55 Notes 1 Letter, Barnes to Sen. H. B. Anthony, Oct. 31, 1877: NA. 2 New York Med. Rec. 13: 211-212 (1878). 3 New York Med. Rec. 13: 220 (1878). 4 Trans. AMA. 29: 45 (1878). The com- mittee also issued a circular appealing to Con- gress to finance the Catalogue. 5 45th Cong. 2d sess. Bill H.R. 4727, May 6, 1878, "A bill authorizing the printing, bind- ing, and stereotyping of an index-catalogue of the Library of the Surgeon General's Office." Around this time for reasons not now known the expression "National Medical Library" used by Billings for several years was dropped, and the title "Library of the Surgeon General's Office" was used thereafter. 6 Letter, Billings to Jacobi, June 20, 1878: MS/C/1. The committee mentioned by Billings was probably the committee of the Medical So- ciety of the County of New York. A Memorial to Congress by this committee, signed by Jacobi and other prominent physicians, is in New York Med. Rec. 13:220(1878). 7 Letter, Billings to Briggs, June 28, 1878, 136 THE INDEX-CATALOGUE AND INDEX MEDICUS marked "personal": MS/C/81. Billings sent the same letter to Theophilus Parvin, editor and teacher, Kentucky, probably substituting the name of a Kentucky congressman in place of Rep. Atkins of Tennessee: MS/C/81. He wrote to Lewis Steiner, an influential physician of Frederick, Md., who wrote to Sen. George R. Dennis, Md., regarding the catalog; see letter, Steiner to Billings, Dec. 20, 1878: NYPL. s Letter, Billings to Van de Warker, Oct. 30 1878: MS/C/81. 9 On Feb. 24 the portion of the bill referring to the catalog was read in the House and passed: see Congressional Record, p. 1867. The bill passed the Senate on Feb. 28. 10 Letter, Billings to Jacobi, Mar. 4, 1879: MS/C/1. 11 46th Cong., 2d sess., Senate Ex. Doc. 62, Feb. 2, 1880, contains letter of Surg. Gen. Barnes requesting $6,500 more for printing and binding volumes 1 and 2. 12 Letters from J. D. Keller, Glenville, Pa., July 5, 1880; A. G. Smythe, Baldwyn, Miss., July 10; J. E. Wharton, Portsmouth, Ohio, Pub- lic Library, July 12; Charles Jewett, editor, An- nals of the Anatomical and Surgical Society, Brooklyn, N.Y., July 12; Thomas Ryerson, Den- nis Library, Newton, N.J., July 14; Charles Rice, Librarian, College of Pharmacy, NY., July 22: MS/C/81. 13 Letters and receipts, Fisher to Billings, Sept. 9; Noyes to Billings, Sept. 11; Gross to Billings, Sept. 20, 1880: MS/C/1. Names of persons, societies, and libraries, here and abroad, who received copies of the Catalogue, are in notebooks, NLM. 14 Letters and receipts, Purdy to Billings, Sept. 10; Flint to Billings, Oct. 1; Rice to Bill- ings, Sept. 21, 1880: MS/C/1. 15 Holmes to Billings, Sept. 12, 1880, copied in scrapbook: MS/C/81; original letter is miss- ing. Billings had one of his clerks compile a large scrapbook of reviews and letters praising vol- ume 1 and subsequent volumes of the Cata- logue: MS/C/81. 16 Cincinnati Lancet-Clinic 44: 286 (1880). 17 Letter, Lee to N. Senn, Oct. 26, 1880: MS/C/81. 18 W. Osier, "Some Aspects of American Medical Bibliography," Bull. Assoc Med. Li- brarians 1: 22-23 (1909). 19 Memo, Garrison for the Surgeon General and Librarian, Aug. 5, 1929, MS/C/166, con- tains a long exposition about the selectivity of Billings and Fletcher on the Index-Catalogue and Index Medicus. 20 Letter, Billings to H. Leffmann, Oct. 20, 1883: MS/C/81. 21 Letter, Garrison to G. Simmons, Aug. 2, 1916: copy at JH. ^ Index-Catalogue, 4s. v. 1, 1936, pp. iv-v. "The printing of the Index Catalogue is prob- ably the most difficult piece of technical work done at the printing office, a great many vari- eties of type being used and many languages. The correctness and beauty of the printed page in a work of this nature is of the utmost impor- tance, and so far it has been carried on in a way that has provoked the admiration of the learned men who use the catalogue in this country and in Europe"; 3 indorsement, Library to the Sur- geon General, Jan. 31, 1913, on memo, Public Printer to Asst. Chief Clerk, War Dept., Jan. 29, 1913: MS/C/116. 23 Sketch of Yarrow in W. T. Parker, Rec- ords . . . Acting Assistant Surgeons, pp. 103- 106. 24 Correspondence of Rice in MS/C/81, par- ticularly to Billings, Sept. 21, 25, and Billings to Rice, Sept. 25, 1880. Rice did not wish to read proof of titles in English because he knew the Library was proficient in this language. A sketch of Rice may be found in Dictionary of American Biography. 25 Index-Catalogue, v. 16, 1895, p. v. A sketch of Chadwick is in Dictionary of American Bi- ography. 26 Letter, Harding to Librarian, Sept. 4, 1909: MS/C/116. 27 Letter, Keen to Maj. Walter D. McCaw, Dec. 28, 1908: MS/C/116. 28 Letter, Billings to Surgeon General, May 27, 1887: MS/C/81. Typewriters were not yet widely used, thus the importance of legible handwriting. 29 E. E. Hume, "The Centennial of the World's Largest Medical Library: The Army Medical Library of Washington, founded 1836," Military Surgeon 78: 241-2 (1936). Welch, in Memorial Meeting in Honor of the Late Dr. John Shaw Billings, April 25, 1913, p. 10. 30 The cost of printing the first series of the Catalogue was $192,000. This was a large sum during the period 1880-1895; in comparison, it was approximately the cost of the building erected in 1886-1887. 31 In 1898 Adolf Growoll, managing editor of Publishers' Weekly, wrote Book-Trade Bib- liography in the United States in the XlXth Cen- tury, in which he placed, pp. lxvii-lxxvii, a bi- ography of Leypoldt, 1835-1884. Growoll said (p. lxxvi): "In 1879 Leypoldt, desiring to carry his bibliographical enterprise into fresh fields, projected the Index Medicus, a monthly key to medical books and periodicals, which should be a periodical supplement to the great 'Index Cat- alog of the Library of the Surgeon-General's Office United States Army', by Dr. John S. Bill- ings, now of the New York Public Library, As- tor, Lenox, and Tilden Foundations. Fearing 137 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE that his friends and associates would be inclined to persuade him from new ventures, he kept his plans quiet until they were nearly ready for the launch." Growoll wrote essentially the same in Frederick Leypoldt; Biographical and Biblio- graphical Sketch (1899), a 15-page pamphlet. I have not seen any other attributing the concep- tion of Index Medicus to Leypoldt. Growoll was associated with Leypoldt and it can be argued that he knew whereof he spoke. Fielding Garrison said this: "One year be- fore the publication of the first volume of the Index Catalogue, Dr. Billings and Dr. Fletcher hit upon another bibliographical expedient. . . . This was the Index Medicus" (John Shaw Bill- ings, p. 225). I have not seen any statement, except Gro- woll's, that disagrees with Garrison's. Garrison was associated with Billings for 5 years, with Fletcher for 22 years, and it can be argued that he was closer to them than Growoll was to Ley- poldt. My personal feeling is that Garrison was correct. It seems to me less reasonable that Leypoldt, who worked in the literature of the book trade and in general bibliography, would have singled medicine out of all sciences and other endeavors as a field in which to publish a bibliographical journal, than would Billings, who had specialized in medical bibliography for a decade. "Dr. Fletcher very deeply resented the use of that term [Index Medicus] as a title for other medical bibliographies, because it was a Latin expression devised by himself which he re- garded as his personal property. . . . More than one medical journal has employed it in this way and he always denounced it to the editors in virgorous terms"; letter, Garrison to George H. Simmons, Aug. 8, 1914: JH. 32 Letter, Fletcher to James Tyson, Aug. 13, 1909: MS/C/116. 33 Index Medicus paid a total of about $50 a month to clerks for copying in the early 1880's, $80 a month by 1899; letter, Fletcher to Bill- ings, April 30, 1899: NYPL. 34 ". . . the work of copying the library cards for redaction having been parceled out. . . among the wives and daughters of the office force, as private work": Fielding H. Garrison, "In Me- moriam Dr. John Shaw Billings," Index Medicus 2S, vol. 11, Mar. 1913. 35 The classification, or table of contents, may be found at the beginning of occasional numbers of Index Medicus, and particularly in the edi- torial at the beginning of the first number, Jan- uary 1884, vol. 6. 36 Fielding Garrison, "Report of Committee on Library Classification," Bull. M. Lib. Assoc. 7: 28 (1917-18); "Subject Bibliography and Shelf Classification," Ibid., 10: 29-37 (1920-21). 37 Letters, E. Brigham to Billings, July 19, 1882; Billings to Brigham, July 22: MS/C/81. See also Joseph E. Garland, The Centennial History of the Boston Medical Library, 1875- 1975, pp. 34-35. 38 C. Martel, "Remarks on Cataloguing and Classification," Bull. Med. Lib. Assoc, n.s. 5: 43-45 (1915/16). 39 Prospectus, dated Nov. 1, 1878, bound at the beginning of vol. 1, Index Medicus, HMD, NLM. 40 Billings, preface to Index-Catalogue, vol. 16, 1895, p. iv. 41 In NLM are several letters to and from Leypoldt in which the publisher mentioned the lack of support for Index Medicus. See, for ex- ample, Billings to Leypoldt, Oct. 25, 1882, MS/ C/81, and Leypoldt to A. Jacobi, Oct. 10, 1881, MS/C/1. See also letter, Billings to A. Van Derveer, May 5, 1884: MS/C/81. 42 "As to the Index Medicus the deficiency was about $1000.00. Five hundred copies of it cost about $5000, and it does not seem possible to cheapen it in any way. The simple truth is that there are only about 250 persons who want it—quite a number took it not because they had any use for it, but for the general good or from friendly feelings to me . . .,"; letter, Billings to C. R. Agnew, Jan. 27, 1885: MS/C/272. 43 Billings, "The Conditions and Prospects of the Library of the Surgeon-General's Office and of its Index Catalogue," Trans. Assoc Amer. Phys. 6: 251-7 (1891). In this article Billings lists the number of subscribers from each foreign country, as Australia 5, Belgium 2, Brazil 1, and so on. "The number of subscribers to the Index Medicus is hardly sufficient to pay Mr. Davis for the expense of printing it, and I have for two or three years feared that he would soon be unwilling to go on with its publication"; letter, Billings to A. Mosso, Turin, Italy, Mar. 7, 1892: MS/C/81. In an effort to attract more subscribers Davis published excerpts from scores of European and American reviews and from letters of physicians in a pamphlet, An Explanation, by the Pub- lisher, of the Nature, Scope, Form and Method of Preparation of the Index Medicus [1886?]: Arch. Coll., NLM. 44 "I believe it [Index Medicus] will be a suc- cess among the scholars in the profession. Un- fortunately, however, that class is much too small"; letter, G. F. Schrady, ed. New York Med. Rec, to Billings, Mar. 5, 1879: NYPL, copy in NLM. 45 A scrapbook containing letters and clip- pings relating to Index Medicus is in NLM. Let- ters, Fletcher to Billings, Nov. 16, 18, 20, 1895, 138 THE INDEX-CATALOGUE AND INDEX MEDICUS has information and a list of American subscri- bers: NYPL, copy in MS/C/276. 46 A list of journals being received is in Index Medicus, vol. 1, Jan. 1879, pp. 4-28. 47 Example: Billings' invitation, May 22, 1882, from the British Medical Association to speak at its 50th anniversary meeting is in MS/C/81. 48 Letter, Billings to H. Byrd, June 5, 1882: MS/C/81. 49 Letter, John Chiene, Edinburgh, to Bill- ings, June 8, 1882: MS/C/81. Chiene, applying for the professorship of surgery, told Billings; "Your name is now well known here." 50 Letter, Billings to D. C. Gilman, June 18, 1883: JH. 51 Letters, Billings to F. A. P. Barnard, Dec. 4, 1883, May 26, 1886: MS/C/81. 52 Letter, Billings to B. Cotting, Sept. 29, 1884: MS/C/81. 53 Letters, Billings to T. Parvin, and to N. S. Davis, Jan. 25, 1883: MS/C/81. 54 The banquet was held November 30, 1895. The silver box that contained the check is in HMD, NLM. Garrison, Billings, pp. 282-7, gives excerpts from speeches at the banquet. 55 Memorial Meeting in Honor of the Late Dr. John Shaw Billings, April 25, 1913, p. 10. As late as the 1930's mail from foreign coun- tries was received at the Library addressed to John Shaw Billings. 139 IX Billings Seeks a Building for the Library and Museum Planning the Building AS soon as Billings won his battle to publish the Index-Catalogue, he began a campaign to persuade Congress to provide the Library and museum with a building of their own. He had gathered so much printed material that he had run out of space in Ford's Theatre. Volumes were double and triple shelved. "There came to be no room for even the storage of books and spec- imens," wrote Charles Smart, "not to speak of facility of reference or advan- tageous display."1 Billings considered placing books in the attic but decided that the weight there might cave in the building, or that if a fire ever broke out the volumes would be burned or ruined by water from fire hoses. Assistant Surgeon David Huntington relieved a bit of the pressure by storing books and undistributed volumes of Index-Catalogue at Soldier's Home about 4 miles away on the outskirts of Washington.2 The ex-theater was undesirable in other respects for its present uses. The Museum, crowded into the third floor, was visited by approximately 36,000 persons a year and was being enlarged by about 500 specimens annually. The lower floor, where clerks searched Civil War records for pension applicants, was dim, illuminated only by gas lamps, and had no ventilation. The Inspector General of the War Department had protested strongly that three times as many clerks were jammed into the space as ought to be.3 The theater had been erected hurriedly in a few months and was poorly constructed. The east wall was more than a foot out of plumb. The southwest corner had given way until there was a large crack in the wall. The weight of books, specimens, furniture, files, and people placed stresses on the floors and walls that the building had not been designed to bear. Officers were appre- hensive that the continual addition of weight would cause the building to collapse. Finally, the building, although the walls were of brick and the floors of concrete, was not fireproof. In 1875 a small frame building adjacent to the south side caught fire. Daniel Lamb, pathologist of the museum, discovered the blaze before it had time to spread widely, but before it was extinguished 141 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE it damaged the photograph room.4 The staff always feared that a fire might start in a neighboring house or shed, jump to Ford's and destroy all their work. It seems that Billings had four choices: to recommend to Surgeon General Barnes that the Library stop collecting (which he would not have done if humanly possible, and which would have ended publication of Index-Cata- logue), to suggest or agree to a merger with Library of Congress (which he did not want to do), to find storage spaces here and there in government buildings (which would have fragmented the Library), or to persuade the Surgeon General to ask Congress for permission and funds to construct a special library-museum building. Apparently, he had no difficulty with the last alternative, for medical officers, from the Surgeon General to the most recent assistant surgeon, were proud of their Library and museum. Billings had learned something about the functional design of buildings years before when he compiled and edited Circular No. 4 of the Surgeon General's office, A report on Barracks and Hospitals, with Descriptions of Military Posts. And he had learned more while consulting with officials of Johns Hopkins about the design of its hospital. He discussed his ideas for a building with Adolph Cluss of the architectural firm of Cluss and Schulze and sketched a floor plan of a building that Cluss translated into a design. Undoubtedly Cluss contributed to the plan; several years earlier he had won third place among 28 entries in a competition for a design for the proposed Library of Congress building. The building was to be L_i-shaped, four stories high. The center segment and the first floor of the wings were to contain offices, workshops, laboratories, and space for records. The upper portions of the wings were to be halls, one for the Library, the other for the museum. The strategy that Barnes and Billings decided upon to gain Congressional support was to emphasize the unsafe condition of Ford's, rather than the lack of space for books and specimens, or the crowded condition of records, and clerks. "In the building . . .," the general reported to his superiors, "these collections are continually exposed to the danger of destruction by fire. This building is surrounded by inflammable houses and sheds . . . destruction by fire of the roof would not only involve the whole Museum Collection in the third story, but, by the fall of at least a portion of the walls, the destruction of the contents of the lower stories, including the Library and the Records, would result."5 Barnes convinced Secretary of War Alexander Ramsay that a new, sturdy, plain, fireproof building, costing a quarter of a million dollars on a site costing about $50,000, was needed for the Library, museum, and records. Ramsay gave President Rutherford B. Hayes information about the building and its contents, and the President was impressed.6 He recommended, in his annual message, that Congress appropriate money for a new structure, stating that7 the Army Medical Museum and Library are of national importance. . . . Their destruction would be an irreparable loss, not only to the United States, but to 142 BILLINGS SEEKS A BUILDING FOR THE LIBRARY AND MUSEUM A ™o\t i_a;.-Tio;*' - ""v \ la.i "' 'u u i nunc! f i oor First plans for the Library-Museum building, 1880, drawn by the architec- tural firm of Cluss ir Schulze, following instructions of Billings. The Library wing is on the left, Museum wing on the right. the world. . . . There are filed in the Record and Pension Division, over sixteen thousand (16,000) bound volumes of hospital records. . . . Aside from their historical value, these records are daily searched for evidence needed in the settlement of large numbers of pension and other claims, for the protection of 143 • u - ~ • *i~i A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the Government against attempted frauds, as well as for the benefit of honest claimants. These valuable collections are now in a building which is peculiarly exposed to the danger of destruction by fire. . . . Perhaps because the Hayes administration and the 46th Congress were both nearing their end no further action was taken, but Barnes and Billings had succeeded in opening the door. The following year, with a new President in office and a new Congress soon to convene, Surgeon General Barnes repeated his request for a building. Sec- retary of War Robert T. Lincoln agreed that Barnes had a good case, and forwarded the proposal to President Chester A. Arthur, who approved and transmitted the communications to the Senate and House on January 19, 1882. Both houses printed pertinent documents on the proposed building.8 Barnes, Billings, and other officers now had to persuade Congress to agree. The general offered to guide Representative James Singleton and other mem- bers of the House Committee on Public Buildings and Grounds (the committee that would decide whether or not a new building should be constructed) through Ford's, and show them the condition of the structure.9 At least one congress- man, Representative Strother Stockslager, toured Ford's with the Surgeon General and later emphasized its unsafe state during debate.10 Barnes also went to Capitol Hill and talked to the House Committee on Public Buildings and Grounds.11 Without detracting from the importance of General Barnes' (and his suc- cessors, General Charles Crane's and Robert Murray's) talks and correspond- ence with members of Congress, it appears that almost all of the lobbying for the proposed building was directed by Billings. When the Senate and House referred the President's message to committees on public buildings, Billings made a list of the names and home towns of each member of the House committee.12 He then wrote to prominent physicians in the home states of these congressmen, explained the necessity for a library-museum building, and asked them to influence their legislators. Thus he began a letter writing cam- paign that would last more than 3 years to encourage American physicians to persuade representatives and senators to vote for the building. Owing to his voluminous correspondence in search of books, journals, and other medical literature; his founding of Index Medicus; his manifold activities in the American Public Health Association, American Medical Association, and National Board of Health; and the publication of Index-Catalogue; Billings was known to and respected by medical editors and leaders in state and national medical societies. Therefore when he asked physicians to help obtain a new building for the national medical Library and museum, many of them responded enthusiastically. William Pepper, professor at the University of Pennsylvania medical school, and Horatio C. Wood, professor in the same school and editor of Philadelphia Medical Times, contacted Representative Shallenberger. James G. Thomas, past president of the Georgia State Medical Association, wrote to Representative Philip Cook, and also asked a Dr. Cooper of Cook's home town 144 BILLINGS SEEKS A BUILDING FOR THE LIBRARY AND MUSEUM to influence the congressman. Professor Austin Flint, Jr. of Bellevue Hospital Medical College wrote to Frank Hiscock, a powerful member of the House Committee on Appropriations. A physician whose identity we do not know of Scranton, Pennsylvania, persuaded a score of his colleagues to send a petition to Representative Joseph Scranton. Jerome Cochran, professor at Medical Col- lege of Alabama; William W. Dawson, professor at Medical College of Ohio and a future president of the American Medical Association; David W. Yandell, editor of American Practitioner in Louisville, Kentucky; Thomas Wood, editor of North Carolina Medical Journal; and James F. Hibberd, past president of the Medical Society of Indiana, promised to help.13 Billings, his associates or his friends, had petitions printed for physicians to sign and send to congressmen. Billings kept a supply at hand to pass out on request.14 Christopher Johnson, professor at University of Maryland Medical School and former president of the Medical and Chirurgical Faculty of Mary- land, obtained the signatures of 32 physicians on a petition and presented it to Representative Robert McLane. Robert A. Kinloch, professor at Medical College of South Carolina and former editor of Charleston Medical Journal, circularized petitions and also talked with a Carolina senator. Claudius H. Mastin, a future president of the American Surgical Association, passed around a petition which he presented to Representative Hilary Herbert and also chatted with his friend Senator John Morgan, who agreed to back the building. Granville P. Conn, secretary of New Hampshire Medical Society, James R. Chadwick, founder of Boston Medical Library, and William Pepper circulated petitions.15 Representative Perry Belmont received a petition signed by Fordyce Barker, Austin Flint, Cornelius R. Agnew, and other physicians; Representative Will Aldrich received a petition from 22 physicians and surgeons of Chicago; Rep- resentative Leopold Morse heard from physicians of Boston and Representative Stanton Peelle from Theophilus Parvin, Allison Maxwell, and other physicians of Indianapolis.16 Several editors publicized the campaign for a building through editorials, published letters, and new items. John V. Shoemaker of Medical Bulletin, Philadelphia, told Billings to send a memo of the facts that he would like to have emphasized and Shoemaker would write an editorial. The first editorial, "A new building wanted," appeared in the March 1882 issue. It noted the size and usefulness of the museum, Library, and Civil War record collection, the crowded, unsafe state of the building, and ended with this appeal: Let every physician consider the cause his own, and work earnestly for its success. Speak at once to your senators and representatives, telling them how important it is that this subject should receive favorable consideration and prompt action. Write to them when the bill is introduced and get your friends to do likewise, and we are certain that the present Congress will perform its duty and provide a suitable edifice for the treasures of the Surgeon General's Office. Thereafter as the occasion demanded Shoemaker ran news items about the Library, museum, building, and Index-Catalogue.17 145 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE TO THE Hj /u Billings' hand-written proposal for legislation to authorize construction of, and appropriate funds for, a Library-Museum building, 1883. orial; Gross, Flint, Tobias Richardson (a former AMA president), David Yandell (another ex-president), and Henry Campbell (a future president). Their mem- orial carried considerable weight; it was quoted in debate and was printed in journals and in Senate and House documents dealing with construction of the Library-Museum Building.37 152 BILLINGS SEEKS A BUILDING FOR THE LIBRARY AND MUSEUM lb. Civil War Pension Records During the years that had elapsed since the end of the Civil War the Medical Department had been receiving more and more requests for information from veterans seeking pensions. By 1882 the backlog of applications had become so large that Congress ordered the employment of more clerks. There was no room for additional workers in the Pension and Record Division on the first floor of Ford's, and the government rented buildings number 935, 937, and 153 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 939 F Street, on the northeast corner of Tenth and F, for use as file rooms and offices for the new employees. There was now another argument in favor of constructing the Library- Museum Building. The government could transfer the clerks and files from the F Street building to the first floor of the new structure and save the money it was paying in rent. At the rate pension applications were arriving, the F Street buildings would be needed for many years; therefore savings would amount to a considerable sum if the clerks could he moved. From 1883 to 1885 the Surgeon Generals emphasized the potential savings, and undoubtedly this was taken into account by economy-minded senators and representatives.38 Attempt to Reduce the Appropriation In early 1883, Billings had to concentrate on blocking another attempt to cut in half the Library-Museum appropriation from $10,000 to $5,000. S. Weir Mitchell talked to Senator Thomas Bayard and learned that Senators John Logan and Preston Plumb were responsible. These two had been among the chief congressional critics of the National Board of Health, and one wonders if they were not trying to scuttle Billings. Senators Bayard and John Mitchell promised S. Weir Mitchell that they would help the Library-Museum obtain its usual amount. Representative McLane told Christopher Johnson that he would assist in the House. Virgil Cubney, New York Academy of Medicine, marshaled physicians to put pressure on Senators Logan and Elbridge Lapham. Undoubt- edly, other senators were asked to help by officers and Billings' friends; and before the Army Appropriation Bill went to the President for approval, it granted the Library and museum the regular amount of $10,000.39 Suggested Merger With the Library of Congress As a coincidence, during the same period in which Billings was seeking a building for the medical library, Congress was discussing the construction of a building for its own library. The Library of Congress, then located in the Capitol, was so crowded from continual purchases, gifts of books, and deposits of copyrighted publications that Librarian Ainsworth Spofford had gloomily forecasted that it would become "the greatest chaos in America."40 Congress had decided that the Library building would be located on Capitol Hill, and for several years legislators, architects, and librarians had been de- bating about the design, size, and interior arrangement of the structure. A question that had to be answered before the final plans could be drawn was this: should all government libraries (Agriculture, Patent Office, Geological Survey, State Department and so on) be merged into the Library of Congress and placed in the new building? There were logical arguments for (convenience of all books in one place instead of dispersed, prevention of duplication, econ- omy) and against (inconvenience to the departments, preference of users) doing this. 154 BILLINGS SEEKS A BUILDING FOR THE LIBRARY AND MUSEUM The debate over this matter was of utmost importance to Billings. If those legislators who favored consolidation of government libraries won, the Surgeon General's Library would be split eventually from the medical museum and moved into the Library of Congress building, where it might be kept intact, but lose some, most or all of its independence. To counter the reasons for merging libraries, Billings used several arguments that he repeated over and over, persuasively, in letters to and in talks before societies. He pointed out that the museum, which was by now the most famous medical museum in the Americas and Europe, needed the Library adjacent to it for ready reference by scientists working on a variety of subjects. He maintained that medical libraries served physicians best, were preferred by the profession, and flour- ished when kept apart from general libraries. Writing to William Poole, head of Chicago's Public Library and an influential leader in the expanding library profession, he expressed his views concisely:41 Mr. Spofford thinks that it should be merged with the general national collection as soon as he has secured a building large enough to receive it, his idea being that the National Library should absorb all the special collections in Washington. Now putting aside all personal feeling in the matter, which I am quite willing to do for the general good, it seems to me that this is a mistake, and that it is better to keep such special collections, medical and scientific, as the library of the Surgeon General's Office, of the Geological Survey, of the Astronomical Observatory, of the Patent Office, and all natural history pertaining to the National Museum, under separate and distinct management, and for them to receive distinct appropriations, as at present. The scientific and medical department of great national libraries, such as those of England, France, and Germany, are very little used by scientific and medical men, who prefer to resort to special libraries, under the direction of special librarians, for the works which they need. The very rapid progress and comparative completeness of this library is largely due to the great interest which has been taken in it by the medical profession of the whole country, who contribute largely to its files and take care to see that it is supplied with that large mass of miscellaneous, current medical matter, which does not come into the book trade, is not copy-righted, is very ephemeral, and to secure which is one of the greatest difficulties of such a library.42 Billings advanced the same reasoning, with more detail, to impress phy- sicians attending the 85th annual session of the Medical and Chirurgical Faculty of Maryland;43 Why then is it that they [British Museum and Bibliotheque Nationale] do not contain all medical books which have ever been printed; and that your medical library in Washington, which is only about twenty years old and has never had in any one year funds sufficient to purchase more than two-thirds of the medical books printed in various parts of the world during that same year, should already be equal if not superior to them in practical value? It appears to me that it is very largely due to the fact that while the Washington library is the National collection, it has been kept separate from the general National library. ... As a matter of fact, comparatively little use is made by medical writers of the collection in the British Museum or Bibliotheque Nationale. They 155 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE consult, in preference, the special medical libraries in London and Paris. . . . It is to such special libraries that physicians give their books and pamphlets; and the rapid growth of the Washington library is largely due to this cause. . . . Now, so long as the library can preserve and extend this feeling of interest in its completeness, so long it is sure to grow in value and usefulness, but if it be merged into a general National library this interest will rapidly diminish. It is not to be expected that the manager of a large miscellaneous library . . . should also be familiar with the various departments of scientific literature. ... I think therefore that you will do well to see that a proper and commodious fire-proof building is provided for your Washington collection, that it is not merged into the Congressional Library, and that it is granted sufficient funds to enable it to secure all new medical books as they are published, and gradually to collect the best of the older literature. In order to persuade senators and representatives to accept his viewpoint, Billings asked his small army of lobbyists to emphasize in memorials, petitions, and resolutions their desire that the museum and Library not be separated, and that the Library remain under the management of the Medical Department. Although Spofford favored merging all government libraries into the Library of Congress, he did not push his views vigorously. If he had he probably would have won, for he mingled with representatives and senators every day at the Capitol. But an anonymous person, perhaps someone in the Library of Con- gress, who was not as gentlemanly as scholarly, book-loving Spofford, initiated a virulent attack against the independence of the medical Library in the Wash- ington Sunday Herald.44 The writer stated that Billings had earlier asked Spof- ford to help him get appropriations for the Surgeon General's Library, prom- ising to keep publications only until the Medical and Surgical History of the War was completed when they would be given to Library of Congress. Spofford, believing he would receive the publications, stopped ordering medical books. The history was now completed but Dr. Billings and all of his associates are very indignant at even the idea of consolidating this medical library . . . with the Library of Congress. If the library were placed under Mr. Spofford's charge it would be accessible to the medical profession. As the affair now stands, the collection, which is one of the best in the United States, and one of the finest in the world, is held for the exclusive benefit of a few people in the Surgeon General's Office and their freinds. And even they make no use of the library which can in any way benefit the public. Aside from the Medical History of the Rebellion, which was a more compilation of other peoples' writings by Dr. Woodward and his associates, this library has published nothing. It is the clearest possible case of a very insignificant and surly dog in a richly-stuffed manger. This article would have angered a saint had it been directed toward him, and it probably infuriated Billings temporarily, but he contacted the editor or a reporter and with his customary tact and diplomacy gave his account of the development of the Library. The result was that a longer, more detailed article appeared the following Sunday, praising the Surgeon General's Library and supporting Billings' campaign for a new museum-library building.45 156 BILLINGS SEEKS A BUILDING FOR THE LIBRARY AND MUSEUM Notes 1 Smart, "The Army Medical Museum and the Librarv of the Surgeon General's Office," JAMA, 24:'555 (1895). 2 Letters, Huntington to Billings, June 17, 1881; Billings to Calvin DeWitt, Oct. 5, 1882: MS/C/81. 3 47th Cong., 2d sess., H. Report 1995 to accompany bill HR 7681, Feb. 28, 1883. 4 Daniel S. Lamb, History of the United States Army Medical Museum, p. 69. 5 Annual Report of the Surgeon General, . . ., 1880, pp. 17-18. The Surgeon General repeated his warning about the unsafe condition of Ford's for several years in annual reports until a new building was authorized. 6 Notation regarding letter, Barnes to Ram- say, Nov. 15, 1880, and letter, Ramsay to the President, Nov. 17, 1880: NA. Letter, Sec. of War re fireproof building for library and mu- seum, received in House, Feb. 9, 1881, and referred to Committee on Public Buildings and Grounds: NA. 7 The portion of the President's message re- ferring to the need for a new building was re- printed in Annual Report of the Surgeon Gen- eral, . . ., 1881, pp. 16-17. 8 Billings drafted the letter from Gen. Barnes to Sec. of War Lincoln, Nov. 21, 1881, date crossed out and Dec. 7 inserted: NA. Copy of letter, Gen. Barnes to Sec. of War Dec. 7, 1881, submitting estimate and plans for building: NA. 47th Cong., 1st sess., Sen. Exec. Doc. 65, con- taining letters of Barnes, Lincoln, and Arthur, extract from the Surgeon General's Annual Re- port of 1881, and three drawings and plans of the proposed building. 9 Copy, letter, Barnes to Singleton, Feb. 2, 1882; NA. 10 Congressional Record, Feb. 16, 1885, pp. 1767-1770. 11 Letter, Rep. William Shallenbarger to Barnes, Feb. 15, 1882, MS/C/1, NLM; Barnes to Shallenbarger, Feb. 17; NA. 12 Billings' list of names is attached to a copy of Senate Executive Document 65: AMM. 13 Letters, Shallenberger to Pepper, Feb. 9, Oct. 2, 1882; Shallenberger to H. Wood, Feb. 9, 1882; Thomas to Billings, Feb. 20, 1882; Flint to Billings, Feb. 20, 1882; Cochran to Billings, Dec. 2, 1882; Dawson to Billings, Nov. 20, 1882; Yandell to Billings, no date; postal card, Hib- berd to Billings, Feb. 13, 1882; T. Wood to Billings, Oct. 5, 1882, May 5, June 11, 1883; all in MS/C/1. Scranton petition, Congressional Record, Mar. 27, 1882. 14 Copies of two different printed petitions are in NLM and AMM. 15 Letters, Johnson to Billings, Dec. 9, 18, 20, 1882; Kinloch to Billings, Oct. 6, Nov. 18, 1883; Mastin to Billings, Sept. 11, 21, 29, Oct. 5, 20, Nov. 15, Dec. 14, 1882; Pepper to Bill- ings, Dec. 15, 1882; Conn to Billings, Sept. 6, 1882; Chadwick to Billings, Dec. 11, 1882; all in MS/C/1. 16 Petitions to Belmont in Congressional Record, Dec. 5; to Aldrich, Dec. 14; McLane, Dec. 18; Morse, Dec. 23; Peelle, Dec. 27, 1882. 17 Letter, Shoemaker to Billings, Jan. 30, 1882: MS/C/1. Med. Bull. 4: 74 (1882). 18 Letters, Minor to Billings, Feb. 18, 1882; Dawson to Billings, Feb. 7, 1882: MS/C/1. Cin- cinnati Lancet-Clinic 47: 116-117 (Jan. 28, 1882). 19 Med. News 41: 577 (1882). Other items on the Library-Museum are in the same volume, pp. 529, 699, and in vol. 40, pp. 137-138 (1882). 20 Nation, Mar. 2, 1882. 21 Nation, Oct. 26, 1882. 22 Meeting of the Medico-Legal Society as reported in the N.Y. Tribune, Mar. 2, 1882, and reference to petition in Congressional Re- cord, June 22, 1882. Letter, G. F. Dudley, Secy. St. Louis Med. Soc., to Surg. Gen. Barnes, Feb. 22, 1882, sending resolution of the society, MS/ C/l. Copy of resolution of St. Louis Medical Society, Feb. 11, 1882, in Army Medical Mu- seum, and reference to resolution in Congres- sional Record, Feb. 28, 1882. Report of reso- lution of Philadelphia Co. Med. Soc. in Philadelphia Med. Times, p. 144, Nov. 18, 1882. Letter, R. M. Wyckoff to Billings, Nov. 28, 1882, sending resolution of Medical Society County of Kings, MS/C/1. Reference to petitions of Centre District Medical Society, Alabama State Medical Association, Hudson. County Medical Society, Chester County Medical Society, in Congressional Record, Dec. 4, 11, 14, 19, 1882. 23 Resolution of American Surgical Associa- tion to the Senate requesting that the $5000 appropriation be increased to $10,000, Phila- delphia Evening Bulletin, June 2, 1882; Boston Med. Sur.J., 106:566-7(June 15, 1882). Letter, Richard Cleeman to Billings, June 7, 1882, sending copy of resolution of College of Physi- cians, Philadelphia, urging Senate to increase appropriation to $10,000: AMM. Butterfield's amendment, Congressional Record, Apr. 5,1882, p. 2632. 24 "This [reduction] has been done on the recommendation of Senator Logan and I am afraid 157 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE it will pass the Senate. . . ."; letter, Billings to Jacobi, June 3, 1882: MS/C/1. 25 "I am happy to say we have induced Sen- ator Logan to have the appropriation restored to the amount usually given"; letter, Billings to Jacobi, June 8, 1882: MS/C/1. 26 Annual Report of the Surgeon General . . 1883, pp. 25-26. 27 Annual Report of the Surgeon General . . 1884, p. 28. 28 Garrison, Billings, p. 165. 29 Letter, Yarrow to Billings, Jan. 15, 1883: MS/C/1. 30 47th Cong., 2d sess., Bill HR 7861, and H. Report 1995 to accompany the bill. The bill and report were reprinted in 48th Cong., 1st sess., Senate Executive Doc. 12, Dec. 17, 1883. 31 Billings' draft of the amendment is in NLM. Letter, Crane to Hawley, Mar. 1, 1883; NA. 32 Letter, Johnson to Billings, Oct. 11, 1883; MS/C/1. 33 Letters, O'Leary to Billings n.d., 1883; Spooner to O'Leary, Jan. 26, 1883; Mastin to Billings, April 1, 1883; Johnson to Billings, April 22, May 12, 1883; Cochran to Billings, May 3, 1883; Wyckoff to Billings, Nov. 16, 23, 1883; Richardson to A. Flint, Sr., Nov. 24, 1883; Par- vin to Billings, May 28, 1883; all in MS/C/1. Mitchell to Billings, Dec. 1, 1883: NYPL. 34 Letters, Reeves to Billings, May 4, 18, 1883; Robertson to Billings, May 12, 18, Nov. 4, 1883: MS/C/1. Med. News, v. 42 (1883), resolutions of med- ical societies of Pa., p. 563; Mass., p. 702; Conn., p. 634; NY. p. 726; N.H., pp. 746-7; Minn., pp. 748-9. Notice of these resolutions may be found in other medical journals. Printed copy of resolutions of Iowa State Medical Association, dated Dec. 13, 1883; typed copy of resolutions of N.H. Med. Soc, dated Nov. 25, 1883; extract from minutes of annual meeting N.J. Med. Soc.: AMM. 35 Congressional Record 1883, Jan. 5 re pe- tition of Phila. Co. Med. Soc.; Jan. 10, of Med. Soc. Kings Co.; Jan. 13, of N. H. Central Med. Soc.; Jan. 22, of physicians of Beaver Co.; Jan. 26, of R.I. Letters, H. F. Campbell to Billings, Jan. 17, 22, 24, 1883; Chaille to Billings, Dec. 29, 1883; W. H. Geddings to Billings, Nov. 7, 1883; A. Flint Jr. to Billings, Nov. 18, 1883: MS/C/1. 36 See, for example, Louisville Med. News 15: 40 (1883); St. Louis Courier Med. 9: 43-45 (1883); Med News 42: 419-20, 428-30 (1883); Nation, June 7, 1883; Boston Med. Surg. J. 108: 20 (Jan. 4, 1883). 37 Resolution of Amer. Surg. Assn., Med. News 42: 693 (June 16, 1883); Boston Med. Surg. J. 108: 561 (June 14, 1883). Copy of resolution of Amer. Laryngological Assoc., Nov. 27, 1883: AMM. Resolutions of Amer. Library Assn. in Med. News 43: 222 (1883) and Library J. 8: 278 (1883). Letter, Holmes to J. R. Chadwick, May 16, 1883; draft of petition, n.d.: MS/C/1. Four drafts of the AMA resolution, with an attached note in Billings hand re the order of signatures, and an endorsement indicating that 600 copies were printed (undoubtedly for distribution where Billings thought it would do most good) is at AMM. The petition and AMA memorial were re- printed in 48th Cong., 1st sess., Sen. Ex. Doc. 12; in 47th Cong., 2d sess. House Report 1991 to accompany Bill H.R. 7681; in a pamphlet containing Bill H.R. 7681 and Report 1991 to accompany Bill H.R. 7681; and cited in later congressional debate over the building. Resolutions reported in Med Times, June 16, 1883, p. 637, and Med. News, June 9, 1883, p. 657. 38 Letters, Surg. Gen. Crane to Sen. J. R. Hawley, Mar. 1, 1883; Surg. Gen. Murray to Rep. S. M. Stockslager, Dec. 28, 1883; Surg. Gen. Murray to Sen. William Mahone, Dec. 14, 1883; Surg. Gen. Murray to Rep. S. J. Ran- dall, chairman House Comm. on Appropria- tions, Feb. 9, 1885; NA. 47th Cong., 2d sess., H. Report to accompany Bill H.R. 7681, Feb. 28, 1883. 39 Letters, Bayard to S. W. Mitchell, Feb. 5, 1883; J. Mitchell to S. W. Mitchell, Feb. 8, 1883; Johnson to Billings, Dec. 9, 1882; Gibney to Billings, Feb. 2, 1883; MS/C/1. Debate in Senate on Amendment to Army Appropriation Bill H.R. 7077, for purpose of reducing Library- Museum appropriation, Congressional Record, Feb. 22, 1883. Boston Med. Surg. J. 108: 278, 309 (1883). 40 Lucy Salamanco, Fortress of Freedom: the Story of the Library of Congress, (1942), p. 217. 41 Letter, Billings to Poole, Sept. 11, 1882. Poole in reply, Sept. 14, promised to use his influence to keep the Library under control of the Medical Department. Letters in MS/C/1. 42 Billings, to my knowledge, had no proof that "the scientific and medical departments of great national libraries, such as those of Eng- land, France, and Germany, are very little used by scientific and medical men." Of course phy- sicians of Edinburgh, Lyons, Hamburg and other towns preferred the convenience of their local medical libraries rather than travel to London, Paris, or Berlin. Furthermore the rapid growth of the SGL was mostly owing to Billings' exer- tions, not to the preference of American phy- sicians who would have sent him books and jour- nals whether he was housed in Ford's Theatre 158 BILLINGS SEEKS A BUILDING FOR THE LIBRARY AND MUSEUM or the Library of Congress. But Billings' argu- ments sounded reasonable, and he made the most of them. 43 Address delivered April 1883, published in Trans. Med. Chirurgical Faculty Maryland 1883, pp. 58-80, and in Med. News 42: 507-511 (May 5, 1883), and reprinted in Rogers, Selected papers on John Shaw Billings, pp. 149-169. Billings devoted part of his speech, "Libraries in Washington," at the meeting of the American Library Association, Buffalo, August, 1883, to the same argument: Library J. 8: 199-200 (1883). Note that he told his audience that the Surgeon General's Library was "your medical library in Washington." Billings cleverly gained support of the medical profession for the Library on every possible occasion. 44 Column entitled "Sunday Gossip," Wash- ington Sunday Herald, Apr. 1, 1883. 45 "The Medical Library," Washington Sun- day Herald, Apr. 8, 1883. According to this ac- count, Spofford, much earlier, had opposed the formation of other libraries in Washington, but Billings had appealed to him, pointing out that the Library of Congress was already over- crowded, that the museum needed medical books at hand for reference, and that if the Surgeon General's library was to be absorbed ultimately by LC, it would be preferable if the SGL was complete. Since that time the SGL had vastly increased, partially through congressional ap- propriations, but "very largely through the lib- erality of physicians in all countries." 159 X The Library-Museum Building on the Mall Billings Is Nominated as Surgeon General BETWEEN 1881 and 1884 important persons in the Surgeon General's Office died. George Otis, curator of the museum since 1864, passed away in 1881. Surgeon General Barnes, head of the department for almost 20 years, retired on June 30, 1882. Charles Crane, Assistant Surgeon General from the Civil War until 1882 and then Surgeon General, died on October 10, 1883. Joseph J. Woodward, Otis' colleague in the museum, the department's best- known scientist, and president of the American Medical Association in 1882, was in very poor health and died in 1884. Billings alone remained of the officers who had developed the Library and museum from a few books and specimens into collections of national prominence. When Barnes retired a number of physicians and scholars tried to have Billings elevated to the post of Surgeon General.1 Billings felt that his friend Assistant Surgeon General Crane, a competent officer with 35 years service, deserved the promotion. "I did not wish my name to be urged against that of General Crane," he said later, "and wrote decidedly to that effect to my friends, though without much effect."2 After Crane died physicians again pushed Bill- ings' candidacy.3 On this occasion he stated his views to Ezra Hunt, president of the American Public Health Association:4 I have no objection to having my name presented to the President by those who think proper to do so, but I shall certainly not do it myself nor ask, or hint to, anyone else to do it. I presume that Dr. Baxter and Dr. Murray are urging their claims from what I see in the papers ... Dr. Murray is the senior officer of the corps and has two years yet to serve before compulsory retirement. He is in every respect a most estimable gentleman. The difficulty is that if he is appointed the war will break out again two years hence, and the medical corps wants the thing settled once and for all. Moreover the practice of promotion in any medical corps by seniority gives bad results as you know. Now I do not consider that I have any claims to the office any more than any other officer who has done his duty. It is open to all. If I should be appointed I shall do my best for the interests of the Department and of the profession. I cannot say I am anxious for the place, it is a high honor, but it brings with it much responsibility and worry. I am content as I am. I 161 A history of the national library of medicine want to do what is right, and I take the duties nearest at hand. I have always found plenty of them. Now I can only advise you to think the matter over + do what you consider best for the service and the profession. There are other comparatively young men in the corps who will fill the office well. I name Moore, Sutherland, + Huntington. Dr. Baxter you know. Do not be swayed in the least by personal friendship in this matter—it is an important one—and I shall esteem you just as highly if you recommend someone else or if you do nothing. But if you have a decided opinion I think you ought to express it. I have written two or three letters similar to this to friends who have asked me what they should do. I cannot in the least tell them what they should do. I know absolutely nothing as to President Arthur's views nor whether he will make the appointment at once, or wait until Congress meets. To my other correspondents I have simply made one request, which I know is not necessary in your case, viz that they should not attempt to depreciate in any way the other gentlemen whose names are before the President. On November 23, 1883 the President chose Robert Murray, who had joined the army before the Mexican War, when Billings was a boy. Perhaps it was just as well for the Library that Billings was not selected. As Joseph R. Smith, medical director, Department of Texas, told him, "You would make a good chief to our corps. I cannot but fear, however, that if you were appointed your duties as chief would much interfere with valuable bibliographic and scientific work."5 Murray was not a young man and his duties weighed heavily on him. He had to oversee a medical organization whose officers served at more than 150 Army posts and treated more than 40,000 cases a year. There were physical and mental illnesses, epidemics, accidents, suicides, and murders at barracks and forts. Cavalry and infantry fought Indians in the West from Montana to New Mexico—in 1880 there were at least 17 engagements in which soldiers were killed or wounded. All manner of administrative, financial, and profes- sional problems came to rest on the desk of the chief medical officer. Murray divested himself of some of his responsibilities by combining the museum and Library into a single entity called the Museum and Library Di- vision, with Billings as director. This happened on December 28, 1883; there- after Billings was curator as well as Librarian.6 Billings now had more paper work and responsibility for larger funds. He could make or change policy for the museum, and he did this in at least one important direction, by ordering the collecting of microscopes of all styles. Known today as the Billings Micro- scope Collection, this is one of the finest historical collections of specialized scientific apparatus in existence.7 The new position and title gave Billings more prestige in his attempts to gain a building, and it made easier the settling of decisions that arose later during construction. Congress Provides a New Building On December 3, 1883, the 48th Congress convened, and Surgeon General Murray started again on the same path that his predecessors had trod in 1880 162 THE LIBRARY-MUSEUM BUILDING ON THE MALL and 1881 by requesting the Secretary of War to help obtain a new building.8 Secretary Lincoln agreed and sent pertinent reports to the White House, where President Arthur approved and transmitted them to Congress.9 Two days after the session opened Senator Joseph Hawley introduced Bill S. 403, and five days later Representative William Rosecrans introduced a companion bill, H.R. 48, for construction of a building.10 Surgeon General Murray urged Senator William Mahone and Representative Stockslager to vote for the building, but again most of the lobbying was directed by Billings. The latter thought that legislation had a good chance of passing during this session; he told Jerome Cochran, "most of the members [of Congress] appreciate the necessity for it and have evidently had some conversation with their medical constituents on the subject."11 Nevertheless he did not slacken his efforts. He furnished Alexander Hutchins, Brooklyn, New York, information on H.R. 48 for Hutchins to incorporate into his inaugural address as president of the Med- ical Society of the State of New York. Hunter McGuire of Richmond, a prom- inent teacher and future president of the AMA, received a copy of Bill S. 403 from Billings, and wrote about it to Senator Mahone, whom he knew. Frank L. Sim, editor of Mississippi Valley Medical Monthly, convinced Representative Casey Young to favor legislation. Representative Theodore Lyman, who knew Billings, helped persuade Representative William Holman. Henry C. Lea wrote to Representative Samuel Randall. The St. Louis Medical Society prepared another memorial to Congress. Beriah A. Watson, influential surgeon and writer of Jersey City, induced the New Jersey Medical Society to pass resolutions favoring the building.12 At the end of April the American Surgical Association, and in May the American Medical Association, met in Washington. These conventions were attended by hundreds of physicians, a large proportion of them influential in their state and local medical organizations. Billings saw the opportunity for more lobbying. He was to be away at the time, so he gave the following instructions to Assistant Surgeon Washington Matthews, who had been assigned to the museum:13 For about ten days . . . there will be a stream of medical men from all parts of the country visiting the Museum and Library to see everything that is no- teworthy. We shall all have to act as showmen for the time being . . . It is . . . desirable that you should make yourself thoroughly familiar with the condition of the movement to provide a new Library and Museum for this department and with the arguments in favor of it. So far as the printed documents are concerned Dr. Huntington will give you all this and also tell you how the matter stands in the Committees and in Congress. Mr. Myers can show you some of the shocking defects and dangers in the present building which you may have occasion to point out to some visitors. During the spring of 1884 Hawley's bill was reported back to the Senate, amended to increase the apropriation to $300,000 for the building and site and accepted without debate.14 Rosecrans' bill was reported back to the House in July. The proposed building had cleared major hurdles. 163 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE But while the committees on public buildings had been looking over Li- brary-Museum bills, other committees had been working on appropriations. Finally the estimated total of civil and military expenses became so large that members of the House Appropriations Committee were unwilling to add the cost of a new building. James F. Hibberd told Billings that Representative Stockslager had stated that the committee was sympathetic but would not recommend an appropriation. Andrew Nebinger, former president of the Med- ical Society of Pennsylvania, relayed a message to Billings that Representative Samuel Randall had reported that the building might have to be postponed a year or more because appropriations were high. As these legislators predicted, the bills of Hawley and Rosecrans were set aside, not to be reconsidered for many months.15 In January 1885, shortly after the second session of Congress convened, Representative Lyman informed Billings that he and his friends would try to have the rules of the House suspended so they could bring out the bill, and he asked Billings to send a memorandum of the most important arguments for a new building.16 As Lyman promised, Representative Stockslager rose in the House on Feb- ruary 16, had the rules suspended, and brought out Rosecrans' bill. Debate was brief, with proponents emphasizing the unsafe, crowded condition of Ford's, the desire of civilian physicians and medical societies for a new museum-library building, and the money that would be saved by transferring pension clerks from rented buildings. "The most magnificent medical museum and library in the world," said Representative John Follett, "is today exposed in a building where no private individual owning such a library would permit it to remain for twenty-four hours." Opponents suggested that the Library be placed in the proposed Library of Congress building, the museum specimens in the Smithsonian Institution, and the records in the new Pension Building. Representative Orlando Potter prophesied that if the legislation passed, "I think it will end in a national library of medicine, a national collection of medical specimens, and finally in a national college of medicine here at the capital." The bill passed without difficulty by a vote of 121 to 23.17 The Senate had shown by its vote on Hawley's bill that it favored the legislation. Nevertheless Billings' friends continued their pressure. S. Weir Mitchell induced Senator Thomas Bayard to talk to influential colleagues.18 William P. Clarke, on behalf of Mitchell, visited Washington and talked to Senators Eugene Hale and George Hoar. Samuel W. Gross and Henry C. Lea obtained promises from Representative Randall of the House Appropriations Committee to aid if he could.19 The Senate passed the bill quickly on Feb. 26, and it was signed by President Arthur on Mar. 2, two days before he left office.20 164 the library-museum building on the mall Construction of the Building on the Mall The law appropriated $200,000 for a building whose design was to be ap- proved and whose site was to be chosen by a commission consisting of the Secretary of War, Architect of the Capitol, and Secretary of the Smithsonian. Three weeks after the law was enacted, the commission selected a quadrangle of ground on the southeast corner of Seventh and B Streets, S.W., measuring 270 feet along B Street (now Independence Avenue) and 170 feet along Seventh Street.21 During months that followed the commission approved the plans and the government advertised for bids for construction. The firm of Bright & Humphry received the contract on a low bid of $179,987.22 Construction pro- ceeded under the eyes of Colonel John Wilson and Lieutenant Colonel Thomas Lincoln Casey, who would become Chief of Engineers. As the work went along Billings was asked to decide such details as the color of the interior walls and concrete floor. He designed the heavy, 25-foot-high iron book stacks, which were fabricated in Trenton, New Jersey, and shipped to Washington.23 Construction was slower than expected because, in the opinion of the en- gineer officers, Bright & Humphrey subcontracted much of the work.24 The building was not ready by the expected time, February 1, 1887, and the pension records and clerks had to remain in the F Street building, forcing the govern- ment to continue to pay rent. Finally the officers compelled the contractor to complete floors and rooms in a certain order so that the Pension and Record Division could move in, even though carpenters and laborers were still scamp- ering around on scaffolds. Among the economies practiced by the builders was the use of secondhand brass knobs on the front doors. These knobs lettered "Public School City of New York" were still giving visitors a laugh three-quarters of a century later. By the time the building was finished inside and out, Congress had appro- priated $245,550; $200,000 in the original act, $38,050 on August 4, 1886, for iron stacks, museum cases, gas fixtures, and furniture, and $7,500 on March 3, 1887, for additional items. The completed structure consisted of a building 112 feet long and 55 feet wide, connected to two wings, each 60 feet along the front and 131 feet from front to back. The center was four stories high above the basement and was divided into offices and workrooms. The first floor of the museum wing contained rooms for scientific work. Above was Museum Hall, 47 feet high from floor to peak, with a gallery circling the hall. The first floor of the library wing was occupied by pension files—it was expected that as time went by and the use of Civil War records decreased, the files could be moved to storage and the first floor be taken over by the Library. Above was the large Library Hall with its bookstacks, desks, and chairs. Both wings could be sealed off from the center building in case of fire, although the entire structure with its brick walls, concrete floors, and ironwork was practically fireproof.25 165 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The Library-Museum building shortly after it was completed. Trees had recently been planted along B street, now Independence Avenue. The Library had no artificial illumination. Light entered through 18 side windows, each 16 feet high and 5 feet wide, through large windows at the front and back, and a clerestory. Lighting proved to be adequate except on overcast, stormy days. There were gas lights in the rooms in the center section and in the large room under Library Hall. Later, in the early 1900s the building would be wired for electricity, but inadequately; in Library Hall only four droplights, consisting of incandescent bulbs with green metal shades over them, would be installed. The building was heated by hot air flowing through ducts and registers from a coal-fired steam boiler. Rooms in the center section had fireplaces in which clerks could burn wood in the winter.26 Library Hall was so cavernous that it proved impossible to warm adequately on extremely cold days. The cast iron book stacks were three levels high, 7 feet 9 inches between levels. The cast iron floors were perforated to allow light to pass through so that messengers would be able to read titles on books. But the light was found to be so dim after the books were emplaced that messengers had difficulty deciphering titles; later, after flashlights were invented, they used these handy 166 THE LIBRARY-MUSEUM BUILDING ON THE MALL Back of the building. The Library wing is on the right, Museum on the left. appliances. Shelves were oak. The estimated capacity of the hall's 22 stacks was 150,000 volumes. Some of the furniture came from Ford's, the remainder was new. It rep- resented the standard office and library equipment of its time, including 11 revolving bookcases, 11 hatracks, 5 water coolers (filled with ice and water each morning), 11 washbowls and pitchers, 78 spittoons, 11 library tables, 42 office revolving chairs, 277 stationary chairs and 4 typewriters (typewriters were still primitive and were not in general use).27 In the original design a small one-story structure projected from the center rear of the main building to house the boiler, toilets, and lavatories. Billings eliminated this structure when Congress reduced his estimate from $250,000 to $200,000. After Bright & Humphrey offered to erect the main building for 8179,987, there remained $21,013. At Billings' request this was applied toward the cost of a small two-story annex, 52 feet long and 24 feet wide, in the rear courtyard, joined to the main building by a covered walkway. In the basement of the annex were placed steam boilers, pumps and coal bins, on the first floor toilets and lavatories, and on the second a pathological and a biological labo- ratory.28 Library buildings of the late 19th century were generally designed for classic beauty or in a style that agreed with the architectural taste of the day rather than as practical work places for readers and librarians. Billings did not do this; he based the design of his building on its function. How much, if any, he may have influenced later library builders is not known. The Library-Museum Build- ing had flaws not anticipated by Billings but revealed by time and use. 167 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The Move From Fords Theatre The transportation of books, journals, museum specimens, scientific ap- paratus, and other items from Ford's Theatre began in August 1887 and lasted for several months. On August 16 Billings packed up his papers in Ford's and moved to the new building.29 The next day Library clerks began packing books into wooden boxes and lifting them onto a wooden chute which extended from a second story window of Ford's out over the sidewalk to the curb. The boxes slid down the chute to a waiting dray, were caught by draymen and stacked in order. For many days Washingtonians could see wagon loads of crated books being hauled by teams of horses down Tenth Street toward the building on the mall.30 On August 31 the last of the books and staff left Ford's Theatre. In the afternoon a clerk opened the Register and wrote in the margin: "First entry in the new building." Then he accessioned Leon Buczwinski's Poradnik Wetery- naryjny (Veterinary Advisor), assigned it number 119,109, and jotted this re- minder: "In the new building. Aug. 31st 1887. (2 p.m.) cool + pleasant."31 After the Library and museum departed from Ford's Theatre the govern- ment did not close the building but moved in hundreds of clerks and continued to use it for the Record and Pension Division. It is a pity that Congress and the Administration did not heed the warnings of Billings and his associates that the structure was unsafe, for during renovations a few years later on June 9, 1893, the interior collapsed, crushing 22 persons to death and injuring 68 others. Had the Library and museum still been in Ford's they would have been badly damaged, and today there might not be a National Library of Medicine.32 The development of the Surgeon General's Library from a collection of a few hundred volumes whose existence was scarcely known outside the Army Medical Department into the largest, most diversified medical library in America, housed in its special fireproof building, known throughout the Western world through its Index-Catalogue, within a time span of a quarter of a century, was a remarkable achievement by Billings. But it was possible only because his superior officers, Surgeons General Barnes, Crane, and Murray, were good managers who delegated authority to him, allowed him to proceed in his own way, and backed him with their influence when he needed it. And perhaps it was possible only in the tightly knit profession of medicine, with its network of communications based on meetings, journals, and transactions, its members disseminated throughout the United States, and its influential personal rela- tionship between physician and patient. Billings' feat in obtaining a building from Congress within a period of 7 years is all the more remarkable because he was involved in so many other activities, among them the American Medical Association, the National Board of Health, the American Public Health Association, over which he presided in 1879-80, the international medical congresses of 1881 and 1884, the construc- tion of Johns Hopkins Hospital, the design of an Army-Navy hospital at Hot Springs, Arkansas, in 1882, lecturing at Johns Hopkins and Columbia, and 168 THE LIBRARY-MUSEUM BUILDING ON THE MALL Interior of Ford's Theatre after a portion of the interior collapsed. On the second floor, right, may be seen a balcony and shelves, probably left behind when the Library moved. The Library and Museum were fortunate; one may imagine how badly they would have been damaged had they remained in the building. 169 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE writing more than a score of articles. He even tried his hand at research, in collaboration with Washington Matthews, making composite photographs of skulls in the museum. And while he left the routine operation of the Library and museum to others, he had to concern himself with the finances, purchases of unusual items, and the adjudication of unusual matters that arose. The Library in the New Building In the new building books and bound periodicals were shelved in Library Hall, current and recent journals in an adjacent room in the center section called the reading room. While Billings was preparing to move from Ford's he devised a new classification for monographs. He divided medical literature into 30 groups, as anatomy, anthropology, biography, biology, and so on, and many of the groups into subgroups, as circulatory system into aneurysm, apoplexy, blood, hemorrhage, heart, pulse, and sphygmograph. Within each group books were placed alphabetically by author.33 When the library was moved, Billings had volumes arranged in the new stacks in a manner most convenient for the clerks and messengers, works used most often being placed on the ground level, those called for least often on the top level. On the ground, first, or A level were placed bound medical periodicals by countries, transactions of societies by localities, folios, bound French dis- sertations by universities, and miscellaneous literature. On the second or B level were placed monographs, unbound dissertations by universities, and bound chemistry, pharmacy, dentistry, and veterinary periodicals. On the third or C level were placed Japanese and Chinese books, incunabula, manuscript vol- umes, bound and unbound pamphlets, scientific periodicals, and documents. Billings considered designating each monograph by a double number, the first part being the accession number, the second a number indicating the book's place in its subgroup.34 Apparently he concluded that a double number was more than was needed, and instead he used a short combination of letters and numbers that told the book's location in the stacks. For example, A, 1, 3, 5 meant level A, range number 1, compartment or section number 3, shelf number 5 (from top).35 Later the designation was modified somewhat, as A27/s- 2 meant A level, 27 compartment, 5 shelf, 2 partition. The number was not painted on the spine but written on a label pasted inside the front cover. Billings, Fletcher, and the clerks occupied rooms in the center section of the building. More than half the remaining rooms in the center were assigned to museum employees, officers in charge of pension records, and other officers of the Surgeon General's office.36 The staff now consisted of a Librarian, Billings; a principal assistant librarian, salary $2,250 a year, Fletcher; a contract surgeon, Wise; 18 clerks, and 1 or 2 messengers. The principal assistant librarian took charge when the Librarian was away, and had more or less general supervision of the preparation of the Index-Catalogue (depending upon the amount of responsibility the librarian, 170 the library-museum building on the mall the official editor, wished to delegate). In the 1890s an assistant librarian would replace the contract surgeon. Of the clerks (class I, $1,200; class II, $1,400; class III, $1,600; class IV, $1,800), one had general charge of library operations, one handled accounts and correspondence, one was in charge of the reading room, one prepared volumes for binding, two (assisted by messengers) ran Library Hall, three accessioned and cataloged, four prepared copy for the Index- Catalogue, and five carded and indexed for the Catalogue. The number of readers each day or year is not known precisely. Beginning in 1888 a register, in which visitors were asked to sign their names, lay open on a desk in Library Hall, but some visitors did not see it or ignored it.37 Army and Navy medical officers, of which there were many, were not required to sign. Some reseachers and writers came to the Library every day for months but signed once or infrequently. It was estimated that 5,000 readers used the collections each year. A visitor to the Library consulted the Index-Catalogue (and Index Medicus if need be). If absolutely necessary, with permission from the Librarian or principal assistant, he could consult the card catalog into which indexers con- tinually filed subject and author cards for the printing of future volumes of the Index-Catalogue.38 The editors were reluctant to allow patrons to handle the cards for fear they might withdraw or misfile one. After the visitor chose the titles he filled out a form for each volume he desired and handed it to the clerk. A messenger located the volumes in the stacks and carried them to the patron. Upon leaving the Library the reader returned the volumes and received the form. Few books were stolen. Thomas S. Cullen of Johns Hopkins, who visited the Library frequently, remembered the institution thus:39 In January 1892 I became an intern in the Department of Gynaecology, under that wonderful surgeon, Howard Atwood Kelly. Dr. Kelly ran into many interesting and unusual cases and suggested that his assistants publish these. We adopted his suggestion and before long some of us found out that much time could be saved by running over to the Surgeon General's Library in Wash- ington to look up the literature on a given subject. The university had made an arrangement with the Baltimore and Ohio Railroad whereby the members of the hospital staff who desired to visit the Washington library could buy round trip tickets for a $1.25. This was a great help to those of us who had little or no money. Before the Washington Union Station was built, the B. and O. Station was about four squares further downtown and from there we easily reached the library which was then and still is at the corner of 7th and B. In later years, many of us went by the Pennsylvania Railroad, got off at 6th street, left the station by the back way, walked across the lawn and in two or three minutes were at the library. Frequently, before going to Washington, we would consult the Index-Cat- alogue and later the Index Medicus, to see what had been written on a given subject. Upon reaching the library, we would go to the reading room and write out on separate cards the books that we desired. Seated at a desk in the reading room was a frail looking man with curly white hair. He had at one time edited a small paper in his home town and later came 171 A history of the national library of medicine to Washington and took charge of the reading room in the Surgeon General s Library. Harry O. Hall was one of the most accommodating men I have ever met and all of us who used the library had a very warm spot in our hearts for him. He would collect our cards, take them out and give them to the men in the stacks. The majority of these men were old and rather feeble but they, too, rendered excellent service. We invariably went back to original sources; for example, if a man reported a case and then analyzed the records of twenty other cases, we just abstracted the case of the author in question and while doing this Mr. Hall and his associates looked up the twenty articles referred to in the article we were studying. In this way we were able to see the pictures accompanying each article and, at the same time, could draw our own conclusions as to the exact condition in each case. We of the medical profession owe much to those men who were so patient and who cooperated with us in every possible way. ***** For years on one Saturday afternoon each year I would take over a Penn- sylvania Railroad carload of fourth year students to the Surgeon General's Li- brary. Colonel John S. Billings would then give us a clear picture of how the library started and of what it now contained, and would tell us how best to use the library. No one else was better able to give us this information, as it was Dr. Billings himself who was largely responsible for this wonderful library. As in Ford's Theatre Billings would not permit patrons to roam the stacks of the new building. His rules were posted for all to see:40 No persons, except the employes of the Library, will be permitted to take down books from, or replace them on, the shelves. Whenever a book is taken from a shelf, and is not to be immediately returned, a card must be put in its place showing where it has gone. All persons other than Library employees wishing to examine books on the shelves, must apply to Dr. Wise for permission, and will be accompanied either by Dr. Wise or by one of the employes of the Library Hall while they are in the alcoves. Such permission will be granted only in special cases and for good reasons. Experience has shown that the allowing persons other than the Library employes to enter the alcoves, gives rise to disarrangement of the books and to possible loss. For local readers who wished to borrow books, Billings posted another set of rules:41 The Library of the Surgeon General's Office, U.S. Army, is a reference, and not a lending Library. To aid the researches of physicians residing at a distance, certain books are sometimes loaned for short periods, but, as a rule, it is expected that physicians residing in the District will consult the books which they wish to see at the Library itself, where every facility will be given them for that purpose. Books will not be loaned to under-graduates in medicine. Unbound books and pamphlets and common text books, manuals, and compends will not be loaned. No book which cannot be readily replaced if lost or injured is to be loaned, and the Officer in charge of the Library is instructed to require in each case of loan a deposit of money amply sufficient to replace the book if lost or injured. 172 the library-museum building on the mall Library Hall on a quiet afternoon shortly after the building opened. At the desk on the left is Thomas Washington Wise, in charge of library operations. Working at a table on the right is John Shaw Billings. At the right end of the stacks is a dumb waiter, used to move books up or down. Library Hall and the rest of the building were kept neat and tidy in contrast to later years when it became crowded, dirty, and run down. It was swept and dusted every day, and floors were mopped once a week. Spitting on the floor was forbidden; signs on the wall prohibited it. But spittoons were distributed liberally about the building until at least the World War I era, and janitors had orders to "wash all spittons in very hot water" every morning. Readers were permitted to smoke, although the staff objected to the leaving of smoldering cigars or cigarettes on tables instead of in ashtrays. Billings, Fletcher, Wise or others had arranged exhibits at least occasionally on the crowded second floor of Ford's. Now with more space available they set up exhibits frequently, sometimes for national medical or scientific meet- ings, for commemorative or historical purposes, or on special occasions, as the display of the publications by and about Florence Nightingale following her death in 1910.42 In Ford's Theatre the Library had been too crowded to be used as a hall for scientific and medical meetings, but the museum had served the purpose. 173 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE On the evening of a meeting clerks pushed the moveable museum cases to the side, leaving a large open area in which they placed rows of chairs facing a table for the speaker. The Cosmos Club held its charter meeting there, the Chemical Society of Washington was organized in the building, and the Phil- osophical Society of Washington met there. The new building was much more spacious than Ford's. Billings and his succesors regarded the use of their facilities by societies as another service to the public. They were very liberal in granting permission for local and national groups to assemble there, among them the American Medical Association, Congress of American Physicians and Surgeons, Association of American Phy- sicians, American Pediatric Society, and Medical Library Association. The inaugural meeting may have been the Congress of Physicians and Surgeons in 1888. Billings presided over this gathering. His personal guest was an influential German physician Friedrich von Esmarch, whose wife was a princess. During a reception the princess asked one of the old retired soldier clerks, assisting with the refreshments, for champagne. The staff had only prepared nonalcoholic punch. The clerk sidled up to Fletcher and asked nerv- ously, "Doctor, what shall I do, the Princess asked for champagne!" Fletcher whispered calmly, "Give the lady what we have, she will understand." And so she did. The First Intruder in the Library-Museum Building: The Army Medical School Billings expected that the new building would remain the uncluttered home of the Library and museum, with free space into which both units could expand in an orderly manner as time passed by. This is the way events proceeded until 1893. Then George M. Sternberg, one of the greatest and most productive American bacteriologists, was appointed Surgeon General. One of Sternberg's first acts was to establish a graduate school for new officers. Aside from good reasons for instructing young officers in certain branches of medicine, Sternberg was probably permitted to set up this school because it did not cost the Army anything. He placed the school in the Library-Museum Building, obtaining instructional materials from Medical Department supplies, and appointed older, experienced officers as teachers. Two large rooms on the museum side of the building were converted into bacteriological and chemical laboratories, the museum specimens being placed in storerooms. Office space for the faculty was set aside in adjacent rooms. Instruction began in November 1893. The course was 4 months long. Walter Reed, curator of the museum, lectured on clinical and sanitary microscopy, Sternberg on bacteriology, Billings on military hygiene, Fletcher on medical jurisprudence, and several other officers on different subjects. This small, makeshift organization developed into an excellent school, the first school of public health and preventive medicine in the United States. If the intrusion of the Army Medical School into the building had been 174 the library-museum building on the mall temporary, the major tenants might not have suffered; but the school was to remain for a generation, eventually squeezing the Library and museum se- verely.43 Billings' Last Days at the Library In 1889 Henry C. Lea, a wealthy publisher and property owner of Phila- delphia, listened to the persuasions of William Pepper, provost of the University of Pennsylvania, and promised to donate money for the erection of a laboratory of hygiene under certain conditions; these included the raising of an endowment by the university and the hiring of Billings to direct the laboratory. Pepper almost immediately rode the train to Washington and pressed Billings to accept the job, which Billings did under conditions.44 The completion of the Index- Catalogue was one of Billings' goals and he would not leave Washington yet, but he agreed to resign from the Army, move to Philadelphia and join the university after it was finished. During the interval he would, if the Surgeon General permitted, plan the laboratory, direct the university hospital, and lecture on hygiene and vital statistics. The Surgeon General, almost always cooperative in the professional advancement of his colleagues, allowed Billings to assume these outside tasks. The university appointed Billings director of the hospital as of January 1, 1890. Officers of the Army Medical Department and Public Health Service stationed in Washington occasionally taught in medical schools of the city, but Billings may have been unique in directing a hospital 125 miles away. While Billings was being recruited by the University of Pennsylvania, the time approached when Surgeon General John Moore would reach the com- pulsory retirement age of 64. Prominent physicians urged President Harrison to appoint Billings to the post. Oliver Wendell Holmes told the President that Billings was "one of the very ablest men I have ever known in the medical profession," and S. Weir Mitchell called him "the most distinguished surgeon the Army medical corps has produced."45 But Billings' opponent was Jedediah Baxter, slightly higher on the seniority list and, more importantly, a personal friend of the Secretary of War and physician to the President. Billings never had much of a chance. Baxter was appointed on August 16, 1890, the day Moore retired. Baxter was only 53 and expected to be Surgeon-General for a long time, but he was felled by a stroke only 4 months later and died on December 2, 1890. ^ Billings' supporters again pushed his candidacy, but President Harrison looked at the seniority list and selected the ranking officer, Charles Suther- land.47 This was the last time that Billings allowed physicians to mount a cam- paign to persuade a President to appoint him Surgeon General of the Army. Bilhngs began to lecture at the University of Pennsylvania in the autumn of 1891, and he planned the laboratory, which opened in February 1892.4H Busy as he was with the Library and museum, editing the Index-Catalogue and Index Medicus, and engaging in other matters (as assisting the Census 175 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Bureau with the census of 1890), he found time to direct investigations in the new laboratory49 and plan the William Pepper laboratory for research in clinical medicine, opened in 1895. ^ In the spring of 1895 Billings finally finished his "labor of love," as he called the Index-Catalogue. Without the local fanfare or publicity that might be ex- pected to accompany the departure of the department's most widely known officer, he relinquished control of the Library and Museum Division on August 20, 1895.51 He moved to Philadelphia and into a house he had purchased in the center of town on October 1, 1895, the day he retired from the Army. Not long afterwards, a survey of 120 medical literature collections in the United States showed that the Surgeon General's Library had leaped ahead of all other medical libraries. It contained approximately 124,000 volumes and 210,000 pamphlets compared with the closest, the library of the College of Physicians in Philadelphia, started in 1788, with 54,000 volumes and 34,000 pamphlets, and the library of the New York Academy of Medicine, 1847, with 50,000 volumes and 15,000 pamphlets. Newberry, a general library in Chicago followed with 30,000 volumes and 25,000 pamphlets. The size of lesser libraries dropped rapidly with more than 90 percent having fewer than 10,000 volumes and more than half fewer than 3,000 volumes.52 Before Billings arrived the Library had received an occasional gift or ex- change. After 1871 gifts and exchanges had become commonplace. Statistics kept from 1886 onward show that from 5 percent to 50 percent of the books acquired annually were donated.53 In 1895 it was estimated that one-sixth of the Library's books and pamphlets had been acquired by gift or exchange. By then the Library owned 73,475 books, 135,844 pamphlets, and 2,614 volumes of pamphlets, each volume containing several pamphlets;54 Therefore, 11,912 books, 22,640 pamphlets, and 435 volumes of pamphlets had been acquired in these manners, assuming the same proportion of each. "There are few medical writers now living who have not sent to the library at least one pamphlet." Billings wrote in that year.55 In a quarter century Billings had developed the largest medical library on the continent, perhaps in the world; had made it the most widely used library, available to tens of thousands of physicians; and had furnished guides, the Index-Catalogue and the Index Medicus, to the world's good medical writings. The SGL was the largest special research collection in the United States in any branch of learning, with possible exception of two or three libraries devoted to history. Billings had not done this without help; officers of the Medical Department had supported him, his co-workers in the Library had followed where he led, and Congress had provided him with more funds, up to $10,000 a year for literature alone, than the trustees of any other medical library in the country gave their librarians. But Billings was the brain that directed the body, and without him the Library of the 1860s might have remained a small de- partmental collection used mainly by Army officers, and there might not have 176 THE LIBRARY-MUSEUM BUILDING ON THE MALL been finding aids comparable to the Index-Catalogue or Index Medicus until a later era. Expansion of the Library During the Billings Era (Billings Became Librarian in the Fall of 1865) Date Volumes Pamphlets October 23, 1865 2,282 June 12, 1868 6,984 June 30, 1871 "about ' 14,000 June 30, 1872 "about ' 19,000 7,000 June 30, 1873 "about ' 25,000 15,000 June 30, 1878 "about ' 46,000 50,000 June 30, 1879 "about ' 49,000 53,500 June 30, 1880 "about ' 51,500 57,000 June 30, 1881 "about ' 54,000 60,200 June 30, 1882 "about ' 57,000 63,700 June 30, 1883 "about ' 60,900 68,700 Date Bound Volumes June 30 Journals Transactions Theses Pamphlets Books 1884 22,050 3,229 1,385 -1,149 37,925 1885 23,039 3,440 1,385 1,213 43,412 1886 24,116 3,532 1,385 1,331 46,368 1887 25,337 3,649 1,385 1,562 53,192 1888 26,891 3,766 1,385 1,768 55,602 1889 28,009 3,981 1,531 1,818 58,612 1890 29,017 4,156 1,574 1,925 61,214 1891 30,048 4,305 1,574 2,039 64,003 1892 31,212 4,504 1,663 2,073 67,748 1893 32,215 4,699 1,663 2,258 69,818 1894 33,297 4,913 1,663 2,604 72,090 1895 34,345 5,067 1,762 2,614 73,475 Unbound Volumes Total Date Other Total June 30 Theses Pamphlet s Volumes Pamphlets 1884 38,583 47,920 65,738 72,219 1885 40,524 55,399 72,719 95,923 1886 42,212 64,419 76,732 106,631 1887 45,279 74,374 85,165 119,653 1888 47,894 82,756 89,412 130,614 1889 49,785 91,199 93,951 140,984 1890 49,407 99,670 97,886 149,077 1891 50,801 104,520 101,969 155,321 1892 53,442 112,564 107,200 166,006 1893 53,693 119,137 110,653 173,100 1894 56,218 127,560 114,567 183,778 1895 57,187 135,844 117,263 193,031 Sources: Catalog of October 23, 1865; catalog of June 12, 1868; annual reports of the Surgeon General, 1872 to 1895. 177 a history of the national library of medicine Billings Develops the New York Public Library As Billings' career in the Army was drawing to a close, the trustees of the recently founded John Crerar Library in Chicago were searching for a person to organize and develop an institution to be erected according to the provisions of Crerar's will. Francis A. Walker, president of Massachusetts Institute of Technology, recommended Billings as the56 one man in the country who above all others has qualifications for the position . . . easily the best medical bibliographer in the world . . . one of our best men of science; one of the most useful men living—practical, sensible, popular. To have such a man as Billings at the head of any great public library would command at once success in the very highest degree. But Walker also stated that he assumed Billings was not available, and I doubt that Billings was made aware of the search being conducted for a librarian. If the trustees had approached him instead of accepting Walker's conclusion and passing him by, it is conceivable that Billings might have accepted and spent the last years of his life in Chicago. As matters turned out, later that year, 1895, Billings was offered and he accepted the directorship of the New York Public Library system. The system had been created in the spring of 1895 through the merger of the Lenox and Astor libraries, and with funds from the Tilden Trust. A trustee, John Cad- walader, was the brother-in-law of S. Weir Mitchell, Billings' best friend. Mitchell told Cadwalader about Billings' abilities and achievements. In De- cember 1895 the trustees listened to Cadwalader's recommendation of Billings and voted to hire him as director. Billings had now been associated with the University of Pennsylvania for 5 years; and even though he liked his duties, he found, when he was offered the opportunity to resume library work, that he liked the latter more. He was embarrassed at leaving Philadelphia so soon after arriving, but he arranged with the university to remain until the end of the school year, June 1, 1896. Billings was 58, at an age when many persons consider retiring, when he undertook the management of the complex, fragmented, sprawling New York City library system. As he had planned the building for the Medical Depart- ment's Library and Museum, so in 1897 he drew up a memorandum giving his conception of a central library building for New York, showing its dimen- sions, lighting, heating, ventilation, service facilities, rooms, book capacity, and estimate of cost. He made a rough drawing of the floor plan. Based on his ideas the present main building of the New York Public Library was erected between 1902 and 1911. And as he had done in the SGL, he devised a clas- sification scheme to encompass the volumes in the reference department, formed by the union of the Astor and Lenox libraries, and had the volumes recataloged and rearranged on the shelves. He began a card catalog to encompass the holdings of all the separate libraries. As he had done in the SGL, he began the practice of indexing selected articles, taking home periodicals each night and checking articles for an indexer to catalog the next day. These subject cards 178 THE LIBRARY-MUSEUM BUILDING ON THE MALL were interspersed in the catalog and were very helpful to researchers in the humanities and social sciences, for at that time there were few published indexes to periodicals.57 On visits to Washington Billings stopped at the Library to see his old associates. He kept an eye out for publications the Library did not have,58 he gave advice when asked for it, he initiated exchanges between the SGL and NYPL, and he used his influence on behalf of the Library when it was needed, as when there was talk of decreasing the congressional appropriation in 1901. As in Washington, be became active in matters outside the NYPL. He was one of the incorporators of the Carnegie Institution in 1902 and was thereafter chairman of the board of trustees. He was associated with the medical statistics of the census in 1900 and 1910. He planned the Peter Bent Brigham Hospital in Boston, and advised the city of Memphis, Tennessee, on a new hospital. He wrote literary and professional articles. He presided over the American Library Association in 1902. He gave advice to libraries, among them a library in Tokyo and one at Harvard. He was one of the founders of the Charaka Club for history of medicine. He was one of the Committee of Fifty, for the investigation of the physiological effects of liquor. One of the remarkable qualities of Billings is that he accomplished much of his work while in poor health. His health began to deteriorate when he was in his forties. He had neuritis in his right arm. He was operated upon five times for cancer of the lip. He had trouble with his teeth. He suffered from gallstones and underwent operations.59 He never complained; not even his wife knew of some of his operations until he returned from the hospital. Fielding Garrison never heard him mention any of his operations, only a casual remark about a rib that he broke when he fell in a jolting railroad car. On March 11, 1913, Billings died of pneumonia following an abdominal operation at New York Hospital. Three days later he was buried in Arlington Cemetery, where lay several of his associates from the Library and museum, among them his old friend and collaborator Robert Fletcher. Of all the good things said about Billings perhaps none was more accurate than the assessment by Garrison years later:60 "Billings was unique in the Surgeon General's Library, but then, he was virtually an all-around superman, who has certainly had no equal." Notes 1 Oliver Wendell Holmes, Harvard Presi- dent Charles Eliot, MIT President William B. 2 Draft letter, Billings to Ezra M. Hunt, Oct. Rogers, William Pepper, George E. Waring, 13, 1883: MS/C/81. Jr., S. Weir Mitchell, Justin Winsor, Henry 3 Some of Billings' friends had printed an Bowditch and other prominent persons urged eight-page pamphlet "Brief upon the Surgeon President Arthur to appoint Billings to the post. Generalship of the Army," extolling Billings, Their letters and printed petitions signed by the and sent a copy to the White House. A copy of faculties of Johns Hopkins, University of Vir- this pamphlet and letters to the President and ginia, and other persons are in N A, copies in the Secretary of War from influential physicians MS/C/273. are in NA, copies in MS/C/273. 179 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 4 Draft letter, Billings to Hunt, Oct. 13, 1883: MS/C/81. 5 Letter, Smith to Billings, May 25, 1882: NYPL, copy in MS/C/276. fi After Billings left the Medical Department in 1895 there were periods when the director- ship of the Museum and Library Division was vested in one person and times when there were a curator and a librarian, separately. 7 The museum already had microscopes pur- chased for use by Woodward and other scien- tists. Billings began to purchase them for pur- poses of history. s Letter, Murray to Secretary of War Dec. 3, 1883, sending estimate of funds needed for building and a copy of pamphlet containing res- olutions of the AMA: NA. The letter and pam- phlet were printed in Senate Exec. Doc. 12, 48th Cong., 1st sess. 9 48th Cong., 1st sess., Senate Exec. Doc. 12. This document contains letters of Murray, Lincoln, and the President; a reprint of Sen. Exec. Doc. 65, 47th Cong.; Bill H.R. 7681 and accompanying report 1995, 47th Cong.; letter, from Gross, Flint, and Holmes to the AMA, along with the AMA resolution and memorial; and three architects' plans of the building. 10 48th Cong., 1st sess., Bill S. 403, Dec. 5, 1883. Bill H.R. 48, Dec. 10, 1883, introduced by Rosecrans. A month later Rep. Robert Davis introduced a similar bill, H.R. 2272, Jan. 7, 1884. 11 Letter, Billings to Cochran, Dec. 22, 1883: MS/C/81. 12 Letters, Murray to Mahone, Dec. 14, and to Stockslager, Dec. 28, 1883: NA. Inaugural address of Hutchins, Feb. 5, 1883, Trans. Med. Soc. State of New York, 1884, p. 11. Letters, McGuire to Billings, Jan. 14, 1884; Young to Sim, Jan 18, and Sim to Billings, May 27, 1884; Lyman to Billings, Feb. 7, 1884; J. V. Ingham to Billings, n.d., re Randall; W. W. Watkins, St. Louis, to Billings, Jan. 18, 1884; Watson to Billings, sending preamble and resolutions, Apr. 24, 1884; Hutchings to Billings, Jan. 8, 1884: MS/C/1. 13 Letter, Billings to Matthews, Mar. 18, 1884: MS/C/81. 14 Hawley s Bill S. 403 was reported to the Senate May 28, 1884, and was amended and passed June 3 (Congressional Record, p. 4603, 4766). 15 Letters, Hibberd to Billings, May 11, 1884; Henry C. Lea to Billings, quoting Randall, June 7, 1884; Randall to Nebinger to H. C. Wood to Billings, June 14, 1884: MS/C/1. 16 Letter, Lyman to Billings, Jan. 14, 1885: MS/C/1. 17 Debate, Congressional Record, Feb. 16, 1885, pp. 1767-1770. 18 Letter, Bayard to Mitchell, Feb. 25, 1885: Billings papers, NYPL, copy in MS/C/276. 19 Letters, Clarke to Mitchell, Feb. 10, 1885; Randall to Gross, Feb. 24; Randall to Lea, Feb. 20: MS/C/1. 20 Congressional Record, Feb. 26, 1885, p. 2117; Mar. 3, p. 2569. 48th Cong., 2d sess., Public Law 62, U.S. Statutes at Large, Ch. 315. 21 Letter, Secretary of the Smithsonian to Surg. Gen. Murray; records SGO, letters re- ceived, file 4938/1880, NA. Washington Star, Mar. 26, 1885. This site had been recommended by Sen. Morrill and other senators on the Com- mittee on Public Buildings: Congressional Re- cord, Feb. 25, 1885, p. 2117. 22 Washington Republican, Aug. 19, 1885. 23 Letter, Wilson to Surgeon General, June 18, 1887, with draft reply in Billings' handwrit- ing for the Surgeon General's signature: NA. The stacks were made by Phoenix Iron Works, with Billings supplying the blueprints. It has been said that these were the third metal stacks in the United States, preceeded only by those in Boston Athenaeum and Harvard libraries. 24 There were at least 34 subcontracts ac- cording to a list in NA. 25 Details about the interior and exterior of the building, its dimensions and fixtures and uses of rooms may be found in: "News Item," Med. News 49: 330-334 (Sept. 18, 1886), with drawing of the building: Library J. 12: 394 (1887) (information provided by Billings): "A Medical Palace," New York Herald June 30, 1889, copy in MS/C/47; Charles Smart, "The Army Medical Museum and the Library of the Surgeon Gen- eral's Office," Military Service Institution United States 19: 277-279 (1896), and JAMA 24: 577- 580 (1895): Joanna R. N. Kyle, "The Army Med- ical Library and Museum," Godey's Mag. 136: 408-418 (1898): Amer. Architect Jan. 16, 1886: Robert S. Henry, The Armed Forces Institute of Pathology. Drawings and photographs are in MS/C/47. Three plates showing elevations and floor plans of the building are in 47th Cong., 1st sess., Sen. Exec. Doc. 65, and in 48th Cong., 1st sess., Sen. Exec. Doc. 12; copies in MS/C/ 47. In the museum letterbook for this period in Otis Archives, AMM, are many letters from Bill- ings to merchants and manufacturers, asking for bids to supply furnishings for the new building. From the letters can be ascertained everything that was bought, from gas light fixtures to win- dow shades. This was the first building in Washington designed specifically for library purposes. 180 THE LIBRARY-MUSEUM BUILDING ON THE MALL 86 These fireplaces were used at least into the 1920s. 27 All of the furnishings of the building from awnings (26) to linoleum (744 Vi yards) to wheel- barrows (2) to ladders (31) were inventoried each year, 1887 to 1915. Inventories are in MS/C/ 307. 28 Draft letter, Surgeon General to Secretary of War, Sept. 29, 1885: NA. The letter was writ- ten by a clerk and changes are in Billings' hand- writing. 29 A clerk with a sense of history noted in the margin of the accession book, "Register Cat- alogue of Books," No. 10, p. 296; "Aug 16/87. Dr. B. Com[menced] to move to new B[uilding]." Details of the move of the Library, Museum, and Pension and Record Division may be found in correspondence in letterbooks in Otis Ar- chives, AMM. 30 "Register Catalogue of Books," No. 10, p. 297: "Aug. 17th, 1887. The Force down to mu- seum helping pack books, etc. Aug. 17th, 18th, & 19th." A reporter's view of the move is in Wash- ington Evening Star, Aug. 20. 31 "Register Catalogue of Books," No. 10, p. 306. 32 A photo by Brady of the interior of the building in July 1893, after the collapse, is on p. 76 of Olszewski, Restoration of Ford's The- atre. From this photo a person may visualize the damage that would have been done to the Library had it remained in the building. 33 Fielding Garrison listed all groups and subgroups in "Classification and Arrangement of Books in the Library of the Surgeon General's Office," Bull. Assoc. Med. Librarians 1: 70-84 (1902). 34 Letter, Billings to P. C. Fisher, Coll. Phys., Phila., Nov. 13, 1886. MS/C/81. 35 The system of indicating the location of a volume by case, shelf, tier, and sequence was apparently used in a number of libraries during this period. See section "Shelf Marks" in Public Libraries in the United States . . . (1876), pp. 493-4. This system was described by F. Garrison, "Classification and Arrangement of Books in the Library of the Surgeon General's Office," Bull. Assoc. Med. Librarians 1.84 (1902). By the 1920's three numbers were used; for example, Sterility 3-1-8 indicated that the subject began in range 3, section 1, shelf 8 (see letter, Robert Austin to W. Miles, Dec. 30, 1978, and notebooks in NLM). 36 Lists of all the furniture in the offices and other rooms may be found in annual inventories of the Museum and Library Division, 1887-1915: MS/C/307. Charles Smart, "The Army Medical Museum and Library of the Surgeon General's Office," JAMA, 24: 577-80 (1895), has a some- what detailed description of the building as of 1895. 3' The Library has few statistics on the num- ber of readers before 1946 when the count be- gan to be printed in annual reports. The early registers are now in HMD. Estimates may be found in questionnaires answered by the Li- brarian, such as questionnaire from Library University of Paris, Nov. 1907 (MS/C/116) and answer, Nov. 18 (MS/fB/101). 38 The Library also had a file of author cards that had been printed in the Index-Catalogue. Subject cards were thrown away when they were returned from the GPO as a precaution against their being inadvertently filed and printed again, but author cards were kept in one alphabetical file. This file became quite large; by 1916 it comprised 30 double drawers. This file was a convenience for the editors; the public was ex- pected to use the Index-Catalogue. 39 Thomas S. Cullen, "Proposed New and Centrally located Surgeon General's Library Building," manuscript volume in NLM. 40 Rules dated May 2, 1890, signed by Bill- ings: MS/C/81. 41 Order, Apr. 15, 1892, signed by Billings: MS/C/81. 42 A list of items in the Nightingale exhibit, Apr. 16, 1910, is in MS/C/116. 43 An account of the development of the Army Medical School may be found in Henry, Armed Forces Institute of Pathology. 44 Garrison, Billings, 278-9. Francis N. Thorpe, William Pepper . . . (1904), 132-140, 187, 295. 45 Letters, Holmes to President Harrison, July 24, 1890, Mitchell to C. E. Smith, Mar. 13, 1890. These and letters from other physi- cians, including one from retired Surg. Gen. Moore, are in the National Archives, copies in MS/C/273. 46 A sketch of Baxter is in James E. Pilcher, The Surgeon Generals of the Army . . . (1905), p. 74-78; and in James M. Phalen, Chiefs of the Medical Department . . . (1940), p. 62-65. 47 A sketch of Sutherland is in Pilcher, p. 79-82, and in Phalen, p. 66-69. Letters sent by physicians recommending Billings for the post of Surgeon General are in the National Ar- chives, copies in MS/C/273. 48 Billings, The Objects, Plans, and Needs of the Laboratory of Hygiene, an address, pub- lished as a pamphlet, delivered at the opening of the laboratory, Feb. 22, 1892. 49 J. H. Wright, "The Bacteria of River 181 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Waters," Mem. Nat. Acad. Sci. 7: 417-21 (1894). Billings and A. W. Peckham, "The Influence of Certain Agents in Destroying the Vitality of the Typhoid and Colon Bacillus," Science, n.s. 1, 169-74 (1895). Billings, "The Influence of Light upon the Bacillus of Typhoid and the Colon Bacillus," Mem. Nat. Acad. Sci. 7: 477-82 (1895). Billings, "On the Influence of Insolation upon Culture Media and of Desiccation upon the Vitality of the Bacillus of Typhoid, of the Colon Bacillus, and of the Staphylococcus Pyogenes Aureus," Mem. Nat. Acad. Sci. 7: 483-^ (1894). Billings, S. Weir Mitchell, D. H. Bergey, "The Composition of Expired Air and its Effects upon Animal Life," Smithsonian Contributions to Knowledge, 29: no. 989, 1895. 50 Billings, The William Pepper Laboratory of Clinical Medicine, an address, published in a 15-page pamphlet, at the opening of the lab- oratory, Dec. 4, 1895. 51 In Army language Billings was relieved from duty as officer in charge of the Division by David Lowe Huntington on Aug. 20, 1895; let- ter, Billings to Surgeon General Aug. 20, 1895: NA, copy in MS/C/273. 52 C. D. Spivak, "Medical Libraries of the United States," Philadelphia Med. J. 2: 851-8 (1898). 53 Annual reports of the Surgeon General. The statistics also show that 75 percent of the pamphlets were donated, as well as many pho- tographs and journals. 54 Statistics as of June 30, 1895, from Annual Report of the Surgeon General. 55 Index-Catalogue, vol. 16, 1895, p. [iii]-iv. Billings said many times that donors would not be forgotten, and he had bookplates printed upon which the name of the benefactor could be writ- ten (a copy of the bookplate is in William Stokes "Lectures on the Theory and Practice of Physic," 1840; NLM call No. WB/S874L/1840); but over the years many of the original bindings upon which the bookplates were pasted, and end pa- pers upon which owners had written their names, were discarded during rebinding, and it is no longer possible to identify the names of many of the contributors. 56 Letter, Walker to trustees Crerar Lib., Feb. 25, 1895, quoted in The John Crerar Li- brary 1895-1944, by The Librarian [J. Christian Bay], 1945, p. 40. 57 Billings' contributions to the New York Public Library are just touched on here. For details see the massive History of the New York Public Library by Harry M. Lydenberg (1923), and The New York Public Library, Phyllis Dain (1972). 58 "I transmit by this mail a package of med- ical dissertations which have just come to me from the University of Berne and which are in- tended for the Library of the Surgeon General's Office. It is my impression that I made an ar- rangement, when in Berne with Prof. Kro- necker, to have the dissertations furnished to the Library . . ."; letter, Billings to W. D. McCaw, Dec. 7, 1912: MS/C/116. 59 "It appeared that on one of his trips from Washington to Baltimore to attend a meeting at the Johns Hopkins Hospital he felt an attack of what is called gallstone colic coming on. At once, to the great amusement of the people in the car, he walked into the aisle and stood on his head, hoping by this way that the gravity of the cal- culus would force it back from the mouth of the duct"; Henry C. Yarrow, Military Surgeon 60: 173 (1927). 60 Letter, Garrison to Klebs, June 26, 1926: MS/C/166. Fielding Garrison wrote the following con- cise outline of Billings' career in a letter to Wil- liam S. Thayer of Johns Hopkins in 1927: During the decades 1880-1900, he was un- doubtedly the leading American physician of his time, in respect of character, achievement and versatility, recognized as such in Europe, and Dr. Welch pointed out at the New York mem- orial meeting in April, 1913, 'The one most fre- quently sought for and chosen to represent this country iii international medical congresses and occasions of importance. His leadership was based upon intellectual power and above all upon strength and integrity of character. He was a singularly wise man, combining with far-sighted vision critical judgment, the gift of persuasion and practical good sense'. To this one might add a quite unexampled combination of physical, mental and moral courage. During his main period of activity (1865-95), he did more to elevate the status of American medicine than any other man of his time, by attacking the evil at the source, viz., the some- what mesquin character of certain persons call- ing themselves physicians, who were permitted and authorized by law to pronounce upon causes of death and diagnoses of disease in reports of vital and medical statistics. His constructive work in this direction was along the following lines: Building up of the Surgeon General's Li- brary, Index Catalogue and (with Fletcher) In- dex Medicus. Management of the vital statistics of the 10th, 11th and 12th censuses of the United States, latter having been defined in Europe as 'worse than worthless' until Billings took hold of them. Reorganization of then Marine Hospital Service, at instance of Secretary of Treasury and with consent of Surgeon General and Adjutant General, during 1869-74: took it out of politics 182 THE LIBRARY-MUSEUM BUILDING ON THE MALL and gave it military organization (accountability and responsibility). The present U.S. Public Health Service is of course far beyond anything Billings ever dreamed of in scope and achieve- ment, but the old Marine Hospital Service up to 1874 was mainly politics. Activities in public health via National Board of Health, American Public Health Association, U.S. Census, work as a heating and ventilating engineer and constructor of hospitals, planning and execution of Laboratory of Hygiene of Uni- versity of Pennsylvania (1892), reports on bar- racks, hospitals and military hygiene (1870-75), plan for triangulating the entire United States as to sanitary defects by areas with a view to 'corrective action' in the military sense (1875)— an actual questionnaire of over 400 items, in- numerable public addresses and papers, etc. Leadership in hospital construction via plan- ning and construction of Barnes Hospital, Sol- diers' Home, D.C. (1873), Johns Hopkins Hos- pital (1875-89), Peter Bent Brigham Hospital (1913). Also Army Medical Museum (1887), Laboratory of Hygiene (1892), William Pepper Laboratory of Clinical Medicine (1895) and New York Public Library (1911). Was entirely self- taught in the business and profited by some blunders made in war period 1861-5. Work for advancement of medical education via organization of medical faculty of Johns Hop- kins Hospital, caustic criticism of status of Amer- ican medical literature in 1876 (a Century of American Medicine), professorship of hygiene in Univ. of, Penna. 1895 (a tactical blunder on his part, however), lectures on history of med- icine (J.H.U.), military hygiene (Army Medical School), public hygiene (supra), vital statistics (Cartwright lectures 1889), etc. Recognition as leader in later period via li- brarianship of New York Public Library (1896- 1913), as trustee of Carnegie Institution of Washington, as secretary National Academy of Sciences, D.C.L. from Oxford and similar de- grees: No American physician had been so sig- nally honored prior to this time, although Benj. Rush directed the mint, etc. Selection of Bill- ings to represent United States at International Medical Congress at London in 1881, Brit. Med. Assoc. 1886, and Internat. Med. Congress, Ber- lin, 1891, suggests how far American medicine had risen in European esteem since the Cen- tennial Year (1876) and that Billings was rec- ognized in Europe as the prime mover. Prior to 1866, Billings had been recognized in the Army and in Europe as one of the best military surgeons in the country (first surgeon in war to excise ankle joint, 1862 [Lister's excision of wrist 1865]). Billings wrote best history of surgery in English in 1895 (Dennis's System of Surgery). He was also recognized as an able military ad- ministrator and was a medical Inspector of the Army of the Potomac at end of Civil War. 183 ,1 Leaders of the Library, 1895-1913. David Lowe Huntington, Librarian 1895-1897 FOLLOWING the departure of Billings from the Library and the death or retirement of the Civil War veterans from the Surgeon General's office, the post of Librarian began to be treated the same as other posts in the Medical Department; officers were detailed there for a time and then relieved and sent elsewhere. Between 1895 and 1913 four different officers served as Librarian, the first being David Lowe Huntington. Huntington had been in the Medical Department for a third of a century and had associated with Billings off and on during that period. Born in Charles- ton, Massachusetts, in 1834, educated at Yale (B.A. 1855) and Pennsylvania (M.D., 1857), he had joined the Army at the beginning of the Civil War, been attached to General Grant's staff, was with General Sherman's Army on its march to the sea, and tended the wounded at Vicksburg, Missionary Ridge, Kennesaw Mountain, and other battles. After the war he was stationed at forts David Lowe Huntington, Li- brarian, 1895 to 1897. 185 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE in the East and West until 1875 when he was brought to Washington as Surgeon of the Soldier's Home. From 1881 to 1883 he was curator of the museum, housed on the third floor of Ford's Theatre, and undoubtedly spent much time in the Library on the second floor editing part 3 of volume 2 of The Medical and Surgical History of the War of the Rebellion. At times he was Acting, Deputy, or Assistant Surgeon General and was a delegate to the Internationa] Medical Convention held at Moscow in 1897. As head of the Museum and Library Division, Huntington had charge of both organizations. The museum, however, was under the active direction of Major Walter Reed, who had been curator since 1893. The Library was running smoothly with Robert Fletcher, principal assistant librarian, overseeing the operations. Huntington remained Librarian until April 1, 1897. He seems to have left little imprint on the Library, not because he lacked talent but because there were no major problems for him to solve, nothing spectacular or newsworthy ocurring during the time. He retired from the Army on April 10, 1898, and thereafter lived in Europe with his family. He died in Rome, December 20, 1899.1 James Cushing Merrill, Librarian 1897-1902 Surgeon General Sternberg first offered Major Walter D. McCaw the op- portunity to succeed Huntington.2 But McCaw preferred another post and Sternberg turned to Major James Cushing Merrill. Merrill was a 44-year-old surgeon who had lived most of his Army life in the West. Born in Cambridge, Massachusetts, March 26, 1853, he had spent his boyhood there, gone to Germany for his collegiate education and to University of Pennsylvania for his medical education (M.D., 1874). Upon joining the Medical Department he had been assigned to posts in Texas, Oregon, Idaho, Montana, and Oklahoma. Interested in natural history, he had collected specimens of animals, birds, insects, and fishes, many of which he donated to the National Museum. He had become a competent ornithologist, publishing articles on the subject. Through his skill as a hunter of big game, including the grizzly bear, he became ac- quainted with Theodore Roosevelt. In 1891 Merrill was brought to the Surgeon General's office and given responsibility for Medical Department supplies. In 1893 Surgeon General Sternberg organized the Army Medical School and appointed him lecturer on comparative anatomy. On April 1, 1897, he was placed in charge of the Library. Unusual as it may seem for an outdoorsman, Merrill was also a scholar. He read 13 languages. In the Library he did not merely look over the shoulders of Fletcher and the other translators, he pitched in, helped compile citations for the Index-Catalogue, and edited volumes 3 to 7 of the second series. In this respect he was like Billings but perhaps more versatile because of his command of languages. And to add to his linguistic accomplishments he began to study Russian. 186 LEADERS OF THE LIBRARY, 1895-1913 James Cushing Merrill, Librar- ian, 1897 to 1902. In the summer of 1902 Merrill's health began to deteriorate. During the intervals when he was away from his office, resting and trying to strengthen himself, Calvin De Witt, head of the Museum and Library Division acted as Librarian.3 Merrill died on October 27, 1902, at the age of 49.4 Walter Reed, Librarian November 1902 The most famous of the librarians during this period was Walter Reed. But his fame resulted from medical research, and few persons other than his biog- raphers know that he headed the Library for a brief period. He was appointed on November 1, 1902, by Surgeon General Robert O'Reilly, 5 days after James Merrill died.5 Reed had been born in rural Gloucester County, Virginia, September 13, 1851. He had gone to University of Virginia at the age of 16 but switched to medicine before graduating. He received two medical degrees, one from Vir- ginia in 1869 and the other from Bellevue Hospital Medical College, New York, in 1870. He remained in the New York area, attached to hospitals and boards of health, until 1875, then joined the Medical Department. For the next 15 years he served at various posts, mostly in the West. In 1890 he was brought east to Baltimore, and while there took the opportunity to study at Johns Hopkins. He wanted to try his hand at research and questioned Billings about the possibility of being assigned to the museum. Billings replied that Reed's assignment "would be agreeable" and promised to tell his superiors this, but he cautioned Reed that the decision lay with Surgeon General Charles Suth- erland.6 Sutherland sent Reed to Dakota in 1891, and he had to wait 2 more years before entering the museum. 187 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Walter Reed, Librarian, No- vember 1902. In 1893 George Sternberg became Surgeon General and immediately up- graded research in the department. He established the Army Medical School with classrooms and laboratory in the Library-Museum Building. This was a notable school—William Welch called it the "oldest school of preventive med- icine in America"—and on its faculty were Billings, Fletcher, Sternberg, and several other officers. Sternberg brought Reed to Washington and placed him on the school's faculty as professor of bacteriology and clinical microscopy. On September 8, 1893, Billings relinquished the curatorship of the museum to Reed, retaining the Library. From then on Reed devoted himself to teaching and research. His demonstration that mosquitoes transmitted yellow fever opened the way for the control of that disease. On one occasion Reed told Fielding Garrison, who labored close by, who may have assisted him with literature searches, and who probably chatted with him about the history of typhoid and yellow fever, that the highest ambition of his life was to succeed Billings as Librarian.7 Yet when the opportunity arrived Reed seemed to be somewhat nostalgic at moving away from research. "Now, upon the death of Dr. Merrill," he told a friend, "I take up the duties of Librarian of the S. G.'s library, and shall get more and more out of touch with practical work."8 In the autumn of 1902 Reed's health began to fail. He was sick when he was appointed Librarian (he was still curator) on November 1. Two weeks later he came down with appendicitis and died on November 23. Because of his 188 LEADERS OF THE LIBRARY, 1895-1913 brief tenure, only 23 days, and ill health, Reed was Librarian largely in name rather than fact. Colonel Calvin De Witt, chief of the Museum and Library Division, acted as administrative head of the Library much of November, while Robert Fletcher directed the operations.9 Reed left little trace of his presence in the Library; only four documents of a routine nature bear his typed name and title as Librarian.10 Although Reed headed the Library for less than a month, he was a familiar sight to readers for he spent much time in the building between 1893 and 1902 as curator of the museum, professor in the Army Medical School, and re- searcher. Those of his contemporaries who wrote biographical and historical pieces recalled their brushes with Reed. One who saw him frequently was Thomas S. Cullen, who knew him from the time Reed studied at Johns Hopkins until his death:" It was early in 1892 that I had the pleasure of meeting Walter Reed and James Carroll in Dr. William H. Welch's Laboratory in the Johns Hopkins Hospital. A few years later I became a frequent visitor to the Surgeon General's Library and often met Walter Reed there. Sometimes we would have a short chat, at other times would stroll over to Harvey's Restaurant on the "Avenue" and have luncheon together. I looked forward with a great deal of pleasure to having a short visit with Walter Reed on my trips to the Library. After making out the list of books I wished to consult, it would frequently take fifteen or twenty minutes before they were on my desk. During this time I would drop in to see Walter Reed or some of the other officers I knew. ***** No one had a clearer view of the value of the Surgeon General's Library than did Walter Reed. Walter Drew McCaw, Librarian 1903-1913 Robert O'Reilly had been appointed Surgeon General in September 1902, at a time when the Army was being reorganized because of flaws that had been revealed in its structure during the Spanish-American War. Improving the Medical Department was the most important task facing him, and he did not concern himself immediately with filling the vacancy in the Library. Captain Carl R. Darnall of the Army Medical School and Robert Fletcher were Acting Librarians at various times,12 and Colonel Calvin DeWitt, head of the Museum and Library Division, signed the letter of transmittal of the current volume of the Index-Catalogue when it was published.13 Finally on October 3, 1903, almost 11 months after Reed died, O'Reilly assigned Walter Drew McCaw to the Library. McCaw was a fifth generation physician; his father was a prominent teacher of medicine, Confederate medical officer, and editor of the Confederacy's only medical periodical, The Confederate States Medical and Surgical Journal. Born 189 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE in Richmond, Virginia, February 10, 1863, McCaw was an exceptional student who completed his courses at Medical School of Virginia at the age of 19 and then attended Columbia University's medical school for 2 years, receiving a second M.D. degree in 1884. Shortly after graduation he joined the Medical Corps and served at forts in the West and South until the Spanish-American War when he accompanied an infantry regiment to Cuba and participated in the Santiago Campaign. Surviving an attack of yellow fever he returned to the United States for a year before accompanying a volunteer regiment to the Philippine Islands. In 1902 the Surgeon General recalled him to the United States, and on Oct. 3, 1903, selected him to direct the Library. McCaw was a fine choice for the position as Librarian. He was a voracious reader, a good conversationalist, and an engaging raconteur. A scholar, his learning was described by a fellow officer as encyclopedic but free from pe- dantry. Popular with women, nevertheless he remained a bachelor. Jefferson R. Kean, a medical officer who knew McCaw well characterized him thus:1"1 McCaw had a photographic memory . . . He could read something and if you were to allude to it a year later he would not only remember it but also probably repeat it. He didn't forget anything and was a constant reader; so he got to be almost an encyclopedia. He was very popular at the Army and Navy Club. A group would pick out a topic that they thought he couldn't possibly know anything about, such as some phase of Buddhism in China, and read up on it and discuss it among themselves. They would then ask McCaw what he thought about it, and he would tell them they had it mostly wrong and tell them all about it. McCaw would have been the greatest man in the Medical De- partment if he had been willing to exercise those talents. I have gotten after him often, saying 'Why don't you do this or that; you really ought to.' He would reply: 'Don't say ought to me, Kean; for me to be sent a job and told to work it out and prepare an indorsement makes me sick.' He didn't like to undertake anything. One time a question arose about the relationship of the Red Cross to the Medical Department. I went to the Surgeon General and said I thought it should be turned over to McCaw—he was at the Library and had all the literature 190 LEADERS OF THE LIBRARY, 1895-1913 at hand. So it was sent to McCaw, who didn't like the idea at all and told me that he saw my finger in it. But he did the job and did it admirably. He was interested in literature and art and didn't like to do anything that he didn't instinctively want to do. Anything he had to do—was made to do—he did admirably. If he had had insight into the importance of things and how to go after them, he would have been truly remarkable. Under McCaw Garrison flourished; he dedicated his classic Introduction to the History of Medicine to McCaw "in acknowledgement of his encourage- ment and his many courtesies in aid of the completion of this book." He was solicitous for Robert Fletcher, now long past the age when most persons retire from their profession. Osier, in his obituary of Fletcher, remarked, ". . . [McCaw's] kindly interest and care of Dr. Fletcher have been much appreciated by all his old friends."15 The work of the Library was chiefly dry and businesslike, relating to in- terlibrary loans, the compilation of the Index-Catalogue, purchase of publica- tions, and providing service to readers, but at times there were queries in the answering of which McCaw's scholarly nature became evident. On one occasion he transcribed parts of a Latin manuscript by John of Arderne for D'Arcy Power, a British historian of medicine, compared Power's translation with the Library's manuscript and, when Power's article appeared, questioned him about the accuracy of the translation of a verb.16 Oil portraits of physicians had been displayed discretely in Library Hall perhaps from the opening of the building. But the overwhelming array of paintings and likenesses that hung there in later days began with McCaw, who collected autographed photos of "old and tried friends of the Library"—Osier, Welch, S. Weir Mitchell, and others—and crowded, some might say cluttered, the walls with them. McCaw, like earlier and later librarians, sometimes wore two or more hats. He was an instructor in the courses in military hygiene and military and tropical medicine at the Army Medical School, he served on the Advisory Board of the Public Health Service's Hygienic Laboratory and on boards that examined officers for promotion and boards that gave physical examinations. During at least one summer he commanded the Field Hospital, Pine Camp (a militia camp), New York. One receives the impression from McCaw's career that the Surgeons General believed that the Librarians did not have much to do in the Library and therefore could always be spared for other assignments. In 1912 the War Department issued the "Manchu" order stating that all officers who had been stationed in Washington for more than 4 years had to be rotated to other posts. Surgeon General George Torney protested, pointing out that certain officers (laboratory workers, for example) contributed more where they were than they would at some other spot. Torney wanted to retain some officers in Washington, among them McCaw at the Library. Leonard Wood, Army chief of staff, agreed to allow McCaw to remain as permanent Librarian on condition that he would be out of the line of selection for any 191 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE other duty or for assignment in case of war. McCaw was unwilling to accept the condition, and Torney had to relieve him from duty in the Library in 1913, and send him to the Philippines in 1914.1T McCaw had charge of the Library for 12 years, longer than any other person except Billings during the Library's first century. During World War I he became Chief Surgeon of the American Expeditionary Force in France, was promoted to the rank of brigadier general in 1919, and retired from the Army in 1927. He died July 7, 1939. One of the Army's large general hospitals was named in his honor.18 Robert Fletcher, Principal Assistant Librarian 1876-1912 The principal assistant librarian was an important person in the adminis- tration of the Library. He provided continuity as Army officer librarians came and went; he acted as Librarian when that officer was absent because of illness, vacations, or Army business; and he helped new clerks learn what they needed to know about bibliography, indexing, and the preparation of the Index-Cat- alogue. Robert Fletcher was the principal assistant when Billings retired, and he remained in that post during the administrations of Huntington, Merrill, Reed, and McCaw. Fletcher had assisted Billings in editing 16 volumes of the first series of the Index-Catalogue, and after Billings left the Library in 1895 Fletcher was prin- cipal editor of the second series, reading proofs of volume 17 to within a few weeks of his death. He had coedited Index Medicus with Billings from the beginning of that periodical until the first series ended in 1899; he had edited the second series with Garrison from 1903 until the 1911 volume was completed when he informed his readers that "the state of my health warns me to withdraw from this engrossing medical work."19 During his almost half century of residence in Washington Fletcher had become well-known in the upper echelons of the town's university, medical, literary, and scientific circles. He was president of the Cosmos Club (he and Billings were two of the founders) and the Literary Society. He was friendly, a learned and eloquent conversationalist, and William Osier considered it "a rare treat to dine with him quietly at his club in Washington. He knew his Brillat-Savarin well, and could order a dinner that would have made the mouth of Coelius Apicius to water." Osier, who knew Fletcher for three decades, "always found him a friendly, wise and generous adviser in all matters relating to medical bibliography."20 One would think that editing Index Medicus, the Index-Catalogue, and carrying out duties that arose in the Library would have been sufficient tasks for any one person; yet Fletcher still had the extra energy and mental agility to teach medical jurisprudence at George Washington University, write articles, and preside over the Anthropological Society of Washington in his sixties and to teach forensic medicine at Johns Hopkins, write articles, and preside over the Philosophical Society of Washington in his seventies. 192 LEADERS OF THE LIBRARY, 1895-1913 Robert Fletcher, Principal Assistant Librarian, 1876 to 1912. Drawing by P. Renouard. The original appeared in Harper's Weekly, p. 892, 1893. Over the years Fletcher's name became familiar to physicians in Europe, America, and on whatever other continents the Index-Catalogue and Index Medicus had found homes. As an expression of gratitude American physicians contributed money in 1903 and 1904 to pay for the painting of his portrait by Wilton Lockwood. Today the portrait showing Fletcher as a frail, scholarly gentleman of 80 overlooks the reading room of the National Library of Medicine. 193 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE In 1905 during a medical meeting in Washington a discussion started about the Library and then drifted to Fletcher's contributions. The men who were present "unanimously determined that . . . Dr. Robert Fletcher should be especially recognized for the magnificent success he has achieved as the editor of the Index Catalogue of the Surgeon-General's Office, U.S.A., and Index Medicus, whereby the medical literature, not only of this country but of the whole medical world, is made easily availabe for use."21 A committee appointed at the meeting sent out invitations to a testimonial dinner to honor Fletcher, and on January 11, 1906, 97 of Baltimore's and Washington's leaders in medicine and science gathered at Rauscher's Restaurant, Connecticut Avenue and L Street. Billings, Osier, Harvey Wiley, William W. Keen, and several other men praised Fletcher in speech and poetry, and presented him with a loving cup. Later, photos and letters from those who attended, newspaper clippings, and other memorabilia of the banquet were bound in a beautiful volume and presented to Fletcher.22 Among the other commendations that Fletcher received during his life were honorary degrees from George Washington University in 1884 and University of Bristol in 1912; but the highest honor was the medal awarded to him in 1910 by the Royal College of Surgeons of England, a medal which had been given to only 11 physicians during the preceding 90 years.23 Toward the end of October 1912 Fletcher's health began to fail. One Sat- urday morning Garrison carried Fletcher's salary to The Portland, an apartment building where Fletcher resided, and found him "all alone, wandering in his mind."24 Garrison summoned medical assistance, but Fletcher lived only a few days longer and died on November 8, 1912, at the age of 89. He was buried 3 days later in Arlington Cemetery, with William Welch and other prominent physicians acting as pallbearers.25 Fielding Hudson Garrison, Principal Assistant Librarian 1912-1930 Fletcher's assistant from 1892 to 1899 was Alonzo Frank Steigers, a one- armed former military surgeon.26 Steigers had graduated from St. Louis Medical College in 1865 and then contracted to work for the Medical Department as an Acting Assistant Surgeon. He was stationed at military installations in the South until 1869 when he was transferred to Alcatraz Island, California, and later to Camp Verde, Arizona Territory. In January 1871 a scouting party from Camp Verde fought a band of Apache Indians. Steigers was hit in the left shoulder by a bullet that tore along his arm and came out of his wrist. After the fight the party made its way back to Camp Verde where Steigers' mangled limb had to be amputated. It would seem difficult for a one-armed man to be a practicing surgeon in the Army, yet Steigers wanted to continue his career and the Medical De- partment retained him. He served at several posts until 1892 when Congress abolished the contract surgeon system. Steigers was then a 27-year veteran, but he had none of the retirement benefits of a regular Army surgeon. He 194 LEADERS OF THE LIBRARY, 1895-1913 Fielding Hudson Garrison, Principal Assistant Librarian, 1912 to 1917. probably would have had difficulty setting up a successful civilian practice as a one-arm physician, but Billings brought him into the Library. Here he re- mained until he died on April 12, 1899, at the age of 55. Following the death of Steigers, a 29-year-old clerk named Fielding Hudson Garrison applied to Merrill and the Secretary of War for the post of Assistant Librarian.27 Garrison had been born in Washington on November 5, 1870, and graduated from Johns Hopkins in 1890. He had sought a job with the govern- ment, and after taking a competitive examination in several languages had been appointed a clerk in the Library on March 3, 1891. While working at the Library he had attended Georgetown University Medical School in the evenings and received his M.D. degree in 1893.28 During the 8 years he had been in the Library he had impressed his superiors, and when the post of assistant librarian became vacant, he had no serious competition for the position. He was pro- moted on April 27 and thereafter was the right-hand man to Fletcher, indexing and classifying current medical literature for publication in the Index-Cata- logue . Fletcher was old enough to be Garrison's grandfather, and Garrison was probably very diffident at first. "It was a pretty cruel and trying ordeal for a youngster (as I then was) to be brought into constant close contact with a man old as Heberden and quite as stately and scholarly and dignified," Garrison wrote later, "I didn't get enough chance to kick up my heels when I wanted to ... I have often regretted that the extreme disparity in our years made it 195 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE somewhat difficult for me to understand him at times in earlier years, when I myself had a good deal of flippancy and coltishness of youth and inexperience. "29 Still, they were both basically hardworking, studious, intelligent men, and they got along very well. In 1902 when Fletcher was given the opportunity to revive Index Medicus, he did so with the provision that Garrison be coeditor. Over the years the two became close. Garrison called Fletcher "one of my very best and kindest friends" and "a fine dear old gentleman."30 Garrison worked in the Library for 15 years before he began to publish and gradually become known outside of the circle of librarians and readers of Index Medicus. He was 32 when his first article appeared in print, on the classification and arrangement of books in the Library.31 He started writing at night while sitting up with his own father, who was suffering from a long, painful illness.32 He found writing a relief from the tedium of his daily bibliographic labors. And finally he was still a bachelor (he married in 1910) and had free time and none of the distractions of family life. Once he began to publish, Garrison turned out several articles each year. In 1912 Fletcher, approaching his 90th birthday, resigned the editorship of the Index Medicus. He recommended Garrison as being "in every respect absolutely competent to continue in charge of it."33 Billings also recommended Garrison for the job. Garrison thus became editor, Fletcher notifying the read- ers: "It is with unalloyed satisfaction that I leave the Index Medicus in the charge of Dr. Fielding H. Garrison ... his experience and scholarship . . . are guarantees that the journal will maintain its high reputation. "34 Later that year Fletcher died. Garrison applied for the post of principal assistant librarian. In recommending Garrison to the Secretary of War, who in those days had the final word on promotions, the Surgeon General wrote: "There is no one else who has the slightest claim to the position in comparison with Dr. Garrison."35 Garrison was promoted on November 13. The year 1912 was momentous for Garrison in another respect: it saw the publication of his list of classic medical publications. The list was a by-product of an exhibit of books, pamphlets and articles that were milestones in the development of medicine from ancient times to the 20th century. Garrison carried out the research necessary to identify the classics. The exhibit was completed in 1910, and Garrison then wrote a 15,000-word account of the advancement of medicine as illustrated by the items.36 McCaw, who considered it "the best essay in brief in the history of medicine that has been written in America" queried the Journal of the American Medical Association about pub- lishing it.37 The essay was too long for the Journal, but the editor ran the portion covering the period from the Greeks through the 16th century.38 McCaw also had Garrison's list of items in the exhibit printed in the current volume of the Index-Catalogue and obtained permission from the Surgeon General to have 500 copies of the pages reprinted.39 A score of years later Garrison expanded, modified, and published his list in Bulletin of the Institute of the History of Medicine .40 Yet later the catalog was revised and enlarged by 196 LEADERS OF THE LIBRARY, 1895-1913 TEXTS ILLUSTRATINC THE HISTORY OF MEDICINE IN THE Library of the Surgeon General's Office, U. S. Army Arranged in Chronological Order KKI'RINT FROM VOLUME XVII, SECOND SERIES, INDEX-CATALOGUE OF THE LIBRARY OK THE SIRGEON GENERAL'S OFFICE WASHINGTON r;ovKKNMi-.vr i-kintink; amer. 1912 The first separate edition of Garrisons Texts Illustrating the History of Medicine. Its descendant, Leslie T. Mortons Medical Bibliography, still flour- ishes at the time of the writing of this history of the Library. 197 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Leslie T. Morton, and now, as a standard work among librarians and historians, is usually referred to simply as "Garrison and Morton."41 The compilation of the list of classics dovetailed with a history of medicine that Garrison had been writing. It is not known when he began to outline and to take notes for his history, but he must have started several years earlier, judging by its ultimate size. He began to write in earnest in 1911, thinking, at first, of a little volume to be titled "A handbook of the history of medicine, based upon the historical collections in the Library of the Surgeon General's Office ..." to be published by the American Medical Association.42 After writing much of the manuscript he changed his mind and decided to seek a commercial publisher. He completed the book in 1912, and it appeared in December 1913 under the title, An Introduction to the History of Medicine with Medical Chronology, Bibliographic Data and Test Questions. It was so popular that it was reprinted in May 1914, went through a second edition in 1917, a third in 1921, and a fourth in 1929. At the time of this writing it is still the most comprehensive and authoritative history of medicine in the English language.43 Through his work in bibliography and history of medicine, Garrison was now the most prominent person, except Billings, who had been connected with the Library. Eventually there were so many demands on his time from phy- sicians interested in history of medicine that he had to "fight to keep people from turning a government office into a bureau of medical history."44 In 1913 McCaw was sent from the Library to the Philippines. He recom- mended to Surgeon General George H. Torney that Garrison be appointed Librarian.45 Harvey Cushing, on his own initiative, also suggested Garrison for the post, telling Torney, ". . .1 cannot imagine a person more admirably fitted for it."46 The Surgeon General agreed with Cushing about Garrison's abilities, but was "not prepared to say that [Garrison] is fitted to take the position made vacant by the detachment of Colonel McCaw."47 Torney noted that it had "always been the policy of the Surgeon General's Office to place an officer of the Medical Corps in charge of the Library and I believe its success has been due to the management of that institution by the several officers who have been in charge, each being in his turn a man of high attainments and of executive ability." There appears to have been no insurmountable reason why Garrison should not have been elevated to the post of Librarian. Apparently the Surgeon General was not ready to break tradition and appoint a civilian to a position that had always been held by an officer. Notes 1 Albert Allemann, an assistant librarian, raphy (1912, 1920, 1928). Brief obituaries of wrote a sketch of Huntington in: Howard A. Huntington appeared in JAMA 34: 61 (1900), Kelly, Cyclopedia of American Medical Biog- New York Med. Rec. 56: 969 (1899), and Yale 198 LEADERS OF THE LIBRARY, 1895-1913 Alumni Weekly, Jan. 31, 1900. See also G. M. Kober, Reminiscences of George Martin Kober, pp. 212-215. 2 Letter, R. Fletcher to Frederick W. Stone, July 26, 1902; MS/C/115. 3 In MS/C/115 are file cards noting actions by De Witt in his capacity as acting librarian. 4 A short biography by Fielding Garrison, an associate of Merrill, is in Howard A. Kelly, Walter L. Burrage, American Medical Biogra- phies, (1920, 1928). A chapter on Merrill, with portrait and several biographical references, is in Edgar E. Hume's Ornithologists of the United States Army Medical Corps, pp. 324-336. 5 Copy of order, O'Reilly to Reed, Nov. 1, 1902; MS/C/115. Merrill died Oct. 27; Reed was appointed Nov. 1. During the interim Calvin De Witt acted as Librarian, according to file cards in MS/C/115. On a few occasions the Sur- geons General did not appoint a new Librarian immediately upon the departure of the old Li- brarian. During these short intervals Fletcher, Garrison, or an officer in the museum or Army Medical School was acting librarian. 6 Letter, Billings to Reed, May 17, 1891: NYPL. 7 Garrison, John Shaw Billings, p. 179, fn. Garrison also stated that Billings had selected Reed for the position. If so, this would have been in 1895 when Billings retired, and the Surgeon General did not agree but appointed Huntington instead. Edgar E. Hume in his book, Ornithologists of the United States Army Medical Corps, p. 327, stated: "... Reed had said that at last he had been assigned to the duty which he most desired of any possible assignment in the United States Army." I have not located the source of Hume's statement. It may have been a story that Hume, Librarian from 1932 to 1936, heard from old employees. 8 Letter, Reed to [Louis] Flexner, Nov. 3, 1902; copy through the courtesy of William Bean. 9 File cards and correspondence under date of November 1902; MS/C/115. 10 File card, Nov. 3, 1902, Reed approving 6 days leave for Fielding Garrison. Second in- dorsement by Reed, Nov. 11, 1902, on letter, J. M. A. Spottswood, G.P.O., to Surg. Gen O'Reilly, Nov. 8. Second indorsement by Reed, Nov. 13, on letter, H. S. Boutell to Gen. W. H. Forwood, Nov. 8. File card, Nov. 15, 1902, Reed approving 3 days leave for H. O. Hall. All in MS/C/115. 11 Thomas Cullen, "Proposed New and Cen- trally Located Surgeon General's Library Build- ing," manuscript in HMD 12 That Fletcher and Darnall were acting li- brarians may be seen by the correspondence of the period in MS/C/115. Biographical informa- tion on Darnall, 1867-1941, is in MS/C/44. 13 Calvin De Witt, born in Harrisburg, Pa., May 26, 1840, served in the Army of the Po- tomac as captain of the 49th Pennsylvania Vol- unteers, 1861-1863. After receiving his M.D. degree from Jefferson in 1865 he practiced med- icine, then joined the Army as Assistant Surgeon in 1867. He served in campaigns in the West and in Cuba, was professor in and president of the Army Medical School, and head of the Mu- seum and Library Division from Apr. 13, 1901 to July 20, 1903. He was promoted to the rank of brigadier general in 1903, retired on Aug. 10, 1903, and died in 1908. 14 Taken, with slight changes, from an in- terview of Brig. Gen. J. R. Kean by Ethel M. Chase, May 9, 1950: MS/C/14. 15 Osier, obit, of Fletcher, Bristol Medico- Chirurgical J. 30: 289-294 (1912). 16 Letters, McCaw to Power, Dec. 8, 1909; Jan. 7, July 22, 1910: MS/C/116. Power, "An Early English Surgeon and What he Knew: John Arderne," Med. Mag. 19: 406-414 (1910). 17 Autobiography of Brig. Gen. Jefferson R. Kean, pp. 145-50, 163-64: MS/C/14. Leonard Wood was a physician. 18 For biographies and obituaries of McCaw see: Old Dominion J. Med. Surg. 3: 492 (1904- 05); Amer. J. Clin. Med. 29: 859 (1922) port.; F. H. Garrison, Military Surgeon 60: 198-202 (1927);JAMA 113:437(1939); J. M. Phalen, Army Med. Bull. No. 64, 135-137 (1942); N.Y. Times, July 8, 1939; National Cyclopedia of American Biography, vol. A, p. 89. 19 Announcement preceeding the title page of the January 1912 issue of Index Medicus. 20 Osier, "In Memoriam. Robert Fletcher,' Bristol Medico-ChirurgicalJ. 30: 289-294 (1912). 21 Printed proposal for testimonial dinner in honor of Fletcher dated Washington, Nov. 25, 1905. 22 This volume is now in the History of Med- icine Division, National Library of Medicine, MS/C/49. 23 Fletcher learned of his award of the medal through a cablegram sent by Osier, Apr. 16, 1910, another indication of Osier's high regard for Fletcher: MS/C/49. Fletcher did not feel well enough to travel to Great Britain, so the British Ambassador presented the medal to him. The medal is now in NLM. 24 Letter, Garrison to Billings, Nov. 8, 1912: MS/C/276. 25 Several biographies and obituaries of Fletcher may be found cited in Index-Cata- logue. In addition see obituary by Garrison in Index Medicus following the table of contents, Jan. 1912 issue; memoir by E. Brodman, Bull. 199 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Med. Lib. Assoc. 49: 251-290 (1961); and E. E. Hume, "Garrison and the Army Medical Li- brary, 1891-1930," Bull. Inst. Hist. Med. 5: 301- 46(1937), particularly pp. 313-18. Memorabilia of Fletcher are in MS/C/49. A folder containing details of Fletcher's service is under date Jan.- July 1895, MS/C/81. 26 As is the case with almost all of its early members, the Library has practically no infor- mation about Steigers. Records concerning his military service as a contract surgeon are in the National Archives. Among them is a copy of the Weekly Arizona Miner, Jan. 14, 1871, contain- ing an account of the fight in which Steigers was badly wounded. Annual Announcement of the St. Louis Medical College, Session 1865-1866, gives Steigers' name as Frank. A brief obituary is in JAMA 32:955 (1899). 27 Copy of letter, Garrison to Secretary of War, Apr. 12, 1899; MS/C/115. In this letter Garrison stated his qualifications for the posi- tion. Biographical information on Garrison may be found in interesting articles in the Fielding H. Garrison Memorial Number of Bull. Inst. Hist. Med. 5: 299-403 (1937), particularly the article by Librarian E. E. Hume, "Garrison and the Army Medical Library". Solomon R. Kagan, Life and Letters of Fielding H. Garrison (1938); Kagan, Fielding H .Garrison, a Biography (1948). 28 "Except in the wards of Providence Hos- pital as a student, I have never practiced med- icine"; letter, Garrison to G. Simmons, AMA, Aug, 2, 1916: JH. 29 The first part of the quote is from letter, Garrison to Harvey Cushing, Nov. 9, 1912, quoted in: E. E. Hume, "Garrison and the Army Medical Library, 1891-1930," Bull. Inst. Hist. Med. 5: 316-317 (1937). The second part is from a letter, Garrison to Osier, Nov. 11, 1912, quoted by Hume, p. 317. 30 Letters to Osier and Cushing, cited above. 31 "Classification and Arrangement of Books in the Library of the Surgeon General's Office," Bull. Assoc. Med. Librarians 1: 70-84 (1902). 32 In letter to Billings Nov. 24, 1901, Gar- rison mentioned "a protracted illness in a mem- ber of my family, requiring me to sit up late of nights, so that I had to bend my mind to writ- ing": NYPL, copy in MS/C/276. In letter to G. Simmons, AMA, Aug. 5, 1914, Garrison recalled his "father's lingering and painful death, which occupied three years. I began to write papers during those long nights, to keep from going crazy, and I have continued to do so, simply to keep alive, mentally speak- ing, and not become entirely submerged in this bibliographical drudgery which puts out eyes and bores holes in the brains." JH. 33 Letter, Fletcher to Billings, Nov. 16, 1911, quoted in Hume, Bull. Inst. Hist. Med. 5:316 (1937). 34 Printed notice, "Withdrawal of Dr. Rob- ert Fletcher," in front of Jan. 1912 issue of Index Medicus. Garrison received $1,200 a year from Car- negie Institution for editing Index Medicus. In comparison, his salary as assistant librarian was $1,800 a year. Later Garrison appointed Albert Allemann of the Library to assist with proof- reading, etc., of Index Medicus at a salary of $1,200 a year, paid by Carnegie. 35 Kagan, Garrison, [p. 90]. A letter from Garrison to Billings, Nov. 8, 1912, asking Billings to recommend him for the post, is in NYPL, copy in MS/C/276. 36 That McCaw initiated the exhibit in 1909 is shown by the Annual Report of the Surgeon General, 1909, p. 155. 37 Letter, McCaw to G. H. Simmons, Mar. 29, 1911: MS/fB/101. 38 "The Historical Collection of Medical Classics in the Library of the Surgeon General's office," JAMA, 56: 1785-1792 (1911). 39 Letter, McCaw to Surgeon General, May 21, 1912: MS/fB/101. Index-Catalogue, series 2, v. 17, pp. 89-178. Reprints of the list, Texts Illustrating the History of Medicine in the Li- brary of the Surgeon General's Office, U.S. Army, Arranged in Chronological Order (1912) are quite scarce. 40 "Revised Check-list of Texts Illustrating the History of Medicine," 1: 333^134 (1933). 41 Leslie T. Morton, A Medical Bibliography (Garrison and Morton): an Annotated Check- list of Texts Illustrating the History of Medicine (3ed., 1970). 42 Letter, Garrison to G. H. Simmons, Apr. 24, 1911, and correspondence between the two continuing through the year: MS/C/166. 43 The third edition, 1921, was reprinted in 1924. The fourth edition, 1929, was reprinted in March 1960 and August 1960. A Spanish translation was published in 1921-22. 44 Letter, Garrison to Welch, July 21, 1933: JH. 45 Kagan, Life and Letters of . . . Garrison, p. 7, referring to a letter of McCaw in Garrison's correspondence. 46 Letter, Cushing to Torney, quoted in Hume, p. 309-310, also in the biographical file of Garrison, MS/C/44. 47 Letter, Torney to Cushing, quoted in Hume, p. 310. 200 XII The Library in Operation, 1895-1913 Day-to-Day Operation of the Library THROUGH the administration of four different librarians between 1895 and 1913 the Library moved along year after year, growing slowly.1 During the hours of service, 9 to 4:30, there was a steady succession of readers, in- cluding local physicians, students from Washington medical schools, research- ers, writers of texts and monographs, officers attending the Army Medical School, and employees of companies sent to the Library to research and ab- stract.2 For the convenience of local physicians who were in their offices during the day, the librarians, from time to time, suggested that the building be kept open until 9 or 10 o'clock at night, but the Medical Department never had funds to pay the salaries of the additional clerks who would have been needed. Thomas Cullen recalled how useful the institution had been in providing him with literature on gynecology:3 During the years I wrote five books and three volumes of short articles. The literature for all of the books and nearly all of the separate monographs was furnished me by the Surgeon General's Library. During the preparation of "Diseases of the Umbilicus," I spent approximately three afternoons a week for three years in the Library looking up the extensive literature in this field. Over a long period I was given one corner of the large room adjoining the stacks and kept this for months at a time, through the kindness of the late Charles G. Toepper, who had charge of that department. During the reading of the galleys of the umbilical book, I made fifty trips from Baltimore to Washington to check all the references. ***** There is no other man in the United States who is under a deeper debt of gratitude to the Surgeon General's Library than I am. For nearly fifty years its vast stores of medical information have been mine for the asking. From the beginning I have been treated royally; if I had been one of the most important personages in the country more consideration of me could not have been shown. Garrison counseled persons writing lengthy pieces to come during the sum- mer since it was "the most favorable period for study and work at the Library, because there is better light and because at that time, most of us have more 201 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE leisure to devote to visitors. In fact, most physicians who are doing historical work come here to work in our cubicles at that time."4 The routine went along as it had since the early 1880's, but the steadily increasing quantity of medical publications required that more and more of the Library's resources be spent producing the Index-Catalogue. Finally 9 months of the staff's time were needed to turn out the annual volumes. Whenever the work fell behind, clerks were shifted from their regular jobs to help somewhere along the assembly line. As a result other work in the Library lagged; for example the carding and handling of public documents was generally in arrears because the clerks in charge were frequently switched to the Catalogue. The number of interlibrary and personal loans became quite large; there seems to have been no other medical library in the country at that time that sent books out on loan. In 1911, 7,500 volumes were sent by express to college, university, public, government, and medical libraries and to individuals who did not live in the neighborhood of a library.5 The Library became unbelievably liberal in lending rare and valuable books. Among the works it sent to borrowers through interlibrary or personal loan was an incunabulum (Bartolomeo Montagnana, Consilia Medica, Venice 1497), Luic& tx(2J+*~h -~St/'A j;-,<,/. c/. w. .j. y//,„, t/ At first local physicians had to come to the Library to consult publications. About 1913 the Librarian relaxed the rules and permitted patrons to borrow books to read at home. The Library continued to lend locally for more than 40 years. 202 THE LIBRARY IN OPERATION, 1895-1913 John of Gaddesden's Praxis Medica (1595), John Jones' Briefe, Excellent, and Profitable Discourse (1572-74), Opuscules de Divers Autheurs Medecins (1552), Galen's Opera (1585), Philadelphia Medical Museum (1804-05), Philosophical Transactions of the Royal Society (1700), and other 16th, 17th and 18th, and 19th century publications.6 On occasion it permitted borrowers to retain books for long periods—one patron kept John Hall's Select Observations on English Bodies of Eminent Persons in Desperate Diseases (1683), from 1913 to 1915 before returning it.7 It began to give local physicians the privilege of borrowing books upon presentation of a library card. It stopped requiring individuals living at a distance to deposit a sum of money before borrowing books.8 Books were shipped, often in wooden boxes in which the department re- ceived bottles of whiskey for medicinal purposes, to every state, to Canada, Germany, and perhaps other countries.9 Books were loaned to libraries for exhibition purposes.10 Librarians did not begrudge the time and expense in lending volumes; the chief concern was the damage done to publications by the jostling of packages in transit.11 Some popular books were requested many times, exposed to much wear and tear, and gradually became unfit for lending. Hundreds, at time thousands, of volumes lay waiting to be rebound. Librarians were always con- scious of the expense of binding, requisitions for which had to be approved by the Surgeon General. Some volumes remained unbound for years because of lack of funds. The Library hoped that by stimulating the growth of other medical libraries, these libraries would fill requests for local patrons and thus diminish the number of interlibrary loans sought from Washington.12 The providing of information for the Surgeon General's office, for Army surgeons, and for patrons living outside of Washington became systematized. Topics to be researched and questions to be answered were divided among members of the staff thus: Garrison, general questions on medical research, physiology, history, and bibliography; Albert Allemann, general medical re- search requiring knowledge of various languages, and medical numismatics; Frank J. Stockman, general research in current medical literature, and prep- aration of select bibliographies of medical subjects for out-of-town physicians; Beruch Israeli, Russian and Polish medicine, and foreign medical legislation relating to army medical service; Felix Neumann, older medical literature, incunabula, and reference work from older bibliographical compilations; and Cary R. Sage, portraits, engravings, letters, autographs, and checklists of in- cunabula. Allemann, Israeli, and other clerks with medical training compiled bibliographies for researchers.13 Queries came from physicians and laymen about topics listed in and not in the Index-Catalogue. Were rays from colored lightbulbs harmful? Was there a connection between dandruff and hay fever? Were germs transmitted by postage stamps? What was known about the morbid fear of thunderstorms? The reference service was international; staff members answered queries from Cuba, Germany, Chile, Greece, Canada, and other countries.14 And staff 203 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE WAR DEPARTMENT, SURGEON GENERAL'S OFFICE, U. S. ARMY MEDICAL MUSEUM AND LIBRARY, C'ornor 7th ■•nd B Streets S W *'t>,,/,4.t,yton, ?;.("-.., May 2,..........., V(590 . Ho persons, except the employes of the Library, will be per- mitted to take aown books from, or replace them on, the shelves. Whenever a book is taken from a shelf, and is not to be imme- diately returned, a card must be put in its place showinr where it has "one. All persons other than Library employes wishing to examine bonks on the shelves must apply to Dr. Wise for permission, and v,'ill he aeompanied either by Dr. Wise or by one of the employes of the Library Hall while they are in the alcoves. Such permis- sion "/ill be granted only in special cases and for good reasons. s Experience has shovm that the allowing; persons other than the Libra- ry employe's to enter the alcoves, f*ives rise to disarrangement of the books and to possible loss. By order of the Surgeon General, ' **m (Sipped) John S. killings, Sumeon, U. S. Amy, Director of the Library. Earlier, patrons had been allowed to browse freely among the books and journals. By 1890 the Library had grown so large and served so many readers that Billings was forced to restrict access to the stacks. members went to considerable length to assist inquirers. On one occasion McCaw, endeavoring to aid a physician in Berlin, Germany, wrote to the health officials of several states to obtain copies of medical certificates required before marriage.15 But if an inquiry demanded an unreasonable length of time, the Librarian suggested that a researcher be hired.16 The Library became the unofficial translating service for the Medical De- 204 THE LIBRARY IN OPERATION, 1895-1913 partment. Garrison translated French, German, Spanish, Italian, and Latin; Allemann all of the above plus Greek and Portuguese; Stockman, German French, Swedish, Dutch, and Danish; Israeli, Russian, Polish, Hungarian, Bohemian, German, and French; Neumann, Latin, German, and French. The Library provided short abstracts or translations to civilian physicians, but if the amount requested was unreasonably long, the Librarian sent the patron a list of names of persons who would do the task for pay. During this period the Library received an appropriation of $10,000 almost every year for the purchase of books and journals. Approximately half of this was spent on subscriptions for periodicals (for example, more than 1,300 journals in 1911), $4,000 for books from Europe, and $1,000 for books published in the United States. Ten thousand dollars was a fairly satisfactory, though not ideal, sum for this purpose when it was first granted in 1896, but as time passed inflation slowly decreased the purchasing value of the dollar, the number of medical publications increased, and $10,000 bought less and less. Since the policy of the Library was to obtain all the medical periodicals published through- out the world, the funds for buying books kept shrinking. The Library had to become very choosy in selecting new monographs.17 This circumstance of shrinking funds was to continue for many years, and as a result the rate of growth of the Library, which had been the highest in the country during Billings' time, would slow down and be surpassed by other research libraries. Starting in 1911, through the cooperation of Herbert Putnam, the Library began to receive duplicates of books on medicine that the Library of Congress obtained under the copyright law and other duplicates that it accumulated.18 Later Putnam offered duplicates of foreign medical books sent to the congres- sional library for copyright in the United States, and duplicates of foreign journals.19 He also sent McCaw proof sheets of monthly accessions lists in related fields (as pharmacy, dentistry, psychology) so that the Library could select other works.20 The Library's delivery wagon brought the first lot of books from the Library of Congress on February 28, 1911.21 The Library of Congress not only helped build the Library's collection but permitted it to save money which it could spend for other works. After the United States took the Philippines under its wing, the Army chief surgeon in Manila sent a circular to his officers asking them to obtain medical works that had been published in the islands and in Spain. As their predecessors had done at home for Billings a generation earlier, the officers scouted around and acquired items that were welcomed in Washington.22 The Library also obtained publications in exchange for the Index-Catalogue, and it received many gifts—about 5 percent of its new arrivals were donated by authors, publishers, and friends. Old and new friends continued to donate books, among them William W. Keen; William Disbrow; William Osier; the Georgia Medical Society and other organizations; Daniel Davis, who presented papers of Frank Hamilton, a physician who attended President Garfield; Abra- ham Jacobi, who donated autograph letters; Mortimer Frank, who gave pho- 205 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE tographs; Sir Thomas Lauder Brunton, who sent 200 bound volumes containing 7,000 articles on pharmacology and therapeutics; and Thomas Windsor, who died in 1910 and remembered the Library in his will.23 Gifts would continue to enhance the collections in the future, although it would become more and more difficult for friends to present a volume that the Library did not already possess. William Beer, of the Howard Memorial Library, New Orleans, indi- cated this later when he sent an item, saying, "You have arrived at such perfection that it is a pleasure to contribute anything."24 The Library became more liberal with its duplicates. It no longer demanded exchanges (except for rare books), instead it donated duplicates to libraries that requested them, provided the recipient send a representative to select the books and journals from the accumulation and pay shipping costs. Indeed the Library came to regard its duplicate collection as a "seed bed" for young libraries and its aid to those libraries as an important service.25 Expansion of the Library within the Building The Library-Museum Building at the time of its completion in 1887 was thought to have sufficient unused shelf space to accommodate incoming books for a long, long time. Yet within a decade librarians could see that all empty shelves would soon be filled. In 1896 Librarian Huntington requested $6,000 for six new iron stacks with iron stairways, perforated iron flooring, and wooden shelves. He did not receive it. Later librarians repeated the request. By 1904 inflation in the cost of materials and wages had more than doubled the estimated cost to $13,000. Finally in March 1905 Congress appropriated $8,000 for the work. When completed by contractors, under the eye of Army engineers, in May 1906, the shelves provided space, it was hoped, for the next 10 years.26 The Library—and museum—also suffered through lack of room. Librarian Merrill noted that the duplicates were so crowded in the "duplicate room in the basement" as to be practically inaccessible.27 Storage space for duplicates became so scarce that Librarian McCaw turned potential donors away and finally had to sell several wagon loads of publications for waste paper.28 The War Department's Record and Pension Division still filed hundreds of thousands of records of Civil War veterans in the large room under Library Hall, and its officers and clerks occupied offices on the first floor front of the building. Librarians and Curators repeatedly asked that the record-pension group be moved out so that the Library could expand into the lower room and the museum into the rooms along the front.29 The Record and Pension Division remained for a time, but fortunately the Army Medical School departed. The school, housed in the building since its founding in 1893, had been so successful that it had expanded. Eventually it had become cramped. Officers on the faculty protested to the Surgeon General that the laboratories were makeshift, inadequate, crowded, and unsuitable, and that the school was encroaching on space "desperately needed" by the Library and museum.30 206 THE LIBRARY IN OPERATION, 1895-1913 The chemistry laboratory which, with a bacteriological laboratory, was in- stalled in the center section of the building for use of students of the Army Medical School. The arrangement was satisfactory for a while, but later the laboratories and classrooms occupied space needed by the growing Library. The Surgeon General finally obtained quarters for the school in a rented building at 462 Louisiana Avenue. The school moved during the spring of 1910. However, the Library and museum did not inherit all the vacated areas. The Surgeon General transferred the Medical Department's architect and chemist to the building and set aside two rooms for use of examining boards.31 Still, the Library and museum received space into which they immediately expanded. The Library shifted its unbound recent journals and some of its documents and pamphlets into a large room freeing space in the stacks in Library Hall for acquisitions. Librarian McCaw said that the move came just in time to save the Library "from being so choked with its own material that it was becoming impossible to keep track of or to find a paper wanted when it was a pamphlet or document or number of any unbound periodical."32 First Renovation of the Building By 1910 the building was almost a quarter of a century old and was beginning to show signs of wear and tear. The roof leaked. The drain pipes within the 207 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE walls flooded at some point every year, ruining the adjacent interior wall area and threatening books and specimens. The inside plaster walls had been cal- cimined originally to save money, but the calcimine surface became dirty and had to be recalcimined frequently so that the total cost was greater than if the walls had been painted. The lavatories, toilets, and plumbing were becoming antiquated and in need of replacement. The exterior was begrimed by Wash- ington smoke and needed to be cleaned. The building was wired for electricity, but inadequately by later standards. Only four droplights, consisting of incandescent bulbs with green metal shades over them, were installed in Library Hall. Flashlights had to be used in the stacks. Around this time the first pay telephone was installed for the use of users of the Library and museum. Routine repairs to the heating system, electrical system, plumbing, and woodwork were made by the mechanic, engineer or assistant engineer, but major renovations called for outside contractors. McCaw estimated that nec- essary repairs, done in the most economical manner, would cost $25,000.33 Congress appropriated $10,000 for the work. With this sum not everything could be fixed, but starting on July 1, 1911, the Library was closed temporarily until the most essential repairs were made to the roof and heating system, the interior painted, and new plumbing installed. Botany Bay Along with more space the Library could have used more and younger employees at higher salaries. The workers hired by Billings when they were relatively young men had grown into middle age by the turn of the century. In 1906 there was one youngster of 25 on the staff, but next in age were three men in their forties, five in their fifties, seven in their sixties, two in their seventies, and one, Edward Shaw, who was 81.34 The average age of the 19 clerks was approximately 59 years. Fletcher, the principal assistant librarian, was 83. In comparison his assistant, Fielding Garrison, was a boy of 36. The assistant messenger (who did not count as a clerk) was an "old soldier with failing eyesight and infirmities of age" named John Fogarty, who had joined the United States Dragoons back in 1855 and been wounded during the Civil War. After the conflict he had tried civilian life for a few years, rejoined the Army in 1871 and been assigned to the Surgeon General's office. He left the Army in 1874 but remained in the Medical Department as a civilian em- ployee. On January 4, 1908, he tottered on the second floor near the main stairway, lost his balance, fell over the banister, fractured his skull and died January 7.35 The Library not only had its own veterans, it became the final haven for elderly clerks from the Surgeon General's office. The Surgeon General and his assistants were considerate of their long-time employees and assigned those who had slowed down physically to the easiest jobs. They believed that Library clerkships were the least demanding in the Medical Department, and when a 208 THE LIBRARY IN OPERATION, 1895-1913 Library clerk died or resigned his place was liable to be filled by an old-timer sent from the SGO. Finally in 1911 Librarian McCaw had to protest against the proposed transfer of a clerk, telling his superiors: "The Museum and Library Division is now much crippled from the fact that many of its old and faithful employees are practically disabled by age and the physical infirmities attendant thereto, and places as they fall vacant must of necessity be filled by young men in order to keep up the work. I sincerely hope this transfer will not be made."36 In the event that the organization was able to find a promising young recruit to fill a vacancy, it was not always able to hold him. The work was often repetitious, tedious, and dull. The copying of titles of books and articles, typing copy, translating, proofreading, day after day, drove many recent employees away. McCaw lamented in 1910 that new men quit the Library for "better places" just "about as soon as they learn their business."37 Salaries were relatively low for the intelligent, competent, hardworking people that the Library sought. In 1905 the total salaries for the 21 persons working there amounted to $29,280.38 In 1911 Robert Fletcher, M.D., the second in command, who had a worldwide reputation, received $2,080 as principal assistant librarian. Fielding Garrison, B.A. Johns Hopkins, M.D. Georgetown, third in command, received $1,800 as assistant librarian. Beruch Israeli, B.A. Yale, M.D. Georgetown, able to translate Russian, Polish, and Scandinavian languges, received $1,400 a year as a clerk, class 2.39 Albert Allemann, A.B. Gymnasium of Soleure, Switzerland, M.D. George Washing- ton, who indexed foreign journals and helped with the Index-Catalogue, also received $1,400 as a clerk.40 In 1908 McCaw offered a clerkship at $900 a year to a Dr. Frank Disney.41 In 1913 the Librarian offered a clerkship, $1,000 a year, to Arthur Eisenberg, M.D., who was earning $1,100 a year as physician Albert Allemann, Principal As- sistant Librarian, 1917 to 1932; coedtforo/Index-Catalogue, 1912 to 1916; editor of series 3, 1918 to 1932. 209 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE in the Indian Service, Lower Brule Agency, South Dakota. Eisenberg accepted the job, apparently in order to return from the frontier to civilization, but he remained in the Library less than a year before resigning to become anatomist of the museum at a higher salary.42 The Librarian frequently asked for per- mission to pay higher salaries, but only occasionally were increases granted.43 On at least two occasions McCaw would not approve a clerk's application for transfer to a better-paying job elsewhere because he felt the clerk was too valuable to the Library.44 It was this combination of the Library being the final berth before retirement for many employees, the low salaries in comparison with salaries elsewhere in the Surgeon General's office, and the difficulity of escape for some employees to other branches of the Medical Department, that caused men in the SGO to begin referring to the Library as "Botany Bay."45 The Library had other problems besides those associated with an aging staff, difficulty of retaining new recruits, and inequalities in salaries. Other branches of the Surgeon General's office, feeling that the Library's mission was the least important in the Medical Department, borrowed clerks and sometimes kept them for months, despite protests of the Librarian.46 Perhaps the Library's recruitment and retention of top-notch persons would have been eased if it had begun to accept women on the staff. In 1903 Kate Levy, M.D. Northwestern, who was experienced in medical library work and "anxious to make a specialty" of it, inquired about a job.47 But the Army Medical Library was not ready to break with tradition, and if Dr. Levy ever entered the medical library field it was elsewhere. The Index-Catalogue Is Continued but the Number of Copies Is Reduced When Billings planned the Index-Catalogue in the 1870's he did not foresee a second or third or fourth series. He told his German friend and book agent Felix Flugel, "I shall never print but one giant catalog and I want that to be as complete as possible."48 But by the 1890's the mechanism and team for producing the Catalogue was running along smoothly, the medical profession had adopted it as an indispensable standard reference tool, and officers of the Medical Department were loath to see it stopped. Long before the final volume, W-Zythus, came from the GPO in 1895, the decision had been made to continue indexing literature that had accumulated and to publish the citations in a second series. Volume one of series two appeared without interruption in 1896. With- out any intention on Billings' part the Library had metamorphosed into a publishing house. As an aside it is interesting to conjecture about the future of the Library if the Surgeon General had halted the Catalogue in 1895. If indexing, translating, carding, proofreading, publishing, and distributing had ceased, half of the staff would have had nothing to do and would have been discharged. The Index Medicus, a by-product, would have stopped publication. The flow of free pe- 210 THE LIBRARY IN OPERATION, 1895-1913 riodicals and books sent for mention in Index Medicus would have ended, forcing the Library to redistribute its funds, and perhaps forcing it to cancel subscriptions. The Library might have received less support from the medical profession, the Army, and Congress. The Library could have developed in possible ways, and it would certainly have been radically different. While volume 1 of the second series was being prepared, Congress in January 1895 passed a law stating that no more than 1,000 copies of any gov- ernment document could be printed. The legislators did this because they were concerned over the ever-increasing number and cost of Federal publications. The Library received its usual appropriation covering the printing costs of 1,500 copies of the Catalogue, but this was 500 more copies than the law allowed. Librarian Huntington asked Surgeon General Sternberg to request the Secretary of War to persuade the House and Senate committees on printing to exempt the Index-Catalogue from the 1,000-copy rule. Sternberg tried to help but to no avail.49 The Catalogue was limited officially thereafter to 1,000 copies of each volume. The Government Printing Office, however, was liberal and provided between 1,000 and 1,500 copies annually, a fortunate circum- stance for libraries of the future.50 The Fall and Rise of Index Medicus During this period the fortunes of Index Medicus, the by-product of the Index-Catalogue, fell and rose. After Billings left Washington in 1895 and moved to Philadelphia and later New York, the burden of publishing Index Medicus fell on Robert Fletcher. He received subscriptions, handled finances, made arrangements with the printer, directed the indexers, kept the work organized, read proof, and saw that copies were mailed to subscribers. Billings' name appeared on the title page as coeditor, but he was busy in New York City developing the public library system and could not assist. Fletcher had a slightly different opinion about selecting material for citation in Index Medicus than had Billings. After Billings left, Fletcher tended to choose some articles for Index Medicus that had not been selected for the Index- Catalogue. He did this "on the ground that current articles of any kind are apt to be of current interest to current readers, some of whom may find in [the articles] just the stimulating or factual statement they are after." The Index Medicus was, therefore, a more complete bibliography, at least during part of its existence, than the Index-Catalogue, "which Billings aimed to make a re- pository of the very best and most select material, but of no other. "51 Fletcher continued to oversee the production of Index Medicus through 1896, '97 and '98, but then he had to give up. In the spring of 1899 he wrote Billings that he was "getting on in years," the steady increase in articles to be indexed was "really appalling," and every expense had increased except the editor's stipend. "If I go on," he said, "the chances are that I should lose both time and money."52 He felt that there was no one else available to take over 211 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the job. With reluctance the two editors let the journal lapse after the ap- pearance of the April 1899 issue.53 Index Medicus might have disappeared forever had not the Carnegie In- stitution of Washington been established in 1902, with Billings as one of the trustees. One purpose of the Institution was to assist research by granting expense money for worthy scientific undertakings. Urged by Billings, the in- stitution agreed to allot $10,000.for publication of Index Medicus, with Fletcher as editor.54 Fletcher might still have declined the proposal had not Fielding Garrison proved himself to be an excellent assistant librarian. Fletcher agreed to resurrect Index Medicus if Garrison could join him as coeditor. The institute agreed and also made the editors' task easier by assuming the business man- agement. Fletcher and Garrison brought out the first issue of the new series in the spring of 1903. Because of funds provided by the Carnegie Institution, the price was lowered to $5. Still the periodical never attracted sufficient subscri- bers to cover the cost, and the institution continued to subsidize it for many years.55 In the spring of 1911 Fletcher, now 88 years old, came down with a severe case of pneumonia. He recovered but never regained his vigor. At the end of the year he resigned as editor, leaving Fielding Garrison the responsibility for Index Medicus.™ Proposals to Remove the Library From the Medical Department On a number of occasions Congressmen suggested that the Library be removed from the Medical Department, either for reasons of economy or because the writings would be more convenient to the public if they were in a different location. In early 1897 Congressman Joseph Cannon, chairman of the House Committee on Appropriations, conceived or adopted apian to move the Library (but not the museum) into the new District of Columbia public library building and give the vacated space in the Army Medical Building to one of the expanding governmental agencies, perhaps the National Museum or Geological Survey. Fletcher first heard of this from Ainsworth Spofford, Librarian of Congress, who would have gained control of the Surgeon General's Library if it were moved to the public library building. Fletcher tried to learn more about Cannon's plans, talking to Representative Henry H. Bingham, to the editor of the newspaper Washington Post, and to other persons, but to no avail because, as he told Billings, "Cannon keeps his plan to himself." Billings, in New York, asked George Shattuck, Horatio Wood, William Osier and other prominent physicians to influence their legislators to permit the Library to remain in the Medical Department.57 Cannon was serious: he requested information as to the number of square feet of space that would be freed if the Library moved, and he came down from Capitol Hill accompanied by two members of his committee and went through the building. Then suddenly he dropped the idea. The reason or 212 combination of reasons that dissuaded him is not known. It may have been Spofford's defense of the Surgeon General's Library, or the National Museum's resistance to being given only half the Army building instead of a new building, or some other circumstance. But it was fortunate for the Library's independence that Cannon changed his mind, for he was the most powerful person in Congress and could have had his way had he desired. In early 1905 the Medical Department began to hear rumors of a proposal to merge the Library with the Library of Congress.58 The LC building on Capitol Hill was new and uncrowded, and the thought occurred to some leg- islators that operating expenses (mainly salaries) of the medical library could be reduced by moving it into the congressional library. Nothing happened at the time, but the idea recurred later. The department's concern for its library may have been heightened in 1906 by a survey, taken by the Executive Branch, of the organization and use of all Federal libraries.59 But other than a reduction in the appropriation from the usual $10,000 to $9,000, nothing untoward occurred. The reduction lasted only 1 year; the appropriation returned to $10,000 in fiscal year 1907. Notes THE LIBRARY IN OPERATION, 1895-1913 1 During this period the librarians answered a number of questionnaires concerning the Li- brary. These contain all manner of information. See Organization and Use of Libraries (ques- tionnaire of Keep Commission), and answers, May 22, 1906: MS/C/116; Questionnaire from Library, Univ. of Paris, Nov. 1907: MS/C/116, with answers, Nov. 18, MS/fB/101. Data on the Library, S.G.O., prepared for the Bureau of Education, May 20, 1908: MS/C/116. Letter, McCaw to Surgeon General, report for the Pres- ident's Inquiry on Economy and Efficiency, Dec. 8, 1910: MS/C/116. Report on the Library . . . in accordance with Circular No. 16, President's Commission on Economy and Efficiency, June 30, 1911: MS/C/116. Letter, McCulloch to R. Meeker, July 7, 1915: MS/fB/101. See also McCulloch, "The Surgeon-General's Library,'' Bull. Med. Lib. Assoc, n.s. 6: 25-39 (1916-17). 2 Annual reports of the Surgeon General from 1928 to 1933 noted the number of company rep- resentatives; for example, "there are nine per- sons permanently engaged in research and ab- stracting," 1931, p, 323. It was perhaps to some of these persons that Victor C. Vaughan referred when he wrote: "There are now certain organizations which for a definite price offer to supply an author with literature of reference. These organizations em- ploy men and women to go through great li- braries, such as those in Washington, Philadel- phia, New York and Chicago, and make out the lists." (Vaughan, A Doctor's Memories (1926), p. 208). 3 The quotation is from Cullen's scrapbook, "Proposed New and Centrally Located Surgeon General's Library Building," copy in HMD. Cullen also wrote: "Some years ago Dr. George Gardner, then my Resident, and now a prominent surgeon in Chicago, and I went motoring over to Wash- ington. He was driving rather fast and I said, 'George, aren't you afraid of being arrested?' He replied, I have never been pinched in my life.' A few moments later, as we neared Washington, I noticed three motor-cycle policemen and they noticed us. As we came into the suburbs of Washington there were several toots Two mo- tor-cycle men came up beside us and one was directly in front of us. One officer, in a gruff voice, said to George, Show us your card. He did so and I pulled out my visiting card and handed it to him explaining that we were on the way to the Surgeon General's Library to do some work. All three officers started to laugh, and one said, Well, we all make mistakes some- times. We thought you two fellows were boot- leggers.' " 4 Letter, Garrison to V. Robinson, Mar. 16, 1920: MS/C/28. * Report on the Librarv of the Surgeon Gen- eral's Office . . . June 30,' 1911: MS/C/116. Loans went directly, or through libraries, to many persons who became famous, among them 213 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Harvey Cushing, William Osier, William Halsted, William A. White, Howard A. Kelly, Frederick L. Hoffman, William Welch, F. Pey- ton Rous, John J. Abel, Graham Lusk, S. Weir Mitchell, Maude E. Abbott, George W. Crile, Solomon Solis-Cohen, Mazyck P. Ravenel, Thomas J. Burrill, Christian A. Herter, R. Tait McKenzie, and Karl Pearson. Names of many borrowers may be found in correspondence in MS/fB/101. J. Tyson, visiting Washington, phoned McCaw for the loan of a book. McCaw sent it to the Willard Hotel for Tyson. It was returned by the Library's delivery wagon. May 11, 1908: MS/fB/101. Victor C. Vaughan, dean of University of Michigan medical school, 1891-1921, recalled the service provided from Washington: "As dean I was able to help the superior student, hungry for more than the routine course offered him. I saw that he had special privileges in the library and could linger among the book shelves at his own sweet will. If the books he wanted were not in our library (though it is one of the best in the country) they could be obtained from the Surgeon General's Library in a few days.'' (Vaughan, A Doctor's Memories (1926),' p. 248). 6 See letterpress book, 1915: MS/fB/101. 7 Letter, McCulloch to James J. Walsh, Jan. 18, 1915: MS/fB/101. 8 Letter, McCulloch to E. C. Ellett, Mem- phis, Tenn. Feb. 24, 1916, "Deposits are not required from reputable physicians': MS/fB/101. 9 Lest it be thought that the use of wooden boxes to ship books seems over-protective, on Aug. 15, 1912, the surgeon at Ft. Apache, Ar- izona, reported that a book for him had arrived soaked by water on the stagecoach: MS/C/116. 10 Example; in December 1914 steel en- gravings of physicians, and books of the 16th, 17th, and 18th centuries were loaned to the St. Louis Medical History Club for an exhibit; see correspondence under date Jan. 1, 1915: MS/ C/137. In 1912 books were loaned to Harvard for an exhibit during the Ninth International Otological Congress; June 12, 1912: MS/C/137. " "Most of our losses and all of our mutila- tions come from the very liberal way in which we lend and send books to physicians and li- braries at great distances from this city. The damage from boxing and the general shaking up of express travel is considerable"; letter, Gar- rison to C. Frankenberger, Librarian, Med. Soc. County of Kings, May 6, 1919: MS/C/166. 12 Garrison stated this very well: "The ideal has been to gradually build up the medical li- brary collections in the larger cities by interli- brary gifts or exchanges of duplicates and to stimulate the growth of these collections, until they are in position to relieve the pressure of this central loan service in their own localities"; memo, Garrison to P. F. Straub, Feb. 7, 1919: file Historical Information, MS/C/309. 13 For example, queries from E. R. Wiese, Allegheny Co. (Pa.) Med. Soc, Feb. 23, 1915, MS/fB/101; M. L. Boyd, Fulton Co. (Ga.) Med. Soc., Mar. 5, 13, 1915, MS/C/137; W. A. Jayme, Medical Society of the City and County of Den- ver, July 7, 1914, MS/C/137; Royal Society of Medicine, London, July 23, 1914, MS/C/i37; Jasper Co. (Mo.) Med. Assn. Feb. 2, 1911, MS/ IB/101; C. Hitchcock, Wayne Co. (Mich.) Med. Soc, May 13, 1913, MS/C/116. Copies of a number of bibliographies com- piled for physicians, 1922-1926, are in MS/C/ 151. 14 Letters, McCaw to I. Adad, Chile, Jan. 10, 1913; to B. Golemy, Greece, Jan. 13, 1913; to J. Guiteras, Cuba, Mar. 26, 1912; to W. Schmidt, Ontario, Oct. 2, 1915: MS/fB/101. 15 Letters, McCaw to J. Schwalbe, ed. Deutsche Medizinische Wochenschrift, Aug. 27, Sept. 8, 1913: MS/fB/101. 16 Several staff members supplemented their incomes by researching for patrons in the eve- ning or on weekends, among them Sage, Neu- mann, Israeli, Allemann, Charles G. Toepper, Homer J. Councilor, and Eisenberg. Several Washingtonians also acted as Library research- ers, among them Dr. Audrey G. Morgan, Dr. George J. Lochboehler, and Dr. Charles A. Pfender. 17 See, for example, letters, McCaw to H. Kimpton, June 1, 1908, and McCaw to Kegan Paul, Trench, Tuebner & Co., July 29, 1912, MS/fB/101, in which the Librarian mentioned a shortage of money for publications. 18 Letter, Putnam to McCaw, Feb. 13, 1911: second indorsement by McCaw to Surgeon General, July 18, 1913 [regarding F. Neumann]: MS/C/116. There were suggestions, from time to time, that one volume of each copyrighted book on medicine and allied subjects be deposited in the Surgeon General's Library. In the 65th Con- gress, 2d session, Bill S. 4423, designed to ac- complish this, passed the Senate but was not acted upon by the House. 19 Letters, F. Ashley, LC, to McCaw, June 19, 28, 1911: MS/C/116. 20 Letters, McCaw to Putnam, Feb. 15, 24, 1911: MS/fB/101. C. H. Hastings, LC, to McCaw, Mar. 2, 1911: MS/C/116. 21 Letter, McCaw to Putnam, Feb. 28, 1911: MS/fB/101. Record of Copyright transfers (of books) from Library of Congress: NLM. 22 Letter, Huntington to Col. Greenleaf, Manila, May 7, 1900: MS/C/115. 214 THE LIBRARY IN OPERATION, 1895-1913 23 For Davis, see correspondence, Mar. 23, 1915, MS/C/137. For Brunton see letters, Nov. 21, 1908, MS/C/81; Nov. 11, 1908, Jan. 8, 1909, MS/C/116; and Annual Report of the Surgeon General, 1909, pp. 155-156. Dorothy M. Schul- lian, "Thomas Windsor, Benefactor of the Army Medical Library," Bull. Med. Lib. Assoc. 38, 135-144 (1950). See also Index-Catalogue, 2nd series, v. 21, preface. Among the notable physicians who would donate in the future would be Harvey Cushing, Arnold Klebs, Howard A. Kelly, William S. Disbrow, and George W. Crile. In 1922 the Library received its largest gift, 50,000 volumes and bound papers from Prudential Life Insur- ance. Prudential, under the direction of its top- notch statistician, Frederick L. Hoffmann, had systematically collected annual reports and other publications of every state and local board of health in the United States and of health agen- cies in many foreign countries. These reports contained a wealth of vital statistics and data on public health. The Library already had some of the reports, but it had never had sufficient man- power to procure all of them year after year. Stimulated by the gift the Library began to write to national and foreign health agencies period- ically to obtain new reports as they were issued. 24 Letter, Beer to Librarian, Jan. 20, 1921: MS/C/151. Readers should not construe this to mean that the Library is complete; it lacks many books of this and earlier centuries, and gifts are welcome. 25 "We are a sort of seed-plant for helping other medical libraries to build themselves up"; letter, Garrison to Col. C. L. Heizmann, Oct. 24, 1917: MS/C/137. Among the libraries invited to send repre- sentatives to pick duplicates were the Cleveland Medical Library, University of Illinois Medical School, New Hampshire State Library, Uni- versity of Michigan, Boston Medical Library, Texas Christian University, Medical Society of the City and County of Denver, and New York State Library. 26 Report of the Surgeon General 1899, p. 13-14; 1904, p. 133; i905, p. 153; 1906, p. 129. Copy letter, Surgeon General to Secretary of War, Apr. 5, 1905; letter, Col. C. S. Bromwell to McCaw, May 12, 1906: MS/C/116. 27 Report of the Surgeon General, 1901, p. 13. 28 Letter, McCaw to J. T. Johnson, June 19, 1908 (McCaw suggested duplicates be given to Public Health Service Library); McCaw to M. C. Noyes, Nov. 4, 1910; McCaw to G. Lake, Mar. 30, 1912; McCaw to R. L. Sutton, July 21, 1913; MS/fB/101. 29 Report of the Surgeon General, 1899, pp. 13-14; 1900, p. 13; 1901, p. 13. The move of the School is described in Henry, Armed Forces Institute of Pathology, pp. 147-149. 30 Memo, Office of the Surgeon General, Mar. 31, 1909: AMM. 31 Memo, McCaw to Surgeon General Nov. 21, 1913, quoted in Lamb, "History of the United States Army Medical Museum," pp. 140-142. 32 The location of books in Library Hall in 1902 is given in: Fielding H. Garrison, "Clas- sification and Arrangement of Books in the Li- brary for the Surgeon General's Office," Bull. Assoc. Med. Librarians 1: 70-84 (1902). For a later arrangement see Champe McCulloch, "Classification and Arrangement of Books in the Library of the Surgeon General's Library," Bull. Med. Lib. Assoc, n.s. 6: 60-70 (1917-18). See also, Memorandum for Colonel Owen on library classification and arrangement of books in the alcoves, Sept. 11, 1917: MS/C/137. 33 Letter, McCaw to Surgeon General, July 18, 1910: MS/C/116. 34 Shaw resigned July 15, 1908 when he was 83; file card, July 10, 1908, MS/C/116. On the card McCaw noted: "His services for many years have been exacting and responsible, and the library loses one of its most valued assistants." 35 Letter, McCaw to Surgeon General, Jan. 8, 1908: MS/fB/101. Memo, McCaw to Surgeon General, Feb. 13, 1904: MS/C/116. 36 Second indorsement by McCaw, Apr. 25, 1911, to 1st ind. by Surgeon General Torney, Apr. 24: MS/C/116. 37 Memo, McCaw to Surgeon General, May 3, 1910: MS/C/116. 38 List of salaries Sept. 1905: MS/C/116. The above total does not include the Librarian who received the pay accorded his rank in the Army. List of names of employees with their duties and salaries may be found in MS/C/116 under the dates Aug. 24, 1907; Sept. 15, Nov. 13, 1909; May 3, Nov. 21, Dec. 10, 1910; Sept. 26, 27, 1911; n.d., probably 1912: in MS/C/137 under dates n.d. 1914; Sept. 17, 1914. See also Index- Catalogue, 2nd series, v. 21, preface. 39 Israeli immigrated from Russia when he was 18 and worked his way through Yale. Con- tinuing to work he supported his sister and brother through college. He began to study medicine at University of Pennsylvania under a scholarship but resigned to accept a job in the Library at $1,000 a year on Aug. 26, 1890 with responsibility for translating Slavic languages. He studied medicine at Georgetown in the eve- nings and on weekends, receiving his M.D. degree in 1897. He died Oct. 16, 1920. Letters, Israeli to Billings, Feb. 20, Mar. 18, 1890; C. Smart to Billings: MS/C/81. Copy letter, Israeli to Surgeon General, June 24, 1904: MS/C/116. 215 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 40 Allemann, born in Soleure, Switzerland, Feb. 28, 1860, attended the universities of Beme and Munich. He came to the United States in 1884 and taught ancient and modern languages in colleges for 16 years. He began to work at the Library on Feb. 12, 1900, and concurrently attended George Washington University Med- ical School, receiving his M.D. degree in 1904. He rose through the ranks to become editor of the third series of Index-Catalogue. He retired on Feb. 28, 1932, and died in December 1942. Robert Austin remembered him this way: "Dr. Allemann was a frail looking little man but he had unlimited energy, an alert mind, and fully aware of what was going on about him. He had two assistants, Mr. Patton and Mrs. Deb- orah Hannon, who were long time, faithful, and devoted workers for him and both of them had great respect and the highest regard of Dr. Al- lemann's knowledge and ability in carrying out his responsibilities in publishing the Index-Cat- alogue. Dr. Allemann very seldom left his office during the day. He was not a sociable person but library staff members respected him as he was always pleasant, polite, and very much the gentleman at all times." Letter, Austin to W. Miles, Sept. 29, 1979. Garrison discussed Allemann occasionally in his correspondence: MS/C/166. Memo, Ash- burn to Chief, Division Professional Service, SGO, Aug. 8, 1931, subject, rerating of Dr. Allemanns position: MS/C/151. Clipping, with portrait, Washington Sunday Star, Feb. 1932. 41 Letter, McCaw to Disney, Dec. 28, 1908: MS/C/101. 42 Memo, McCaw to Surgeon General, Jan. 18, 1913: MS/C/116. Orders, Mar. 17, 1913, attached to resignation, Feb. 26, 1914: MS/C/ 137. Eisenberg was hired to fill the vacancy that occurred after clerk Lewis H. Rose was killed by a trolley car, 10 o'clock at night, Dec. 21, 1912. 43 Report of the Surgeon General, 1913, p. 195; 1914, p. 180; 2915, p. 177. Some members of the staff supplemented their incomes by assisting in the preparation of Index Medicus in the evening or on weekends; for example, Allemann received $120 a year for compiling and proofreading. Some carried out literature research for patrons who lived too far away from Washington to visit the Library; for instance, Israeli made abstracts for clients, Al- lemann provided translations from the French, Charles Toepper furnished literature refer- ences, etc. 44 Edgar A. Tibbetts, clerk, was able to speak 10 languages and to translate German, French, Spanish, Italian, Portuguese, Dutch, Danish, Norwegian, Finnish, Swedish, Russian, Hun- garian, Bohemian, Roumanian, Greek, Arabic, Turkish, Chinese, Japanese, and other lan- guages. In 1904 he desired to transfer to the Bureau of Military Information, where transla- tors were paid several hundred dollars more than his $1,400 a year salary. McCaw wrote to the Surgeon General: "The services of Mr. Tib- betts are considered indispensable to the library of the Surgeon General's Office, because of his ability to translate from certain languages. . . . His loss would certainly cripple the work of in- dexing. If he were transferred his place would have to be supplied here by a man of special knowledge of these languages, and this would undoubtedly be exceedingly difficult. For this reason his transfer is disapproved." Letter, Tib- betts to Secretary of War, Feb. 6, 1904, with 2nd indorsement by McCaw, Feb. 15: MS/C/ 116. One cannot help but feel that Tibbetts was treated unfairly in having a promotion denied him on the ground that he was too valuable to the Library. Tibbetts came to the Library in 1893. He was killed by a collision with a horse and wagon while riding his bicycle home, Jan. 30, 1908: MS/fB/101. In 1904 Albert Allemann desired to transfer to the position of anatomist in the museum. McCaw noted that Allemann was a "very val- uable clerk," and would not recommend his transfer; letter, Allemann to Surgeon General, July 28, 1904, with 1st indorsement by McCaw, July 28: MS/C/116. Allemann was promoted later and therefore possibly did not lose through McCaw's refusal. 45 The museum was jokingly called the "Pic- kle Factory." The expression "Botany Bay" may be found in memo, probably by Champe McCulloch, July 17, 1917: MS/C/137; in memo, William Owen to Surgeon General, Dec. 10, 1918: MS/C/151; and elsewhere. 46 Memo, McCaw to Surgeon General, May 3, 1910: MS/C/116. 47 Letters, Levy to Billings, Dec. 1903; Bill- ings to Levy, Dec. 14, 1903: MS/C/115. Kate Levy was the first woman, to my knowledge, to ask for a job in the Library. The first woman to be hired may have been Miss Harriette B. Blackwell, appointed clerk, class 1, Sept. 25, 1905 (see file card, MS/C/116). Miss Blackwell later worked for the museum. 48 Letter, Billings to Flugel, Dec. 7, 1875: NLM. 49 Copy of letter, Sternberg to Secretary of War, Feb. 28, 1896; letter, Sternberg to Hun- tington, Feb. 29: MS/C/115. 216 THE LIBRARY IN OPERATION, 1895-1913 50 An interesting "Memorandum on subject of issues of Index-Catalogue," 1908?, is in MS/ C/116. 51 Memo, Garrison to the Surgeon General and Librarian, Aug. 5, 1929: MS/C/166. 52 Letter, Fletcher to Billings, Apr. 30,1899: NYPL. 53 When Index Medicus suspended publi- cation, the French and Austrians carried on for a time with the Bibliographic Medica (Index Medicus) . . . (Paris, 1900-1902) and Index Medicus Novus . . . (Vienna, June 1889-Feb. 1900). 54 Letter, Fletcher to C. Walcott, Carnegie Institution, Jan. 3, 1903, gave the cost of pub- lication of the final volume in 1898 and esti- mated the cost of the first volume under aus- pices of Carnegie: MS/C/115. Correspondence regarding the Index Med- icus is in the records of the Carnegie Institution. 55 A few letters concerning the yearly grants of $10,000 provided by the Institution to Fletcher are in MS/C/116; as letter of Dec. 21, 1904. Reports of the yearly grant were printed in the Institution's Year Book. The amount of the grants varied from $10,000 to $17,500 per volume, depending upon the size of the volume. The first notification of the revival of Index Medicus attracted less than 300 subscribers; clippings from unidentified journal, Apr. 25, 1903, MS/C/115. 56 Fletcher's resignation became effective Dec. 31, 1911, according to letter, R. S. Wood- ward to Fletcher, Jan. 4, 1912: MS/C/49. 57 Letters, Fletcher to Billings, Jan. 26, Feb. 2, 5, 9, 1897, NYPL; Billings to Fletcher, Jan. 27, 1897, MS/C/115; Rep. Henry H. Bingham to H. C. Yarrow, Feb. 8, Billings to Fletcher, Jan. 28, 1897: MS/C/1. Memo, Objections to removing the Army Medical Library from its present location, 1897: MS/C/115. There were rumors at this time that the Army Medical Library might be removed from the Medical Department and placed in the Library of Congress. In a discussion following a talk en- titled "The Army Medical Library and Mu- seum" by David Huntington before the'Medical Society of the District of Columbia, Mar. 17, 1897, members of the audience spoke of the importance of keeping the AML where it was, and the society adopted a motion to do every- thing in its power to prevent removal of the Library to Library of Congress; see National Med. Rev. 7: 66-72 (1897-98). 58 Memo for Surgeon General, "Reasons why the Library of the Surgeon General's Office should not become a part of the Library of Con- gress," Jan. 13, 1905: MS/C/116. 59 Printed questionnaire, "Organization and Use of Libraries," and separate handwritten draft of replies, 1906: MS/C/116. 217 Xffl The Library During World War I Champe Carter McCulloch, Librarian 1913-1919 LIEUTENANT Colonel Champe Carter McCulloch* was born in Texas, September 10, 1869. He earned an A.B. degree from Baylor University, a civil engineer degree from Texas A & M, an M.D. degree from Virginia in 1891 and another M.D. from Columbia in 1892. Later he acquired an M.S. degree from Columbia. With these five degrees he was looked upon as some- what of a student by his fellow officers after he entered the Army Medical Department in 1892. McCulloch's career for the next two decades was typical of that of the medical officers of his time. He was stationed at a succession of posts, served with the Army in the Philippines during the insurrection and spent 2 years in the Panama Canal Zone. On July 3, 1913, he was assigned to the Library. While he was Librarian he was on the faculty of the Army Medical School as professor of military and tropical medicine and later professor of military hygiene, and from August 1915 to June 1916 he was also curator of the museum. McCulloch revived the old practice of collecting photographs of prominent physicians, a custom that had declined since Billings departed a generation earlier. He went about it systematically, writing many letters requesting photos each year.l He had the photos mounted and placed in portfolios, perhaps the first time this was done.2 He also began to purchase photographs from com- mercial studios.3 McCulloch seems not to have a uniform policy in lending. He declined to send out pamphlets by Jenner because they were "very old and rare and can never be taken from the Library, "4 and a book by Purkyne because it was in the Exhibition & Historical Collection and "we don't lend it outside the Li- brary. "5 On the other hand he loaned incunabula and rare books of the 16th, 17th, 18th, and 19th centuries. During the first half of his term the institution moved along normally, McCulloch overseeing administration, Garrison editing the Index-Catalogue and directing Library operations. McCulloch had more than a passing interest *His name was Champe Carter McCulloch, Jr., but he seldom appended Jr. to his signature 219 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Champe Carter McCulloch, Li- brarian, 1913 to 1919. in the organization he headed; he joined the Medical Library Association and presided over it from 1914 to 1916. Then ripples from the World War grew into waves, and the Library became a busy, crowded establishment. McCulloch and Garrison acquired additional duties, one of which was laying the foundation for the official history of the Medical Department's activities during the conflict. McCulloch, who had wanted to go to Cuba with the Army in 1898 and had to remain in Florida, who had wanted to go to France with the AEF and had to remain in Washington, finally went to France in July 1918 as a planner of the history. Soon after he returned from Europe in December 1918 he was trans- ferred from the Library. Garrison, with whom he remained on friendly terms all his life, remembered him as "a kindly, yet a very strange man, with the sombre contrariness of the Scotch, crossed by some ply that yearned to function as a play-boy, yet not really jolly in the English sense but rather saturnine and sardonic. "6 McCulloch retired from the Army on November 30, 1922. There- after he was deputy state health officer of Maryland until he died at Walter Beed on October 14, 1928.7 Influence of the Library of Congress McCulloch, like other officers during the period of the Army trusteeship of the Library, did not know anything about, or presumably have any thoughts about, running a library before he was sent there by the Surgeon General. But after he arrived he set about to learn the fundamentals of librarv science and 220 THE LIBRARY DURING WORLD WAR I to try to improve the organization's way of doing things. He was impressed by some of the practices followed by the Library of Congress and decided to adopt them. One of McCulloch's innovations was a card catalog for the use of the public. Earlier, when Billings had begun cataloging, printed catalogs had been the usual form. Billings had published catalogs in 1868, 1872, 1873-74, and finally the Index-Catalogue from. 1880 onward. But the lower cost and other advantages of card catalogs had caused many libraries to swing from printed to card, and McCulloch decided that it was time for his organization to do so. In 1916 McCulloch made arrangements to receive from the Library of Congress printed author cards for books.8 These cards began to arrive July 1, 1916. The Library also purchased a quantity of lined index cards, identical in size and quality to the Library of Congress printed cards, with the intention of preparing author cards for volumes in the Library, for which LC cards would not be available.9 The preparation of cards was not carried very far at the time because clerks were too busy with other tasks, and the war soon disrupted normal operations. After the armistice the Surgeon General assigned six hospital corpsmen temporarily to the organization. One of the jobs given these men was to cut author entries from pages of the Index-Catalogue and paste them on blank filing cards.10 These were interspersed among the LC printed cards and handwritten cards in the filing cabinet. Thus came into existence the motley array of typed, handwritten, pasted, and LC printed filing cards that constituted the main public card catalog of the Library for a third of a century, from the 1920's through the 1950's. McCulloch was impressed by other things at the Library of Congress. He pointed out to Surgeon General Gorgas that the salaries at LC and elsewhere in the government were higher than those in the medical library and that "this was due, perhaps, principally to the fact that the employees here have been designated as clerks, although doing the same class of work as men with profes- sional titles elsewhere."11 His reasoning may have been logical, but it did not lead to an increase in salaries or a change in titles. McCulloch also requested that the Library be permitted to remain open until 10 o'clock at night, instead of 4:30 in the afternoon, and on Sundays and legal holidays from 2 to 10, like the Library of Congress. Earlier librarians had considered the advantages to the public of the institution's remaining open in the evening, but they had been stopped by lack of funds to pay additional employees. McCulloch asked the Surgeon General to request an additional $5,000 in the next appropriation to allow the Library to remain open longer, but $5,000 was a large sum compared with the $10,000 appropriation for books and the approximately $28,000 for salaries, and McCulloch did not receive it.12 World War I Disrupts Procurement of European Publications Soon after World War I began in Europe during the summer of 1914 its effects were felt in the Library. Before the year was over all Belgian medical 221 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE periodicals, most of the French, and many of the Italian had suspended pub- lication. By 1915 the supply of Russian, Russian-Polish, German, and Austrian journals was cut, and the flow from other countries was impeded.13 Turmoil within belligerent countries was partially the cause of the stoppage, but the Library's system of payment was also responsible. The Librarian, by government regulation, could not pay dealers for journals, books, and other publications until they reached the institution; in other words, the Librarian could not pay in advance.14 If a European bookseller sent a bundle of journals to the Library and the journals went down with a torpedoed freighter, the seller bore the loss. Therefore sellers accumulated journals for the Library but would not ship them. The absence of European journals delayed the preparation of many citations for the Index-Catalogue and Index Medicus. McCulloch endeavored in vain to restore the flow of Russian journals by asking the U.S. Embassy in Petrograd to help him locate a bookseller (Russian periodicals had been coming through a dealer in Leipzig, Germany).15 He borrowed some German and Austrian journals from the Boston Medical Library and New York Academy of Medicine and from the editors of the Journal of the American Medical Association and the Boston Medical and Surgical Journal, who were still managing to procure the periodicals from Europe.16 With these borrowed copies the Library kept somewhat up-to-date with its indexing of German and Austrian periodicals. In Europe hundreds and finally thousands of dollars of the bookseller's capital was tied up in bundles of journals that gathered dust. It became apparent that after the war a large quantity of journals from Germany and Austria, and a lesser quantity from France, Switzerland, Italy, Portugal, Spain, and other countries would reach the Library. The Library could not put aside money to pay the sellers because, by law, an appropriation that was not spent within a certain time reverted to the Treasury. Congress rescued the Library from its dilemma by doubling the usual appropriation to $20,000 for the fiscal year ending June 1919 and again for 1920. The larger appropriation would also permit the purchase of rare works that might be offered for sale at comparatively low prices after the war, plus publications of the 1914-1918 period that were ex- pected to be higher in price because of inflation. After the fighting ceased the channels of communication opened rapidly, and during 1919 practically all of the missing periodicals from Germany, Austria, and a few other countries arrived. The Library was still unable to locate a bookseller in Russia, and gaps remained in the serials of that country.17 With European books and pamphlets the situation was different. Routine ordering procedures had been disrupted. The Library had not ordered books published in enemy countries. Dealers had not accumulated books for the institution, as they had journals. In 1919 the Library had begun purchasing from Europe, but many of the volumes had been printed in small editions because of wartime conditions and were no longer available. The Library was unable to acquire as many works published between 1914 and 1918 as it desired. 222 THE LIBRARY DURING WORLD WAR I TIEWAIBIEM,!! Weekly Chatter ot U. S. Army Hospital No. 12 VoL VI—No. 6 5c PER COPY July 26, 1919 HOW TO KEEP 'EM DOWN ON THE FARM Title page of one of the short-lived magazines published by doughboys in World War I Army hospitals. 223 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Aside from the customary publications, the Library sought official docu- ments issued by European army medical departments, especially from 1917 onward when the United States was involved in the war. In the view of the librarians these documents might contain information, based on actual wartime conditions, about the operations of military and civilian medical agencies that would be of use to the United States Army Medical Department. McCulloch suggested to his superiors that they order the medical officers at the U.S. embassies in London and Paris to obtain such reports.18 He re- quested the French Ambassador in Washington to have French military pub- lications brought across the Atlantic by diplomatic couriers.19 He asked the director of the British Army Medical Service for manuals, reports, and other publications issued by the Royal Army Medical Department.20 British and French officials cooperated by supplying documents, not numerous in total number but relatively complete for the war period.21 Another type of wartime publication sought by the Library soon after the armistice was the Army hospital magazine. Published by enlisted men at a number of general and base hospitals during 1918 and '19, their titles reflected the doughboy humor of the times: Gee Aitch 43 (from General Hospital no. 43, Hampton, Va.), Mess Kit, Ward Healer, Biand-Foryu, Star Shell, Plattsburgh Reflex, Trouble Buster, and others. Garrison, Acting Librarian, wrote to editors for copies and succeeded in obtaining almost all of them.22 Because of his foresight the Library contains one of the best collections of these scarce mag- azines, containing photos and drawings of surgeons, soldiers, and nurses now dead and buildings and facilities now gone. Impact of the War on Employees The war affected the staff of the Library in several ways. Divisions of the Surgeon General's office continued to reach into the Library and borrow clerks, occasionally for long periods of time. In 1916 during the trouble with Pancho Villa along the Mexican border, the SGO requisitioned half of the clerks and retained them for 4 or 5 months. In March 1917, just before the United States entered World War I, six clerks were borrowed for more than a month. When these clerks were elsewhere the indexing of journals and preparation of the Index-Catalogue slowed down.23 The expansion of the military services as the United States approached the war drew men from the Library. Charles Toepper, who had left the Library in 1905 to accept a lieutenancy in the Philippine constabulary and returned in 1908, left again to become an officer in the ordnance department. Howard M. Savage also accepted a commission in the Army. Two other clerks transferred to combat-related parts of the Surgeon General's office. Garrison, who had joined the Officers Reserve Corps with the grade of major in April 1917, was called to active duty in July 1917. ^ He went to the military camp at Plattsburgh, New York, for training and thereafter was sta- 224 THE LIBRARY DURING WORLD WAR I tioned at the Library. He was appointed to the Medical History of the War Board in August and spent much time on the history during the next 2 years. Therefore, although he was assistant to the Librarian and ran the Library when the commanding officer was away, he could not devote much of his time to library affairs. There were veteran employees, men who had been with the organization for decades, who simply could not work at an accelerated wartime pace. David O. Floyd, principal clerk, died April 23, 1918, after 36 years of service. Fred- erick W. Stone, who had joined the Union Army in 1861, later gone into the Surgeon General's office and been Billings' secretary, had a stroke in 1918 but continued to work. Harry O. Hall, brought to the Library by Billings in 1875, still presided over the reading room. Robert W. Hardy, a clerk for 49 years, had slowed down because of ill-health and age. John J. Beardsley, in the Federal service since 1863, was now so infirm as to be "deadwood."25 Instead of obtaining the sort of intelligent, hard-working persons that McCulloch desired, the organization had to fill some vacancies with clerks "whose usefulness had ended in other divisions" of the SGO and were sent to the Library "largely as pensioners." One of these was unable physically to perform the work in other divisions, another was transferred without the knowl- edge or consent of the Librarian, and another, blind in one eye and almost blind in the other, was sent "in order that he might be given a desk at which to sit until he could no longer report."26 McCulloch protested, telling his superiors that "this branch of the [Surgeon General's] Office should no longer be used as Botany Bay to which the wreckage of all other divisions of the Office are sent to die. Each part of the Office should be compelled to [take] care of its own wreckage, and not make this a dumping ground."27 Morale was low because of the department's policy regarding the grades of library clerks. During the previous two decades the grades and salaries of clerks gradually slid downward. As clerks with higher grades died, resigned, or re- tired, the Medical Department forced the Library to hire clerks at lower grades. In 1894 six clerks earned $1,800 a year; by 1917 only two. Six $1,600 clerks of 1894 decreased to four in 1917; nine $1,400 clerks gave way to four, and eight $1,200 clerks to six. In contrast, four $1,000 clerks in 1894 increased to 13 by 1917.28 While the SGO was cutting the number of high grades in the Library, it was bestowing promotions elsewhere. McCulloch noted that the "M. & L. force is demoralized by the fact that the work devolves upon low grade clerks, and there is no inducement to become efficient."29 To enable the Library to continue to operate, the War Department per- mitted it to hire temporary employees. Several of these were women, among them Audrey G. Morgan, M.D., and Loy McAfee, M.D. As in factories and offices throughout the country, the war period opened the Library for the first time to women employees in significant numbers.30 None of these women were trained librarians, but they learned quickly what they needed to know. A few 225 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE found they liked the profession and stayed on during the 1920's and 1930 s. In 1919, the war over, the government began to lay off temporary employees and by the end of the year the Library had lost many of its new workers. In 1919 as the temporaries were being discharged, the Surgeon General assigned six sergeants to the Library. These men prepared cards for the new public card catalog by clipping entries from the Index-Catalogue and pasting them on blank cards. They rearranged books, pending the preparation of a proposed shelf list and a new classification.31 They remained about a year, until their enlistments were up in 1920, and then departed.32 Wartime Compression in the Building The war forced the Medical Department to jam more officers, NCO's, and civilians into the crowded building. Besides the Library and museum the struc- ture still housed the 50-year-old accumulation of Civil War pension records administered by the Adjutant General's office. Chemists and draftsmen occu- pied other rooms. The editor of Military Surgeon and the officer in charge of Confederate graves had offices there. At least 11 rooms in the center wing, the capacious first floor room under Library Hall, and much of the cellar was occupied by these intruders.33 Now the department decided that the studio of a group of photographers, recruited to produce movies, slides, filmstrips, and photos for instruction at army camps, would be installed in the building. Space also had to be made for several artists of the anatomical art section; for additional officers detailed to the museum for work in pathology; for other groups, and for specimens shipped from the war zone. The museum was compressed much more than the Library, but the latter lost space usually reserved for clerks, readers, and acquisitions. The room in the basement where duplicates were stored was overflowing, and donations of duplicates, accumulated for presentation to needy libraries, had to be refused because there was no place for them.34 There was no shelf space for incoming government documents, and some had to be piled on the floor of the third tier of stacks. The staff wondered where they would shelve the flood of European publications expected to arrive after the war ceased. Fortunately for the Library, in 1918 the War Department agreed to remove the pension records filed in the large room beneath Library Hall and in the cellar. Garrison, the Acting Librarian, proposed to convert the front end of the room into a reading room and stack area for journals and the back end into a stack area for documents. This was done; temporary wood stacks were erected therein as soon as possible. The floor of this room consisted of wood planks laid atop wood joists. The area, therefore, with wood floors, furniture, and stacks, and paper publications was considered to be somewhat of a fire hazard by the safety-conscious staff. Garrison recommended that the wood floor be replaced by concrete and the wood stacks by iron, but this was not done until some years later.35 Bound periodicals and public documents were moved from the second levels 226 THE LIBRARY DURING WORLD WAR I of stacks in Library Hall to the lower room, freeing considerable space for acquisitions. With space available on the shelves Garrison hoped to reclassify and rearrange the books.36 The reclassification did not come about, but new works soon came aplenty, so much so that within a few years an officer of the Corps of Engineers would advise caution in adding more books else the safe capacity of the floor beams and girders in Library Hall would be exceeded.37 Proposal to Merge the Surgeon Generals Library With the Library of Congress Another side effect of the war was an attempt to remove the institution from the Medical Department and integrate it into the Library of Congress. A member of the Senate Committee on Military Affairs suggested that this be done. The reasons for the proposal are not known, but perhaps the Senator was puzzled by the presence in the Army of a major research library whose readers were largely civilians, just as a later generation of Pentagon executives would question the arrangement. The Secretary of War did not object, so the following amendment was added to the Army Appropriation Bill: ". . . on or before January 1, 1915, said Library shall be transferred to and become a part of the Library of Congress, and so much of the amount herein appropriated as may be necessary is made available for paying the expenses of such removal." There were reasonable arguments in favor of the move. The Library of Congress was open until 10 o'clock in the evening and therefore accessible to more readers than the Army Library, which closed at 4:30 in the afternoon. It would be to the advantage of scholars and students to have libraries in one location rather than separated. There were opinions that it would be more economical. The Medical Department opposed the legislation. Librarian McCulloch asked physicians and organizations to influence their congressmen against the amendment. Medical societies cooperated, sending resolutions opposing the move to senators and representatives of their states. Editors stirred up their readers.38 The House Committee on Military Affairs would not agree to the amend- ment, and it was deleted from the bill.39 The Library remained where it was, but it may have come close to being severed from the Medical Department and sent to the congressional library building on Capitol Hill. The History of the Medical Department in World War I The idea that a history of the Medical Department's activities in the war be written probably occurred to a number of persons, but the architect of the history was Garrison. In August 1917 McCulloch requested Surgeon General William Gorgas to create a board to collect material for the preparation of a medical and surgical history of American participation in the war, the board to consist of Garrison (a major since July 1917), Captain John S. Fulton, and McCulloch.40 Gorgas established the board a few days later.41 Thereafter Gar- 227 A history of the national library of medicine rison was not only involved in library affairs, but for the next 3 years he spent much time planning for, corresponding in connection with, and advising on the history. Garrison initiated the collecting of much of the basic information for the history, although other names often appeared on orders and letters. Upon his suggestion reports by medical officers who had been sent to Europe as observers were obtained and cataloged. He arranged for the compilation of administrative histories of the divisions of the Surgeon General's office. He suggested the preparation of semiannual histories by each division of the office. He was responsible for instructions being sent to camps and hospitals to compile his- tories. Between May 19 and June 19, 1918, Garrison visited 20 camps and air fields in the South Atlantic, gulf, and mid-Western states to show surgeons the proper way of compiling histories of their installations. He asked the Surgeon General to send a circular to camps and base hospitals in the United States and France requiring that war diaries be kept. Also at his suggestion circulars were sent to officers informing them of the proposed history and asking them to collect material.42 As the collection of documents progressed there was not sufficient space in Garrison's office or elsewhere in the Library-Museum Building for the ex- panding historical work, and another room was obtained in the Surgeon Gen- eral's office, which had moved into temporary building F in the center of Washington.43 On July 2, 1918 the Surgeon General appointed to the History Board an advisory council composed of Casey Wood, Victor Vaughan, and William Welch, all three temporary officers. Wood was the most active in the history program and was soon placed in charge of the office in Tempo F. The History Board encouraged medical officers to publish articles about their experiences. To make certain that articles would meet professional stand- ards and not reveal military secrets, the Surgeon General established a board of publications in April 1918. McCulloch presided over the board; Garrison was secretary for a few months.44 During the time that the Nation was in the war McCulloch was eager to sail to Europe with the troops. In May 1917 he had offered his services to former President Theodore Roosevelt, who had planned to raise a volunteer regiment and lead it overseas.45 After the War Department's disapproval had ended Roosevelt's dream of an expedition, McCulloch remained at his post in Washington while all around him medical officers headed for the war zone. In July 1918 McCulloch finally managed to be sent overseas, using as his excuse the necessity for conferring with the chief surgeon and other medical officers of the A.E.F. about the proposed history. He saw the medical sights of London, visited medical headquarters in France, toured battle areas, went to the great library of the Faculty of Medicine in Paris, and started home in December. McCulloch's desire of serving in France was never fulfilled, but he had a glimpse of the war at close range. 228 THE LIBRARY DURING WORLD WAR I During the 6-month period that McCulloch was overseas, Garrison worked on the history of the war, reviewed manuscripts sent to the board of publica- tions, coedited Index Medicus (he had asked Frank Stockman to assist) and, as Acting Librarian, directed the organization. In October 1918 Surgeon General Gorgas retired and Merritte Ireland became the chief medical officer. Ireland reorganized the Surgeon General's office. The Historical Board of Garrison, McCulloch, and Fulton was renamed the Historical Section of the Library Division.46 By this time Garrison had a firm conception of the history. He and Casey Wood conferred with Ireland, who approved a tentative draft of the publication program for a 15-volume series and assigned authors.47 Shortly after the armistice the Surgeon General's office began to consider the writing and publication of the individual volumes. On January 8, 1919, an editorial board of 30 officers, Garrison among them, was created to judge the manuscripts submitted for publication. Garrison concentrated on writing a history of the administration of the SGO, but during the year four different officers were given command of the Library, and Garrison had to spend much of his time keeping the organization running smoothly. The compiling, writing, and editing of a multivolume history by more than a score of authors was a major undertaking, and the Surgeon General finally decided to establish a much larger, formal group, to produce the volumes. On December 4, 1919 he abolished the Library's History Section, replacing it by a History Division in the SGO. The History Division was headed by Francis A. Winter, then by Paul F. Straub, concurrently with their jobs as librarians. Contract surgeons were sent to the Division to help manage the large project.48 Garrison was not assigned to the History Division. Busy in the Library, he continued to write the administrative history of the SGO.49 But those who followed in Garrison's footsteps changed the scope of the volume and omitted his name from the title page and chapter headings when the volume was published in 1923. ^ The complete series of 15 volumes was published from 1921 to 1929 under the title, The Medical Department of the United States Army in the World War. No other branch of the Army compiled a history of comparable size. The foundation of this massive, impressive set lay in Garrison's conception, planning, and hard work that inspired and stimulated the senior officers in the SGO to develop and continue the project until it was completed. By-products of Garrison's research were the lectures on the history of military medicine he delivered at Carlisle Barracks in 1921 and the articles he published in Military Surgeon between 1916 and 1922.51 McCulloch Suggests Abolition of the Index-Catalogue At about the time the long war was beginning in Europe the Library gave away its last complete set of the Index-Catalogue, first series. Shortly thereafter the Patent Office Library, needing shelf space for its expanding collection, offered to return its set. Librarian McCulloch gladly accepted the offer. Sur- 229 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE mising that other governmental, nonmedical libraries might not be using their copies, McCulloch asked them to return idle sets.52 Within a few years all sets reclaimed from Federal agencies had been given away. Thereafter libraries could only obtain recent volumes from the Library or Superintendent of Doc- uments and had to pick up early volumes as they appeared occasionally in catalogs of antiquarian booksellers, who acquired them from estates of physi- cians.53 The distribution of the Catalogue in 1914 was typical of yearly distribution during this period. Out of 1,000 copies 403 were donated to libraries in the United States, 303 to libraries in other countries, 25 copies were retained for use in the Library, leaving only 269 copies for sale by the Superintendent of Documents.54 Since all of the latter volumes were sold within a few years of publication (the price was only $2 a volume, more later, always an extraordinary bargain) there remained for distribution only the 25 copies stored in the Library. The Librarian doled these copies out carefully, generally to new libraries. During the war copies of the Catalogue on the way to European libraries were lost when ships were sunk in the Atlantic. The Library stopped sending volumes abroad until the conflict was over; then it dispatched copies again. But some years elapsed before connections were reestablished with all its European friends.55 Useful as the Index-Catalogue was, it could not keep up with current lit- erature. The number of journals and books published each year increased while the Catalogue fell further and further behind. The most recent references might be 15 or 20 years old. For instance, a reader in 1912 seeking references to articles on tuberculosis would find them in the volume published back in 1893, 19 years earlier. The reader would then have to consult all the volumes of the Index Medicus between 1893 and 1912 to be up-to-date. Furthermore, the preparation of the Catalogue was a never ending task that absorbed much of the library's resources. Therefore when the preparations for the final volume of the second series were completed in 1916, McCulloch wanted to end the work unless the medical profession overwhelmingly favorr d continuation. Garrison, the principal assistant, had mixed feelings. He opposed continuing the work unless the medical profession demanded it.56 On the other hand from his viewpoint as a historian of medicine he was reluctant to see the bibliography stopped. ". . . the value of the Index-Catalogue is not so much for the immediate present as for the future, where it would be difficult to bring these things together again," he told a correspondent, "I should like to say that the medical profession will lose a great deal if it passes up the Index-Cata- logue. "57 McCulloch sent a circular letter to medical libraries, medical school facul- ties, medical societies, and prominent physicians requesting their opinion. As an alternative he promised to continue indexing, placing the cards in a public file cabinet, and to publish special bibliographies on topics of wide interest, such as pellagra and influenza.58 230 THE LIBRARY DURING WORLD WAR I The replies were unanimous for the continuation of the Catalogue.™ McCulloch felt that he had to go ahead, and he requested an appropriation for printing the first volume of series 3. This volume was published in 1918 (normally it would have appeared in 1917, but was delayed a year by war conditions) with changes designed to save time and money. Reprints were no longer listed, contractions were used, a smaller font of type was adopted, and articles of little value were omitted. Garrison noted that thereafter the "process of exclusion [of worthless articles] had to be carried out with the utmost rigor" because of the high cost of printing.6*1 Albert Allemann, who had assisted Garrison with the editing of the Cata- logue since 1912, became the chief editor when Garrison went into the Army. Allemann was a conscientious, hard-working Swiss with deep affection for the institution. Born in 1860, he had immigrated in 1884 and supported himself by teaching languages. At the age of 40 he had come to the Library and, believing that he ought to learn something about medicine since he was reading about it every day, attended Georgetown Medical School in the evenings, receiving his M.D. degree in 1904. He edited practically all of series 3 (1918- 1932), carrying out the "process of exclusion" and other policies suggested by Garrison and the librarians to reduce the cost and hasten the preparation of the volumes. First Step Toward a Bibliography of Incunabula The war was responsible for the temporary abandonment of the Library's compilation of a bibliography of incunabula. The first incunabula had been obtained by Billings in the 1860's. He did not go out of his way searching for them but picked up several each year, purchasing copies when they were advertised at comparatively low prices.61 Copies also arrived through gift and exchange. Through the slow but steady acquisition of pioneer printings, the institution had a sufficiently large collection to be of use to John Stockton- Hough, the first Ameican physician to study medical incunabula in the 1880's. Billings loaned some incunabula to Stockton-Hough, sent him transcriptions, and allowed him to have photographs taken (Billings did not want photos made and gave permission grudgingly).62 During the early 19th century the clerk most interested in incunabula was Felix Neumann.63 Urged by Garrison, Neumann agreed in 1915 to compile a catalogue of the Library's holdings.64 Garrison searched through 800 pamphlet boxes looking for items for Neumann.65 Their enthusiasm for the early printings infected McCulloch, who directed that they be purchased whenever possible66 and even thought of bringing Arnold Klebs, a Swiss physician and expert on incunabula, to the Library to work on the volumes by employing him under contract as an acting assistant surgeon.67 In late 1915 Klebs came to Washington at his own expense and remained almost a year, working on the Library's collection.68 During that period the old publications, which were dispersed throughout the building shelved ac- 231 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE cording to subject, were brought together and placed in glass exhibition cases. Klebs and Neumann cooperated, intending to produce a bibliography which would have been published in the Index-Catalogue and as a reprint, but because of the war it was not completed.69 McCulloch finally published the first list of the Library's 231 incunabula in Annals of Medical History in 1917.70 Owens Dream The first move to obtain a new Library-Museum Building came not from the Library but from the museum. In 1882 a young physician named William O. Owen demonstrated his abilities to an examining board and was accepted by the Medical Department as an Assistant Surgeon. Over the years he rose to the rank of colonel and then in 1914, owing to a mix-up in the records, was retired. In May 1916 the error was rectified, and he was called back into the department and placed in charge of the museum. As a coincidence in 1916 Congress established the Public Building Com- mission to determine what buildings would have to be constructed to contain all the government agencies in Washington. Perhaps this survey was the stim- ulant that started Owen thinking about a new home for the crowded museum and Library. Owen began to plan a large three-story structure that would house the museum, Library, Army Medical School, and Field Medical Supply Depot (the latter was then in a rented building at 21 M St., N.E.) and also have rooms where medical and scientific societies could meet. The structure would have 118,260 square feet of floor space (the current building had somewhat more than 40,000) and would cost an estimated $2,300,000. It would sit on the south side of the Mall between 12th and 14th Streets.71 Owen circulated his plan among his colleagues.72 Only the commanding officer of the school objected, on the grounds that the structure would not be suitable if the department enlarged the school in the future. Surgeon General William Gorgas was captivated by the concept and told Owen to proceed. Owen consulted the Commission of Fine Arts to ascertain the style of archi- tecture and design that the building should have and had an architect draw up floor plans and a front elevation. Gorgas requested, but did not receive, $10,000 from the Secretary of War to engage an architect to draw up detailed plans and specifications. Gorgas also asked Lieutenant Maurice L. Bower, an artist who was with the museum during the war, to paint a picture of the proposed building, and for more than a quarter of a century this painting hung in the Surgeon General's private office. The Commission of Fine Arts, a body authorized to approve the design of proposed buildings for the purpose of maintaining architectural harmony along the Mall, assigned a site between 41/2th and 6th, A and B Streets, S.W., and told Owen to redesign the structure, making it less ornamental and grandiose. Owen had plans drawn up for a plainer, four-story structure.73 Owen not only planned and pushed for the building within the Medical 232 THE LIBRARY DURING WORLD WAR I A third of a century after John Shaw Billings planned the first Library- Museum building, Colonel William O. Owen proposed this new, larger build- ing . The painting was made by Lt. Maurice L. Bower, who served in the Medical Department during the war. Department, he also directed Major Robert W. Shufeldt to rally civilian phy- sicians to urge Congress to give approval and funds. Shufeldt had retired from the Medical Department in 1891, begun to practice medicine in Washington, and been recalled to active duty in January 1918.74 He sent a circular letter to scores of prominent physicians and officers of local and state medical societies, asking them to endorse legislation for a new building. He mimeographed copies of the replies and stapled the copies together in a volume an inch and a half thick. He presented copies of this volume, which he entitled "Letters from Medical and Surgical Societies, Deans of the Medical Colleges of Class A, and from Eminent Physicians and Surgeons of the United States making an Appeal to Congress for an Appropriation to be applied to the building and equipping of the proposed new Army Medical Museum . . ."to members of the House and Senate committees on military affairs, and to other influential legislators. He visited Representative Julius Kahn and asked him to introduce a bill on the subject. Kahn replied that the House committee had discussed the proposal to some extent and advised Shufeldt to postpone action until a more propitious time. Apparently military matters connected directly with the war monopolized the committees' attention and kept the Museum-Library's friends from pro- ceeding.75 Surgeon General Gorgas retired on October 3, 1918, and was succeeded by Merritte W. Ireland, who preferred that the new library be erected close to Walter Reed General Hospital rather than on the Mall.76 This was the beginning of a debate that would last a third of a century over the site of a new library building. 233 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Owen's "dream," as he called it, of a new building stopped here.77 Never- theless he and Shufeldt had impressed the Medical Department and Congress, and in 1919 a bill was passed appropriating $350,000 for the purchase of land "for the final location of the Army Medical Museum, the Surgeon General s Library, and the Army Medical School," contiguous to Walter Reed, where the department hoped to establish a great medical center.78 World War I marked the end of an era in the Library. During the period the last of the first generation of clerks and almost all of the second generation clerks, men who had been indoctrinated by the founders, disappeared. Women employees began to displace men. The last long-term Librarian was gone, and hereafter the normal tenure of librarians would be 4 years. Shelf space became scarce. The dearth of trained employees at a time when the war was stimulating the demand for more service caused the organization to fall behind in its work.79 "The business ... is actually several years in arrears, with the current and absolutely necessary work several months in arrears," noted an Acting Librarian in 1920.m The war years marked the first peak in the Library's existence; during the next two decades it would slide downhill. Notes 1 See McCulloch's correspondence in MS/ fB/101. 2 Index-Catalogue, 3 series, vol. 1, p. iv. 3 On one occasion he bought 43 photogra- vures from Berlin Photographie Co.: Letters, Mar. 16, 20, 25, 1916, MS/fB/101. 4 Letter to librarian, N.Y. State Lib., Sept. 25, 1914. 5 Letter to librarian, N.Y. Acad. Med., Apr. 6, 1916. 6 Letter, Garrison to A. Klebs, Oct. 17, 1928: MS/C/166. 7 Biographical information on McCulloch may be found in MS/C/137, Army Register, Bull. Med. Lib. Assoc. 13: 21-3 (1923-24) (an editor's account of McCulloch's autobiographical speech at an MLA meeting), and JAMA 91: 1564 (1928). 8 Index-Catalogue, 2nd series, vol. 21, 1916, p. vi. Letter, Garrison to W. Gilbert, Mar. 7, 1921: MS/C/166. "We have arranged with the Library of Con- gress to have all our author cards printed in modern style for consolidating our four author catalogues into one (the whole to be placed in cabinets in front of the book stacks pro bono publico)"; letter, Garrison to William Osier, copy at JH. 9 Memo, McCulloch to Mr. Wilson, Jan. 24, 1917: MS/C/137. C. C. McCulloch, "Classifi- cation and Arrangement of Books in the Library of the Surgeon General's Office," Bull. Med. Lib. Assoc, n.s. 6: 61 (1917-18). 10 Memo, Garrison to Straub, Feb. 7, 1919: MS/C/309. 11 Report of the Surgeon General, 1916, p. 215. 12 Report of the Surgeon General, 1916, p. 215. 13 Letters, McCulloch to F. A. Brockhaus, Jan. 22, 1915; to librarian, Mass. Gen. Hosp., Feb. 24; to H. Goulon, Paris, May 1; to K. L. Rikker, Petrograd, June 3: MS/fB/101. 14 Letter, McCulloch to O. Harrascowitz, Leipzig, July 24, 1915: MS/fB/101. 15 Letters, McCulloch to A. Wadsworth, Feb. 11, 1916; to U.S. Embassy, Petrograd, Feb. 17: MS/fB/101. 16 Letters, McCulloch to J. F. Ballard, Bos- ton Med. Lib., Mar. 18, 31, Apr. 12, 1916; to C. M. Williams, N.Y. Acad. Med., Apr. 13; to G. Simmons, JAMA, Feb. 25, Mar. 11, 17, 24, 31; G. Smith, Boston Med. Surg. J., Mar. 1, 18, 31, Apr. 12: MS/fB/101. Letter, Garrison to John W. Farlow, Boston Med. Lib., Mav 12, 1916: JH. 17 Report of the Surgeon General, 1920, p. 365; 1921, p. 170. Memo, Librarian to Surgeon General, Jan. 9, 1920; memo, Garrison to Sur- geon General, Aug. 3, 1920; letter, Secretary of State to Secretary of War, Aug. 23, 1920: MS/ C/15. A brief account of the effects of the war on the supply of European medical publications is in the section by McCulloch on the Library in: 234 THE LIBRARY DURING WORLD WAR I The Medical Department of the United States Army in the World War, vol. 1, The Surgeon General's Office (1923), p. 516-519. See also McCulloch's preface to Index-Catalogue, 3S, v. 1, 1918. 18 Draft of memo for the Surgeon General, no date; memo for the Surgeon General, Mar. 15, 1917; letter, Surgeon General to Col. A. E. Bradlev, American Embassy, London, Mar. 15, 1917: MS/C/137. 19 Letter, McCulloch to J. J. Jusserand, French Ambassador, Oct. 8, 1917: MS/C/137. 20 Letter, McCulloch to Surgeon Sir Alfred Keogh, Oct. 8, 1917: MS/C/137. 21 Letters, Surgeon Sir A. Keogh to Mc- Culloch, Oct. 29, 1917; McCulloch to Keogh, Nov. 12, 1917; Col. A. E. Bradley to the Sur- geon General, Apr. 24, 1917, listing official doc- uments obtained for the Library; MS/C/137. 22 For example, letters, R. Davis, ed. Bomb- proof, to Garrison, Dec. 15, 1918; A. Wikel, ed. Bayonet, to Garrison, Dec. 18; Garrison to Davis, Dec. 19: MS/C/151. 23 Memos, McCulloch to Surgeon General, Oct. 13, 1916; Apr. 14, 1917: MS/C/137. 24 Albert Allemann moved into the post of principal assistant librarian, vacated by Garri- son, and Frank Stockman into the assistant li- brarianship vacated by Allemann. Garrison was promoted to lieutenant colonel in August 1918. 25 Memo, Owen to Surgeon General, Aug. 20, 1918: MS/C/151. Beardsley died in August 1920. Stone died Mar. 25, 1919. Hall retired in 1921. 26 Memo, Noble to Surgeon General, Sept. 19, 1919; memo, chief clerk to Col. P. Straub, Apr. 2, 1919: MS/C/151. Letter, Noble to Sur- geon General, Apr. 23, 1920: file Personnel au- thorization: MS/C/309. 27 Memo, McCulloch [to Surgeon Gen- eral?], July 17, 1917; MS/C/137. 28 Comparison of number of clerks in M. & L. Division 1894-1917: MS/C/137. 29 Unsigned memo, 1917: MS/C/137. 30 The trend to hire women continued as vacancies occurred during the 1920's and 1930's, and by World War II women comprised 80 per- cent of the staff. The wartime recruit who remained at the Library the longest time may have been Chris- tine C. Hilbrandt, who assisted with the Index- Catalogue until she retired in September 1954. During one stretch of 26 years she was never absent on sick leave, surely somewhat of a re- cord in the Library. 31 Letter, Garrison to Noble, Oct. 7, 1920; memo, Librarian to Surgeon General, Jan. 9, 1920: MS/C/151. A 15-page "Tentative classifi- cation for arrangement of books," 1917, is in MS/C/137. Report of the Surgeon General, 1920. p. 365. 32 Letters of recommendation that Garrison wrote for these men are in MS/C/166. Lists of names, salaries, and duties of per- sons employed in the Library including tem- porary employees, may be found in MS/C/137 under dates Oct. 3, 1916; June 30, 1917; Oct. 3, 1917; 1918: in MS/C/151 under dates 1918; Apr. 10, 1918; Feb. 12, 1919; Feb. 18, 1919; Apr. 4, 1919; Apr. 25, 1919; Sept. 19, 1919: and in MS/C/309, file A9a, Feb. 7, 1919. '■" Letter, [W. Owen?] to Surg. Gen. Gor- gas, May 22, 1917, with attachments and in- dorsements: file Space Information. MS/C/309. 34 See, for example, letter, Garrison to Sec- retary of the National College of Pharmacy at George Washington University, Oct 3, 1918, declining an offer of journals: MS/C/151. 35 Memo, Garrison to C. R. Darnall, Dec. 27, 1918: MS/C/151. Memo, Garrison to Straub, Feb. 7, 1919: MS/C/309. Report of the Surgeon General, 1918, p. 433; 1919, p. 1258. 36 In the NLM manuscript collection is a 15- page "Tentative classification for arrangement of books in Surgeon General's Library," 1917, apparently drawn up by Garrison and Mc- Culloch for the proposed reclassification: MS/ C/137. Garrison considered adopting James Bal- lard's classification in use at the Boston Medical Library; letter, Garrison to J. W. Farlow, Oct. 16, 1917: copy at JH. See also letter, Garrison to Welch, Oct. 17, 1919, mentioning that Li- brarian R. Noble was to visit medical libraries to examine classifications: JH. 37 Letter, Maj. B. Somervell, Corps of En- gineers, to officer in charge, Army Medical Museum, Nov. 7, 1928; letter, S. Blackman, junior engineer, to Mr. Merrick, Oct. 27, 1928: file Old Building and Restoration, MS/C/309. 38 Letters, McCulloch to J. A. Spalding, Mav 1, 1914; McCulloch to Rep. E. Y. Webb, Apr. 30, 1914: MS/fB/101. Letter, McCulloch to J. A. Spalding, Apr. 25, 1914: MS/C/137. Memo, McCulloch to Acting Surg. Gen., 1915: file A- 9a, MS/C/309. Editorials, Bull. Med. Lib. As- soc. 3: 56-57 (April, 1914);/AMA 62: 1100 (1914). Rep. James Lloyd of Missouri became in- volved in a confused, interesting misunder- standing with the secretary of the Missouri State Medical Society over the amendment. See let- ter, McCulloch to E. J. Goodwin, June 15, 1914; MS/fB/101. /. Missouri State Med. Assoc. 11: 27, 90-91, 95-97 (1914). Statement by Lloyd, Congressional Record, Jan. 22, 1915, pp. 2277- 2278. Statement opposing transfer of Library, 1914, 235 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE given to committee by Neilson Falls of the Li- brary: MS/C/137. 39 The House did not single out the amend- ment regarding the Library. It disagreed with all Senate amendments to the Army Appropri- ation Bill. 40 Letter, McCulloch to Gorgas, Aug. 9, 1917: MS/C/137. Fulton was secretary of the Mary- land State Board of Health, a captain in the Reserve Corps, and an expert in medical statis- tics. 41 A.G.O. Special Orders 196, para. 217, 218, Aug. 23, 1917. 42 Plan for a medical and surgical history of the American participation in the present Eu- ropean war, [1917]: MS/C/137. Medical and sur- gical history of the war-July 1917-July 1918 [July 1, 1918], MS/C/151; also published in Military Surgeon 43, 347-350 (1918). Report of the Di- vision of Medical and Surgical History of the War, attached to letter, McCulloch to Surg. Gen. Gorgas, July 12, 1918: MS/C/151. Report of the Surgeon General, 1918, pp. 436-437. At the Library there were four temporary employees working on the war history under Garrison's direction. 43 The room was on the second floor of Tempo F, occupied by the SGO from May 3, 1918, to Aug. 30, 1920. See floor plan in The Medical Department of the United States Army in the World War, vol. 1, p. 128. 44 An account of the work of the Board and a list of the persons on it is in The Medical Department . . . in the World War, vol. 1, pp. 520-523. 45 Letters, McCulloch to Roosevelt, May 8, 1917; W. E. Dame to McCulloch, May 11; McCulloch to R. Derbv, May 16; Derby to McCulloch, May 17: MS/C/137. 46 SGO Office Order 97, Nov. 30, 1918. The Museum and Library Division, established in Billings time, was split. The Library Division was set up, consisting of the Library Section and the History of the War Section. The mu- seum was placed in a new Laboratory Division. See organization chart, The Medical Depart- ment . . . in the World War, vol. 1, p. 540. 47 Letter, Garrison to Brig. Gen. W. McCaw, Dec. 11, 1918: MS/C/151. Garrison's outline of the series is in an article by him and Wood, Military Surgeon 44: 521- 529 (1919). 44 A brief account of the work of the History Division of the SGO and its predecessors, the History Section of the Library Division and the History Board, is in The Medical Department ... in the World War, vol. 1, pp. 525-528. See also Loy McAfee, "Book Making Thru Military Channels," Med. Rec. 101: 130-4 (1922). 49 Letter, Garrison to Wood, July 27, 1920: MS/C/166. See also letters in Kagin, Life and Utters of Fielding H. Garrison, pp. Ill, 125, 135. 50 An acknowledgement of Garrison's serv- ices is on p. 13 of The Medical Department . in the World War, vol. 1. 51 Titles of these articles may be seen in the bibliography of Garrison's writings in Kagan, Life and Letters of Fielding H. Garrison. Some of Garrison's correspondence, outlines, draft, instructions and notes regarding the war history may be found in MS/C/137, MS/C/151, and MS/ C/166. 52 Letters, McCulloch to librarian of Weather Bureau and Justice Dept., June 29, 1914: MS/ fB/101. McCulloch likely wrote to every non- medical federal library. 53 "The entire first series . . . and the first ten volumes of the 2nd series of the Index-Cat- alogue are entirely out of print. Because of this fact, recently established medical institutions in the United States and Europe are unable to secure a complete set of the Catalogue . . ."; letter, R. E. Noble to W. W. Strang, Apr. 24, 1922; see also Circular letter No. 2, by Col. C. R. Darnall, Feb. 4, 1928: MS/C/154. 54 Letter, McCulloch to Superintendent of Documents, Jan. 29, 1915: MS/C/137. See also Memorandum concerning the mail- ing and distribution of Index-Catalogue, by McCaw, Sept. 13, 1912: MS/C/116. 55 Letter, Phalen to Director, Bibliotheque Cantonale et Universitaire Lausanne, Mar. 16, 1927: MS/C/154. 56 Memo, Garrison to Col. Darnall, Nov. 26, 1920: MS/C/151. 57 Letter, Garrison to C. P. Fisher, Apr. 20, 1916: JH. 58 Memo, Garrison to Col. Darnall, Nov. 26, 1920: MS/C/151. Memo, Garrison to Surgeon General, May 31, 1922: MS/C/166. 59 Resolution of the Medical Library Assn. for the continuation of the Catalogue, Bull. Med. Lib. Assoc, n.s. 6: 14 (1916), copy in MS/C/154. On p. 14 of the Bulletin is a statement that the Mass. Med. Soc, and the Boston Med. Lib. had also passed such resolutions. Letter, J. C. Hay, John Crerar Lib., to Garrison, Apr. 27, 1916; resolution of medical faculty of Johns Hop- kins, May 1, 1916; and other letters from groups in the United States and Great Britain favoring continuation, Feb.-July 1916, in MS/C/154. 60 Memorandum for the Surgeon General and the Librarian S.G.O. on the Index-Catalogue and Index Medicus, by Garrison, no date: MS/ C/166. 61 "Have never tried especially to obtain them"; letter, Billings to J. Stockton-Hough, Aug. 236 THE LIBRARY DURING WORLD WAR I 30, 1889: MS/C/81. As late as 1908 the Library was offered an incunabulum for $15.50; letter, C. P. Fisher to McCaw, Apr. 17, 1908: MS/C/ 116. 62 Correspondence between Billings and Stockton-Hough, 1880's, in MS/C/81. 63 Felix Neumann was born in Hoenigsberg, Germany, Sept. 10, 1858, and emigrated to the United States as a young man. From May 1, 1900, to Sept. 30, 1907, he was employed in the Library of Congress reference division, and from Oct. 1, 1907 to April 1, 1908, in the Smith- sonian's bureau of international exchanges. He then came to the Library where he selected, ordered and cataloged all books purchased and also selected books from the Library of Congress duplicate copyright volumes. Eventually he rose to the position of assistant librarian. Interested in early printers and their publications, he was the Librarys first expert on incunabula and be- came well-known in this field. In 1931 George- town University awarded him an honorary doc- tor of laws degree. In his later years he was in poor health, but he continued to work at the Library until he was forced to retire by the Economy Act on July 1, 1932, almost 74 years old. He died in February 1934. Robert Austin remembered Neumann thus: I always enjoyed conversing with Mr. Neu- mann as his German accent in pronouncing words in English fascinated me. He would invariably greet me with the expression "Ach! Life is so sad." Mr. Neumann had a fine sense of humor and, from time to time, would drop by and visit with library staff. He was some- what "eccentric" in his work routine—he al- ways insisted on locking the door to his room upon leaving each day. This caused somewhat of a problem for cleaning personnel at night when they cleaned the entire building. By special arrangement one of the library's mes- sengers would do the necessary chores in Mr. Neumann's room when he would arrive at work each morning. This room, the largest private office in the library, had book shelves down thru the center of it and book shelves from floor to ceiling along two walls and in spaces between windows. Books were everywhere and very little space was left for work area. Perhaps it was just as well the cleaning people couldn't get into the room as it was a hopeless place to clean—only the work area around Mr. Neu- mann's desk could be touched. Going to and from the library, Mr. Neumann always carried a green cloth bag under his arm and employ- ees wondered what was in the bag—perhaps his lunch and/or his home work? Document, Felix Neumann applying for job at Library, Feb. 14, 1908: MS/C/116. P. Ash- burn, Med. Life 43: 575 (1936). Clipping from Washington Sunday Star, with portrait, n.d.: HMD. Letter R. Austin to W. D. Miles, Sept. 29, 1979: HMD. 64 Letter, Garrison to A. Klebs, Apr. 7, 1915: MS/C/166. 65 Archivists who handle dusty documents occasionally develop allergies or other ailments. This happened to Garrison. He remarked to his friend Arnold Klebs: "I have never cared par- ticularly for those venerable items [incunabula] because the fine, impalpable dust they engen- der, like that from the cire-cloth of an Egyptian mummy, will get up into air-passages, causing considerable physical discomfort unless you plug the nostrils with cotton" (letter, Jan. 24, 1930: MS/C/166). Garrison was annoyed with ab- scesses on his fingers caused, he thought, by dirt from incunabula. 66 "Notwithstanding the limited means I have tried to enlarge our collection of early printed books and during my administration have suc- ceeded in increasing the number of our incun- abula"; McCulloch, Ann. Med. Hist. 1:301 (1917). McCulloch gave a talk "On Incunabula" be- fore the MLA, May 1915, published in Bull. Med. Lib. Assoc, n.s. 5: 1-15 (1915-16). 67 Letter, Garrison to Klebs, June 27, 1915: MS/C/166. Other letters from Garrison to Klebs regarding incunabula are in this collection. 68 "One of our most distinguished authorities on old-book lore, Dr. Arnold C. Klebs . . . spent over ten months ... in connection with the recataloging of our . . . collection of 15th cen- tury medical books"; memo for the Surgeon General, June 12, 1917: MS/C/137. 69 Letter, McCulloch to Public Printer, Feb. 1, 1916: MS/fB/101. McCulloch, Bull. Med. Lib. Assoc, n.s. 5: 14 (1915-16). Klebs published an article while he was studying at the Library, "Desiderata in the Cat- aloging of Incunabula," Papers of the Biblio- graphical Society of America, 10: 143-163 (1916). 70 "A Check List of Medical Incunabula in the Surgeon General's Library," Annals Med. Hist.h 301-315 (1917). R. W. Shufeldt, an officer on temporary duty with the museum, wrote an illustrated article about the collection, "Various Incunabula and other Rare Works in the Library of the Surgeon General's Office," Med. Review of Reviews 24: 326-341 (1918). 71 65th Cong., 2d sess., Sen. Doc. 155, Re- port of the Public Buildings Commission . . pp. 172-173, 194-195. 72 Owen's correspondence, drawings, and photographs regarding the building are in MS/ C/47. Memo, Owen to Surg. Gen. Gorgas, Dec. 8, 1916: MS/C/309. The need for a new building, from the mu- seum's viewpoint, is discussed in Henry, The 237 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Armed Forces Institute of Pathology, pp. 167- 169, 191—195. Two typed drafts of a proposed bill that Owen drew up, hoping a new building would be au- thorized, are under the date Feb. 15, 1917: MS/ C/137. 73 A bird's-eye view of a model of the mall, showing the proposed location of the building close to the Capitol, is in MS/C/47, and in Owen's article, "The Army Medical Museum," New York Med. J. 107: 1034-36(1918). 74 A sketch of Shufeldt (1850-1934), a ver- satile, interesting person, is in Edgar E. Hume, Ornithologists of the United States Army Med- ical Corps, pp. 390-412, portrait, and biograph- ical refs. 75 Some of Shufeldt's correspondence, a vol- ume of the mimeographed letters, and a bound volume containing the original letters, are in MS/C/133. Shufeldt wrote illustrated articles on the proposed building, "The New Army Med- ical Museum on the Map," Med. Review of Re- views 24: 596-599 (1918), and "The Need of a New Army Museum," Nat. Humane Rev. 6: 108- 109 (1918). 76 Memo, Surg. Gen. Ireland to Owen, Nov. 16, 1918: file New Building Location, MS/C/ 309. 77 Owen called it his "dream" in a letter to the Fine Arts Commission, Dec. 14, 1917: MS/ C/47. 78 Act approved July 2, 1919 (41 Stat. L., 122). Also, Act of Sept. 22, 1922 (42 Stat. L., 1029) appropriating funds for, among other things, the "site of the Medical Museum and Library." 79 For example, interlibrary and local loans tripled between 1915 and 1920; memo, Noble to the Surgeon General, Dec. 10, 1920: MS/C/ 151. 80 Memo, Maj. James Coupal, acting librar- ian, to chief clerk, SGO, Sept. 9, 1920: MS/C/ 151. 238 XEV The Library in the 1920's The Let-down After the War AFTER the war the demand for library service did not drop to the prewar level but continued to grow. By 1922 it was estimated that the workload had increased threefold or more since 1914. * While the Library's work was increasing, the government was reducing its war-related spending as rapidly as possible. The Medical Department's funds were so limited that it could not provide even the few additional employees needed to maintain the Library in top shape. Also, vacant shelf space was becoming scarce. Under these conditions the Library had to concentrate on providing essential services—interlibrary loans, indexing for the Index-Catalogue, answering inquiries received by mail, acquiring publications, compiling of special requested bibliographies2—while allowing other tasks to lag behind. The shelf listing, recataloging, and rear- ranging that Garrison had hoped to undertake had to be left undone. The cataloging and arranging of documents and pamphlets dropped further and further behind. The public card catalog was not kept up to date. The acquisition of catalogs and announcements of medical schools and reports of hospitals and health organizations became haphazard because no one could be spared to keep track of and write for them. The systematic collection of photographs of phy- sicians was curtailed for the same reason. The plan for expanding and mounting the collection of autographs and letters of famous physicians was abandoned. For a period after the war the Library could not even spare clerks to send out copies of its famous product, the Index-Catalogue.3 Paul Frederick Straub, Librarian 1919 After the armistice as the American Army was busy demobilizing, Surgeon General Ireland appointed Colonel Paul Frederick Straub Librarian.4 Little is known about Straub, which is unfortunate for he was unique among the Li- brarians in possessing the Congressional Medal of Honor. Born in Germany on July 3, 1865, he was brought to the United States when his family immigrated and settled in Iowa. He received medical degrees from University of Iowa, 1885, and University of Berlin, 1892. He entered the Medical Department in 239 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Paul Frederick Straub, awarded the Congressional Medal of Honor for Heroism, Librarian, 1919. 1892 and served in the Spanish-American War, in the Philippines, and in World War I. In 1910 he published a little text, Medical Service in Campaign: a Handbook for Medical Officers in the Field, much of which was based on his own experience. During the Philippine Insurrection, Straub was surgeon of the Thirty-sixth United States Volunteer Infantry. At Alos, Zambales, Luzon, on December 21, 1899, a detachment from the regiment was attacked by insurgents. He helped fight off the attackers and risked his life to rescue and carry to safety a wounded comrade. For his heroism he was awarded the Medal of Honor. He was decorated on two other occasions. At the end of World War I, Straub was within a few months of retirement age. The Surgeon General apparently thought that the Library was a quiet, restful place for him to wait out his remaining days in the Army. He sent Straub to the institution in early 1919. With Straub the Surgeons General began the practice that continued for a quarter of a century of assigning to the Library officers approaching the end of their Army careers. The precise date when Straub entered the institution is not known, but by February he was signing outgoing correspondence. He did not have time to learn much about the art and science of librarianship for he left the Army on May 6, barely 3 months after he arrived at the institution. He moved to Hol- lywood, California, practiced medicine until 1927, and died in Los Angeles on November 25, 1937. 240 THE LIBRARY IN THE 1920S Francis Anderson Winter, Librarian May-September 1919 Francis Anderson Winter was born on a plantation in St. Francisville, Lou- isiana, June 30, 1867. His father was professor of Greek at Centre College. He attended Bethel Military Academy, Warrenton, Virginia, and St. Louis Medical College (M.D., 1889). In 1891 in St. Louis he watched the military funeral of General William T. Sherman and decided to join the Army. He served at several posts in the West, went to Cuba during the war with Spain, was stationed in the Philippines three times, taught at the Army Medical School, commanded the Army-Navy Hospital at Hot Springs, Arkansas, and in 1917 was sent to Europe with the A.E.F., where he was promoted to the rank of brigadier general. Returning to the United States in December 1918, he was appointed com- mandant of the Army Medical School and also on May 17, 1919, Librarian of the Surgeon General's Library.5 Winter had led an active life and did not relish desk jobs at the school and Library. After serving as Librarian for less than 4 months, he requested a transfer and in September was sent to Fort Sam Hous- ton, Texas, as chief surgeon, where he remained until he retired in September 1922. Thereafter he lived in Washington and died there January 11, 1931.6 Little can be said of Winter as Librarian. He served one of the shortest tenures, along with Straub and Walter Reed. One would assume that Garrison directed the operations much of the time; during Winter's absences he was officially Acting Librarian.7 Francis Anderson Winter, Li- brarian, May to September, 1919. 241 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Robert Ernest Noble, Librarian 1919-1925 The Librarian who had to contend with the postwar conditions was Robert E. Noble, sent to the institution in 1919 after two previous librarians had come and gone in 9 months. Noble had been born in Rome, Georgia, November 5, 1870. He studied civil engineering (B.S., 1890) and chemistry (M.S., 1891) at Alabama Polytechnic Institute before finally settling on medicine (M.D., Co- lumbia, 1899). In 1901 he joined the Army as assistant surgeon and by 1918 had risen to the wartime grade of major general, with permanent grade as brigadier general. Along the way he served in the Philippines from 1903 to 1907, assisted Surgeon General William Gorgas in eradicating yellow fever in the Panama Canal Zone during construction of the canal, had charge of the anti-mosquito campaign in Puerto Rico in 1911-1912, accompanied a commis- sion to Ecuador to study yellow fever in 1912-1913, was a member of the commission sent to Transvaal, South Africa, to study causes of pneumonia among miners in 1913-1914, and headed the Personnel Division of the Surgeon General's office from 1914 to October 1918, where he organized the Medical Service and Nurse Corps for war duty. Also from February 1918 to October he was in charge of the Hospital Division. He sailed for France in October and was chief surgeon of two A.E.F. units.8 In September 1919 he was appointed Librarian.9 Noble, an expert in disease control and medical administration, was now in a field about which he knew nothing, library administration. With Garrison as tutor he began to learn how to manage a library. But he barely started before Surgeon General Ireland placed him on the Rockefeller Foundation Yellow Fever Commission to the West Coast of Africa. When Gorgas, the leader, died on the way Noble became Robert Ernest Noble, Librar- ian, 1919 to 1925. 242 THE LIBRARY IN THE 1920S head of the commission. From May 1920 until Noble returned in December, Garrison ran the Library.10 Noble endeavored to continue the reclassification and other improvements started by McCulloch and Garrison and to obtain more funds and employees. But this was a period of poor economic times, with the government trying to bring the country back to normal following the war, and he obtained sympathy but little else. He saw the half-century old name "Library of the Surgeon General's Office,'' replaced by a new name, "Army Medical Library," on Jan- uary 10, 1922.u Noble confined his activities in the Library to managing the day-to-day operations of the organization and, unlike his predecessors and succesors, did not participate in extracurricular library activities. He wrote only two articles during his 5-year stay in the institution in contrast to other librarians who mined the rich resources of the collections to turn out books and articles on history, biography, bibliography, and library matters. Noble remained in the Library until he retired from the Army on February 8, 1925. Thereafter he lived in Anniston, Alabama, devoting much of his time to volunteer work with the Boy Scouts. In 1955 he was named "Man of the Year" in Anniston for service to his community. He died September 18, 1956, aged 85. James Matthew Phalen, Librarian 1925-1927 Noble was succeeded as Librarian by James Matthew Phalen. Born in Harvard, Illinois, November 26, 1872, Phalen studied pharmacy at North- western (Ph. G., 1892) but later turned to medicine (M. D., University of Illinois, 1900). He entered the Army on October 30, 1901, and advanced eventually to James Matthew Phalen, Librar- ian, 1925 to 1927. 243 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the grade of colonel. He served at several posts in the United States, was stationed in the Philippines twice, graduated from London School of Tropical Medicine in 1907, and lectured on tropical diseases at New York Post Graduate Medical School from 1911 to 1913. During World War I he was a division surgeon and medical inspector in the A.E.F. and after the armistice was a surgeon with the Army of Occupation. Returning from Europe in 1920, Phalen attended three Army military schools, including the Army War College, and then directed the Hospital Division in the Surgeon General's office. In 1925 he was appointed Librarian. Garrison once compared the Library to a "land-locked bay or hollow in the woods from which one emerges occasionally to see the world outside."12 This describes the Library during Phalen's tenure. Nothing unusual happened to interrupt the quiet routine, and the organization moved along unobtrusively. Phalen directed the Library only 2 years before his 4-year tour of duty in Washington expired. He was sent to the Panama Canal Zone where, he told Garrison, he was "somewhat homesick at times for the Library."13 In 1930 he returned to the United States and was attached to various National Guard units until he retired in 1936. Phalen had a literary streak and was quite at home in the Library.I4 During his term plans were being made for production of the monumental Dictionary of American Biography. Phalen agreed to write sketches of a number of prom- inent American physicians. He began researching and writing in 1927 and continued after he reached Panama; the necessary books and journals were sent to him on loan. By the time the 20-volume DAB was completed in 1936, Phalen had provided 101 biographies, which put him among the top 14 con- tributors. After Phalen left the Army he settled in Washington and spent most of his days at the Library, researching history and writing biographies. In 1940 he published Chiefs of the Medical Department, United States Army: Biographical Sketches. That year he was appointed editor of Military Surgeon and wrote many editorials and biographies for the periodical during his long term. In 1942 he published Sinnissippi, a popular local history of Rock Valley in Illinois and Wisconsin. Four years later he wrote, / Follow Mr. Thackeray, an account of a tour he and his wife made through Ireland. In 1950 he brought out In the Path of Stones. Phalen continued to write and edit until a few months before he died of heart disease at Walter Reed on October 5, 1954, at the age of 81.13 Percy Moreau Ashburn, Librarian 1927-1932 At the time Phalen's term was approaching its end and Surgeon General Ireland was considering a succesor, Fielding Garrison thought he could have received the post of Librarian if he had requested it. He did not do so because, under the "Manchu" regulation, he would not have been permitted to remain long.16 Instead he stayed on as assistant and the Surgeon General appointed Percy M. Ashburn Librarian. 244 THE LIBRARY IN THE 1920S Ashburn, born in Batavia, Ohio, on July 28, 1872, graduated from Jefferson Medical College (M.D., 1893) and joined the Army in 1898. He was stationed for a long time in the Philippines, where he was a member of the Army Board for the study of tropical diseases. While there he wrote Elements of Military Hygiene (1909, 1915). He seved in Panama from 1914 to 1917, was in the A.E.F. from 1918 to 1919 and in the Surgeon General's office from 1919 to 1920. He established the Medical Field Service School at Carlisle in 1920 and directed it until 1923. From 1923 to 1927 he taught military hygiene at West Point, and in 1927 was appointed Librarian. "Like most of those who will succeed me (unless the law be changed)," Ashburn recalled later, "I went to the Library without either training or ex- perience in that sort of work." But Garrison took him in hand and instructed him in the fundamentals. "I was glad to have him to induct me into library work and he did it gladly and made me like it," wrote Ashburn. "By practicing what he taught me, I soon learned how he could be so well informed on ancient and current medical literature and I even came to feel that, had I been caught by the Library as early as he was caught and lived my life in it as he had lived his, I might have been able to know it as well as he."17 At first Ashburn contributed to the routine by scanning journals written in English, French, Italian, Spanish, and Portuguese, selecting articles for inclu- sion in the Index-Catalogue. Then at the request of Surgeon General Ireland he began to compile a history of the Medical Department. He had never done anything like this before, but with assistance from Garrison, whose office ad- Percy Moreau Ashburn, Li- brarian, 1927 to 1932. 245 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE joined his, and Louis C. Duncan, a medical officer who had written many articles about the Civil War, he moved ahead and published the history in 1929. His interest in history thus awakened, Ashburn began to read everything he could find about the influence of disease on the early colonization of South and North America. After researching for 4 years he wrote a "Medical History of the Conquest of America in the Sixteenth and Seventeenth Centuries" but could not find a publisher who thought the story would sell. Ashburn put the manuscript away. Several years after his death his son Frank found a firm willing to accept it, and it was published under the title The Ranks of Death, a Medical History of the Conquest of America (1947).18 By the time Ashburn was approaching the end of his term he liked library work so much that he attempted, with approval of Surgeon General Ireland, to circumvent the "Manchu" regulation and remain as permanent Librarian. He retired on December 31, 1931, but returned the next day on active duty. Since the 4-year rule did not apply to retired officers, he seemed safely en- trenched in the post. Undoubtedly he would have continued as Librarian until he died or became incapacitated had not the Depression caused Congress to seek ways of reducing Federal spending. A law was passed cutting the pay of retired officers on active duty, and Ashburn left on August 15, 1932. In 1934 Ashburn accepted the position of superintendent of Columbia Hos- pital in Washington and remained in that post until a few months before his death on August 20, 1940.19 Shortage of Trained Personnel During the 1920's the normal staff consisted of a Librarian (an Army officer), a principal assistant librarian, one or two assistant librarians, and 20 to 25 clerks.20 Librarians asked for authority to hire more clerks, but the Medical Department, beset by requests from other units for additional men and bounded by congressional appropriations and War Department regulations, did not have necessary funds.21 A serious ailment of the organization was a chronic shortage of trained employees. Librarian Noble suggested in 1920 that the Medical Department establish a school to instruct "properly qualified men in all matters appertaining to a library, care of books, classification, cataloguing, etc., and that the Library School be a part of the educational system of the Army."22 Surgeon General Ireland told Noble that it was hopeless to ask for legislation to train civilians, but that there would be no difficulty in setting up a school for enlisted men when the Library moved to Walter Reed. Many of the men who came into the Library did not have the spirit and dedication of the earlier clerks. Often newcomers decided, after they had experienced the preparation of the Index-Catalogue or other tedious duties, that they preferred to spend their lives at other tasks in other places at higher salaries.23 Unable to hire qualified men, the Library hired women. Originally staffed by men, the organization had had to employ women during the war and 246 THE LIBRARY IN THE 1920S found them as proficient as male clerks. Thereafter women vied against men for vacant positions. By 1927 women outnumbered civilian men 12 to 11, and they held jobs as responsible and highly salaried as men.24 As in every organization there were employees with idiosyncrasies. One librarian washed his socks and handkerchiefs somewhere in the building and hung them to dry on a line strung across his office. Another, who could not control his appetite, became so corpulent that he had difficulty walking up and down stairs. He was inordinately fond of strawberries with milk, and in the spring he would buy crates of berries from hucksters passing by. After he died his associates found dozens of empty berry boxes and milk bottles in his office. At the other end of the building museum employees prepared the skeleton from the body of one of their associates (he had willed his body to the museum) and sat it in a chair in front of a window facing homes across the street until neighbors complained. Maintaining an adequate number of trained clerks was only part of the Library's personnel problem: the other part was maintaining continuity in important positions. In 1930 the lack of continuity in the directorship and leadership became critical. Garrison left. Allemann was past the compulsory age of 70 and would have to retire in February 1932. Neumann, 2 years older than Allemann, was forced to retire in July 1932 at the age of 74. Librarian Ashburn had to leave in August 1932. Ashburn had foreseen these departures and in the late 1920's he had persuaded Surgeon General Ireland to sponsor legislation, passed in 1931, that permitted the institution to establish the po- sition of Principal Librarian. This was the highest civil service rating in the organization. The incumbent had to be a physician, have an intensive knowledge of medical literature, and an extended knowledge of European languages. Ash- burn appointed a person whom he and Garrison knew to be highly competent, Beatrice Bickel, experienced as a practicing physician, medical editor, linguist, and public health physician.25 Bickel took up her duties on May 12, 1931. She acted as deputy to the Librarian, she chose the articles to be indexed for Index- Catalogue, and selected the medical subject headings for the articles. Ashburn also sought a person to edit the Catalogue when Allemann would leave. After a long search for a scholarly physician able to fill Allemann's shoes Ashburn found26 a Hungarian doctor who would be a jewel in this setting if I could get him. He is about 35 years old, has taught pathology, specialized in urology, and is now in charge of a commercial laboratory in Brooklyn which does all sorts of medical laboratory work. He can work in all the modern European languages except the Slavic group, reads and talks Latin fluently, knows Greek and has studied He- brew and several other Semitic languages, and he wishes to come to the Library. Doubtless you will consider this last fact an evidence of mental infirmity. The Hungarian doctor, Claudius Francis Mayer, arrived on February 25, 1932, three days before Allemann retired.27 From the beginning the duties of Mayer, as editor and compiler of Index-Catalogue, overlapped those of Bickel. At times 247 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE there was a difference of opinion about the subject classification, and then Mayer would change or subdivide Bickel's heading. Still, the two got along amicably although Mayer, a much more forceful person than Bickel, gradually overshadowed his superior and made the decisions regarding the Catalogue. Garrison, now at Johns Hopkins, summarized the problems in Washington thus: "That Library is in a very bad way. 1. through dying off or evanishment of trained worthwhile personnel: 2. through too much rotation of presiding or commanding officers, nearly all of whom, after the death of Walter Reed, had to unlearn the mentality and way of life of army posts and of the two big wars they served in (1899 and 1917-18). "28 The Quarterly Cumulative Index Medicus Garrison had edited Index Medicus alone until World War I placed so many additional burdens upon him that he had to seek a coeditor. The person that he chose was Frank John Stockman, a young man who had started to work in the Library several years before and become so much interested in history of medicine that he had assisted with the proofs of Garrison's History of Medicine. In the evenings he had attended Georgetown University, receiving his D.D.S. degree in 1912. Later he had attended courses in medicine and received his M.D. degree from Georgetown in 1917. In 1917 when Garrison entered the Army, Albert Allemann was promoted to the position of principal assistant librarian vacated by Garrison, and Stockman moved into the post of assistant librarian vacated by Allemann. Stockman then occupied the third highest position in the Library. He was Garrison's "right- hand assistant," working on the history of the Medical Department's partici- pation in the war and coediting with Garrison Index Medicus, 1917-1919, and the War Supplement volume. At the end of December 1919 Stockman, whom Garrison now considered to be "the most talented young man we have ever had here," resigned to work for the American Medical Association, leaving Garrison again with the sole responsibility and labor of editing Index Medicus.29 Garrison edited the 1920 volume by himself, but the work proved so bur- densome that he recruited Albert Allemann as coeditor for the 1921 volume. He considered transforming the Index into a yearbook or having it published monthly by a medical journal. In the end he converted it from a monthly into a quarterly and changed the classification to alphabetical, under subject head- ings. He did this because most of the old-timers who had assisted by copying citations in their spare time were now gone, because it required so much of his time to sort index cards upon which citations were written, and because of his disenchantment with the subject classification.30 In 1921 the Surgeon General's office decided that Garrison should serve a tour of duty overseas and scheduled him for the Philippines. Major Edgar E. Hume, Major Arthur Newman Tasker, and Captain William S. Dow were assigned to the Library as Garrison's replacement.31 Knowing that he could not assist with the editing of Index Medicus in the Philippines, Garrison asked 248 THE LIBRARY IN THE 1920S James Ballard, assistant librarian of Boston Medical Library, to coedit with Allemann. Ballard declined. Garrison then instructed Hume and Tasker in the art of bibliography, and while he was away they assisted the editor of the Index- Catalogue. Garrison handed the coeditorship of Index Medicus to Tasker, be- ginning with the July 1922 number. Tasker was a 16-year veteran of the Medical Department, having served in the Philippines, been stationed at posts in the United States, campaigned with Pershing along the Mexican border, and been gassed at Ypres in World War I. He had taught military hygiene at West Point, zoology at New York Post Graduate Medical School, and, while assisting in the Library, was teaching medical entomology in the Army Medical School. A graduate of Wesleyan University, George Washington University Medical School and Johns Hopkins Medical School, he was well-read, spoke eight languages, and was considered by some of his associates to be the most erudite officer in the department.32 Tasker coedited Index Medicus through 1924 and then returned his share of the editing to Garrison, who had come back from the Islands. By now Garrison was growing increasingly tired of the routine of indexing. He had been asso- ciated with the Index-Catalogue for more than a quarter of a century and Index Medicus for two decades. He referred to the preparation of the indexes of the latter as "drudgery of the most devitalizing kind, ruinous to the eyesight, with consequent impact upon the nervous system, and wearying to the flesh." Fur- thermore his labor on the periodical promised to increase because his assistant and sister, Florence Garrison, was leaving. Florence Garrison had started to work at the Library during the war. In- telligent, competent, and industrious, she had been retained when most of the temporary employees had been discharged following the armistice. By 1927 she had risen to the responsible position of chief of indexers. Garrison referred to her as the "real prime mover and backbone of the old Index Medicus, doing all the drudgery on it and managing the finances."33 But Florence finally felt obliged to stop assisting with the preparation of the Index in order to help care for their mother, who was in her eighties, half blind, partially deaf, and ill. "I had no one else to carry on" Garrison wrote, "in the sense of arranging and alphabeting the pile of 15,000-20,000 cards which came .up for every quarterly number, a gigantic game of poker requiring incredible patience, accuracy and industry. "34 Some years before Garrison had suggested to George H. Simmons, editor of Journal of the American Medical Association, that Index Medicus be com- bined with the AMA's Quarterly Cumulative Index and be published by the AMA. The Quarterly, started by the AMA in 1916, differed from Index Medicus in indexing only the most important journals, in classification, and in other details. A union of the two periodicals would save labor, time, and money. Simmons did not agree, but in 1925 when Garrison suggested the plan to Morris Fishbein, Simmons' successor, Fishbein favored it.35 During the next year there was constant correspondence between Garrison 249 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE and Fishbein and conferences in Washington and Chicago between represen- tatives of the AMA, Army Medical Library, and Carnegie Institution.36 Finally an agreement was reached that provided for the publication by the AMA of a journal to be called Quarterly Cumulative Index Medicus, with financial as- sistance from the Carnegie Institution for 5 years. Garrison would send index cards to Chicago every week where they would be interspersed among the cards prepared in the AMA Library. Two volumes would be published each year. The editorial board would consist of two persons from the Library and two from the AMA. There would be an advisory board composed of one rep- resentative from the Library, one from the AMA, and one from the Carnegie Institution.37 The first number of the Quarterly Cumulative Index Medicus appeared in January 1927. The final number of Index Medicus was published in June 1927, there being an unavoidable overlap.38 The cooperative venture proceeded smoothly, considering the volume of indexing carried on in two libraries hundreds of miles apart, and the logistics.39 Garrison was relieved of some of the routine work. He continued as one of the editors for 2 years, but he had had enough. In December 1929 he told Fishbein, "Due to abuse of the eyesight over close work, night and day, for a prolonged period, and its impact upon the nervous system ... I conclude that, at my time of life, it is wiser to relax, go slow and take things as they come."40 Garrison dropped off the editorial board and became a member of the advisory board.41 The cooperation between the two libraries continued until 1932 when the Carnegie Institution withdrew its fi- nancial support. The AMA then assumed complete responsibility for indexing and for publishing the QCIM.42 The Yearbook Proposal No one was more aware of the large, growing backlog of Index-Catalogue citations than Garrison. Perhaps this was because every month in Index Medicus he published citations that would not appear for years in the Index-Catalogue. In 1920 he suggested an alternative to the perpetual publication of series after series of the Catalogue; that the third series be finished in half the time by doubling the size of the volumes and that thereafter yearbooks be issued. Each book would list the complete medical literature of that year. Since the citations in the yearbook would duplicate those in Index Medicus, the latter could be discontinued. Thus two volumes, one of the Catalogue and one of Index Med- icus, would be replaced by one volume, a yearbook. Physicians and researchers would be served better. The burden on the Library would be eased, and economies would result. The librarians of the 1920s adopted Garrison's idea in principle.43 However, they could not obtain the unusually large sums of money needed to print double-size volumes of the Catalogue.44 Back in 1916 at the end of series 2 the Librarian, McCulloch, had been afraid to take the responsibility of stopping the Catalogue. As the end of series 3 came in sight the librarians were ready, but the Surgeon General was re- 250 THE LIBRARY IN THE 1920S luctant. So in 1930 Surgeon General Ireland sent a form letter to libraries and institutions asking for their opinion. "As you know," Ireland stated, "all of the current literature is now indexed in two volumes per year by the Quarterly Cumulative Index Medicus, and reprinting it in the Index-Catalogue is a some- what expensive luxury."45 But medical libraries and societies, not having to do any of the tedious bibliographical work and receiving the results free (or for only $2.00-$2.75 a volume if they had to pay), naturally voted for the contin- uation of the Catalogue.46 Therefore even before the final volume of series 3 appeared in 1932 Librarian Ashburn had to put the yearbook from his mind and begin making plans for series 4. In 1925 someone, probably Garrison, saw a means of completing the series within a decade, so the Library could switch to a yearbook. Garrison and Morris Fishbein of the American Medical Association had agreed to unite Index Med- icus with the AMA's Quarterly Cumulative Index to form the Quarterly Cu- mulative Index Medicus, publication to start in January 1927. Since the QCIM would print references to current articles, the same references could be left out of the Index-Catalogue and the latter could be prepared much more rap- idly.47 The Librarian gave orders to do this and it was done starting with volume 6, 1926. The Catalogue thereafter listed only titles of articles that had appeared before 1926 and titles of books regardless of date.48 With fewer citations to print the Library was able to complete series 3 in 10 volumes in 1932 instead of 25 volumes in the mid-1940s.49 But by the time the series was completed 'the idea of a yearbook was dropped. Fielding Garrison Leaves the Library After the war Garrison continued to work in the Library as a temporary officer. He seems not to have been entirely content; the reasons are not clear, but after 30 years perhaps he was frustrated at not being able to move ahead in his profession. He hoped that an academic position would be offered— William Welch had suggested that Johns Hopkins would be the place for him, and Winford Smith, superintendent of Johns Hopkins Hospital, had discussed it with him—but none was forthcoming and in September 1920 he accepted a commission as a lieutenant colonel in the Regular Army.50 Eventually the Medical Department, rotating officers around various posts, selected him for a tour of duty in Manila. Garrison felt that he was more useful in the Library than he would be in the Philippine Islands and he did not want to go, but he did not protest and he was sent in 1921.51 Garrison found existence in Manila monotonous, and he did not feel at home in the tropical climate, but for the first time since he entered the Library he had the leisure to reflect upon his life and it made him melancholy. He told his friend Arnold Klebs:52 I myself have lived and worked for over 30 years in a drab, dull milieu of low spirits and lowered vitality and I am paying the piper for it now, when I really need the pep. This alone saddens me that amidst all the bouquets and encom- 251 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE iums, no one gives a bibliographer credit for the horseloads of work he has done and how much it takes out of his vitality. At best, only a discerning few—e.g., the French medico who said of the Index-Catalogue, "C'est un travail hercu- leen," or one or two sympathetic utterances of your own about me. I once asked Billings' daughter: "Was the Doctor always so sad?" She replied immediately, "Always!" and went on to describe his nightly labors up into the small hours of the morning. The eyes of steelly Prussian blue became rather bleared in the long run, although the bodily frame was a tremendous horse-power. . . . This brain-tire, a mortally depressing, at the same time, exasperating feeling of ennui and mental helplessness, goes back to all those years of dull drudgery in the Library, and if that sort of thing could take some starch out of even a superman like Billings, you will realize how well it has done its work in my case. . . . As his stay in Manila neared its end, Garrison decided that he did not wish to return to the Library immediately. His self-examination of his 34 years in the institution had made him reluctant to take up his old position. Yet, there was still no academic opening for him and in the autumn of 1924 he was back in Washington as assistant to the Librarian. He did not display his feelings by decreasing the quality and quantity of his work, but his colleagues observed a change in his personality. Allemann noted that Garrison had been generally kind, pleasant, and polite, although occasionally nervous, before he went to the Islands, but after he returned he was irritable and "demonstrated at times moods which affected his relationship with associates and friends."53 While some of Garrison's moodiness had been brought on by the tedium and monotony of decades of toil over bibliographies, some stemmed from his position as a perpetual subordinate in the Library. He had gotten along well with the early librarians. He said he "liked" Billings, Merrill, Reed, McCaw and Straub very much.54 He wrote that McCulloch was "very good and kind to me in all really fundamental, first-class situations."55 But a recent librarian, probably General Noble, had embarrassed him, accused him of being a poor administrator, and made him determined to leave a situation where he would always be under the command of a person who was at the top because of his military rank, not because of proved professional ability. He confided to Klebs:56 I don't think you have ever realized how very painful and humiliating it has been to remain in a subaltern and secondary position, officially and militarily, for nearly forty years, the insults and rebuffs which must be weathered and (worse than that) the feeling engendered among friend and colleagues (e.g. [Harvey] Cushing, [Edward C] Streeter and yourself) that one has, after all, no 'administrative' ability. In that very ungenerous pronouncement, all you people have overlooked the fact that the Library is run by military administra- tion, i.e. with the aid of a good chief clerk (the equivalent of an efficient orderly or desk sergeant in the military) it is a machine that runs itself. When Noble was in Africa for six months, I ran it mutterseelenallein and everything went forward like clockwork, although, God knows, before that semester, I had never been given a chance to demonstrate so-called 'administrative' ability, which to my mind would be, getting a maximum amount of work done with a minimum of friction. To my knowledge only one librarian, Noble, out of the 11 with whom 252 THE LIBRARY IN THE 1920S Garrison associated, said that Garrison could not administer.57 But Albert Al- lemann, who worked under Garrison and succeeded him as principal assistant librarian, said, "He supervised the whole clerical force [i.e., library staff] and assigned to each clerk his or her work."58 He was Acting Librarian during long absences of the regular Librarian. During 1918 he directed the Library for 6 months while McCulloch was overseas, and in 1919, when the establishment had four librarians in succession, he ran the Library most of the time. Librarian Straub wrote: "He was the main spring of the machine and in my time [1919] was almost entirely responsible for the success of the institution. He was most tactful, and I soon acquired the conviction that he was able to conduct an efficient and systematic library service in spite of amateurish ideas that may have influenced the officer in charge."59 One can only wonder what adminis- trative task Garrison could not have handled in an organization employing approximately 25 persons and spending $20,000 a year on publications. It is now impossible to ascertain in what way Garrison failed to live up to Noble's standards for administration, but the charge seems unreasonable. Another Librarian, Phalen, under whom Garrison worked after he returned from the Philippines, had a different opinion for the reason why Garrison had not been appointed Librarian: "I may say that Garrison was neurotic, very easily offended at times, suspicious, sensitive and shy, and that [he] was con- sidered temperamentally unsuited for the duties of the librarianship, and for that reason, and that alone, he never attained that position."60 Phalen may have been at fault, not Garrison, for he ran the organization in such a manner that Garrison asked visiting historians to meet him outside of the building, remarking that the Library was reserved for business.61 There is no indication that Garrison ever showed his dissatisfaction openly. He continued to work hard at the tasks that fell to his lot as assistant to the Librarian, and he instructed new librarians—Phalen, Ashburn, Hume—as they were detailed to the Library. But he kept looking for a different job, and finally in the fall of 1928 William Welch offered him the post of librarian and lecturer on history of medicine at Welch Medical Library, Johns Hopkins. In January 1930 Garrison began to spend every Sunday and one other day during the week at the Welch Library. In the spring he moved his family to Baltimore, which he found he preferred to Washington. At the end of April he left the Library that he had entered 40 years earlier, as a young man of 20, and began to work full time at Johns Hopkins.62 Even then his sense of duty was so great that he traveled to Washington every Saturday to assist in the Library until his replacement arrived.63 Before he left, Librarian Ashburn bemoaned the Library's loss, telling Morris Fishbein:64 Colonel Garrison's method of work is to allow a tremendous pile of journals to accumulate throughout the week and then on some day, usually Friday just before the cards have to be sent away, he gets at them and heads about three times as many as anyone else can do in the same time and they are sent off to 253 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE you as promptly as any of the other cards. The other matter in which I fear I might have misled you was my rather silly remark that in a sense my job will be simpler when Colonel Garrison gets away. 'In a sense' simply means that I will know just what to expect from each person and will have no one else giving instructions that are at variance with my expectations but that is a very small sense and the total result of Colonel Garrison's leaving will be nothing but loss. My work will be more than doubled and there will be many problems whose solution I cannot now foresee. Librarians Ashburn (1927-1932) and Edgar E. Hume (1932-1936) consulted him in person and by mail about the new library building the Army hoped to have built at Walter Reed Hospital, about proposed changes in the Index- Catalogue, and other matters.65 At Johns Hopkins William Welch became very friendly with Garrison, whose advice he sought often on matters of history. "I count it the greatest piece of good fortune for our medical library," Welch told him, "that you were induced to leave the S.G.O. Library to take our librarianship, and nothing can deprive you of the only reputation worth having, recognition by your peers as a leader in your special field."66 Garrison lived only a few years longer, dying of cancer on April 18, 1935. He had worked in the Library for four decades, a record surpassed by only a few persons, he had labored over many volumes of the Index-Catalogue, edited or coedited 26 volumes of Index Medicus, and become known as a top-notch bibliographer and historian throughout the medical profession of the Western world. Ashburn, the last Army Librarian under whom Garrison worked, remem- bered him as67 A rare and remarkable genius . . . His industry was prodigious and he worked without regard to hours. His mind was versatile and more nearly concerned with "all knowledge" than any other which I have known. His information was as though mentally card-indexed, always promptly available. And it was not merely medical information—music and higher mathematics were his hobbies and thoroughly familiar to him in theory and practice; he knew the world's literature, and I mean that statement literally. Not only did he know the good things of English, French and German literature, the Russians whom so many have read in translation, the Greek, Roman and Hebrew classics, but he was familiar with current trends in Spanish and Portuguese, in Scandinavian and Italian, and his knowledge of Chinese and Japanese literature, classical and modern, astonished me. And Garrison was not a man who tried to astonish. He always acted as though I were as familiar with the subject as he, and mentioned an author or quoted his works with an air of apology. ... I even came to feel that, had I been caught by the library as early as he was caught and lived my life in it as he had lived his, I might have been able to know it as well as he. But only special gifts of God, which I know have been withheld, could have made me capable of loving and understanding mathematics, languages, and music as he did or could have made me as industrious. I trust that in some heavenly Academy he is walking with the great ones of intellect and of art, enjoying communion with Hippocrates, Galen and Harvey, with Newton and Galileo, St. Paul and Moses, with Beethoven and Mozart, that he hears the music of the spheres and is accompanist to the heavenly choir. 254 THE LIBRARY IN THE 1920S 1 Memo for Noble, unsigned, Feb. 21, 1922: file Historical Information, MS/C/309. 2 Copies of many of these multipage bibli- ographies are in MS/C/151 and MS/C/166. 3 "The delay which you experience in re- ceiving volume 2 [of series 3, Index-Catalogue] arises from the fact that we have been reduced to such a point in our library personnel that we have been unable to undertake the general dis- tribution of this volume"; letter, Garrison to W. S. Miller, Nov. 27, 1920: MS/C/154. 4 Dates concerning Straub's military career may be found in Army Register. Brief obituaries are in Military Surgeon 82: 74 (1938) and New York Times, Nov. 26, 1937. Gerard F. White of the Medal of Honor History Roundtable also provided information. Straub published a little text, Medical Serv- ice in Campaign in 1910, 2nd edition in 1912. The earliest date I have seen in connection with Straub is a memo, Garrison to Straub, Feb. 7, 1919: MS/C/309. 5 Memo, by Col. C. R. Darnall, May 17, 1919: MS/C/151. Librarian Paul Straub retired from the Army on May 6, 1919. Francis Winter was assigned to the Library on May 17. I assume that Fielding Garrison acted as Librarian during the interval. 6 Autobiography: MS/C/44. National Cyclo- pedia of American Biography, vol. 28, p. 259. Obit, by J. R. Kean, Military Surgeon 68: 294- 6 (1931). 7 Documents signed by Garrison as Acting Librarian are in MS/C/151. 8 Biographical information on Noble may be found in MS/C/44; Army Register; obituary in JAMA 162: 1408 (1956) and Mil. Med. 119: 346 (1956). 9 Documents in MS/C/151 show that Noble was appointed Librarian in September 1919. 10 See for example, letter, Garrison to Noble in Nigeria, Oct. 7, 1920, reporting events in the Library: MS/C/166. 11 Army Regulation 40-405, Jan. 10, 1922. 12 Letter, Garrison to Phalen, Jan. 18, 1928: MS/C/166. 13 Letter, Phalen to Garrison, Mar. 15, 1928: MS/C/166. 14 "I can understand how you might wish that you were back in the Library as you un- doubtedly got a great deal of kick out of it, prob- ably more than most officers"; letter, Garrison to Phalen, Jan. 18, 1928: MS/C/166. 15 National Cyclopedia of American Biog- raphy, vol. 45, p. 228-9. Army Register. Obit- uaries in Mil. Surg. 115: 473-^ (1954); JAMA 156:1265 (1954); Washington Post, Oct. 6, 1954; Washington Star, Oct. 6, 1954. 16 "There was a juncture when I think I might have had the librarianship on application, about 1928 (I think), but in that case, my stay there would have been brief, and I preferred to go on serving there up to my promotion and on my initial station, at Walter Reed, instead of on a War Department detail, the limit of which is four years (1924-8)"; letter, Garrison to Welch, Aug. 9, 1932; JH. 17 Ashburn, "A Greenhorn's Experience in the Library," Med. Life 43: 573-9 (1936). Most of the Librarians did not leave any reminis- cences of their life in the Library. Ashburn is one who did, in the above article, although un- fortunately too briefly. 18 Ashbum's manuscript and notes are in MS/ C/27. 19 Biographical data in MS/C/44. Army Reg- ister. Obituaries in JAMA 115: 872-3 (1940), Washington Star, Aug. 20, 1940. 20 Lists of employees, their grades, duties, and salaries, are in memos for Library force, SGO, by Noble, Jan. 26, 1920, Feb. 14, 1920; memo for Heads of Divisions, SGO, Sept. 13, 1920: MS/C/151. Memo, Librarian to Surgeon General (1921); memo for General Noble, Feb. 21, 1922; list dated 1927: file Historical Infor- mation MS/C/309. Letter, Garrison to A. Mal- loch, Apr. 12, 1926: MS/C/166. File Personnel Authorization, MS/C/309. 21 For example, see memo, Noble to Sur- geon General, Dec. 10, 1920; memo, Noble to Surgeon General, Sept. 14, 1921, with memo- randum for General Noble returning his mem- orandum of Sept. 14, Sept. 17, 1921; memo, Noble to Surgeon General, Sept. 19, 1921: MS/ C/151. "When you consider that the Library of Con- gress employs 600 persons, which is 24 times the number employed here, whereas we have about one-quarter as many items as they have, you will see that we are not particularly well off if the ratio were kept up . . . We ought to have 150 people employed here. Of course this is not an apt comparison because the two institutions are not alike . . ."; memo Jones to the Surgeon General, Sept. 2, 1936: MS/C/205. 22 Letter, Librarian to the Surgeon General, Jan. 9, 1920, with 1st ind. by Surgeon General, Jan. 27: MS/C/151. 23 "Our main problem ... is to build up a new and adequate personnel"; letter, Garrison to Klebs, June 12, 1930: MS/C/166. The size of the staff, number of vacancies, and other infor- mation can be found in the annual reports of the Surgeon General, 1920 to 1940. 24 List of employees, [1927]: file Organiza- tion, MS/C/309. 255 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 25 Beatrice Adelaide Bickel was born in Ger- many. She received her medical degree from Cleveland Medical College and then took grad- uate courses in comparative anatomy, anthro- pology, and physiology. She practiced medicine for a decade, was an acting assistant surgeon in the U.S. Public Health Service for 6 years, and a medical editor for 7 years. In 1930 she became a contract surgeon for the Medical Department and was assigned to the Library. When Garrison retired and went to Johns Hopkins, Bickel took over part of his duties, in the discharge of which Garrison considered her "highly competent." She was appointed Principal Librarian (some- times referred to as Chief Librarian) on May 12, 1931. She retired Aug. 31, 1942, and died June 11, 1946. Robert Austin, whose career in the Library spanned the 1930s and 1940s, had this impres- sion of the Principal Librarian: "Dr. Bickel was a very private person and, as far as I know, only one or two people on the staff had a relationship with her that revealed very much about her private life. She owned a house in the Glen Echo area of Washington where she lived alone. I found Dr. Bickel a very interesting person. She was always gracious to me and cooperative and quick to understand my problems when I had occasion to go to her in the absence of the Librarian. Dr. Bickel was attractive, of medium build with a very nice figure. She wore expen- sive looking clothes of good taste. She was in- telligent, had a good knowledge of foreign lan- guages, was quick in her thinking and in her movements. She was tidy in her work habits and never left unfinished work on her desk at the end of the day. Her handwriting was very distinctive—rather masculine in appearance— using bold strokes with letters formed in a straight perpendicular position. . . . One summer Dr. Bickel went to Mexico and someone said she had an interest in the ancient Indian culture of Mexican, Central American, and South Amer- ican Indians." Letters, Austin to W. D. Miles, Sept. 29, 1979, Jan. 3, 1980: HMD. Letter, Garrison to M. Fishbein, Oct. 2, 1930: MS/C/166. Infor- mation on list AML personnel ca. 1935: MS/C/ 309. Brief obituary from Washington newspa- per: MS/fB/120. 26 Letter, Ashburn to McCaw, Dec. 1, 1931: MS/C/166. 27 Allemann wanted to continue working like Fletcher, who retired at the age of 91, but he was already over the statutory age limit of 70 and had to leave. He died Dec. 10, 1940. Mayer was born in Eger, Hungary, July 6, 1899. He attended Leopold-Franzens-Univer- sitat, Innsbruck; Royal Hungarian Pazmany Peter University, Budapest (M.D., 1925); and University of Leipzig. He served as pathologist to the Pathological Institute and intern in the Urological Clinic of University of Budapest; pa- thologist and serologist at the Hospital of Na- tional Institute for Social Insurance, Budapest; and consultant in medical history and bibliog- raphy to Ministry of Health, Museum for Public Health and Sociology, Budapest. He came to the United States in 1931 and worked as medical director of Lindsay Laboratories, Brooklyn, N.Y., until he accepted the post at the Library in 1932. He wrote articles, chapters, projected a bio- graphical-bibliography of 16th century books, and edited the Index-Catalogue for a generation before leaving the Library in 1954. See bio- graphical information in MS/C/42. 28 Letter, Garrison to Welch, July 31, 1932: JH. 29 Stockman was born in St. Louis, Aug. 28, 1887. After leaving the Library in December 1919 he worked for the American Medical As- sociation, assisting Morris Fishbein, and then went to the American Institution of Medicine. He was hired by Winthrop-Stearns as medical director in 1925 and rose to the position of senior vice-president. He died on Apr. 17, 1955, while on vacation in Florida. See obituary, N.Y. Times, Apr. 19, 1955; letter, Garrison to V. Robinson, Dec. 23, 1919, containing quotes above, MS/C/ 166. Information was also obtained from AMA and Georgetown. 30 Letter, Garrison to E. C. Streeter, Apr. 6, 1920, in Kagan, Life and Letters of . . . Gar- rison, pp. 120-121. 31 Hume was assigned to the Library full time, Tasker and Dow of the Army Medical School part time; memo, Noble to Col. R. G. Humber, Oct. 24, 1923: file organization, MS/C/166. 32 Tasker was born in Washington, D.C., Feb. 3, 1878. His father, who had been a cavalryman during the Civil War, kept two horses, and equitation became one of Arthur's hobbies. Like Garrison he was fond of music. He was an ex- cellent violinist, attended opera and symphon- ies, and collected recordings of classical works. He enjoyed traveling and toured many coun- tries. After retiring from the Army with the rank of colonel he lived in Baltimore and died there May 30, 1977, at the age of 99 years. For bio- graphical information, see items in NLM. 33 Letter, Garrison to Klebs, June 12, 1930: MS/C/166. Garrison wrote to Klebs from the Philippines on Mar. 4, 1923; "The Index Med- icus is now run by Major Tasker, Allemann and my sister": MS/C/166. "My little sister was really the motor power of the Index Medicus after Dr. Fletcher's death, in the sense of doing all the drudgery and at- 256 THE LIBRARY IN THE 1920s tending to all the business details, until the long last illness of my mother compelled her, and also me, to give it up"; letter, Garrison to Henry B. Jacobs, Aug. 21, 1930: JH. See also letter, Garrison to Welch, Mar. 7, 1923: JH. Correspondence between Morris Fishbein and Florence Garrison regarding the Index may be found in MS/C/156 and MS/C/166. 34 Letter to Klebs, June 12, 1930. Florence Garrison entered the Library Jan. 24, 1918, and resigned Feb. 15, 1930. 35 Letter, Garrison to Fishbein, Mar. 21, 1925: MS/C/166. See also letter, Fishbein to Richard- son, Oct. 23, 1925, MS/C/166, which gives the impression that Simmons and Fishbein initiated the joining of the two indexes. 36 Some idea of the differing viewpoints that had to be reconciled, particularly with regard to classification, may be seen in Garrison's cor- respondence, especially between Garrison and Fishbein beginning Mar. 21, 1925, and extend- ing through 1926, in MS/C/166 and MS/C/156. A few of these letters were printed by Kagan in Life and Letters of . . . Garrison. Correspondence regarding the QC1M is in the records of the Carnegie Institution. 37 The method of cooperation between the AMA library and AML is explained in preface, QC1M, vol. 1, Jan. 1927. * In the "Valedictory," p. ii of the June 1927 issue, is a brief history of the Index Medicus from its inception in 1879, and a list of editors, publishers, and printers. 39 Many questions sent by the AMA to the AML regarding entries in the QCIM may be found in correspondence between Fishbein and Garrison, 1927-1932, MS/C/166 and MS/C/156, and Ashburn and Garrison, MS/C/151. 40 Letter. Garrison to Fishbein, Dec. 4, 1929; see also Fishbein to Garrison, Apr. 22, 1929: MS/C/166. 41 QCIM, vol. 5, 1929, was the last volume to carry Garrison's name as editor. Garrison re- signed from the advisory board in 1931; letter, Garrison to O. West, Oct. 20, 1931: MS/C/166. 42 Accounts of the joint venture may be found in: Morris Fishbein, A History of the American Medical Association 1847 to 1947, pp. 1165- 1169; F. H. Garrison, "The Quarterly Cumu- lative Index Medicus, what it stands for and how to use it,"/AA/A 89: 26-29 (1927). 43 Report of the Surgeon General, 1921, p. 170; 1922, 176-177; 1923, 178;1924, 237. Index- Catalogue, vol. 3, 1922, p. iii; vol. 4, 1936, p. iv. In a number of letters and documents of the 1920s are indications that the Library planned to stop the Catalogue when series 3 ended and publish a yearbook; for example, Garrison to M. M. Tye, May 8, 1925, and Garrison to Fish- bein, Oct. 15, 1925: MS/C/166. 44 The cost of printing series 1 and 2 was borne by congressional appropriations.'The first volume of series 3, 1918, was financed by an allotment from the general military fund of the War Department, in keeping with military pro- cedure during the war. The War Department "quietly and generously" continued to provide allotments for series 3. See Memorandum for the Surgeon General ... by Garrison, n.d., MS/C/166. The printing of the Catalogue was meticu- lous and therefore expensive. For example, the cost of printing volume 5 in 1925 was $18,500 plus $800 for proof corrections, or $19,300. The usual number of copies, 1,000, Was printed. Copies were sold by the Government Printing Office for $2.55 each. Therefore, the govern- ment lost $16.75 on each volume it sold. In 1936, the cost of printing volume 1, series 4, was approximately $33,000, or $33 a volume. The GPO sold the volume for $2.50. 45 A copy of the form letter sent by Ireland to M. Fishbein, May 6, 1930, is in MS/C/156. 46 Harvey Cushing's protest against aban- donment of the Catalogue, May 5, 1930, is in MS/C/183. Index-Catalogue vol. 10, 1932, p. iii. 47 Garrison also suggested that efforts be made to bring the QCIM to such pefection that a year- book would not be needed, and the Library would be freed from the task of publishing a bibliographical volume each year. See Memo for the Surgeon General and the Librarian SGO on the Index-Catalogue and Index Medicus, n.d.: MS/C/166. 48 The measures that Librarian Phalen took to reduce the number of citations in the Cata- logue, thereby completing series 3 as quickly as possible, are given in detail in a memo by Albert Allemann, "Instructions of Col. James M. Phalen for preparing the subject cards for the printer," [1928]: MS/C/154. See also Index-Catalogue, vols. 6-10, 1926-32, letters of transmittal. 49 The disadvantage was, that a person now had to consult the Catalogue and the QCIM. But researchers had been consulting both the Catalogue and Index Medicus for decades, so any disadvantage was minor. One wonders why the plan was not adopted much earlier. For reasons beyond the control of the Li- brary there were a few years during which the Index-Catalogue, series 3, was not published on schedule: 1919, 1921, 1924, 1927. In 1924, for instance, the delay was caused by the lateness of the session of Congress, which in turn af- fected the schedule of the Public Printer. 50 "Welch put up the proposition to me at 257 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Atlantic City once . . . Winford Smith can- vassed the whole matter with me at the end of the war, but as nothing offered, I had to go into the Regular Army"; letter, Garrison to Klebs, Mar. 4, 1923:'MS/C/166. See also letters, Gar- rison to Welch, Aug. 4, 1920, Oct. 22, 1922: JH. Garrison s official station was Walter Reed, but he was detailed to the Library as assistant to the Librarian (see, for example, letter, Gar- rison to E. B. Krumhaar, Aug. 11, 1926: MS/ C/166). 51 "I sometimes wish I had made a strenuous stand [against being sent to the Philippines] on the ground that I was doing the best work for the government where I was . . . if it [a post at Hopkins] had been offered me before I left for this place [Manila], I should have accepted with alacrity"; letter, Garrison to Klebs, Mar. 4, 1923; MS/C/166. 52 Letter, Garrison to Klebs, May 15, 1924: MS/C/166. 53 Allemann quoted by Kagan in Fielding H. Garrison, p. 78. Garrison was aware of his waspishness dur- ing this period. "I am still very irritable, cap- tious, sensitive, cantankerous, jahzorning, crit- ical and even unjust at times"; letter, Garrison to Klebs, Sept. 1, 1926: MS/C/166. 54 "I can recall some military chiefs—Bill- ings, Merrill, Walter Reed, McCaw and partic- ularly Straub, whom I liked very much"; letter, Garrison to Klebs, Jan. 3, 1923: MS/C/166. 55 Letter, Garrison to Klebs, Oct. 17, 1928: MS/C/166. 56 Letter, Garrison to Klebs, June 26, 1926: MS/C/166. 57 "As a medical historian he was outstand- ing; as an administrator, a minus quantity "; let- ter, Noble to E. E. Hume, quoted in Bull. Inst. Hist. Med. 5: 335 (1937). 58 Allemann quoted by Hume, Bull. Inst. Hist. Med. p. 341. 59 Straub quoted by Hume, Bull. Inst. Hist. Med. p. 335. 60 Letter, Phalen to Solomon R. Kagan, quoted by Kagan in Fielding H. Garrison, p. 28. 61 "I request or insist that our meeting in future be outside the Library for the simple and sufficient reason that my position there has been and is subalternized and therefore painful and sometimes humiliating"; letter, Garrison to Klebs, June 26, 1926: MS/C/166. "I should be content if I never saw the Wash- ington Library again, on account of many painful memories associated with my last six years there"; letter, Garrison to Welch, Aug. 9, 1932: JH. The librarians during that time were Phalen (1924-27) and Ashburn (1927-1932). 62 Correspondence between W. Welch and Garrison at Welch Medical Library, particularly Welch to Garrison, Nov. 27, 1928; Jan. 11, 1928 [1929]; Jan. 6, 15, 1930. Garrison retired from the Army in May 1930 with the rank of colonel. 63 Letter, Garrison to Klebs, June 12, 1930: MS/C/166. 64 Letter, Ashburn to Fishbein, Feb. 21, 1930: MS/C/151. 65 Correspondence between the librarians and Garrison may be found in MS/C/166, MS/C/151, MS/C/152, and in file New Building Construc- tion in MS/C/309. 66 Letter, Welch to Garrison, Aug. 11, 1932: Welch Med. Lib. 67 Med. Life, 43: 573-5 (1936). 258 XV The Library During the Depression Edgar Erskine Hume, Librarian 1932—1936 THE Great Depression touched the Library in several ways. As economic conditions plummeted, the Librarian was Percy Ashburn, who had been appointed in 1927, retired from the Army in 1931, and been permitted to remain. He might have kept the post for many more years had not Congress enacted legislation to reduce government expenditures and assist the economy. Among the new laws was one which cut off pay of retired officers on active duty. Ashburn tried to be exempted from the law, seeking help from Senator Frederic C. Wolcott (William Welch's nephew) and other influential persons, but he was not successful.1 He left the Library in 1932 and was succeeded by Major Edward Erskine Hume.2 Hume was born in Frankfort, Kentucky, December 26, 1889. After at- tending Centre College (B.A., 1908, M.A., 1909), Johns Hopkins (M.D., 1913), University of Munich and University of Rome, he joined the Army in September 1916. At Army Medical School he ranked first in his class. Following graduation he was sent to Fort Leavenworth, brought back to Washington for a few months, and then ordered to France. He was present at the battles of Meuse-Argonne and Saint Mihiel, then went to Italy and was in the battle of Vittorio Veneto. After the war he was named American Red Cross Commissioner to Serbia and surrounding territory, and he directed the antityphus-fever campaign in the Balkan States until August 1920, when he returned to the United States. From the autumn of 1920 to June 1922 Hume was in the I Corps Area Laboratory at Fort Banks, Massachusetts. On his own time he attended classes at Harvard and M.I.T., receiving a certificate in public health and a diploma in tropical medicine. Hume had shown skill in writing, translating, history, and biography (he had published a genealogy of the Hume family when he was 24) and for these reasons he was assigned to the Library in 1924 to replace Garrison. Before Garrison left for the Philippines he instructed Hume.3 For 2 years Hume worked in the institution, mainly assisting Albert Allemann prepare the Index-Catalogue. Concurrently he attended Johns Hopkins and received the degree of doctor of public health. Leaving the Library in April 1926, Hume 259 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Edgar Erskine Hume, Librar- ^ ian, 1932 to 1936. served at Fort Benning until 1930, then instructed in the New Hampshire and Massachusetts National Guard. When Percy Ashburn left the Librarian's post in 1932 several officers desired the job.4 Hume received it, and the Surgeon General could hardly have made a better choice. Hume was familiar with the routine, he spoke five languages and could translate five more, and he was at home in the scholarly, bookish atmosphere. Unfortunately, economics dictated that the Library could not ad- vance, and. Hume could only mark time. In 1936 Hume's 4-year term as Librarian expired. He was sent to the Medical Field Service School and then to Winter General Hospital. In April 1943 he was assigned to General Eisenhower's staff in North Africa. Eisenhower appointed him chief of Allied Military Government in Italy in August 1943, and Hume eventually governed two-thirds of the country. From September 1945 to June 1947 he was chief of Military Government in the U.S. zone of Austria. Thereafter he was chief of the Reorientation Branch, Civil Affairs Division, Department of the Army; chief surgeon of the Far East Command on General MacArthur's staff; director general of medical services of the United Nations Command in Korea; and surgeon on the staff of the Supreme Com- mander for Allied Powers. He retired with the rank of major general in 1951. Hume was a handsome, pleasant person with tremendous energy, the in- tellectual curiosity of a scholar, and seemingly no fear. At the battle of Vittorio Veneto he was wounded and received his first medal for heroism. He was wounded twice in Italy during World War II and twice in Korea. By the time 260 THE LIBRARY DURING THE DEPRESSION he reached the end of his career he was the most decorated medical officer in the Army. Among his decorations were two distinguished service medals, the Legion of Merit, the Navy Bronze Star, the Air Medal, and the Soldier's Medal. He received the last for crawling into the cellar of the bombed post office in Naples and rescuing five wounded persons before the building collapsed. He was decorated by 37 countries in Europe and Latin America, was presented with honorary degrees by 10 American and several European universities, received the Gorgas Medal and the Sir Henry Wellcome Prize in 1933 while at the Library. He was an honorary colonel in the Serbian Army and an honorary citizen of two-score Italian and Austrian towns. Hume was lecturer in history of medicine at Georgetown and University of Kansas. He was more interested in history and biography than any other person associated with the Library, except Garrison, and this was reflected in many of his articles and in his books, among which were Max von Pettenkofer, Medical Work of the Knight's Hospitallers of Saint John of Jerusalem, Victories of Army Medicine, and Ornithologists of the United States Army Medical Corps.5 Hume died of an aneurysm of the aorta January' 24, 1952, shortly after retiring from the Army.6 The Depression Retards the Library The effects of the Great Depression were felt in the Library when the usual appropriation of $19,500 was reduced to $14,300 for fiscal year 1933-34. Forced to reduce purchases, Librarian Hume decided to spend funds entirely on jour- nals. He reasoned that books were less important and could be purchased later from second-hand dealers, whereas back issues of periodicals would be difficult to obtain. Furthermore, periodical literature was the backbone of the Index- Catalogue. The devaluation of the U.S. dollar to 60 cents forced the Library to pay more for European journals, leaving less money for American. Hume explained the shortage of funds to domestic publishers and asked them to give journals to the Library. The majority did so. Still there was not sufficient money to continue all subscriptions. Hume evaluated journals to decide which would be discontinued until economic con- ditions improved. Besides estimating the value of each journal to patrons, he considered the availability of the journal in other medical libraries of the area, as Welch Library in Baltimore.7 Hume had to cut the subscription list from 2,041 periodicals to approximately 1,600. The following year Congress repeated the appropriation of $14,300. Hume continued the policy of concentrating on journals. When he requested American publishers again to send journals free, some agreed but the majority refused, asking why they should donate to the Library when the government was col- lecting more taxes and spending large sums on Depression projects. During these 2 years the Library purchased very few books, only 16 between July 1, 1933, and May 1, 1935. "No rare medical items have been purchased 261 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE since June 9, 1933, although the economic distress world-wide has brought many rare and desirable old medical books on the market at sacrifice prices, noted Hume in April 1935. Fortunately the Library of Congress continued to send some of its duplicate American medical books.8 During the Depression the Library suffered in other ways. Persons could not be hired to replace employees who retired.9 Salary increases were not permitted. The Government Printing Office bound fewer volumes. The Index- Catalogue was suspended after the final volume of series 3 appeared in 1932 and was not resumed until 1936. The years 1933, '34 and '35 were the worst for the Library. In 1935 Congress increased the appropriation to $15,700, only $1,400 more but important in a low budget. The organization began to purchase books again. In 1936 Congress elevated the appropriation to $20,660 and the 3-year depression was over for the Library, although the effects would linger for some time. The Beginning of the Fourth Series of the Index-Catalogue After the third series of the Index-Catalogue ended, Garrison and other persons concluded that it was not as useful as the first and second series for several reasons, one of which was the omission of citations printed instead in the Quarterly Cumulative Index Medicus. Librarian Hume therefore decided to resume the earlier practice of printing all citations, whether or not they appeared in the QCIM, and to include citations that had been left out of series 3.10 The new editor, Claudius Francis Mayer, arrived only 2 days before the previous editor, Allemann, retired in 1932 and therefore had no one to coach him. But Mayer was an extremely intelligent person—Librarian Jones consid- ered him to be a genius—and he took up the job without difficulty. He began to think of changes that would reduce the time and cost of preparation and allow more citations per volume. Hume asked Garrison, Morris Fishbein, and others for opinions of Mayer's proposed modifications.11 They agreed that most were beneficial, and Hume ordered these to be adopted. Thereafter Arabic numerals replaced Roman, paginations were reduced, margins were narrowed, abbreviations were short- ened, and other measures were taken to conserve space.12 The fourth series was scheduled to begin in 1933, but because of the Depression no funds were available for 3 years.13 The publication came dangerously near to being sus- pended for all time. Volume 1 finally appeared in June 1936 amid favorable publicity.14 Through the remainder of the 1930's the Library published a volume each year. Progress Toward a New Building In 1930 Reed Smoot, chairman of the Public Buildings Commission, in- formed Secretary of War Patrick Hurley that the Library and museum would have to vacate their home as soon as possible. The old building would have to 262 THE LIBRARY DURING THE DEPRESSION Claudius Francis Mayer, editor of the Index-Catalogue from 1932 to 1954, at his specially-designed semicircular desk. be torn down because it did not fit into the plans for development of the Mall and the beautification of Washington.15 But the Army could not transfer the Library and museum from the building immediately because there was no other place to house the collections. To prepare for the eventual move officers in the Surgeon General's office and the Quartermaster Corps began to draw up preliminary plans, elevations, and perspectives for a new building costing $2,086,000.16 In the autumn of 1930 these plans were submitted to the Director of the Budget who recommended to President Hoover that Congress be asked to appropriate money for construction. The President decided that because of the large deficit in the national budget construction should be postponed until development of the Mall required removal of the old building.17 News that a new building was in the offing spread around, and in June 1931 the American Medical Association passed a resolution favoring a site on Capitol Hill, rather than Walter Reed, under the belief that Capitol Hill would be more convenient for visiting physicians coming in on the train. Surgeon General Robert Patterson objected, pointing out that the average physician of Wash- ington was as close to Walter Reed as Capitol Hill, and that only an insignificant number of out-of-town physicians came to the library (72 in 1930) because 263 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE interlibrary loans were so easy to arrange (308 institutions borrowed 9,764 books in 1930). This was the beginning of a long tug-of-war between physicians who preferred a site on Capitol Hill and those who favored Walter Reed.x The United States was then sinking into the long business depression of the 1930's. When Franklin Roosevelt was elected President, he persuaded Congress to appropriate a large sum to stimulate industry and employment by construction of public works. The Medical Department saw that the public works program offered an opportunity of gaining a new building, and Surgeon General Patterson asked friends to help obtain the necessary legislation. At his request the American Medical Association and other important medical soci- eties urged Congress and the Administration to allot $2,000,000 of the public works fund for construction of a Library and Museum Building at Army Medical Center.19 The most influential lobbyist may have been Harvey Cushing, who had begun borrowing books in the 1890's when he was a young surgeon and con- tinued after he had become a teacher at Johns Hopkins and Harvard, surgeon- in-chief of Peter Bent Brigham Hospital, and finally professor of neurology at Yale's Medical School. Cushing was a bibliophile, biographer, and a leader in his specialty, neurosurgery. One of his daughters, Betsey, had married James, son of President Roosevelt. In the summer of 1933 Patterson asked Librarian Hume to request Cushing to inform the President about the need for a new Library-Museum Building. Cushing obliged by writing the following letter to Roosevelt:20 The fact that one Sara Delano Roosevelt is my grandmother and another one my granddaughter, and that you by some strange fate have become my stepson or brother-in-law or whatever it may be—I was never good at genealogy—is, I suppose, the reason why people like this Major Hume think I may conceivably have some influence with you and may therefore be prevailed upon to inject myself into your Blue Eagle activities. Most things of this sort I pretend never to have received, but this one I really feel I must hand on to you. You of course know all about the Surgeon-General's Library, for which John S. Billings was originally responsible. It is the only great medical library in the world, and the Index Medicus and the Index Catalogue are probably more widely used throughout the world than any other medical book which has ever been published since the book of Isaiah. I happened to be writing for this thesis which I needed and probably the only place in the world where it could be secured was in Washington. This is an indication of how the Library is continually being used by the medical profes- sion. The question of what to do with the Library in the future, for it will have to be moved away from the present site soon, has been a problem long agitated. The Army is very proud of it, and justly so; and though Herbert Putnam would take it with the Congressional Library, he rather thinks it is better where it is, and there is a consensus of opinion among the medical profession, the Army Medical Corps and the Medical Library that the proper place for it would be in connection with the Walter Reed Hospital, for it would be convenient to the workers there and no less convenient than it is for the general profession. 264 THE LIBRARY DURING THE DEPRESSION But you mustn't believe me about this or anything else without looking into it further. And I don t know any man in the world who would be more proud to have a note from you at this juncture than William H. Welch who at eighty- four is recovering from an operation at the Johns ,Hopkins Hospital and can be reached there. If you should ask Miss Le Hand to drop him a note and say your step-son suggested that you write to ask him what is his opinion about where the Surgeon-General's Library ought to be moved and whether it is of any use to anyone and ought to be kept up at whatever cost, he will tell you better than anyone else the true facts, for he was close to Billings ever since its original foundation. Perhaps as a result of this letter the President asked Herbert Putnam for his "personal judgment" of the proposal for a new building. Putnam affirmed the importance of the Library and the necessity for new housing, repeated that he did not favor consolidating the AML with Library of Congress, and that he preferred a site on Capitol Hill.21 Roosevelt also ordered the Director of the Budget to study the proposal to erect a building at Army Medical Center. The Director reported in favor.22 Despite these recommendations nothing could be done because public works funds had already been allotted to projects of greater importance. The Administrator of Public Works placed the proposal on a pre- ferred list for action when additional funds would become available. The Pres- ident did not forget, for in February 1934 his secretary asked Surgeon General Patterson to bring plans to the White House.23 Roosevelt made one decision that was important in planning thereafter, that the site be Capitol Hill.24 In the Spring of 1934 Patterson again asked Hume to ask Cushing to in- tercede with Roosevelt. Cushing suggested to Hume that the President's phy- sician be asked to talk with the President about the building.25 Cushing also wrote the following letter to the White House:26 Again may I remind you, as I did a year ago, of the great opportunity if not obligation on the part of the Government to be of service to the united medical profession of the country by properly housing the Surgeon-General's Library and Museum. The facts are briefly these: (1) The Library and the world-renowned Index Catalogue which it publishes are of the utmost importance not alone to the Army Medical Officers but to the medical profession as a whole throughout the world. (2) The present Library building is not only outworn, outgrown and un- sightly, but stands in the way of the future development of the Mall. (3) In 1922 by Act of Congress a proper site for the future Library was purchased in the vicinity of the Army Medical Center and the architects' plans and specifications for a building estimated to cost ca. $2,000,000 were completed. Work can be started so soon as funds are available and competitive bids for construction made. (4) A year ago, if I understand correctly, the Director of the Bureau of the Budget reported favourably on the matter which was turned over to the Director of Public Works who saw the merits of the proposition. Inasmuch as no money was then available, he stated that the project would be put on a preferred list should further funds become allocatable for public works. (5) In view of the probability that through Congressional action a generous 265 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE sum for public works is likely to be put in your hands, this would seem to be a proper time to recall to the attention of the Director of Public Works the desirability and importance of this particular project. Roosevelt directed his assistants to look into the matter, and several days later he replied:27 I have your letter of April 25 reminding me, as you did a year ago, that the Government can be of service to the united medical profession by properly housing the Surgeon General's Library and Museum. I agree that the facts as they are subdivided in your letter undoubtedly are well taken and that this Library and Museum could be considered as strictly utilitarian. The question naturally arises, however, as to the wisdom of asking for $2,000,000 for an expenditure of this kind at this time. If surplus monies were available, I would have no hesitancy in endorsing the request. Insofar as plans and specifications are concerned, I find none has been prepared. The estimated cost of $2,000,000 is more or less tentative and the plans have never exceeded the sketch stage. The project could be placed on a preferred list should surplus monies become available for work of this kind. However, as matters stand today relative to the building program for the District of Columbia, it does not appear that we could include it in the present-day comprehensive plan. The President attached to this typed letter a hand-written note: "H.C. The above is the "official" answer—all the same I am going to try to get that building started next year! F.D.R." A likeness of the proposed Library-Museum building was optimistically in- serted into this photo taken from the Capitol. The Supreme Court now occupies the site suggested for the Library-Museum, across the street from the Library of Congress. 266 THE LIBRARY DURING THE DEPRESSION The Library remained on the list of public works, but other buildings were decided to be of greater importance. Roosevelt explained this to Cushing in August 1934:28 The situation in regard to the building for the Surgeon General's Library is this. We are all tremendously keen about a new building for it. However, out of Public Works funds we must keep the District of Columbia somewhere within a reasonable ratio of expenditures compared with population, remembering that these Public Works appropriations are primarily to relieve unemployment. We have to consider the most pressing needs first and, therefore, have allocated this year enough money for a) One new building to take care of actual Govern- ment workers; b) A new sewage disposal plant, very much needed, as my nose on River trips testifies; c) A T.B. sanitarium to meet a serious T.B. situation; d) a stack room to take care of important current documents. These projects all put together exceed what should be the District's quota by about 100%. Therefore, with much reluctance, I have to put the Surgeon General's Library building over to another year. . . . At this time a large annex for the Library of Congress was being constructed on Capitol Hill. This annex had much free space into which the Library of Congress would expand in later years. The idea arose that half of one floor of the annex could be used to house the Army Medical Library, the latter being either united with the Congressional library or kept separate and administered by the Medical Department. Cushing learned of this idea from Herbert Putnam at lunch in Washington in January 1935, and he undoubtedly alarmed the Medical Department when he told Fielding Garrison of Putnam's views:29 I learned to my surprise that Mr. Putnam had appeared to change his mind about an association between the Congressional Library and the Surgeon-Gen- eral's Library and that he felt that one of the floors in the huge new annex might be a very suitable place for it. He felt that the books would be much more available and accessible there to the many people who use the Library than if it were moved out in connexion with the Walter Reed Hospital. I am handing this on to you to ask what you personally would think about it. It might be just at this juncture a great opportunity to get the books all gone over and repaired, and since Mr. Putnam apparently has no difficulty in getting all the money he needs from Congress for his purposes it might be a wise move. I also saw Senator Fess there and he seems to be very much disturbed about the present condition and future status of the Surgeon-General's Library, and perhaps this might be a good time to have the matter reviewed. But before going into it any further, I would like to get your personal slant on the matter. The Surgeon-General persuaded me now almost two years ago to intercede with the President who in a personal note promised me that he would take the matter in hand and would do what he could. I do not like to pursue him further in regard to it without knowing just how the Medical Corps might feel in regard to going under the wing of the Congressional Library. The uniting of the medical library with Library of Congress was an old idea but apparently new to Cushing.30 Surgeon General Patterson and Garrison told him their reasons for preferring to keep the Library independent and locating it at Army Medical Center,31 but Cushing felt strongly that the Library would benefit if it were connected with LC, as he informed Garrison:32 267 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE I agree absolutely with you that wherever the Library should be moved, it still ought to remain as the Surgeon-General's Library and be under a librarian appointed by the Army just as it is now. At the same time, I cant help feeling that at present the Library is neglected and forgotten and that on the other hand the Congressional Library under Mr. Putnam's leadership gets all the money it needs without difficulty, and it is rather too bad not to have the S.G.O. Library profit by this. Cushing did not push the union of the two libraries, but he liked the idea of housing the medical library in the annex. He suggested this to the President, who replied:33 I am delighted to know of that new suggestion in regard to the Army Medical Library. We might even add another story to the new Annex and architect it to look like a pillbox. Franklin Delano, uncle of President Roosevelt and chairman of the National Capital Park and Planning Commission, had also heard about the idea and he favored it. Possibly he viewed it as a quick means of emptying the old building for demolition. He urged Patterson strongly to accept the alternative. Patterson compromised a bit by promising to send medical incunabula from AML to Library of Congress, but he would not give up the Library.34 While fears of a forced merger with or housing in the Library of Congress continued, the Army Medical Library approached the 100th anniversary of its birth, set arbitrarily by Hume as 1936. Cushing seized the approaching Cen- tenary Celebration as an excuse to remind the President about the need for a new building. He wrote:35 I am informed by the Surgeon-General that preparations are on foot to celebrate the centenary of the founding of the Surgeon-General's Library some- time in November. He has asked me to deliver an address on the occasion; but my brain being not much better than my legs these days, I felt obliged to decline, and suggested that some distinguished foreign medicos be invited to come and take part in the ceremonies. This recalls to me that two years ago the present urgent needs of the Library were brought to your attention and the desirability of moving it from its present site to that long allocated for the purpose near the Walter Reed Hospital. You kindly replied, explaining why it was impossible to allocate funds at the time, but enclosed a pencilled note to the effect that you would bear it in mind and strike when the circumstances were more favourable. Could you possibly find the ways and means now, there would be abundant reason to celebrate this 100th anniversary of the Library's foundation, either by starting the evacuation for the new building or even possibly actually laying its cornerstone. The occasion would be doubly worth celebrating should it more or less coincide with the beginning of your second term of office, about which I haven't the slightest manner of doubt. Roosevelt replied:36 I wish I were the dictator you assume me to be! I most assuredly do want to get the proper housing for the Surgeon-General's Library started but it must be a monumental building and cannot be done out of Work Relief funds: there- 268 THE LIBRARY DURING THE DEPRESSION fore, it will require an Act of Congress. We have had such demands tor office space these two years that all special buildings of this type have been deferred. I hope much, however, that the next Congress, either at the first or second session, will authorize it. Perhaps I could say as much as this at least when the Centenary takes place in November. The President was kept aware of the Centenary of the Library and when the actual time arrived he invited Sir Humphry Davy Rolleston, the principal speaker, to the White House for a chat. Notes 1 Letters, Welch to Garrison, July 30, 1932; Garrison to Welch, July 31: JH. 2 During the period between the departure of Ashburn and the arrival of Hume, Maj. P. E. McNabb, curator of the museum, was Acting Librarian. 3 Garrison and Hume became friends. Gar- rison characterized Hume as "a gentleman, who was very kind to my aged mother before her death, and that I shall never forget saecula sae- culorum"; letter, Garrison to Welch, July 31, 1932: JH. 4 Letter, Garrison to Welch, July 31, 1932: JH. 5 A complete bibliography of Hume's arti- cles, translations, book reviews, and books is in MS/B/181. 6 References to many sketches of Hume are in the bibliography of his writings in MS/B/181. An Army information release is in MS/C/44. Obituaries are in Military Surgeon 110: 244 (1952), JAMA 148: 485 (Feb. 9, 1952), Ann. Int. Med. 36: 1154-5 (1952), New York Times, Jan. 25, 1952. 7 Letter, Hume to Garrison, Feb. 19, 1934? MS/C/152. s For the effect of the Depression on the purchase of journals and books see annual re- ports of the Surgeon General, 1934, 1935, 1936; memo, Hume to General Patterson, Dec. 10, 1934 in file, Historical Information, MS/C/309; memo, Hume to Colonel T. J. Flynn, Apr. 29, 1933, in file, Cost Estimates, MS/C/309. 9 The entire Library staff consisted of 29 persons in 1934: 1 Librarian, a medical officer 1 chief librarian $5,600 yr. 1 librarian 3,900 yr. 2 junior librarians 2,050 yr. each 1 principal library assistant 2,500 yr. 2 library assistants 1,830 yr. each 5 junior library assistants 1,695 yr. each 6 under library assistants 1,460 yr. each 1 principal clerk 2,300 yr 1 senior translator 2,000 yr 1 clerk stenographer 1,850 yr 2 junior clerk typists 1,680 yr each 1 junior typist 1,560 yr 2 messengers 1,320 yr each 2 junior laborers 1,140 yr each Total salaries $58,215 10 Annual Report of the Surgeon General 1936, pp. 198-9. Index-Catalogue 4S, 1, 1936, p. iv, vi. 11 Letters, Fishbein to Hume, Feb. 27, 1933; Hume to Fishbein, Mar. 7, 1933: MS/C/156. Letter, Garrison to Hume, Mar. 24, 1932: MS/ C/166. 12 Changes are listed in Index-Catalogue 4S, 1, 1936, p. v. Later modifications in policy and format are mentioned in Annual Report of the Surgeon General, 1941, p. 250. 13 The Library had the text of the first vol- ume of the fourth series of the Index-Catalogue ready for the GPO, but under the Economy Acts of 1933 the sum of $43,000 for printing reverted to the Treasury because the job could not be completed by June 30, 1933. Annual Report of the Surgeon General, 1934, p. 183; 1935, pp. 178-9. Index-Catalogue 4S, 1, 1936. p. vi. 14 For example, Time, June 22, 1936, carried two columns with a portrait of Hume: clippings in MS/fB/120. 15 Letter, Smoot to Secretary of War, Jan, 25, 1930: file, Location of New Building: MS/ C/309. 16 Documents in file, new Building Con- struction: MS/C/309. 17 Memo, Army Medical Library, by C. F. Mayer, Jan. 17, 1935: MS/C/309. 18 Letter, Patterson to E. S. Judd, president AMA, Oct. 10, 1931: file, Location of New Building: MS/C/309. Thomas Cullen of Johns Hopkins was a leader in urging physicians to support the campaign for 269 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE a new library building. He favored a site in the center of Washington rather than at Walter Reed. Cullen compiled a large scrapbook of letters and clippings relating to his activities, 1931-1943. A copy of this scrapbook is in NLM. 19 Letters, Patterson to presidents of the AMA, APHA, and other organizations, May 1933: file, New Building Misc. Corr.: MS/C/309. 20 Copy of letter, Cushing to Roosevelt, Aug. 21, 1933: MS/C/183. 21 Copy of letter, Putnam to the Secretary of the President, Nov. 20, 1933, accompanied by copv of Putnam's report to the President: file, Transfer of AML: MS/C/309. 22 Memo, F. W. Lowery, asst. dir. BOB, for Mr. Douglas, Nov. 10, 1933; memo, dir. BOB to the President, Nov. 14, 1933; file, Transfer of AML: MS/C/309. 23 2nd Ind. to letter, to the Quartermaster General from Surgeon General Patterson, Feb. 24. 1934; file, New Building Construction: MS/ C/309. 24 "The President's attitude in opposition to the Army Medical Center was well known to me . . . "; Surgeon General Charles Reynolds in letter to Col. Leon Gardner, Mar. 15, 1946, copy attached to speech, "The Army Medical Library": file, Historical Info.: MS/C/309. 25 Letter, Cushing to Hume, May 5, 1934: MS/C/183. 26 Letter, Cushing to Roosevelt, Apr. 25, 1934: MS/C/183. 27 Letter, Roosevelt to Cushing, May 9, 1934, quoted in: John Fulton, Harvey Cushing, a Bi- ography (1946) p. 664. 28 Letter, Roosevelt to Cushing, Aug. 25, 1934, quoted in Fulton, Harvey Cushing, p. 664-5. 29 Letter, Cushing to Garrison, Jan. 3, 1935: MS/C/183. 30 The idea of uniting the Library with some other agency had been suggested several times before this. In 1921 a scholar named Arthur MacDonald advocated consolidating 33 agen- cies, including the Surgeon General's Library and Library of Congress, in the Smithsonian Institution (Congressional Record, Oct. 26, 1921). In 1933 MacDonald recommended placing the Library under jurisdiction of LC because LC was open in the evenings, librarians rather than Army officers would be in charge, rare books would receive better treatment and be more available, economy would result, and other rea- sons. At this time MacDonald persuaded four Congressmen who were also physicians to sign a petition to the President to unite the two li- braries. The Surgeon General had to busy him- self writing letters to rebut MacDonald's argu- ments (see file, Transfer of AML: MS/C/309.) 31 Letters, Garrison to Cushing, Jan. 7, 1935, copy in MS/C/183. Patterson to Cushing, Jan. 8: MS/C/183. 32 Letter, Cushing to Garrison, Jan. 10, 1925: MS/C/183. 33 Letter, Roosevelt to Cushing, quoted in Fulton, Harvey Cushing, p. 665. 34 Letters, Patterson to Admiral Cary Gray- son, Jan. 22, 1935; Patterson to Delano, Feb. 18, May 14: file, New Building Construction: MS/C/309. Patterson to Walter Bierring, pres. AMA, May 8, 1935: file, New Building Misc. Corr., MS/C/309. Cushing to Delano, Feb. 25, 1935: MS/C/183. 35 Portions of letter, Cushing to Roosevelt, Aug. 21, 1936, quoted in Fulton, Harvey Cush- ing, p.665. 36 Letter, Roosevelt to Cushing, Aug. 25, 1936, quoted in Fulton, Harvey Cushing, p. 666. 270 XVE The Library on the Eve of World War II Harold Wellington Jones, Librarian 1936-1945 TO succeed Hume the Surgeon General designated Colonel Harold W. Jones, a surgeon approaching the end of his career in the Army. Born in Cambridge, Massachusetts, November 5, 1877, Jones attended Massachusetts Institute of Technology from 1894 to 1897 and Harvard Medical School from 1897 to 1901. After receiving his M.D. degree he spent 2 years at Children's Hospital, Boston, and then practiced medicine in St. Louis and taught at St. Louis University Medical School. Joining the Army in 1905 Jones was stationed in the Philippines. Later he was a surgeon on troop ships and was attached to General Pershing's command on the Mexican border in 1916. For Pershing's expedition he organized the first motor ambulance company in the Army and afterward helped develop the standard motor ambulance for the Medical Department. During World War I Jones commanded the large (22,000 persons) Beau Desert Hospital Center near Bordeaux. In 1920 he went to the Philippines again, where Brigadier General Johnson Hagood called him "the best post surgeon that has ever served under my command," and hoped that he would become "a general officer of the Medical Corps and Surgeon General of the Army."1 Thereafter Jones was chief of the surgical service of large Army hos- pitals, coming from Tripler Hospital, Hawaii, to the Library in 1936. Jones was modest, an excellent surgeon, fond of Shakespeare, and author of almost two-score articles. And like almost all of his predecessors he knew nothing about the administration and internal workings of the Library. "After serving more than thirty years in the Army, much of it in the field and more of it in the operating room, to my amazement I was ordered to Washington to finish out my active service as The Librarian," Jones reminisced later.2 He was cautious and diffident at first, but as time passed and he became familiar with the theory and practice of good library management he gained confidence and brought about improvements as rapidly as conditions would permit. He urged the Surgeon General to continue efforts to have legislation passed to provide a new building, he began to diversify the bibliographies published by the Library and he cooperated in having microfilming facilities introduced into the 271 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Harold Wellington Jones, Librarian, 1936 to 1945. institution. He visualized an Army Medical Library Quarterly for articles by the staff. He wondered if the Library could provide postgraduate study for medical librarianship, bibliography, and history. Jones' tour of duty would normally have ended on August 6, 1940, when he would have completed 4 years service as Librarian. He would then have been nearly 63 years old and approximately a year away from retirement. He asked Surgeon General James C. Magee to allow him to remain at the Library for his final year, instead of being transferred to some other post. Magee agreed and Jones stayed on. Shortly before he would have retired in December 1941 the Medical Department, needing all its young officers for the war, retained Jones on active duty at the Library.3 The Centenary of the Library As though to mark the end of the Depression the Library celebrated its 100th anniversary in 1936.4 Actually the Library did not have a birthdate because it was not established on a definite day, as was the museum (May 21, 1862). Instead it evolved from a bookcase in the office of the first Surgeon 272 THE LIBRARY ON THE EVE OF WORLD WAR II Audience of distinguished physicians listening to Sir Humphry Rolleston in the reading room during the Library's Centennial Celebration. General. Librarian Edgar Hume probably did not know this when he began to think of a centenary, but when he became aware of it he did not find the absence of a definite date an insurmountable objection. He decided that 1836 was a reasonable arbitrary choice. Eighteen thirty-six marked the end of the career of Surgeon General Lovell, during whose term the first books were purchased, and the beginning for Surgeon General Lawson, by whose order the first catalog was compiled. One- cannot help noting that the year 1818 seems more logical than 1836 for a birthdate, since it was in 1818 that Lovell took office and since Lovell acquired the first books. One suspects that Hume chose 1936 because it per- mitted a centenary to be observed while he was there, whereas 1818 would have placed the centenary in 1918, already 18 years in the past. As to the day, Hume picked November 16, the date on which the medical officers stationed in the District of Columbia were scheduled to hold one of their monthly meet- ings.5 Hume laid the foundation and began to make plans for the Centenary before he was succeeded as librarian by Jones in 1936. Before leaving, Hume discussed with Jones the question of who should be the main speaker. They decided on 273 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Harvey Cushing.6 Cushing declined and suggested Sir Humphry Davy Rol- leston, physician to King George V, formerly professor of physic at Cambridge, formerly president of the Royal College of Physicians of London, and Surgeon Rear Admiral of the Royal Navy. Rolleston accepted the invitation.7 Jones made the arrangements, including the sending of approximately 1,200 invitations to medical organizations and libraries in North and South America, Europe, Asia, Africa, and Australia. A few days before the meeting library furnishings were moved out of Library Hall and hundreds of folding chairs were placed in rows facing a speaker's platform erected at the end of the hall opposite the book stacks. Rugs that Jones had brought from the East were laid on the platform. Flags of many nations were hung about the hall. Scrolls and letters of congratulation were displayed.8 On Monday evening, November 16, nearly 600 guests arrived. Among them was the Cuban ambassador, British and German military attaches, former surgeons general and librarians, representatives of organizations from many countries, medical officers, and private physicians. Library Hall became full, and many visitors had to sit in the reading room below, listening to the speeches through speakers. Following the invocation, Jones read a message from President Roosevelt and the names of scores of organizations that had sent messages of congratu- lation. Surgeon General Reynolds then introduced Rolleston. As the Wash- ington Star pictured the scene, Sir Humphry, "an apple-cheeked Briton with thinning hair and rimless spectacles perched on the end of his nose, spoke glowingly of the library's history" while "men in white, attired for the occasion in dinner dress, and women in evening clothes strained to catch his soft-spoken syllables, for he could hardly be heard beyond the fourth row of the high- ceilinged library. Downstairs, however, an overflow audience heard his every word blaring through amplifiers."9 Afterward the guests sipped gin-rum fruit punch, ate chicken salad, finger rolls, and cakes and drank coffee while strolling along the corridor looking at rare books displayed in glass cases and listening to the Army Band. The next day the folding chairs, flags, decorations, and amplifiers were removed, and the Library returned to its normal routine. Accounts of the affair, with quotes from Rolleston, were carried in Washington newspapers. The longest lasting benefit of the centenary to the Library may have been the effect of the publicity on legislators, particularly Rolleston's remark: "what better way of celebrating the commencement of the second century of the library could there be than the erection of a new building so urgently needed and so thor- oughly deserved?"10 New Bibliographies Possibly because of the thoughts about the past and future of the Library aroused by the 100th anniversary celebration, Librarian Jones began to broaden 274 THE LIBRARY ON THE EVE OF WORLD WAR II his view of the organization's activities." For more than a century the Library had been collecting literature, and for more than 50 years it had been dis- seminating references to its literature through the Index-Catalogue. Now Jones decided to issue other bibliographies. The Library had no funds for publication, other than for the Catalogue, and it was doubtful that funds could have been obtained, but Jones could get special bibliographies into print by attach- ing them to the Catalogue. The first of these, conceived and compiled by Claudius Mayer, was a list published as a supplement to the Catalogue under the title "Congresses: Tentative Chronological and Bibliographical Reference List of National and International Meetings of Physicians, Scientists, and Experts. "12 Jones visualized a number of other special bibliographies, one of which, on legal medicine, reached about 20 percent of completion before it ceased owing to the retirement of the compiler Loy McAfee.13 Another special bibliography was the "Bio-Bibliography of XVI Century Medical Authors" by Mayer. Mayer intended this to be a union list of all 16th century works, not merely those in the AML, with biographical data and portraits of the authors. Jones had spec- imen pages of this bibliography, beginning with Abarbanel and ending with Adrianus, published at the front of Index-Catalogue, volume 4, 1939. Encour- aged by the favorable reaction of readers, Mayer continued his task, obtaining information from several American and European libraries. Jones planned to publish a part of the bibliography in each volume of the Catalogue until it was complete, then to reprint it as a separate book. The first part covering half of the letter A appeared as a supplement to volume 6, 1941. Unfortunately the war caused Mayer to stop work on what promised to be a useful, authoritative reference book, and it was not continued.14 Jones' most ambitious plan in the field of bibliography was the compilation of a World Catalog of Medical Books, a complete inventory of all medical books ever published.15 The foundation of the World Catalog was to be the Library's card catalog. The catalog was to be brought up-to-date by a partial reclassifi- cation of the Library's books, in accordance with modern library practice. Card catalogs of other libraries were to be microfilmed. From the film cards were to be made and interspersed in the AML catalog. Authors and titles of books would be placed in the Index-Catalogue. The microfilming of catalogs of other libraries began in 1940, but the war halted this project and eventually it was abandoned forever. Although the portrait collection seems unrelated to the Index-Catalogue, the development of the collection was, in the 1930's, supervised by Mayer. In 1939 it was decided to broaden the card catalog of portraits into a Union List of Medical Portraits. Cards in the portrait catalogs at New York Academy of Medicine, College of Physicians of Philadelphia, Northwestern University Medical School, John Crerar Library, and Jefferson Medical School were photographed and combined with AML cards.16 The war intervened and this work was stopped. 275 a history of the national library of medicine Edgars Bequest Helps Buy Arabic Manuscripts The Library has received many gifts of printed and manuscript material, of pictures and photos, but only a few of money. The second largest sum came from William F. Edgar, a physician who had wagon-trained west over the Oregon Trail in 1849 and eventually settled in California. There he prospered; and in 1893 and '94 he drew up a will leaving his estate to his wife during her life, to charitable, educational, and civic organizations after her death, and, for reasons not known to us, the residue to the Army Library-Museum. Edgar died in 1897, his wife a third of a century later. The trustees of the estate approached the Secretary of War in 1931, but the Library and museum could not accept the bequest until 1933 when Congress passed a joint resolution permitting them to do so. Under the terms of Edgar's will the Library received one-fifth of the residue, $3,662, the museum four-fifths, $14,647. Thirty-six hundred dollars was a respectable sum in the Great Depression year of 1933, when Congress appropriated only $14,300 for acquisitions. The Librarians found the bequest useful in purchasing items or having work done for which there was no appropriation. One of the earliest uses for the money was to cover the cost of repairs to portraits, and to pay artist Franklin B. Clark for an oil painting of Garrison. Some expenses of the Centenary Celebration in 1936 were covered by the bequest. In 1940 Jones set aside a Arabic manuscript by al-Razi dealing with intestinal diseases. Written in 1094, this is the oldest book in the Library. 276 THE LIBRARY ON THE EVE OF WORLD WAR II small area in the basement as a staff lounge, where employees who brought lunches from home could eat, and he paid for the furnishings with Edgar monies. The Librarians spent the money sparingly, generally less than $200 a year during the 1930's, nevertheless because it was available for unusual ex- penses Jones considered it to be "a great comfort to the Library in time of need."18 While there was still a considerable sum remaining in the Edgar bequest, Jones had the opportunity of purchasing a group of Arabic medical manuscripts. These writings were part of a large collection assembled by Abraham S. Yahuda, a scholar who had brought them to the United States when he fled the war in Europe. In 1940 Yahuda sent packing cases filled with his manuscripts to the Library and spent weeks there sorting out the medical items. Jones was hesitant about buying such exotic material, but after much deliberation and negotiation he bought one lot and later another lot, 130 documents in all, for about $7,500, some of the money coming from the Edgar fund.19 Even at that, Jones felt that the sum was so large in comparison with the annual appropriation that he spread the payment over several fiscal years. After this the librarians again drew money conservatively from the bequest, less than $100 or $200 a year until 1956 when the balance was exhausted by the purchase of 5 tables and 20 chairs for the Library's dining area.20 The Library Is Full During the tenures of Ashburn and Hume shelves became filled in Library Hall, the reading room, and the corridors. Publications had to be stored in every nook and cranny.21 By the time Harold Jones arrived in 1936 he found the Library's portion of the building about to overflow:22 As far as I can see there is literally not an inch of room for expansion anywhere in the entire building except a dirty old coal hole in the cellar which is simply unspeakable. Everywhere books and magazines are piled high, and how anybody knows where things are or how anybody can get at anything if they want it, is beyond me. . . . Everywhere you go, every dark cubby-hole that is opened up in the basement, shows stacks and stacks of books and periodicals rising to the ceiling, the shelves groaning and'bent under the weight, and really the confusion is indescribable. Valuable books are left uncared for, there is no rhyme or reason as to why they are placed where they are, and if anything happened to the people who know the locations I doubt if they would ever be found. The longer this confusion goes on the worse it will be when we try to eventually straighten things out, and not one move can be made now because there is nowhere to go except out on the street. Jones searched the building and managed to find space here and there for additional shelves. He placed a few bookcases in Library Hall and the reading room, thereby decreasing space for readers.23 By 1939 Jones could not find any more usable space. "Now the end has been reached," he informed the Surgeon General, "and the Librarian is using the last available space for between four and five thousand books. In a little more than a year there will be no room 277 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE whatever and by no stretch of the imagination can any more books be received unless something is done."24 Jones recommended that a temporary wing be erected next to the Library end of the building, or that space be borrowed from the neighboring Depart- ment of Agriculture, or that an empty house, hall, or church be rented.25 But the Medical Department had been encouraged by the passage of legislation authorizing a new Library-Museum Building, and it would not accept Jones' suggestions. Jones had no alternative but to move volumes out of the building. He had all the duplicates, about 50 tons, packed into 500 boxes and shipped to the Army Medical Center for storage. Part of the freed space in the cellar was shelved for volumes, part was used for expansion of the infant microfilm service. Still searching for storage Jones thought of the recently erected National Archives Building. He asked Robert D. W. Connor, Archivist of the United States, for a loan of shelf space. Connor kindly offered 1,000 linear feet.26 One wonders from whom Jones would have borrowed space next if events during World War II had not brought another temporary solution to the Library's space problem. The Library Is Dirty The Library was not only crowded, it was becoming run-down. The ad- vancing age of the building was partially responsible, but there were other reasons. Washington now had many more buildings and houses than it had in the 1880's when the Library was erected, and the coal furnaces of these struc- tures threw smoke into the air much of the year. Impalpable dust found its way into the Library and settled on volumes. A vacuum cleaner was in use constantly.27 Several janitors spent their time cleaning and dusting.28 The plumbing and toilets were antiquated. Some of the furniture and rugs were badly worn. Paint was not applied often enough. When Jones was ap- pointed Librarian in 1936 the Library looked like this to him:29 It is frightfully dirty, ragged, unkempt, and disorderly. Dirt is rampant, and you can hardly touch anything here without having to wash your hands. The linoleum is ragged and disreputable, the walls grimy, the paint flaking off, the books dusty and the leather bindings cracking, and so on. There seems to be no standard of decency, no minimum housing and working conditions. The place lacks proper toilets and lavatories. It is badly lighted, and while I do not wish to complain personally, the office of the Librarian is quite unspeakable. . . . We need the whole place cleaned, we need a lot of paint and electric wiring on the inside, we need varnishing, we need workers to go over the books and treat the bindings, we need people with vacuum cleaners, we need all the floors gone over, we need new linoleum, or better still floor rugs, we need new furniture, new shades, and many other things. . . . Prodded by Jones the department repainted Library Hall and the reading room, installed reading lamps, touched up the exterior, repaired leaks in the roof, purchased new furniture, and enlarged the visitors parking lot. More radiators were placed along the walls of the reading room. The building stopped 278 THE LIBRARY ON THE EVE OF WORLD WAR II using its boiler and began to receive central heat from the government heating plant. Still, the department was reluctant to sink much money into the old structure since it was thought that a new building would soon be constructed. Friends of the Library, the Beginning of Microfilming, and the Establishment of Current List In 1907 Atherton Seidell, a biochemist, published the first edition of his classic reference book Solubilities of Inorganic and Organic Substances. During the years that followed he spent many hours in various libraries compiling data for later editions. In 1926 at Maison de la Chimie in Paris he became acquainted with microfilm. Two years later in France he had to leave his family and laboratory to travel to Monaco to peruse a specialized journal. It occurred to him that this time-consuming trip would not have been necessary if microfilm facilities had been available for scholars and scientists engaged in library re- search. Thereafter he never stopped his efforts to encourage libraries to develop free microfilm service for patrons.30 In the 1930s he was a leader in organizing the American Documentation Institute, a nonprofit microfilm service. The Department of Agriculture loaned the institute office space. Seidell installed a camera in the Agriculture Library and began to provide microfilm at a low price. Subsequently he placed cameras in the National Bureau of Standards Library, the Geological Survey Library, and, in 1937, the Army Medical Library. The medical library, understaffed, could not spare a person to operate the camera, and Agriculture sent over a photographer two or three times a week to film orders that had been received. During fiscal year 1938-1939 this service filled 1,591 orders totaling 5,000 pages of text.31 Microfilming was moving slowly into libraries at this time. Firms were developing cameras and viewers, libraries were purchasing equipment and integrating microfilming into their operations, and researchers were being in- formed of the availability of film. By 1940 Librarian Jones was convinced of the potential usefulness of microfilm, and he wanted the service improved. He did not have funds to purchase a camera and other equipment and to hire an operator, but Seidell offered to form a volunteer organization to sponsor mi- crofilming and publish a periodical that would inform researchers of recent articles available on film.32 Seidell began in August 1940 by inviting five prominent physicians of Wash- ington to join him in a group to be called "Friends of the Army Medical Library."33 These men were Hugh Cumming, formerly Surgeon General of the Public Health Service and now director of Pan American Sanitary Bureau; Aristides A. Moll, secretary of Pan American Sanitary Bureau; George B. Roth, professor of pharmacology at George Washington University; Michael X. Sul- livan, director of Medical Research Institute, Georgetown University; and William L. White, National Institute of Health. After these men had agreed to unite with him in the undertaking, Seidell set about enlarging the group. He des- 279 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Atherton Seidell, who introduced microfilming into the Library. He devised a number of simple, inexpensive magnifying viewers to enable persons to read microfilm in their laboratories, offices, or homes. Here he is looking through a microfilm viewer built into his lamp shade. Another of his viewers, consisting of a handle and magnifier, is on the table. ignated the original six as the executive committee and himself as executive secretary. He was, in fact, the active member of the original Friends and paid the starting-up expenses out of his own pocket; the others were silent partners who added prestige by their presence. He sent out 2,800 form letters inviting physicians and scientists to become Friends, to use the microfilm service of the Library, and to subscribe to his proposed journal.34 In the months that followed many individuals and libraries became Friends, 280 THE LIBRARY ON THE EVE OF WORLD WAR II but in the meantime Seidell proceeded with microfilming and the periodical. He gave his camera and processing equipment to the Library, paid the cost of installation, and advanced $200 to start the work. Under his direction and the nominal sponsorship of the Friends, "Medicofilm Service," as it was named, produced its first film in September 1940, filling 122 orders for 22 customers.35 Medicofilm Service was managed by Seidell, and the work was done by library employees on their own time. Two members of the reference staff collected and brought volumes to the camera, for which they received 3 cents a volume. Two other employees filmed the material. The expense and the remuneration of the workers was paid by charging 30 cents (reduced to 25 cents in July 1941) for an article up to 25 pages in length, plus 10 cents for each succeeding 10 pages. Microfilms were made free for the Surgeon General's office and the Library. The operation became self-supporting eventually and thereafter showed a profit. At first patrons were informed of the new microfilm facilities by a pamphlet, "Medicofilm Service of the Army Medical Library; its purpose and plan of operation together with a list of more than 400 abbreviated titles of modern periodicals currently received by this library."36 To publicize the services more widely, Seidell began publishing on January 1, 1941, a pocket-size 20-page weekly periodical, Current List of Medical Literature. It appeared under spon- sorship of the Friends, but it was managed entirely by Seidell. The titles in Current List were copied from index cards prepared for Index- Catalogue. A library employee, Deborah Hannon, typed the manuscript out of working hours. The copy was pasted in columns and reproduced by the Washington Planograph Co. Each issue contained about 1,000 titles. The work was done so rapidly that a subscriber was furnished with the titles of articles eight to 10 days after journals arrived at the Library. In contrast, readers of Quarterly Cumulative Index Medicus had to wait from 2 to 3 months to learn of the articles. Articles in Current List were arranged under approximately 50 subject headings dealing with medicine and allied sciences. A researcher glancing at articles under his speciality, as cardiology, dentistry, ophthalmology, could ascertain quickly the presence of new articles he might wish to read. Current List did not displace other index journals; it was merely a rapid, convenient, inexpensive way of announcing new articles, microfilms of which were obtain- able quickly from the Library. On the inside of the back paper cover was frequently printed an order blank for readers to use in sending for film. At other times the inside of both covers carried news and announcements of the Friends and the Library, and editorials written by Seidell, Jones, Claudius Mayer, and other persons. On occasion the Library used the covers of several issues to publish a long list of wanted journals needed to fill gaps in the journal collection. Beginning in February 1941 the Friends began to issue the Library's "Recent Book Acquisitions," as a supple- ment to Current List with hope of attaining wider distribution of the former. 281 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The publication of Current List, including typing, printing, and postage, cost about $5,000 a year. The subscription price was $5 a year (which amounted to about 10 cents a number). The cost of starting the journal was paid by Seidell. The number of subscribers increased rapidly, but the journal did not begin to pay for itself for some time. Seidell supplied almost all of the deficit, the remainder coming from profit earned by Medicofilm Service.37 The plan of informing researchers of newly arrived articles and supplying microfilm copies was very successful. The number of customers increased rap- idly. During the first 6 months an average of 444 orders arrived each month. By June 30, 1941, 1,300 persons and institutions had become Friends. Med- icofilm Service had exposed almost 2 miles of film to fill 4,736 orders for 950 universities, hospitals, research institutions, individuals, and government agen- cies. With funds from Rockefeller Foundation and assistance of the Sanitary Bureau of the Pan American Union, Current List and microfilm copies of medical publications were being sent free to 150 medical institutions in Central and South America. Legislation for a New Building Talk of unification of Army Medical Library with Library of Congress or removal to the LC annex persisted. In November 1936 Harvey Cushing told Surgeon General Charles Reynolds that Herbert Putnam saw no reason why the medical library could not be located in the annex while retaining its name and being operated by the Surgeon General's office:38 I have talked once or twice with Herbert Putnam about it and he is under the impression that the medical profession doesn't quite know what it wants, whether to go to the site near the Walter Reed Hospital or to join up with the Congressional Library. I think that he himself, now that the new building is going up, feels differently from what he originally did. He intimated to me that one floor of this new building would be about double the space now occupied by the Library and Museum and that he did not see any reason why it should not be called the Surgeon-General's Library and be run by the Army just as it now is. Meanwhile, it could take advantage of their cataloguing system and all the rest; and what is more important still, the Library of Congress had very little difficulty in getting money for whatever it wanted whereas the Surgeon- General's Library might sometime have difficulty in getting support. Something more was said about the suggestion that the incunabula might be moved over to the Congressional Library where they could be put in the air-conditioned room, for they were rather deteriorating in their present quar- ters. Finally Librarian Jones decided that he had to separate rumor from reality and he, with Surgeon General Reynolds in tow, went to see Putnam. Putnam told them that "certain influential persons" had advised the President not to erect a new library building at Army Medical Center, that he did not believe that it would necessarily be more economical if the AML were transferred to LC, that he preferred AML to be in its own building, but that he would have 282 THE LIBRARY ON THE EVE OF WORLD WAR II to admit, if questioned by congressmen, that LC had plenty of space to absorb AML.39 It is usually impossible to learn precisely all the events that cause a bill to be introduced into and passed by Congress. The Medical Department had many friends besides Cushing urging Congress and the Administration to pro- vide a new building. Yet, probably none of them was able to approach President Roosevelt as closely as Cushing, and it may have been Cushing's letters to the White House that finally resulted in the President's sending for Surgeon Gen- eral Reynolds in April 1938, to tell him legislation would be prepared. The President suggested that he marshal public sentiment to urge Congress to act and that he hold a news conference to inform reporters that a new library- museum would be forthcoming.40 Within a few days Reynolds requested from the Adjutant General an al- lotment of $3,750,000 from Public Works Administration or other funds for construction of the building at Army Medical Center.41 The War Department placed the building on a list of construction projects that would be presented to the PWA.42 Librarian Jones and Curator James E. Ash of the museum now began a broad campaign to persuade Congress to pass the bill that would come from the White House. They drew up lists of hundreds of names of medical libraries, institutions, and influential persons to whom the Surgeon General could write asking for support.43 Scores of replies reached the Medical Department and were later presented to the congressional committees that, in the meantime, had received the bill.44 On April 28 Representative Andrew J. May and Senator Morris Sheppard introduced identical bills, drawn up by Surgeon General Charles Reynolds, to authorize construction of a new Army Medical Library-Museum Building in Washington.45 Congress enacted the legislation very rapidly, and the President approved the law June 15.46 The Secretary of War now had permission to construct a building costing no more than $3,750,000 on a site approved by the National Capital Park and Planning Commission, but he had not been given any money to carry out the work. On June 13 Roosevelt asked Congress to appropriate $3,750,000 for con- struction of the proposed building.47 The Senate passed a bill quickly appro- priating one-third of the sum, but the House did not have time to act before Congress adjourned on June 16, and the bill died. More than a year passed before the legislative process began again, with the White House directing the War Department to include funds for the build- ing in its estimate of appropriations.48 The department's estimate, submitted to Congress on January 4, 1940, requested $470,000 to purchase a site and $130,000 for plans. The House Committee on Appropriations agreed to the amount for plans but not for a site, pointing out that the law passed in 1938 had not authorized the buying of land.49 The Senate did not agree with the House and desired to give the entire sum of $600,000. But the House remained 283 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE adamant, stating that money was needed more urgently for other military projects. The final appropriation act, June 153, 1940, thus gave the Army $130,000 for planning the building.50 A supplemental appropriation act passed several days later specified that the Secretary of War and Surgeon General should approve the selection of the architect and the design.51 On October 4, 1940, the Secretary of War authorized Surgeon General James Magee to form a committee to chose an architect and a design. This committee selected the firm of Eggers and Higgins, New York, which had participated in the design of the National Gallery of Art, Thomas Jefferson Memorial, and National Archives. The Secretary approved and a contract was drawn up.52 The architects developed a series of plans that they submitted first to Jones and Ash, and, after May 1941, to a board consisting of Jones, Ash, former librarian James Phalen, and two other officers.53 Meanwhile President Roosevelt had told the Army to place the building behind the Library of Congress near East Capitol Street.54 Through 1940 and '41 the National Capital Park and Planning Commission kept changing its overall plan for the Hill area as it sought to make a harmonious setting for the Supreme Court building, the proposed Justice Holmes Memorial Garden, and other structures. Finally in March 1941 the commission and the Surgeon General agreed on a block on the south side of East Capitol Street between Third and Fourth streets.55 In October 1941 the Commission of Fine Arts approved the architects plans but asked for more ornamentation (one result of which was a planned statue of Billings) and suggested a larger site.56 The Army still did not have funds to purchase ground on Capitol Hill. In June 1941 Surgeon General Magee had asked Representative May to introduce a bill that would provide the Army with $1,000,000 for the land.57 May's bill passed but like previous legislation it only authorized, it did not appropriate, funds.58 The sense of the House during debate was that nothing more than planning of the building would be done until the war emergency period had passed.59 In the spring of 1942, at the request of'the Army, the contract with the architects was canceled because the United States was now at war.60 Jones Organizes the Staff The employees, up to this time, were organized very loosely, as they had been since the days when Billings directed the Library. Everyone knew his or her job and carried on without much supervision.61 When the promise of a new building brought Jones and the architects together in 1940, he realized that the staff would have to be organized along functional lines if the interior of the Library's half of the structure was to be laid out for maximum convenience and efficiency. Finally in November 1941 Jones carried out his ideas and grouped the employes into three divisions and one department named the Index-Catalogue 284 THE LIBRARY ON THE EVE OF WORLD WAR II and Research Division, the Acquisition, Finance and Supply Division, the Custody and Loans Division, and the Clerical Department.62 The duties of the Index-Catalogue and Research Division, headed by Clau- dius Mayer, included: cataloging all publications for the library, maintaining the main card catalog, selecting articles and sections of books for inclusion in Index-Catalogue, publishing Index-Catalogue, developing the portrait collec- tion and catalog, arranging the manuscript and autograph collection, performing bibliographical research for government agencies and private individuals, trans- lating, and abstracting. This division also did the planning to fill in Jones' ideas for changes in organization, cataloging, accessioning, subject classification of books, and other matters. The Custody and Loans Division had charge of the main book and periodical collections, served readers in the library, and ran the interlibrary loan system. The Acquisition, Finance and Supply Division searched book-trade sources for works that should be acquired, ordered the works, handled the financial ac- counts (this had been done in the Surgeon General's office until early 1941), and accessioned new arrivals. The Clerical Department included the clerical, messenger, mailing, and labor services, and later the microfilming service. Thereafter Jones modified the organization from time to time to meet changing conditions.63 Notes 1 Efficiency reports on Jones by Hagood, 1923-1924: MS/C/8. 2 Jones, "The Army Medical Library: in Ret- rospect and Future," Bull. Med. Lib. Assoc. 34: 4 (1946). 3 Biographical information on Jones may be found in his papers in MS/C/8, and in his arti- cles: "A Journey to the Kingdom of the White Elephant," Military Surgeon 56: 159-68 (1925); "The Pill Artillery in Mexico," ibid., 59: 545- 568 (1926); "A Doctor chases the Pulajanes," ibid., 67: 297-316 (1930); "Following Rainbows 'Round the World," ibid., 71: 76-85, 172-181 (1932); "Looking Backward," ibid., 76: 74-83 (1935); "Delegate-at-Large," ibid., 81: 430-442 (1937). 4 Correspondence regarding the arrange- ments for the Centenary, letters of congratu- lation, scrolls, programs, clippings, and reprints of articles are in MS/C/140. Several articles were written for the Centenary: Jones, "The Cente- nary of the Army Medical Library," Military Surgeon 80: 1-4 (1937); Rolleston, "the Oration Commemorating the One Hundredth Anniver- sary of the Founding of the Army Medical Li- brary, Washington," 5-20; Jones, "The Greet- ings from Beyond the Seas," 21-31; Claudius F. Mayer, "From Drawings to Photography in Color," 31-44; E. E. Hume, "Buildings for the Army Medical Library," 45-52. Jones', Rolles- ton's, and Mayer's articles were also published (without the illustrations used in Military Sur- geon) in The Army Medical Library Number of Med. Life, 43: Dec. 1936, along with additional articles: P. M. Ashburn, "A Greenhorn's Ex- perience in the Library "; J. M. Phalen, "Amer- ican Medical Literature"; Albert Allemann, "Dr. Billings and His Work." Jones had reprints of all the articles in Military Surgeon and Med. Life bound in volumes for presentation; The One Hundredth Anniversary of the Army Medical Library, Washington, D.C., 1936. 5 Letters, Hume to Victor Robinson, July 11, 1936; Surg. Gen. C. R. Reynolds to H. Cushing, Aug. 11: MS/C/140. 6 Letters, Hume to C. R. Reynolds, Aug. 11, 1936; Reynolds to H. Cushing, Aug. 11: Jones to Reynolds, Aug. 24: MS/C/140. Fulton, Harvey Cushing, p. 665, 676. 7 Jones' remarks on arrangements in Bull. Med. Lib. Assoc. 40: 103-104 (1952). 8 Hume and Jones prepared for distribution 285 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE to the guests an eight-page pamphlet, Routine Operation of the Army Medical Library. A copy is in Archival Collection. 9 Star, Nov. 17, 1936. 10 The Washington Star, Herald, and Post all mentioned the need for a new building in their accounts of the Centenary. " Annual Report of the Surgeon General, 1939, p. 248. 12 Index-Catalogue vol. 3, 1938. The 288- page supplement has its own pagination; ap- parently Jones hoped to have copies printed, bound, and issued separately. An addition to the list was published in Index-Catalogue, Vol. 4, 1939. 13 Memo, Jones for Dr. Bickel and the in- dexing department, May 31, 1940: MS/C/42. 14 Mayer's plans, sources, and methods for the bibliography are in his seven-page intro- duction to the supplement. 15 Annual Report of the Surgeon General 1939, p. 248. Index-Catalogue 5, 1940, p. iii; 6, 1941, p. iv. Current List Med. Lit., 5: Aug. 5, 1943, inside cover. 16 Changes in the style of cataloging and cov- erage in the fourth series are listed in Annual Report of the Librarian, FY 1940-41: file, Con- solidated Fiscal Year Activities, MS/C/309. 17 Jones, editorial inside covers Current List, 4: no. 23, June 10, 1943. 18 Annual Report of the Surgeon General, 1940, p. 260. 19 A survey of the manuscripts may be found in: Sami Hamarneh, "Arabic Manuscripts of the National Library of Medicine, Washington, D.C." /. Hist. Arabic Sci. 1: 72-103 (1977). 20 For background of the Edgar bequest see Henry, Armed Forces Institute of Pathology, p. 234-5. Brief remarks on the fund are in annual reports, 1937-1949; AML Bulletin, Jan. 3, 1952, May 23, 1956. Correspondence between Jones and Sommer, NLM. Correspondence between Jones and Mayer, and Mayer and Yahuda, MS/ C/42. Claudius F. Mayer, "The Collection of Arabic Medical Literature in the Army Medical Library," Bull. Med. Lib. Assoc. 30: 96-104 (1941—42); "Checklist of Arabic Manuscripts," Bull. Hist. Med. 16: 201-16 (1942). Princeton University purchased the bulk of Yahuda's man- uscripts. 21 "The other day, one of our staff was com- plaining about the crowded conditions in the 'Thesis Room' . . . unfortunately for our peace of mind this is not the only place where we keep such dissertations, for it is impossible to keep them confined to a single room. They crawl all over the library, some 200,000 of them . . . There is not a single inch of space left in any of the boxes for the squeezing in of any more theses. All the available room is taken up now by the medical dissertations of the last three centu- ries." C. F. Mayer, Current List Med. Lit. 1: No. 14, April 2, 1941, inside cover. A list of all the rooms used for library pur- poses, the number of square feet in each room, and the use made of the room is in Memo, Jones to Surgeon General, Mar. 16, 1937: file, Space Information, MS/C/309. 22 Memo for the Surgeon General by Jones, Sept. 2, 1936: MS/C/205. 23 Some of the cases had glass fronts and locks. In these all the incunabula, more than 450, were brought together and arranged in alphabetical order. Similarly 3,000 16th-century volumes were selected from the general collection and placed in locked cases for the first time. Erotica was locked up in a cherrywood book case with a solid front. A unique copy of the 1721 reprint of Thomas Thatcher's A Brief Rule to Guide the Common- people of New-England how to order themselves and theirs in the small pocks, or measels, a broadside, and perhaps a few other small, rare publications were kept in the Library's safe. 24 Report of the Surgeon General, 1939, p. 249. Letter, Jones to Surgeon General, Oct. 12, 1939: file, Space Information, MS/C/309. 25 Memos, Jones to Surgeon General, Oct. 5, 1939, Oct. 12, Nov. 28: file, Space Infor- mation, MS/C/309. 26 Letter, Jones to Connor, July 16, 1941, and attached corr.: file Space Information, MS/ C/309. Books, including the stock of Index-Cat- alogue and the old Medical and Surgical History of the War of the Rebellion, were stored in the Archives from Sept. 1941 until January 1944, when they were moved to the Cleveland Branch. 27 In 1910 the Library acquired its first vac- uum cleaner, a Duntley Pneumatic Cleaner. It was in constant use for 2 years before it wore out. Librarian McCaw told the Surgeon General that the "method of cleaning books and shelves in the Library by a pneumatic machine is in- valuable," and requested a stronger, more du- rable cleaner. See letter, McCaw to Surg. Gen., Feb. 5, 1913; MS/C/116. 28 The Librarians complained in their annual reports to the Surgeon General that more jan- itors were needed. 29 Memo, Jones to Surgeon General, Sept. 2, 1936: MS/C/205. Jones also said: "To my mind the Museum is in an infinitely better position than the Library. It is fairly clean and looks prosperous, apparently has plenty of space in which to display its wares, and meanwhile the Library is barely able to stagger along and is in a condition that has to be seen to be appreci- ated." 30 Elizabeth E. Medinger, "A Brief look at the activities of Atherton Seidell, Ph.D. (1878- 1961) in the field of documentation," typescript 286 THE LIBRARY ON THE EVE OF WORLD WAR II in MS/C/198. Sketches of Seidell may be found in: Proc. Nat. Microfilm Ass. 10th Convention, 1961, pp. 302-305 with port.; Wyndham D. Miles, American Chemists and Chemical En- gineers, (1976), 432-433, with refs. Information was also obtained from Miss Medinger (Seidell's niece) and from Joseph H. McNinch. Reginald Hawkins, Production of Micro- Forms, (1960) and Jean Stewart, Doralyn Hickey, and others, Reading Devices for Micro-Images, (1960) provide an account of the development of microfilm for library use, and refer to Seidell and the AML. 31 Annual report of the Librarian, FY 1938- 39: file Consolidated FY Ac, MS/C/309. 32 Another purpose of this organization was to attract gifts to the Library, but so far as I am aware this did not happen. 33 Letters, G. B. Roth to Seidell, Sept. 3, 1940; W. C. White to Seidell, Sept. 4; Seidell to Surgeon General James Magee, Nov. 8: file, Friends of AML, MS/C/309. 34 Letter, Seidell to members of the Friends, Nov. 25, 1940, with draft of form letter attached: file, Friends of AML, MS/C/309. A copy of the printed form letter is also in this file. 35 Current List Med. Lit. 1: No. 5, Apr. 9, 1941, gives statistics for the first few months of service. Information on microfilming in the Li- brary by Medicofilm Service and its successor, Photoduplication Service, may be found in Cur- rent List and in reports of Photoduplication Service, annual reports of library activities, and reports of activities of the Medicofilm Service, MS/C/309. A good account of microfilming, the Friends, and Current List is on pp. 128-146 of "The National Medical Library: Report of a Sur- vey of the Army Medical Library . . . Appen- dixes," by Keyes D. Metcalf and others, 1944, in Archival Collection or MS/B/190. 36 Published in September 1940. A copy is in Archival Collection. 37 "Dr. Seidell has already sunk a good deal of money in it and I doubt very much if he gets it back"; H. W. Jones, Brief notes for answers on war effort in Army Medical Library, 1942; file, Historical Info, MS/C/309. 38 Letter, Cushing to Reynolds, Nov. 25,1936: MS/C/183. Thomas S. Cullen's scrapbook, Proposed New and Centrally Located Surgeon General's Li- brary Building, copy at NLM, contains corre- spondence and clippings regarding efforts to obtain a new building during this period. 39 H. W. Jones, "Interview with Mr. Her- bert Putnam . . . January 5, 1937"; Reynolds, "Record of conference with Dr. Putnam . . . January 5, 1937"; letter, Putnam to Jones, Jan. 8, 1937; Memo, Reynolds to Jones, Jan. 11: file, Transfer of AML, MS/C/309. 40 Letter, Reynolds to W. Bierring, Pres. AMA, July 21, 1938; this letter states that Rey- nolds talked with Roosevelt on April 18. An- other document, "Efforts to secure congres- sional appropriation for new army medical library building," p. 6, gives the date as April 21. Let- ter, Reynolds to Marvin Mclntyre, Secretary to the President, Aug. 5, 1938, also gives the date April 21. File, New Building Misc. Corr., MS/ C/309. 41 Letter, Reynolds to Adjutant General, Apr. 21, 1938: file, New Building Misc. Corr., MS/ C/309. 42 Extracts concerning Army Medical Li- biary and Museum, Apr. 15, 1942: file, New Building Misc. Corr., MS/C/309. 43 Jones, memo for the Surgeon General; in letters to secure site for new library and mu- seum, May 3, 1938: file, Location of New Build- ing, MS/C/309. 44 Letters or excerpts are in "Hearings be- fore the Committee on Military Affairs of the House of Representatives, Seventy-Fifth Con- gress, Third Session, on H.R. 10455"; in the hearings before the Senate Committee, and in H.R. Report 2493 to accompany bill H.R. 10455: copies are in MS/C/47. Henry, Armed Forces Institute of Pathology, pp. 236-240. 45 75th Cong., 3d sess., bill H.R. 10455, Apr. 28, 1938 and bill S. 3919, Apr. 28, 1938, "To authorize the Secretary of War to proceed with the construction of certain public works in con- nection with the War Department in the Dis- trict of Columbia." Copies of these bills, accom- panying House and Senate reports, excerpts from Congressional Record, and Communication from the President, are in MS/C/47. Reynolds stated that he drafted the bill, in letter to Col. L. Gardner, Mar. 15, 1946: file, New Building Misc. Corr., MS/C/309. 46 P.L. 611, 75th Cong.: copy in MS/C/47. 47 75th Cong., 3d sess., Senate Doc. 204: copy in MS/C/47. 48 Memo, A. G. Love to Gen. Magee, Feb. 5, 1940: file, Location of New Building, MS/C/ 309. 49 76th Cong., 1st sess., H.R. Report 1912, "Military Establishment Appropriation Bill, Fiscal year 1941," p. 16. 50 Congressional Record, June 10, 1940, pp. 7895-7896. 76th Cong., Public Law 611, ap- proved June 13, 1940, p. 15. 51 76th Cong., Public Law 668, approved June 27, 1940, p. 32. 52 Status report of Army Medical Library and Museum by H. C. Jones, Apr. 2, 1941: MS/C/ 47. 53 Office order 119, May 21, 1941, estab- lished this Board: file, New Building Boards and Meetings: MS/C/309. 287 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 54 Memo, A. G. Love to Gen. Magee, Feb. 5, 1940: file, Location of New Building: MS/C/ 309. 55 Memos and letters regarding sites on Cap- itol Hill and a large map are in file, Location of New Building: MS/C/309. 56 Records in Eggers & Higgins Corr., file, Location of New Building: MS/C/309. 57 Letter, Magee to May, June 24, 1941, in H.R. Report 884, June 28, 1941. 58 77th Cong., 1st sess., bill H.R. 5146, in- tra. June 24, 1941; H.R. Report 884, to accom- pany bill H.R. 5146, June 28, 1941; Senate Re- port 600, to accompany bill H.R. 5146, July 28, 1941; Senate Report 665, to accompany bill H.R. 5146, Aug. 21, 1941; P.L. 256, approved Sept 24, 1941; copies in MS/C/47. 59 Congressional Record, 77th Cong., 1st sess., pp. 4748, 7122, 7214, 7378, 7415, 7571. 60 George F. Denniston of Eggers & Hig- gins, office instructions and report, Feb. 7, 1944: file, New Building contracts: MS/C/309. 61 The organization of the Library in the 1930's, with a list of all employees (30 civilians and one medical officer) and their duties, is in Report of survey of the duties and responsibil- ities of the positions in the Army Medical Li- brary, Nov. 6, 1936: MS/C/186. 62 Library Order 6, Oct. 29, 1941, to take effect Nov. 1: file, Library Orders, MS/C/309. Annual report of Library activities for FY 1942; file, Consolidated Fiscal Year Activities: MS/C/ 309. The names of the above divisions were modified later. 63 Details and dates of the many changes in organization during World War II may be found in file, Library Orders: MS/C/309. 288 XVII The End of the Old Library and the Beginning of the New Changes During World War II AFTER the United States declared war in December 1941, Jones prepared the Library for emergencies that might arise. He appointed air raid war- dens for the building and for each floor. Staff members were taught to use firefighting apparatus. On Sundays an employee designated as the "Library Officer of the Day" remained in the building to provide emergency service (later the Library expanded its service because of the war and remained open on Sundays). Consideration was given to moving the 1.5 million index cards that had been prepared over a span of 15 years for printing the Index-Catalogue, but eventually the cards were microfilmed and the film safeguarded. The por- trait collection was readied for shipment out of Washington on 24-hours notice.l The Surgeon General changed the status of the Library and museum from departmental to field installation on July 1, 1942.2 The Library was now com- parable to a medical supply depot or medical equipment laboratory. It had greater independence from the Surgeon General's office which, from the li- brarian's viewpoint, led to easier operation. It became practically impossible to buy books and journals of enemy coun- tries, for which the Library in normal times spent about two-fifths of its ap- propriation.3 The number of journals received dropped from about 2,200 to around 1,300. Jones borrowed some missing journalsfrom libraries that man- aged to obtain them and had microfilm copies made for the compilers of the Index-Catalogue. The microfilms were kept on the shelves until the missing issues were acquired after the war. He also borrowed and filmed journals from the Office of Alien Property Custodian and from military intelligence agencies. Late in the war the number of journals received rose to approximately 1,900, chiefly owing to the acquisition of Latin-American and newly established U.S. periodicals. Early in the conflict the demand for library services increased only slowly. But as the country concentrated on the war and the armed forces expanded, requests from Army and Navy hospitals and other military medical units for 289 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE services accelerated. More and more orders arrived for microfilm, translations, abstracts, bibliographies, and information. Much translating was done for med- ical officers who could not read certain foreign languages, for the Military Information Division of the Surgeon General's Office, and for other parts of the War Department. Many bibliographies were compiled and sent out, the highest 12-month production being 554 between July 1944 and June 1945, 90 percent going to members of the armed forces. Loans, which had reached 15,000 a year before the war, gradually decreased to the 12,000 range. The loan policy was liberalized. If a book or journal could not be sent because it was needed in Washington a photostat or microfilm copy was offered. The development of microfilm facilities made possible the mailing of film copies and reduced the number of volumes that had to be sent. Previously the largest borrowers had been universities and medical societies, as Medical College of Virginia, Pittsburgh Academy of Medicine, Tulane, Louisiana State, and Yale, but now the Army, National Institute of Health, and Department of Agriculture requested the most volumes. The largest increase in service was the demand for microfilm copies of articles and even entire books from military hospitals and units and research institutions. Copies of Current List of Medical Literature sent to military med- ical units kept the personnel informed of recent articles, and as a result the number of requests for microfilm of articles rose beyond all expectations. It was much easier and cheaper to sent microfilm overseas than to send books and journals. Filming made possible the filling of requests from several places for the same article. Indeed, one wonders what the Library would have done if microfilm had not been perfected and simultaneous requests had arrived for the same journal from the South Pacific, North Africa, and other theaters of war. Jones considered the development of microfilm as one of the two most notable events in the Library during his tenure. The increasing work in the Library could not have been carried out without additional employees. One officer and eight civilians were added during fiscal year 1942, raising the total number of workers to 46. The authorized total in FY 1943 grew to 69. By June 1, 1945, it had leaped to 156.4 Shortly after the war started the Library lost men to the armed forces and two of its top staff, Beatrice Bickel, the Principal Librarian, and Charles Toep- per, the chief assistant librarian, through retirement.5 Fortunately from time to time Jones managed to acquire top-notch professional librarians. The first of these was Thomas Keys, who obtained a leave of absence from Mayo Clinic, received a commission as 1st lieutenant in the Medical Department and came to Washington in June 1943. Jones and Keys became close, and Jones relied upon him for advice in many matters.6 Shortly after war arrived Jones tried to obtain additional space by suggesting that a temporary two-story fireproof brick annex, large enough to hold 80,000 to 100,000 volumes, be constructed close to the west side of the building, connected by a bridge, but the War Department disapproved.7 Fortunately he 290 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW soon acquired, under very reasonable conditions, use of part of a building in Cleveland, and moved about one-quarter of the Library's possessions there. The shifting of books to Cleveland set free space for microfilm cameras, developers, other equipment, and for new employees, but before long the Library was again crammed full of readers, workers, volumes, and furniture. Finally in 1943 Jones was able to obtain about 5,000 square feet of space on the ground floor of the Washington Auditorium, 19th and E Streets, N.W., and there the indexing, translating, and binding assembly units and a few thousand books were placed. But the auditorium was almost 2 miles from the Library, and a truck had to cam' volumes back and forth. Eventually Jones gained permission to use more than 8,000 square feet in the Fisheries Building Annex, east of the Library on Independence Avenue, and the Fisheries Building at 8th and Independence Avenue. This accommodated the indexing, translat- ing, binding, and emergency shelflisting units, the finance section, the acqui- sition division, and tens of thousands of books.8 Space became available within the building as employees and books moved to other locations. Some stacks were removed from the reading room to give visitors more space. Units were moved up, down, and sideways to improve the flow of material. A general house cleaning was carried out. New lights were installed in the reading room and stack area. Stacks were lighted adequately for the first time; previously attendants had to use flashlights. A new telephone system was installed with additional outside lines and interoffice communica- tions; before this only two lines led into the building, and if one division phoned another division, all service was blocked and no outside calls could come in. In the midst of the war Jones obtained a grant from the Rockefeller Foun- dation to finance a detailed study of the Library by a group of practicing librarians. The group's criticism of the method of operations and the crowded, poorly maintained building caused Jones to turn his thoughts again to the proposed new building, plans for which had been put away early in the conflict. The approved location was still Capitol Hill, more so now than ever because President Roosevelt had approved Archibald MacLeish's idea of a cultural center around the Capitol comprising Folger Shakespeare Library, Library of Congress, National Archives, Army Medical Library, and museums.9 Jones asked for $5,500 to pay architects to revise plans along lines suggested by Keyes Metcalf, Harvard librarian, one of the study group. Congress approved the sum in the Army Appropriation Bill, and Jones changed the plans in many ways, including the insertion of a tunnel to connect the building with the Library of Congress.10 During the replanning Jones made a new estimate of the growth of the Library and museum. Owing to the wartime expansion of both institutions, and the establishment of the Army Institute of Pathology (spawned by the museum in 1943), it appeared that the proposed building would have to be much larger than conceived originally. But the Fine Arts Commission had placed restrictions on the height of buildings and setback from the street; 291 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE therefore a bigger building could not be erected on the chosen site. Jones decided to ask for twice as much land, so the building could be broader and wider. Government agencies and private firms coveted land on the Hill, and Jones' request was certain to stir up considerable opposition. But before it proceeded very far Surgeon General Norman Kirk, Museum Curator James Ash, Jones and other officers began to debate the future relationship between the Library and museum. Kirk decided on May 5, 1945, that while the Library would be in a logical location adjacent to the Library of Congress, the museum and Army Institute of Pathology ought to be close to hospital facilities at Walter Reed. The Library was to be separated from its old partner, the museum, and it could now look forward to expanding into the entire proposed building. Jones had to think about revising plans again.11 During the first 2 years of the war Jones was busy finding room for expansion of the Library, enlarging facilities to provide services to United States military forces in all parts of the world, and solving the many abnormal problems in acquisitions, circulation, and services caused by the war. In the remaining years of the war he would begin to change the Library drastically, pushing it from the old into the modern era. Survey of the Library by Professional Librarians In 1943 the Army, not satisfied with the performance of a segment of the Medical Department, conducted a thorough inspection of the Surgeon Gen- eral's office. Jones worried that the inspection might extend into the Library, and the investigators find "what they might regard as a state of confusion." He decided to head off a possible military survey by having a group of professional librarians visit the Library, observe the staff at work, and suggest ways of improving the operations and management. Jones asked the Carnegie and Rockefeller foundations to finance a survey. Largely through the urging of Alan Gregg, the Rockefeller Foundation agreed to provide $20,000 to pay expenses for such a study under the sponsorship of the American Library Association.12 The ALA appointed a team of six librarians: Keyes D. Metcalf, Harvard University; Janet Doe, New York Academy of Medicine; Thomas P. Fleming, Columbia University; Mary Louise Marshall, Tulane University; L. Quincy Mumford, New York Public Library; and Andrew D. Osborn, Harvard Uni- versity. These persons visited the institution several times during the summer and autumn of 1943. They called in experts in certain fields, as William Jackson of Harvard, who gave an opinion about the rare book division at the Cleveland Branch. The surveyors criticised the old building for its lack of space and incon- venient arrangement of rooms (which would have been remedied by a new building had the war not intervened), the administrative and organizational structure (which Jones was improving), the low appropriation, the insufficient 292 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW number of professional library employees, the absence of a shelf-list, and other things. They noted that the rate of growth of the Library, which had been the most rapid in the country, perhaps in the world, during Billings' time, had decreased until it was probably the slowest among large research libraries. The acquisition of monographs and texts was not comprehensive, and many important works were missing. The acquisition of publications of international congresses and of state health reports had been incomplete, and these collections were no longer outstanding. The acquisition of publications in the fields related to medicine, such as biochemistry, biophysics, and nursing, was particularly weak. A number of important journals were not being received, and there were gaps in some series. The surveyors pointed out that the incompleteness of the collections was largely the fault of the relatively small appropriations that the Library had been receiving for many decades while the output and prices of medical publications had been climbing. On the other hand they felt that the Library could have acquired more items if exchanges and gifts had been pursued more vigorously and if acquisition procedures had been more efficient. The surveyors were distressed by the shabbiness of the main card catalog, a hodge-podge of cards of different designs. They also discovered that the catalog was incomplete; when 4,690 titles of publications on the shelves were verified against the catalog, 1,047 titles were not found among the cards. A reader in search of a book might have to check the card catalog, all four series of Index- Catalogue, plus the cards being compiled for Index-Catalogue. Furthermore, a reader might not find a book he was searching for because many entries did not conform to American library practice. Finally a reader might find a card that had no classification mark, in which case an attendant might not be able to locate it (surveyors estimated that some staff members spent two-thirds of their time tracking down books for readers). The surveyors recommended that the card catalog be scrapped and a new catalog be compiled not from old cards, but from the publications, according to standard library practice. The preparation of a new card catalog would be a long, expensive ($500,000 to $750,000) job; yet the surveyors felt that it was worth it and that the longer it was delayed the worse readers would suffer. Examining the classification system the surveyors found that it was no longer as useful as it had been in the 1870's when Billings had developed it. The Library had grown and there were too many publications for a simple classi- fication. The system had been revised on occasion, most recently by Jones in 1942, but it was inadequate. Furthermore the majority of the collections (dis- sertations, pamphlets, statistical works, reference volumes, periodicals, rare books) were not classified; each group had its own arrangement. Among the books that had been classified, the classification names had not been written on the spines of the volumes where they could be seen but on bookplates inside the front covers. Many class names had not been written on 293 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE cards in the catalog, and attendants could not tell, except by experience, where the books were located in the stacks. Because there were no class marks on the spines, books were frequently misshelved when they were returned to the stacks. The surveyors believed that the only solution was the adoption of a new classification system, and the reclassification of every item in the Library. The surveyors found much fault with Index-Catalogue; such as unnecessarily complete coverage of some journals (as Journal of the American Chemical Society), the inclusion of books and journals remote from medicine, excessive coverage of some books and insufficient coverage of others, lack of uniformity in subject headings within the four series, use of little-known headings, lack of cross references, and even the punctuation, format, and typography. They felt that the Library had concentrated on the Index-Catalogue to the detriment of reader service, acquisitioning, cataloging, and other functions; and to remedy this they recommended that the Index-Catalogue Division be reduced in size and responsibilities to that of a publication office for Index-Catalogue. The surveyors critized the Library for not having taken part in important cooperative ventures of the library world, such as the compilation of the mon- umental Union List of Serials. They recommended that Jones forget his pro- posed "World List of Medical Literature" that the Library had started to com- pile a few years earlier. They suggested that Mayer discontinue, at least for the present, the "Bio-Bibliography of XVI Century Medical Authors" already begun in series form as a supplement to Index-Catalogue. The surveyors disclosed their observations and recommendations in a small book, The National Medical Library: Report of a Survey of the Army Medical Library, published by the American Library Association in 1944. The surveyors also provided a typed appendix, giving additional comments for the staff but of less interest to outsiders. The report criticized the Library strongly. Yet it was remiss in not empha- sizing that the Library's plight was not of its making; that former librarians extending back to McCaw, McCulloch, and Garrison (and the Surgeons General as well) were aware of some of the shortcomings but could not obtain the necessary funds, space, and employees required to maintain the Library on the trajectory set by Billings. The report could leave a reader who did not know anything about the history of the institution with the false impression that the employees, from the Librarian down, were responsible for the low state of affairs, which was far from the truth. The report reiterated the need for improvements that Jones was bringing about. It gave him and his successors guidelines for further action, and, by publicizing the poor, shabby condition of the Library, it put pressure on the Army to support requests for larger appropriations that would prevent the institution from slipping backward into its prewar mediocrity and keep it moving upward in search of excellence. The survey started the transformation of the Library but in so doing brought about conflicts between the past and present, conservatives and modernizers. 294 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW The leader of the conservatives was Claudius Mayer, Principal Librarian and editor of Index-Catalogue. Mayer was a genius, with great energy and drive. But he was unwilling to delegate authority and despite his productivity was somewhat of a one-man bottleneck in the publication of the Catalogue. He resented bitterly the criticism of the Catalogue in the survey report. He re- sented the coming of nonmedical people—professional librarians, administra- tors—to reorganize the institution. Conservative Mayer did not get along well with reformer Jones; they had battles ending with each man storming into his office and slamming the door behind him. Still Jones was never deterred from his aim to improve the Library, and Mayer never ceased resisting change. Jones accepted the survey report as his Bible. In doing so he marked the beginning of the end of the old Library and the beginning of the new. To aid him in carrying out the recommendations of the surveyors he brought to the AML on November 3, 1943, Private Francis R. St. John, in peacetime a skillful administrator of the New York Public Library. Jones recommended St. John for Officer Candidate School, and after St. John had been commissioned as a 1st lieutenant appointed him as his assistant.13 St. John knew many competent library specialists, and he recommended persons whom Jones persuaded to move to Washington and help lead the reorganization. Among St. John's suggestions was M. Ruth MacDonald, head cataloger of the Detroit Public Library, whom Jones lured to the AML to supervise recataloging of the collections. Another was Scott Adams of the order- cataloging department of Providence, Rhode Island, Public Library, whom St. John invited to head the AML Acquisitions Department. Another was Sergeant Ralph R. Shaw, head of the Department of Agriculture Library in peacetime.14 Not all those whom St. John and Jones sought were willing to uproot themselves and come to the capital, but by June 1945 there were 48 professional class employees on the staff whereas in 1940 there had been only 5.15 St. John and Shaw introduced up-to-date management practices and the latest library technology. Time-studies were made of operations; functions and responsibilities of employees were clarified; records were kept to demonstrate effectiveness of employees; and the compilation of a manual of operations was begun. St. John and Shaw moved sections around to bring about the most efficient flow of materials and cooperative working conditions. By the end of the war the employees were organized into 6 divisions composed of 26 sections, compared with the first organization, 4 years earlier, of 3 divisions and 1 department.16 With experienced librarians as supervisors and with additional employees and space, Jones was able to improve the AML in many ways. Shelf listing was started. When completed in 1945 the Library had for the first time an inventory of its books (but still not of its pamphlets and dissertations). The development of a new classification was begun under the direction of Mary Louise Marshall of Rudolph Matas Medical Library, Tulane, assisted by a group of librarians. Revision of the standard list of subject headings was started. Modernization of 295 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the card catalog began with consolidation of files of cards, preparation of new guide cards, and insertion of new typed cards in place of cards on which were pasted clippings from the Index-Catalogue. Journals, previously arranged by country or language, were rearranged according to the Union List of Serials. Steps were taken to reorganize the portrait collection along subject lines.17 In May 1944 Jones reached the peak of his reorganizations by persuading Surgeon General Kirk to change his title from Librarian to Director and by obtaining permission to place the operations of the Library in the hands of a civilian professional librarian titled The Librarian.18 Jones appointed St. John as Acting Librarian on September 1.19 After considering 35 persons for the job, Jones appointed Wyllis Wright as Librarian in the summer of 1945.20 Wright had begun his career at New York Public Library, continued at the American Academy in Rome, and returned to New York as chief cataloger before coming to Washington in July 1945. Arriving at the Library he faced the formidable task of modernizing the organization and solving the problems that arose with the end of the war and the return of peace. He studied problems thoroughly before choosing solutions, and for a time the long, slow rebuilding of the Library proceeded smoothly. But unfortunately the authorities of the Director and Librarian had not been adequately defined. The dual responsi- bility for administering the institution did not work as well in practice as in theory. Friction developed between the two top administrators, and later the split had to be mended. Part of the Library Moves to Cleveland and Becomes the History of Medicine Division The destruction of cultural treasures in Europe aroused fear for the safety of similar objects in the United States. Archibald MacLeish, Librarian of Con- gress, and Robert D. W. Connor, Archivist of the United States, asked libraries, museums, and agencies in Washington about their plans for storing irreplace- able objects in safe areas.21 Jones looked over the Library's collections and estimated the amount of storage space that would be needed.22 He took pre- cautions to protect rare manuscripts and publications. The title page of each incunabulum was photographed for identification, the volumes were placed in numbered boxes and moved to a room in the basement. Sixteenth century books were shelved in steel cases in the same room. Seventeenth and eighteenth century books (about 27,000 in all) scattered through the stacks were brought together over a period of months, inventoried, and boxed. The necessity for a safe place to store the Library's prized possessions became a lever that Jones used to pry space from the government. In January 1942 he suggested that a small branch library be set up in a temporary building at Army Medical Center or in a town close to Washington, perhaps Rockville, Frederick, Warrenton, or Fredericksburg. Into this tempo would be moved 296 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW rare books and other works needed least during the war, such as documents and older statistical publications.23 Jones was told to seek a place in the Midwest. He looked at sites offered to the government and in a short time selected part of the Dudley P. Allen Memorial Library Building owned by the Cleveland Medical Library Associ- ation. This was located at 11000 Euclid Avenue about 4 miles from the center of Cleveland. The trustees offered rooms rent-free, requesting only that the government reimburse the association for a proportionate share of the cost of maintaining the building.24 The final agreement called for a rental payment of $1 a year plus $8,000 a year for expenses effective June 1, 1942, with privilege of renewal for 8 years. The Army Medical Library utilized most of the rooms on the third floor of the structure, plus tiers 8 and 9 of the stacks.25 On July 3, 1942, Jones detailed Thomas Keys to direct the Cleveland Branch, arrange facilities, hire employees, receive shipments of books from Washington, and start the work of unpacking and shelving. Keys, with advice from the Army district engineer office and a firm of architects, ordered steel and wooden shelves. He engaged typists, two librarians, and Max H. Fisch, assistant pro- fessor of philosophy at Western Reserve University, to be civilian head of the branch and curator of rare books.26 The first shipment of rare books left Washington on August 25, 1942. Other shipments followed until almost all the rare books, documents, and statistical volumes, packed in 952 boxes weighing 75 tons, had been sent. A steel cabinet for storing elephantine folios and anatomical atlases was dismantled, packed into a dozen crates and shipped. Students from Western Reserve, hired tem- porarily, unpacked, dusted, and shelved the books in the tiers of steel stacks. Incunabula were placed in a separate room in locked, glass-door cases sent from Washington. Documents and statistical works were arranged on wooden shelves in a large central room. The early tasks of the branch were cataloging, shelf-listing, repairing, re- binding, and microfilming. The two librarians began to draw up a shelf-list of the rare books, and Fisch a catalog of incunabula. For the classification of rare books it was decided to arrange them by century, and alphabetically by author within each century. Documents and statistical publications were classified by country, United States documents by state or city. Efforts were made to obtain missing documents from the issuing agencies. While arranging books members of the staff culled the ones that needed rebinding or repairing. It was found that several thousand 16th-, 17th-, and 18th-century volumes were in poor condition. Some had been badly treated before they reached the Library, some had been handled carelessly afterward. All had been exposed to dust and dirt, and to the extremes of humidity and temperature. Covers were warped and split, spines broken, leather torn and crumbling. Pages were loose, torn, cracked, stained, and missing. Corners were bent and broken. It was estimated that three-fourths or more of the pre-1800 volumes needed 297 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Binding Studio in Cleveland, 1945. Jean Eschmann works by the window, right. restoration. With advice from experts, Jones and Keys laid out a plan. The books were to be considered as part of a research library, not museum pieces. The volumes, then, were to be restored to a condition where they could be handled easily and without damage. Original bindings would be repaired if practical. If not, the oldest volumes would be rebound in a simple, dignified leather binding with a few lines of tooling, rather than in a "period" binding that slavishly imitated those used in the place and at the time when the book was printed. Only the best English oasis morocco would be used. Metal clasps would be restored or replaced. Slipcases would be made for books whose clasps might damage adjacent books and for volumes with delicate or easily soiled bindings. All books printed before 1600 would be rebound in full leather; those before 1700 in half leather; those before 1800 in quarter leather. Furthermore the volumes were placed in one of three groups: those that, because of rarity or importance, would be painstakenly restored, those that would receive lesser treatment, and those that would be repaired as economically as possible. In its restoration program the branch was aided by advice from Thomas Holmes, a professional bookbinder who had also compiled monumental bib- liographies of the writings of Cotton Mather, Increase Mather, and other mem- bers of the Mather family. Holmes walked into the reading room one day for a bookman's chat with Keys and to look at the old volumes. Keys grasped the 298 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW opportunity to enlist him for service in the Honorary Consultants. After be- coming a consultant Holmes delivered an informative lecture entitled "The form of the Book and the Restoration Programs at the Army Medical Library" at one of the meetings in order to stimulate interest in the important work going on in the bindery.27 In February 1943 a contract was entered into with National Library Bindery Company, East Cleveland to repair and rebind the early books, and also to machine-bind later books, pamphlets, and documents. In September 1943, because of difficulties under government regulations of having manuscripts and rare books restored, repaired, and rebound by contractors, the Library set up its own bindery. A studio was leased in the building of the National Library Bindery Company for $75 a month, and several persons were employed to do this work under the direction of Jean Eschmann, a master craftsman who had learned the art in Europe and practiced it in Cleveland for many years. This bindery became, according to experts who visited it, the best of its kind in the United States.28 The rare book collection soon became the chief concern of the Cleveland Branch. In 1943 Fisch's designation as "Curator and Civilian Head of the Branch Library" was changed to "Curator of Rare Books." There were not as many visitors as there would have been in normal times, but scholars stopped by occasionally to consult the collection.29 Exhibits were arranged for visitors, the first being a display of the works of Vesalius in commemoration of the 400th anniversary of publication ofFabrica. In March 1944 Fisch began a preliminary inventory of incunabula. On June 1 Dorothy Schullian, instructor in classics at Albion College, joined the branch and began to prepare a full bibliography for eventual publication as a printed catalog.30 In 1945 Keys suggested that the Cleveland Branch be named the Medical History Division and that all the branch's functions concerned with rare books be kept together as a division when the branch returned to Washington. Jones agreed. The division was organized into three sections; the Rare Book section, consisting of a reference and catalogue unit; the Rare Book Binding Section; and the Medical History Section, consisting of a Medical History Unit and a Medical Biographical and Portrait Unit.31 Thus the Cleveland Branch, con- ceived as a means of freeing space in Washington and as a safe storage place for valuable and hard-to-replace publications, metamorphosed into the History of Medicine Division of the Library. Separated from the main library in Washington, the History of Medicine Division in Cleveland was obliged to maintain most of the activities of an independent library, including book selection, cataloging, reference use, in- terlibrary loans, microfilming, and binding. It continued many of these func- tions, acting as a library within a library, after it returned from Cleveland to join its parent. The size of the staff at the end of the war, 19 (fewer later), was almost as large as that of the main library in prewar years.32 299 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Medicofilm Service Ends, Photoduplication Service Begins The Library service that increased most during the war was the providing of microfilm for the armed forces, hospitals,and researchers. During fiscal year July 1941 to June 1942, 6,208 orders arrived from 1,198 customers requiring exposure of 3 miles of film. After war started the Medicofilm Service received a huge order from the American Bureau for Medical Aid to China to film 14 copies of 67 complete medical journals for air delivery to Chinese institutions. Expressed in other terms, 425,538 pages were filmed 14 times, for a total of 7 million frames, requiring 60,000 feet or 12 miles of film.33 Later, the Library microfilmed 100 journals regularly and more than 100 texts for Chinese medical centers. Chinese hospitals and institutions had practically no current medical literature except that sent by the Library. The privately sponsored Medicofilm Service functioned quite satisfactorily, but with the arrival of war Jones decided that the Library needed a unit under his command to microfilm material for the armed forces and to copy material for safe keeping. During March 1942 the Library started its own Photodupli- cation Service, as the microfilm operation was named.34 Hundreds of thousands of index cards, and thousands of pages of books and journals were filmed in 1942. Photoduplication Service also began to microfilm articles for military hospitals. For persons who did not have a viewer for reading microfilm the service at first made photographic enlargements. Later it used V-mail equip- ment to produce photoprints. In January 1943 Jones adopted a policy that Atherton Seidell had been advocating for years, that microfilm be furnished free in place of volumes being loaned. Seidell announced this in Current List of Medical Literature:35 A notable if experimental step toward facilitating the dissemination of medical literature which has just been taken by the Librarian of the Army Medical Library, is the decision to substitute microfilm copying without charge for the interlibrary loan of books in all cases where they may be desired by accredited libraries. This has been made possible by the acquisition of equipment required for the expanding needs of photoduplicating service to military and emergency establishments. The increased facilities now permit the Library to send out limited amounts of microfilm copies of articles in bound journals at no greater cost than it entailed in sending out and getting back books on interlibrary loan, considering the damage suffered by the passage of books in the mails. It is thus now able to extend its service to medical research by the adoption of this highly efficient means of rendering its collections more widely available. This marks the beginning of the recognition of microfilm copying as a service which public reference libraries might render to those at a distance on the same gratuitous basis that long custom has authorized them to serve those who are unable to come in person to the library. The gradual extension of microfilm copying in lieu of loans of scientific journals may perhaps contribute as much to the advancement of science as any other innovation of library practice of recent times. Now that the Library was offering free microfilm to almost all customers, 300 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW only commercial firms and persons who did not have access to interlibrary loans patronized Medicofilm Service. The latter filled a diminishing number of orders from home and abroad until the end of 1943, and then it expired.36 While the Friends of the Library were publicizing and encouraging the use of microfilm, Seidell was persuading manufacturers to devise inexpensive view- ers that researchers could use in laboratories, at desks, at home, or in new military installations where large viewers were not available. By the summer of 1943 three types of hand-held viewers had been developed, selling at prices from $3.50 to $7.00.37 The Library helped civilians obtain them by accepting and passing orders to the manufacturers. It provided viewers free to military personnel who needed them. In the autumn of 1943 Cosby Brinkley, chief photographer of Photoduplication Service, developed a monocular viewer with variable focus.38 Seidell had 300 of these manufactured for $1,000 and offered them to readers for $3.75 each. The demand for microfilm increased greatly as the war progressed. In January 1943 Photoduplication Service filled 1,229 orders for 49,769 pages, in January 1944, 3,030 orders for 117,496 pages, and in December 1944, 9,032 orders for 509,138 pages. In 1945 it produced 2,034,306 pages of negative film and 4,550,000 pages of positive film, about 90 percent of which went to medical units overseas. It filmed regularly each issue of 45 medical journals and sent the film by air to more than 90 military installations.39 It produced photoprints and photostats for government agencies upon request. And the service was fast; only 48 to 72 hours elapsed between the arrival of an order and the sending of the film. To handle the large number of orders, to expose, develop, dry, package, and mail hundreds or thousands of feet of film each day, the Library had to purchase additional cameras, and developing and drying equipment. It had to hire more men until there were eight, including the supervisor, Brinkley. The service finally took over the periodical reading room and the two adjacent offices used by indexers of Index-Catalogue—for whom office space had to be found in another building.40 The Army War College and National Archives assisted with film processing; otherwise the Library might not have been able to handle the volume of orders that poured in toward the end of the war. Microfilming proved so useful during the war that Jones called it one of the two most important events in the Library during his term in office. If microfilm facilities had not been available, the Library would have had to send volumes. The logistics, then, would have been overwhelming. More persons would have had to be hired, large numbers of identical copies of journals would have had to be purchased, more shelf space would have had to be found somewhere, and volumes sent out would have displaced other cargo on military air trans- ports. In Jones' opinion, an adequate quantity of medical literature could not have been supplied to the armed forces in the field without the use of mi- crofilm.41 301 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Current List Changes Hands and the Friends of the Library Expire In the autumn of 1941 it had occurred to Seidell that he might be able to widen the circle of users of microfilm and Current List if the Medical Library Association would accept cosponsorship with the Friends. He began corre- sponding with Mary Louise Marshall, president of the association, and after considerable discussion the association agreed to his proposal at its spring 1942 meeting.42 Beginning with the July 1, 1942, issue Current List appeared under the auspices of both organizations. The Friends and MLA were very generous in distributing copies of Current List. They sent free copies to more than 100 libraries that did not subscribe. In 1942 with the cooperation of the Pan American Sanitary Bureau and funds provided by Nelson Rockefeller the Library began to send copies to medical schools, libraries, and scientific institutions in Central and South America. This gave Latin American institutions access to material in the Library and benefited the Library by bringing exchanges.43 By 1945 free copies of Current List were being sent to all U.S. and Allied military hospitals and medical units. More than 500 copies were being sent as exchanges. Jones felt it was not justifiable to ask the Friends and MLA to continue to be responsible for a bibliographic journal so important to the Med- ical Department and Library. Furthermore Seidell was scheduled to go to France and would no longer be available to edit the periodical. Jones obtained permission from the Army to publish Current List. The August 31, 1945, issue was the last under the sponsorship of the Friends and MLA, the September 7 issue the first under the Library. Gone, now, were the main reasons for which the Friends had been formed 5 years earlier. Although the organization had attracted more than a thousand members, no one in the Library had the vision to see other uses for the group or the initiative to keep it going. Seidell was busy elsewhere.44 Without a leader and a purpose for existing the organization expired. The Association of the Honorary Consultants to the Army Medical Library In 1933 at the request of Librarian Hume, Surgeon General Patterson had invited several prominent physicians and librarians to become an advisory committee to the Library.45 Apparently Hume never consulted with any of these persons, and his successor, Librarian Jones, was not aware of them until he began to think about getting advice on the proposed new building in 1938. Jones then suggested to Surgeon General Reynolds that the committee be revitalized and enlarged, but Reynolds did not do so. The idea of an active advisory committee remained in Jones' mind, and in the spring of 1943 he asked Surgeon General Kirk for permission to revive the group of volunteer consultants. Jones felt that experts in areas of medicine, librarianship, and book 302 the end of the old library and the beginning of the new Five members of the Honorary Consultants viewing a drawing of a proposed new Library-Museum building, 1944. From left to right: Thomas J. Holmes, bibliographer; Pierce Butler, professor of bibliographical history, University of Chicago; John F. Fulton, professor of physiology, Yale University; Keyes D. Metcalf director of Harvard University libraries; Thomas S. Cullen, professor of gynecology, Johns Hopkins University. collecting could give worthy, practical suggestions about improving the orga- nization and its services. Kirk approved the idea, and through 1943 invitations went out to carefully selected persons to become Honorary Consultants to the Army Medical Library.46 The thought occurred to Jones that the consultants would be an effective "lobby" for the Library, particularly for a new building, if they were organized into a group. He sounded out a few of them about organizing, and the positive answers encouraged him to go ahead. He arranged a meeting on October 5 and 6 in Washington, to acquaint the men with the plight of the Library and need for a new building. He made arrangements for them to form an association if they wished to do so. Fifty-seven of the seventy-seven consultants attended. After receiving a thorough briefing on the operation of the Library they organized themselves into a formal association with John F. Fulton as president; Chauncey D. Leake, vice president; Jones, secretary-treasurer; and these three plus four others 303 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE (Clyde Cummer, Wilburt Davison, Morris Fishbein, and Henry Viets) as the executive committee. The executive committee met a month later in Cleveland. They revised the draft constitution, applied for a grant from Rockefeller Foundation to cover expenses, and appointed committees to give advice on acquisitions, rare books, a new building, and endowments and grants. Rockefeller Foundation agreed to provide $6,000 a year for 5 years (later reduced to a total of $19,500) and the American Medical Association offered $1,500. The Honorary Consultants and its executive committee were now organized and ready to function. The first request for the committee's advice came from the Surgeon General in April 1945, when there was a discussion about sites for the new building. Two months later Jones called together the acquisition and rare books committees to discuss ways of strengthening the collections. Thereafter the consultants met with Jones individually, in committees, and annually as the full organization to assist with the development of the Library. Director Jones Retires So many moves, changes, and improvements were made during the 3V2- year period from 1942 to mid-1945 that readers who went away at the beginning of the war and returned at the end must have been amazed. Service was faster, surroundings were much more conducive to studying, and more literature was available. The credit belongs to Jones. He had recognized some of the faults of the Library—lack of space for employees and literature, out-of-date facili- ties—after he had arrived in 1936 and made his first inspection. He learned of others—low salaries, obsolete classification, no shelf-list, too few employees, insufficient funds—after he had been there a while and become involved in the operations. His perception of the need for improvements was broadened by his emergence from medicine into the library field and by his mixing with and learning from medical librarians. He became so active in the Medical Library Association that he was elected president in 1940 and 1941 and edited the association's Bulletin in 1941 until his war-related duties forced him to give it up. He was courageous for requesting a survey and for beginning what must have seemed a very expensive, interminable modernizing of the institution. Under his direction the Library began to ascend out of the mediocrity into which it had been sliding for a quarter of a century. Next to Billings, Jones was the librarian who had the greatest impact on the old institution.47 By VE Day Jones was 5 years past the normal retirement age and was not in good health.48 On August 31, 1945, he was relieved from duty. The last major act of the Friends, before that organization dispersed, was to raise a fund to have Jones' portrait painted by Rolf Stoll of Cleveland School of Art. The inscription read: "Presented by the Friends of the Army Medical Library in recognition of his contributions to the advancement of medicine, and of his interest in extending the Library's service to the field of microfilm copying."49 304 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW Western Reserve University bestowed an honorary doctor of laws degree on him in 1945, the citation reading: "We owe more than we can acknowledge to Colonel Jones for his reorganization and expansion of the Army Medical Li- brary. " During retirement Jones coedited Blakeston's New Gould Medical Dic- tionary, and later the medical sections of Encyclopedia Americana. The Medical Library Association presented to him the Marcia C. Noyes Award in 1956 for his outstanding services to the medical library profession. He died April 5 1958.50 Notes 1 The most useful sources of information on the impact of, and changes during, the war are in files in MS/C/309. 2 Office of the Surgeon General, Office Or- der 237, July 1, 1942. 3 Some literature being sent to the Library was lost when ships were sunk at sea. Con- versely, copies of the Index-Catalogue being sent to Europe went to the bottom: in one shipment 65 copies of volume 6 for Great Britain went down. 4 Lists of names, grades, salaries and duties of employees may be found in files Personnel Authorization, Personnel Control Forms, MS/ C/309. During the war the Library also acquired a few enlisted men who were placed in charge of supplies and given other housekeeping duties. The detachment was gradually disbanded dur- ing 1951. 5 Toepper was bom in Missouri, Feb. 9, 1874. He joined the Navy when he was 16, came out when he was 19, attended Michigan Military Academy for a year, enlisted in the Army and served as a sergeant in the Sixth Cavalry until 1898. Leaving the military for a time he worked at the Washington Navy Yard, then for a firm in Joplin, Mo. On Aug. 1, 1905, he entered the Library, but left on Dec. 26 to accept a com- mission as a lieutenant in the Philippine Con- stabulary. He returned to the Library on Feb. 15, 1908, and remained until 1916 when he be- came a captain in the Ordnance Department. He returned again in 1920 and stayed until ill health forced him to retire on Jan. 31, 1942. He died in Florida on Mar. 21, 1942, and was bur- ied in Arlington Cemetery. Toepper was the last of the second-genera- tion librarians. When he began working, Fletcher, Garrison, McCaw, and Civil War vet- erans ran the Library. He was the final survivor of that group, and with his death the last per- sonal tie between the old library and the new was severed. Robert Austin, who associated with Toepper for a quarter of a century, recalled him thus: Mr. Toepper was a mild mannered, soft spoken, man of medium height and build, who, like Garrison was inclined to have moody periods and preferred to be left alone. He was always cooperative when I needed his help in locating library materials, and I owe a lot to nim in help- ing me to learn the off-beat locations of books and the clues to pursue that usually produced results. If Mr. Toepper couldn't find a book or amphlet, no one on the staff could. When I ad to go to him, I told him all the places I had looked; he would then take the request from me, pick up his flash light, and start the search but he would never let me go with him—he had his own special routine based on many years of servicing the collection and he didn't want to share it. However, when he located the mate- rial, he would tell me where he found it so I could mark the location in the book or on a card. Document, C. G. Toepper applying for reinstatement, May 28, 1908, with favorable endorsement by McCaw, May 29: MS/C/116. Brief obituary, Bull. Med. Lib. Assoc. 30, 372 (1942). Letter, R. Austin to Wvndham Miles, Jan. 3, 1980. As in World War I, some members of the staff entered the military forces. One of these was I. Nathaniel Markfield, a graduate of George Washington University, who came to the Li- brary in December 1931, volunteered after the U. S. entered the war, was commissioined as a second lieutenant, was seriously wounded in France in November 1944, and returned to the Library in 1946, where he served until he re- tired in 1971. 6 Keys came to the Library June 1, 1942, in compliance with War Dept. special orders 129, according to Office Order 12, July 7, 1942: file, Library Orders: MS/C/309. 305 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Thomas Edward Keys was born in Green- ville, Miss., Dec. 2, 1908. After receiving his B.A. degree from Beloit and MA. from Chicago he began his library career at Newberry Li- brary, Chicago. He went to Mayo Clinic Library in 1934 and from there came to the Army Med- ical Library in 1942. During the war he ad- vanced from the rank of lieutenant to lieutenant colonel and was awarded the Army Commend- ation Ribbon. In 1946 he returned to Mayo Clinic as librarian, retiring in 1972. In the latter year Beloit awarded him an Sc.D. degree, h.c. At Mayo he also taught history of medicine from 1956 to 1972. Keys wrote many articles, Cardiac Classics (with F. A. Willius), The History of Surgical Anesthesia, Foundations of Anesthe- siology (with A. Faulconer), Applied Medical Library Practice and Classics and other Selected Papers for Medical Librarians (with J. D. Key). He presided over the Medical Library Associ- ation and received the Marcia C. Noyes Award. He lectured extensively at home and abroad. From 1959 to 1962 he served on the Board of Regents. See biographical sketch in Bull. Med. Lib. Ass. 63, 415-7 (1975), unpublished mem- oirs (copy in NLM) and Who's Who in the World (1978-79). 7 Memo, Jones to Exec. Officer, SGO, Jan. 29, 1942: file, Security, War Measures: MS/C/ 309. 8 Library business ended at the auditorium and began at Fisheries on July 7, 1944; Office Order 17, Julv 11, 1944: file, Office Orders, MS/ C/309. 9 Letter, MacLeish to Jones, July 22, 1943: file, Location of New Building: MS/C/309. 10 Eggers & Higgins, office instructions and report, Feb. 7, 1944: file, New Bldg. Construc- tion: MS/C/309. 11 Annual Report, 1944-45, p. 16-19: file, Consolidated Fiscal Year Activities: MS/C/309. Henry, Armed Forces Institute of Pathology, p. 270-4. 12 Jones' statement of the origin and an out- line of the survey are in minutes of the first staff meeting at the Army Med. Lib., Mar. 31, 1943; file, Min. Div. Chief Meetings: MS/C/309. An account of the background of the survey, what the surveyors saw, and what they rec- ommended is in The National Medical Library: Report of a Survey of the Army Medical Library . . . By Keyes D. Metcalf, et al., (1944); and in the typed, unpublished appendix to the report. Copies in archival collection, NLM. Informa- tion is also in file, Survey Library: MS/C/309. Articles summarizing the report are: F. R. St. John, "Survey of the Army Medical Li- brary," Library J. 70: 195-197 (1945); W. B. McDaniel, "Study of the Army Medical Li- brary," Coll. b Res. Libr., 6: 191-192 (1945); H. W. Jones, "The Army Medical Library: in Retrospect and Future," Bull. Med. Libr. As- soc. 34: 3-11 (1946). 13 Office Order 4, Mar. 10, 1944: file, Li- brary Orders: MS/C/309. Francis R. St. John was born in Northamp- ton, Mass., June 16, 1908. After receiving his A.B. degree from Amherst in 1931 he became assistant in the reference department of New York Public Library, 1931-1939. While at NYPL he attended Columbia and received his B.L.S. degree in 1932. He was assistant librarian of Enoch Pratt Library, Baltimore, 1939-1941, chief of circulation at NYPL, 1941-1947, director of library service of the Veterans Administration, 1947-49, and chief librarian of Brooklyn Public Library, 1949-1963. At the end of the war St. John received the Army's Legion of Merit for his assistance in reorganizing the Library. He was an advisor on library matters, organized the firm of Francis R. St. John Library Consultants in 1964, and published many professional arti- cles. He died July 19, 1971. For obituaries see New York Times July 20, 1971, Lib. J. 96: 2725 (1971), and other library publications. 14 Office Order 4, Mar. 20, 1945: file, Li- brary Orders: MS/C/309. Ralph Robert Shaw was born in Detroit, May 18, 1907. He was hired as an assistant at the Cleveland Public Library in 1923 and held this position until 1928, concurrently attending Western Reserve and receiving his A.B. degree in 1928. He then moved to New York and worked at the New York Public Library, 1928-29, and Engineering Societies Library, 1929-36, also at- tending Columbia and obtaining his B.S. and M.S. degrees in 1929 and 1931. From 1936 to 1940 he was chief librarian, Gary, Ind., public libraries; 1940 to 1954 director of the U.S. De- partment of Agriculture libraries: 1954 to 1964 professor (and sometimes dean) of Rutgers University Graduate School of Library Service; and 1964-69 professor at University of Hawaii. Shaw was a vigorous, energetic, imaginative person who tried to find ways of improving li- brary service and transmission of knowledge. Among his inventions, some of them patented, was the rapid selector and the photoclerk. He founded the Scarecrow and Nokaoi presses for publishing works in the library and book fields. He served as a consultant to government and industry, and was recipient of the Dewey Medal. Shaw died Oct. 14, 1972. "Essays for Ralph Shaw," edited by Norman D. Stevens (1975) contain a biographical sketch and reminiscences of Shaw. 15 Lists of names, grades, salaries, and duties of employees may be found in files Personnel 306 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW Authorization and Personnel Control Forms: MS/ C/309. 16 The many organizational changes during World War II may be traced through Library Orders and other files in MS/C/309. The func- tion of each section and division in the Library in mid-1945 is given in detail in Annual Report, 1944—45, in file, Consolidated F.Y. Activities, MS/C/309. 17 Letter, St. John to Romona Javitz, NYPL, Nov. 10, 1944: file, Personnel Authorization, MS/C/30. 18 Office Order 13, May 23, 1944. Army Reg- ulation 40-405, change 1, July 3, 1944. 19 Diary in file, Historical Information, MS/ C/309. 20 Wyllis Eaton Wright, born in Jackson- ville, Fla., Dec. 13, 1903, died in California, Oct. 2, 1979. He received his B.A. and M.A. degrees from Williams College and his B.S. from Columbia School of Library Science. He was sworn in as Librarian, AML, on July 2, 1945. After leaving Washington he was librarian of Williams College, 1947-68, then was associated with Stanford until he retired in 1974. He was an officer in several library societies, served on international and national committees, edited books, wrote articles and published Colonel Ephraim Williams. He was awarded the Dewey Medal and Margaret Mann Citation. See Who's Who in America, profile by Deoch F. F. Fulton in Bull. Bibliog. 20, 105-7 (May-Aug., 1951), files in MS/C/309, and letters, Wright to Wyn- dham Miles in NLM. 21 Letter, MacLeish to Jones, Dec. 11, 1940; file, Security, War Measures: MS/C/309. 22 Letters, Jones to MacLeish, Jan. 17, Sept. 24, 1941; Jones to Brooks, chief clerk, SGO, Sept. 23, 1941: file, Security, War Measures: MS/C/309. 23 Memo, Jones to Surgeon General, Jan. 27, 1942; file, Security, War Measures: MS/C/309. 24 Resolution of Board of Trustees, May 11, 1942; letter, Clyde Cummer, Cleveland Med. Lib. Assn. to Jones, May 12, 1943: file, Misc. Civilian Committees: MS/C/309. Information regarding events in Cleveland may be found in annual reports of the branch, 1942-1948: file, HMD Fiscal Year Activities, MS/C/309. A scrapbook of clippings, letters, photos, and other memorabilia is in the posses- sion (1980) of Thomas E. Keys. 25 Diagrams of the third floor and of the tiers are attached to inspection reports, U.S. Army Insector General, 1944-50. Diagrams showing arrangement of books in the tiers are in report of operations and activities, Cleveland branch . . . July 13, 1942 to July 1, 1943; file, HMD Fiscal Yr. Activities: MS/C/309. 26 Max Harold Fisch, born Dec. 21, 1900, educated at Butler and Cornell (Ph.D., 1930), taught philosophy at Cornell and Western Re- serve before joining the Library in 1942. From 1946 to 1969 he was professor of philosophy at University of Illinois. He has also been a visiting professor at several universities, here and abroad, and an officer in learned societies. Fisch has written, edited and translated a number of books, including Nicolaus Pol Doctor 1494, and has written scores of articles, biographical sketches, and other contributions. At present he is work- ing on a two-volume biography of Charles S. Peirce, the great American philosopher, and ed- iting a 20-volume series of Peirce's works. A biographical sketch of Fisch and a list of his writings is in Studies in Philosophy and in the History of Science: Essays in honor of Max Fisch (Richard Tursman, ed., 1970). See also Who's Who in the World (4 ed., 1978-79), and sketch with port, in Illinois Alumni News March 1965. 27 For Honorary Consultants see later in this chapter. Letter, Keys to Wyndham Miles, Mar. 3, 1979: NLM. Thomas James Holmes was born in New- castle-under-Lyme, England, on Dec. 27, 1874. After serving an apprenticeship to a bookbinder he entered the trade. In 1902 he and his wife emigrated to the United States. He bound books in New York and in Cleveland. Eventually he became personal librarian to Samuel and Wil- liam Mather and compiled bibliographies of the works of their ancestors. In his later years Holmes lived on a farm in Newbury, Ohio. He died Feb. 7, 1959. See The Education of a Bibliographer: an Autobiographical Essay by Thomas James Holmes, Bibliographer of the Mathers (1957); T. E. Keys, "Bookmen in Biology and Medicine I have known,"/. Hist. Med. Allied Sci. 30, 326- 30 (1975); Holmes, "The Form of the Book Proceedings of the Second General Meeting of the Honorary Consultants . . . Oct. 5 and 6, 1945. 28 "Having been thwarted in the attempt to secure the money in a mass appropriation to repair it [rare book collection] because of legal restrictions, we hit on the idea of opening our own studio. This was perfectly legal": letter, Jones to R. Fritz, Mar. 14, 1944: MS/C/148. Jean Charles Eschmann was born in Basel, Switzerland, 1896, served his apprenticeship there, and came to the US. in 1919. He worked at Riverside Press; Cranfield Academy of Art, Bloomfield Hills, Mich.; Artisan Guild, High- land Park, Mich.; National Library Bindery, Cleveland; and Cleveland Branch of AML. His hand bindings were exhibited at the Grolier Club and other places in America and Europe. See: 307 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE NLM Bulletin Jan. 25, 1961: "Jean Eschmann," Bookbinding and Book Production 49: No. 6, 44-45 (June 1949); G. Miller, "Medicus Libro- rum; Jean Eschmann, Restorer of Rare Books," Bull. Cleveland Med. Lib. 3: 3-8 (1956). Es- chmann died Jan. 18, 1961. Thomas Keys, "The Restoration Program," Bull. Med. Lib. Assoc. 33: 172-4 (1945). 29 The register signed by visitors starting February 1943 is in NLM. 30 Dorothy May Schullian, born in 1906, at- tended Western Reserve and University of Chi- cago (Ph.D. in Latin). She was a fellow of the American Academy in Rome for several years and then taught at Western Reserve and Albion before coming to the Library. In 1961 she went to Cornell as curator of the history of science collections and held this position until she re- tired on June 30, 1972. She has translated, ed- ited and written several books, including A Cat- alogue of Incunabula and Manuscripts in the Army Medical Library (with F. E. Sommer), Music and Medicine (with M. Schoen), and The Baglivi Correspondence from the Library of Sir William Osier. Most of her many articles deal with history of medicine, and several concern the Library and books in HMD. A very readable history of NLM by her and Frank B. Rogers appeared in Library Quart. 28: 1-17, 95-121 (1958). She has edited the notes and events sec- tion of Journal of the History of Medicine and Allied Sciences for a quarter of a century and is engaged in other historical endeavors. A brief biography by Max H. Fisch and partial bibli- ography of her writing is in Bull. Hist. Med. 47: 91-96 (1973). 31 Annual Report of Library Activities for 1945, p. 33: file, Consolidated Fiscal Year Ac- tivities: MS/C/309. Report of annual general in- spection, Oct. 17, 1945: NLM. 32 The chiefs of the division were: Major Thomas Keys, July 3, 1942-Dec. 31, 1945; Max Fisch, Jan. 1, 1946-September 20, 1946; Robert Austin, Sept. 21, 1946-June 15, 1947; William J. Wilson, June 16, 1947-Aug. 31, 1954; Harriet C. Jameson, Sept. 1, 1954-Oct. 1959; Dorothy May Schullian, 1959-July 1961. 33 Annual report of Photoduplication Service for 1942; file, Photoduplication Sect. F.Y. Act MS/C/309. 34 Office order 5, Mar. 7, 1942; file, Library Orders, MS/C/309. 35 Volume 4, No. 1, Jan. 7, 1943. The policy of the Library in furnishing microfilm free was stated in Current List 6: No. 15, April 14, 1944; 7: No. 1, July 7, 1944; 9: No. 1, July 6,' 1945.' The policy regarding loan, sale, or gift of mi- crofilm varied at times. The variations are not dealt with here. 36 Current List 4: No. 16, April 22, 1943; 5: No. 12, Sept. 23, 1943. Monthly statistics of the number of orders, customers, and other data of Medicofilm Service for the period September 1940 through February 1941 are in Current List 1: No. 15, April 9, 1941; March 1941 through September 1941 in 1: 42, Oct. 15, 1941; for October 1941 through September 1942 in 3: No. 16, Oct. 15, 1942. The annual report of Pho- toduplication Service for 1943 is the last in which statistics for Medicofilm Service are given, but the service may have functioned on a small scale into 1944. 37 Current List 4: No. 21, Mdy27, 1943, and later issues. 38 Office Order 20, July 31, 1944: file, Li- brary Orders: MS/C/309. Brinkley received an award for developing this viewer: file, Library Orders: MS/C/309. 39 In Current List 6: No. 3, Jan. 21, 1944 is a map of the world showing locations to which microfilm was sent. 40 A floor plan showing the location of the Photoduplication Service's equipment in the reading room and offices is in Current List 6: No. 11/12, Mar. 12/24, 1944. 41 "The most important events in the . . . library in the last ten years . . . have been . . . (2) the growth of the Photoduplication Service on a large scale as a vital contribution to the war effort, without which medical literature could never have been supplied the Armed Forces in any adequate amount"; H. W. Jones, Annual report of the library activities for 1944: file, Consolidated F.Y. Act.: MS/C/309. Jones wrote the following articles and notes publicizing and describing the Library's micro- film service: "Medical Research and the Micro- film," Military Surgeon, 89: 172-6 (1941); "Ex- tension of the Loan Service of the Army Medical Library to include Photoduplication for Army Hospitals," Military Surgeon 90: 328 (1942); "Nicer Film Service," Canadian Med. Assoc. J. 46: 391 (1942); "Photoduplication Service of the Army Medical Library,"/. Chem. Educ. 21: 342- 3 (1944). 42 Correspondence between Seidell, Mar- shall, and Jones beginning Oct. 28, 1941, is in file, Friends of the AML: MS/C/309. Letter, Jones to Marshall, Dec. 18, 1941; "I think the main purpose of Dr. Seidell's proposal is to get someone to take over the actual responsibility of the publication of the Current List. He is not a physician or a librarian and he is seeking some- one identified with library work who could take his place now that the Army Medical Library itself cannot take this over, but the financial responsibility involved makes it impossible for 308 THE END OF THE OLD LIBRARY AND THE BEGINNING OF THE NEW anyone here to assume any responsibility for the publication." 43 Editorials and announcements on the cov- ers of Current List provide information about distribution and subscriptions, for example 1: No. 27, July 2, 1941; 4: No. 1, Jan. 7, 1943; 8: No. 1, Jan. 5, 1945; 11: No. 20A. 44 Lists of members were printed in Current List 1: No. 7, Feb. 12, 1941; 1: No. 8, Feb. 19, 1941; 1: No. 17, April 23, 1941. 45 The names of members and other infor- mation about the committee, 1933-41, are in The National Medical Library: Report of a Sur- vey, Appendixes, pp. 19-22. 46 The idea of reviving the advisory group was arrived at by Jones and Thomas Keys. Keys was then Jones' assistant. Correspondence, notes, minutes of meet- ings, and other records of the Honorary Con- sultants are in MS/C/148. Accounts of several of the consultants' annual meetings were pub- lished in Bull. Med. Lib. Assoc. A bound set of reprints of accounts of all meetings is in Archival Collection. 47 John Fulton wrote a long editorial in ap- preciation of Jones' work at the Library in Bull. Med. Lib. Assoc. 33: 409-12 (1945). 48 Jones' remarks about his health are in a letter to John F. Fulton, Sept. 18, 1945: MS/C/ 8. 49 Jones portrait hangs in the reading room, NLM. Current List 6: No. 20, May 19; No. 22, June 2, 1944, has information on the Friends' role in providing the portrait. 50 Obituary by Thomas E. Keys, Bull. Med. Lib. Assoc. 46: 646-9 (1958). 309 XVM Modernizing the Library WHEN peace arrived the improvements begun in the Library during the war had not been completed. The vigorous acquisition of journals and books, planned but delayed by the conflict, had to be accelerated. The campaign for a new building to house the collection and provide adequate space for librarians and readers had to be continued. Shelf-listing, the development of a classification system, cataloging, and recataloging had to be carried on until finished. The expanding, largely new staff had to be synchronized into a smoothly running, efficient organization. Publication of the Index-Catalogue had to be resumed. The Current List had to be enlarged and improved until it reached the level of a major reference periodical. Responsibility for seeing that these objectives were attained rested on three directors: Leon Lloyd Gardner, 1945- 1946; Joseph Hamilton McNinch, 1946-1949; and Frank Bradway Rogers, 1949- 1963. Leon Lloyd Gardner, Director 1945-1946 As Harold Jones approached retirement in 1945 Surgeon General Norman T. Kirk picked Colonel Leon Lloyd Gardner as the next Director "because of his knowledge of books."1 Gardner had been born in China, April 28, 1894, and grown up there, with the exception of the Boxer Rebellion period when his parents had sent him to the United States.2 He graduated from Pomona College and then obtained his master's degree in zoology and doctor's degree in medicine from University of Pennsylvania. After instructing in anatomy at Vanderbilt and practicing as a surgeon he entered the Medical Department in 1924. Gardner graduated first in his class at Army Medical School in 1925, re- ceiving the Hoff Medal, and first at the Medical Field Service School, receiving the Skinner Medal. He served at various forts, was stationed in the Philippines for 3 years, then returned to the United States. In 1937 he attended the Command and General Staff School at Fort Leavenworth. During World War II he served in every major theater of operations and commanded a general hospital in France. Gardner arrived on September 10, 1945, at an unsettled time in the Library. The war was barely over and the enlarged staff was still not well organized and not functioning at high efficiency. A year before the top management had been 311 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Leon Lloyd Gardner, Director of the Library, 1945 to 1946. divided between the Director, as administrative head, and the Librarian, as technical head.3 Gardner, the new Director (the title was soon changed tem- porarily to Commandant), and Wyllis Wright, the first civilian Librarian, who had been on the job only 2 months, had no precedents to guide them in their relationship although Wright had worked successfully under a similar arrange- ment at New York Public Library. As the months passed by disagreements began to arise between Gardner and Wright. The reason for the differences between the two men is obscure, but the probabilities are that it lay in the split between the conservatives and reformers, the split that had opened 2 years earlier when former Director Jones began to carry out the recommendations of the survey. Wright was committed to progress. Gardner seems to have been impressed by the viewpoint of the conservatives and began to oppose some of the changes ordered by Wright. Well-liked by the staff, Wright was a rather inflexible, stiff-lipped, almost humorless New Englander cast in the mold of Calvin Coolidge, with a rigid way of doing things. It is possible that some of the friction was caused by Wright's reluctance to compromise. In the summer of 1946 senior staff members rebelled. Wright resigned, effective June 30. At the urging of Gardner, he postponed his leaving until the end of the year. Other employees tried to meet with former Director Jones, hoping he would intercede, but Jones, out of loyalty to a fellow officer, refused an interview. Finally the chairman of the Library Staff Association and M. Ruth MacDonald persuaded him to listen to their complaints. In the meantime John Fulton and other members of the Honorary Con- 312 MODERNIZING THE LIBRARY Joseph Hamilton McNinch, Di- rector of the Library, 1946 to 1949. sultants had become aware of the disagreements between Gardner and Wright and the unrest among the employees. The threats of resignations and the tangled administrative difficulties caused Fulton to act. On December 4 he wrote to Kirk, stating that the Library was in serious difficulty and requesting a meeting of Kirk, himself, Luther Evans, and Keyes Metcalf. Receiving the letter, Kirk asked Jones for advice. Jones recommended that Kirk relieve Gardner without delay and appoint a new Commandant. Kirk asked Jones to suggest a replacement. Jones ran his eye down the Army list and selected several, which led Kirk to remark, "you certainly have picked the best men in the Army and most of them cannot be taken off the jobs they have." Jones replied: "There has always been the danger of taking a mediocre man simply because he is available. Mediocre people are always available. What you have to do is pick a good man, even if it hurts. Here is Colonel McNinch . . . one of the best of the younger administers I know of." Joseph Hamilton McNinch was then in charge of the group writing the medical history of the war, but Jones argued that McNinch could also manage the Library if he were assisted by a good librarian. Kirk lost no time in transferring Gardner and naming McNinch Commandant of the Library.4 Gardner then directed the Physical Standards Branch of the Surgeon Gen- eral's office. He also attended Johns Hopkins' School of Public Health and Hygiene, receiving a master of public health degree in 1948. After retiring from the Army on May 31, 1949, he practiced medicine for a time in Washington and later in San Diego, California. Joseph Hamilton McNinch, Director 1946-1949 Joseph Hamilton McNinch was born in Indianapolis, October 5, 1904. He 313 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE received his bachelor's and doctor's degrees from Ohio State and entered the Army in 1930. He was stationed at Army camps, taught at Army Medical School, was assistant chief of the Medical Statistics Division of the Surgeon General's office, and served in the European Theatre during the war. In 1945 the Surgeon General named him editor-in-chief of the medical history of World War II, and he retained the editorship when he was appointed Commandant (a title soon changed back to Director) on Dec. 23, 1946.5 When Colonel McNinch entered the Library he interviewed the senior staff members to learn about them and the friction within the organization. He adopted, with one exception, the report of the surveyors, published a few years before, and used it as his Bible. He left the operations of the organization in the hands of professional librarians and concentrated on administration. "Colo- nel McNinch was a most excellent choice for the directorship," recalled Li- brarian Wyllis Wright. "He was a firm, capable administrator and anxious to take the trouble to understand the workings of a library." After Wright departed at the end of 1946, McNinch appointed Scott Adams the Acting Librarian. Adams found that McNinch had insight, was judicious, had directness of pur- pose, and sensed the underlying problems of the institution.6 Experience eventually persuaded McNinch that the surveyors had been wrong in recommending that administration be divided between a military director and a civilian librarian:7 I decided that the assignment of two individuals to jointly operate the library had some inherent problems. It seemed to me that either we should take a well-qualified professional librarian and send him or her to medical school, or take some well-qualified physician and send him to library school. The latter course of action seemed to be more practical from a number of points of view. The next question was: should the doctor be a member of the Army Medical Corps or a civilian physician. I saw no reason to send a medical corps officer to library school, assign him to the Library, and then transfer him away from Washington at the end of four years in accordance with an old law which pro- hibited regular military officers from staying in Washington for more than four years. However, one of my Army mentors, Colonel (later Major General) George Dunham, had taught me never to believe anything without looking it up. On looking up the law to which I have just referred I found that it made an exception for medical corps officers and chaplains. I immediately then recommended that the library assignment be made a career assignment. I sent a photostat copy of the law and its exceptions with a staff paper to the Secretary of the Army and we received an immediate approval. With this approval, I then recommended that the position be advertised in the Army and Air Force (Air Force Medical Service at that time was still in the Army) and that the officer selected be sent to library school. The Surgeon General accepted all but one of McNinch's recommendations, that the new Director be given the rank of brigadier general.8 A committee made the final selection and chose Major Frank Bradway Rogers, then attached to Walter Reed Hospital, as the future Director. "I did have opposition to the selection of Major Rogers on the ground that he was too young," recalled 314 MODERNIZING THE LIBRARY McNinch, "but was able to point out that the famous and eminent John Shaw Billings was in his thirties when first assigned to the Library. For some reason, most people seemed to think that he had always been the age at which time his portrait for the library was painted. "9 Among the other important actions that McNinch participated in were those concerning the location of the proposed new building, the future of the Index- Catalogue, and the charges for microfilm. Along the way he fell in love with Eleanor Coffyn, the very able head of the reference section, and they were married. After Rogers received his degree in library school in 1949 and was ready to assume command of the Library, McNinch departed. He then held a number of posts, among them chief surgeon, U.S. Army Far East Command; chief surgeon, U.S. Army, Europe; and commanding general, Army Medical Re- search and Development Command. After retiring with the rank of major general in 1962 he occupied high positions in the American Hospital Association and the Veterans Administration. He also served on the Library's Board of Regents.10 Frank Bradway Rogers, Director 1949-1963 Frank Bradway Rogers was born in Norwood, Ohio, December 31, 1914. Assisted by a scholarship he worked his way through Yale, graduating in 1936. He worked for 2 years at various jobs in New York, Boston, Cincinnati, Chicago, and St. Louis, and then entered Ohio State University College of Medicine where he was a member of the Reserve Officers Training Corps and where he Frank Bradway Rogers, Direc- tor of the Library, 1949 to 1963. 315 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE graduated in 1942. After interning at Letterman General Hospital he was called to active duty and sent to the Medical Field Service School, Carlisle Barracks, for training. He remained at Carlisle as an instructor until 1945 when he was ordered to the Philippines, and thence to Japan where he served as surgeon, 25th Infantry Division. In 1947 he returned to the United States and was assigned to Walter Reed Hospital as a resident in surgery. One day he saw on the hospital bulletin board a notice that the Surgeon General was seeking a young officer to direct the Library. Rogers had always felt at home among books and had even hoped that he might be lucky enough to end his Army career at the Library. He was one of several applicants, was interviewed by a committee,11 and received the job. He reported for duty at the Library on March 1, 1948, was given a desk in Director McNinch's office, and began to learn how the institution operated. He was sent to Columbia University School of Library Service. During school vacations he worked at the Library with McNinch. After receiving his master's degree in librarianship he returned to the Library in September 1949 and became Director on October 21, 1949, when McNinch left.12 The library degree was particularly important at that time because the organization was being modernized, and many improvements were being made. The Director needed to know why and how library operations were done. The degree gave Rogers standing within the Library group, none of whom could denigrate his ideas as not coming from a "librarian." Rogers set about diagnosing the weaknesses in the institution's operations and seeing to it that they were strengthened. He rounded out the modernization of the Library's organization and methods begun in the 1940s by Jones. Under his direction the Library passed from military to civilian control, moved from the old to a new building, and mechanized the production of indexes. He kept in touch with everything going on in the Library's divisions. To his associates he was an industrious perfectionist; and Kanardy Taylor, Librarian from 1951 to 1956 said, "I don't think that anyone could have done better."13 Rogers' 14-year term bracketed a transition period in the life of the Library. When he arrived, the institution was still largely old-fashioned. When he re- signed on August 31, 1963, to become librarian and professor of medical bib- liography of the University of Colorado Medical Center, he left behind an up- to-date progressive organization entering the electronic era. To compare Rogers' accomplishments with those of other directors would be a meaningless exercise because of the profound differences in the circum- stances that had to be faced by the incumbents. What distinguished Rogers from almost all of his predecessors was the extraordinary range of significant library activities in which he involved himself with a resultant record of con- sistently high quality achievement. His accomplishments in developing the Library were recognized by his peers by the presentation to him of the Marcia C. Noyes Award, Dewey Medal, Horace Hart Award, Cyral Barnard Memorial Prize, and the Distinguished Service Medal. The Medical Library Association 316 MODERNIZING THE LIBRARY elected him president in 1962, and the American Association for the History of Medicine in 1966-68. He published a number of articles on the Library, and he compiled many of the writings of his professional ancestor into a book, Selected Papers of John Shaw Billings. In retirement in Denver he acted as a consultant to libraries, and he devoted considerable time to his hobby, the restoration and binding of rare books. In 1975 he was awarded an honorary doctor of science degree by the Medical College of Ohio at Toledo.14 Acquisitions The war over, the Library set out to acquire literature published in enemy countries during the conflict, to obtain works published in the United States during the Depression, and to reestablish commercial ties with booksellers in all areas of the world.15 The State Department's Intelligence, Acquisition and Dissemination Division assisted in initiating exchanges and negotiating con- tracts with book dealers in France, Italy, Spain, Portugal, Russia, Brazil, Great Britain, Egypt, and other countries. The Inter-Departmental Committee for the Acquisition of Foreign Publications, established in July 1946 within the National Intelligence Authority at the suggestion of Luther Evans, Librarian of Congress, also assisted. The committee lasted less than a year before it was absorbed by the State Department, but during that time it sent the Library about 10,000 issues of German wartime periodicals, about 3,000 monographs, and more than 1,200 theses published in France during the occupation. The Library of Congress organized a cooperative acquisition program in Germany to purchase wartime publications of Austria, France, Italy, Germany and other countries for more than 100 American libraries and to select captured German documents for research libraries. Scott Adams, chief of the Library's Acquisition Division, was with the LC mission in the autumn of 1946 locating German and Austrian medical publications. Several thousand books and serials were obtained for the Library. Military Intelligence and other War Department agencies assisted by chan- neling German and Japanese military medical documents to the Library. Strange as it may seem, the Army Medical Library had a very incomplete collection of U.S. military medical research reports. The War Department finally put out an official circular in 1946 requesting Army, Navy and Air Force medical agen- cies to send a copy of every publication to the Library. As Army hospitals closed after the war their books and journals were shipped to the Library. These provided duplicates, some of which, with the Library's other duplicates, were sent to 18 Veterans Administration libraries. Other duplicates were exchanged with American and foreign medical libraries. Lit- erature not exchanged was offered to the American Book Center, to the Amer- ican Library Association's Committee on Aid to Libraries in War Areas, and to other agencies to help rebuild libraries damaged during the war.16 The American Medical Association began to donate back issues of journals from its large accumulation. It sent these in yearly batches, starting with 25,000 317 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE issues of 1932. These journals were particularly welcome for they filled gaps that had occurred during the Depression when lack of funds had forced the Library to discontinue many subscriptions. Duplicates were made available to other libraries through the Medical Library Association Exchange. The reestablishment of commercial ties in the book trade took some time. It was not until the Spring of 1947 that the Library received its first postwar shipment of serials and books from a firm in Berlin. After normal relations were reestablished with foreign nations, the Acquisition Division made certain that the institution would receive the most important journals of countries and areas by compiling lists of all journals published. On occasion these lists were sub- mitted to specialists for evaluation. For instance, a jury of physicians examined a list of 1,600 Latin-American journals and judged 65 to be outstanding, 175 fairly important, several hundred of minor value, and the remainder incon- sequential. The Library then had a logical priority system of selecting journals from that part of the world. In July 1948 Joseph Groesbeck, chief of the Acquisition Division, journeyed to Japan to make arrangements with publishers and book dealers for the opening of trade channels with the Library. Previously the supply of Japanese journals and books had not been adequate although the Library had begun acquiring Japanese medical writings during Billings' time. Groesbeck also reopened and extended the Library's exchange relationships with Japanese institutions and made arrangements to provide medical schools with recent American medical literature.17 In obtaining old books the Library was limited by funds and by the difficulty in locating desirable books it did not already possess. One method of obtaining the literature was hit upon by William Jerome Wilson, a charming, witty scholar and bibliographer of considerable stature who had written many articles and collaborated with Seymour de Ricci on the Census of Medical and Renaissance Manuscripts in the United States and Canada before coming to the Library as chief of the History of Medicine Division in 1947.18 Wilson conceived the plan of filling gaps in the collection with microfilm copies of early books. From 1950 to 1955 the New York Academy of Medicine graciously loaned 232 16th century books for microfilming. HMD halted the project in 1955 in order to concentrate on other matters, and it was never resumed.19 The History of Medicine Division also applied microfilming to produce a portable catalog of its books, which Wilson carried in a brief case on a buying trip to Europe in 1953. The catalog was made by photographing the 23,000 item checklist of the collection, cutting the film into strips and mounting the strips in transparent envelopes. The strips were read by a device consisting of a magnifying glass and flashlight. Consulting this list in each book shop he visited, Wilson found 600 volumes for purchasing out of several thousand that he examined.20 Exchanges of duplicates had taken place with other libraries since the 1870's, but the institution had never had sufficient employees to maintain the duplicates 318 MODERNIZING THE LIBRARY in an orderly arrangement, permitting easy locating and withdrawal of specific books or journals. Now the Library had the manpower to bring order out of the chaos. It sent lists of duplicates to 157 libraries in Australia, South America, Asia, Middle East and Europe to initiate piece-for-piece exchange. It sent a gift of several tons of duplicates to Japan. It drew up want lists of journals published in specific countries or geographical areas and sent them to libraries in the countries. For example, a want list distributed to French libraries brought in 2,665 serial issues. International exchange resulted in the Library's obtaining thousands of publications, only a small proportion of which was available com- mercially. The exchanges also served as a vehicle of good will between coun- tries. Exchanges and gifts (particularly journals from AMA) were of considerable importance to the Library during this period. For example in fiscal year 1950 the Library obtained 43,337 serial issues by exchange and gift out of a total received of 75,074. In fiscal year 1951 two-thirds of serial issues were acquired by exchange and gift, 94,000 pieces were sent on exchange in the U.S., 50,000 were sent on exchange to foreign libraries, and 184,000 exchange pieces were received. Photographs of physicians and medical subjects were pursued as actively as printed materials. Ten thousand pictures of hospitals, medical objects, and persons were obtained from the Armed Forces Institute of Pathology, 2,200 portraits from the Army Medical Illustration Service, and hundreds from the Navy and Air Force medical departments. Posters were acquired from the Red Cross, National Institutes of Health, and military medical agencies. Duplicate pictures came from New York Academy of Medicine and College of Physicians, Philadelphia. Individuals sent material, two unusual collections being Morris Fishbein's medical bookplates and Webb Haymaker's portraits of 618 individ- uals who attended the 4th International Neurological Conference, Paris, 1949. Letters, more than 10,000, sent to teachers in medical schools, members of medical organizations, directors of hospitals, and physicians soliciting portraits and pictures brought in thousands of items. In the 10-year period following the war the portrait and print collection jumped from 15,000 items to almost 60,000.21 Binding The binding studio of the History of Medicine Division in Cleveland re- mained in the National Library Bindery Company building from September 15, 1943, until July 30, 1948, when it moved to the Allen Memorial Library, close to HMD. By then the major portion of the damaged early books had been repaired and rebound, and one by one the employees left for other jobs. By October 1952 only Jean and Elia Eschmann remained. On June 30, 1955, they completed the last binding and the restoration program, perhaps the most extensive undertaken by any medical library, was finished. The equipment was 319 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE shipped to Washington, and the Eschmanns turned to practicing their art for other patrons in Cleveland. During the 11 years that the bindery existed the Eschmanns and their assistants carried out 10,317 operations on 9,717 volumes, restoring 4,246 of them, binding 2,012 in full leather, 2,689 in half leather, 543 in buckram, and making 827 slipcases. The total cost of salaries, supplies, and rent amounted to $178,325. Thus the average cost of restoring a volume was $18.35. They returned to usefulness and attractiveness volumes that had deteriorated under the ravages of time, temperature, transportation, water, dirt, insects, and care- less readers. To those who remembered the shabbiness of the books in their old battered condition, their fresh, clean, neat look was almost unbelievable.22 Routine binding followed a different course from that of the special Cleve- land binding. The Library was required by law to have publications bound at the Government Printing Office. It had to pay for this service, but it never received sufficient money from the Medical Department to bind the accu- mulations. Each year from the 1870's onward there had been a backlog of journals, pamphlets, and paperbacks; and as time passed and the collections grew, as the number of periodicals increased, and as much-used volumes began to need rebinding, the backlog became larger. During Jones' librarianship the clerical work involved in sending items to and receiving them from the GPO was handled by a small unit called the Binding Records Section. In June 1945 Jones renamed this the Binding Section, gave it the job of readying items for binding at the GPO, and told it to do as much pamphlet-binding as it could. This was the stitching or fastening of pamphlets in commercial or homemade binders, the preparation of cut-flush type bindings, recasing, mending, repairing, and labeling. At first the section rebound only a few hundred items a year, but from 1949 onward it turned out thousands of pamphlets annually. One advantage of inhouse binding was that publications were out of circulation a much shorter period than those sent to the GPO. In 1948 at the suggestion of Helen Turnbull, head of the section, the Library designed its own endpaper for use in its bindery. This gave the publications a distinctive appearance and saved money. Seldom could the section plan its deliveries to the GPO in advance because it did not know how much money it would receive and when. During 4r/2 months in 1951 it was given so little that it could send only 193 volumes. Then suddenly it was allotted $20,000 to be spent in the final 6 weeks before the end of the fiscal year and everyone had to work overtime to send off 3,678 volumes. Worse, in 1952 it was suddenly allotted $96,000 for the period March through June. Temporary employees had to be hired and vacations were post- poned, but still the section could spend only $76,000. Fortunately from then on budgeting and planning became more certain. By the end of fiscal year 1952 the GPO had bound approximately 100,000 items, the Binding Section one- quarter as many. The GPO's monopoly on binding, which had irritated every Librarian since 320 MODERNIZING THE LIBRARY Billings, was finally ended by Rogers. In 1953 he asked the Department of Defense for permission to have volumes bound by commercial firms under contract, emphasizing that the Library would save money and be able to plan binding more effectively. His request, which required a waiver from the Congressional Joint Committee on Printing, was granted in the spring of 1955, effective July 1. The firm awarded the first contract proved to be unreliable, but later contractors were satisfactory.23 Scope and Coverage In 1948 McNinch invited several dentists, pharmacists, and medical spe- cialists to examine the collections to determine whether the Library was ac- quiring the important publications in their fields.24 The following year Rogers went further and established an internal Committee on Scope and Coverage to define the subjects to be collected and the degree of collecting within each subject.25 This committee, comprised of Estelle Brodman, Scott Adams, and Joseph A. Groesbeck, using the framework of the Library of Congress classi- fication to define the Universe of Discourse, determined the medical and nonmedical (as physics, chemistry, technology) subjects that should be col- lected, and it defined four degrees of coverage for the subjects: skeletal, ref- erence, research, and exhaustive. It also recommended policies for specialized areas within the Library, as the Art Section and History of Medicine Division. It met with representatives of several other government libraries to see how the policies of these libraries would affect that of the AML, but only with the Department of Agriculture Library was there an overlap, in the area of vet- erinary medicine. The committee's report provided a basic policy for acquisition and was revised periodically thereafter. A by-product of the scope and coverage study was the withdrawal of books that were judged "out of scope." Estelle Brodman looked at every book in the collection, a task that took years, and weeded out those that did not belong. Out went Arrowsmith, Dr. Serocold, and a number of mystery novels in which physicians figured prominently. Also disposed of were J. Bokalders, The Latvian Economist; Frank Brandegee, Address on the Life, Character, and Public Serv- ices of William McKinley; F. H. Bowman, The Structure of the Cotton Fibre in its Relation to Technical Applications; William H. Brown, The Art of En- ameling on Metal; annual reports of the Boy Scouts of America; a book on diseases of high altitudes, which turned out to be a satire on the political situation in Peru; and a book classed under "Electrotherapy," which proved to be a trouble-shooter's handbook on Krankheiten of lead storage batteries. Vol- umes withdrawn were given to the Department of Agriculture, Army, John Crerar, and other libraries, or placed in the duplicate collection.26 The Library's basic policy had been to try to acquire all publications in all languages, but the cost of processing seldom-used leaflets, broadsides, school catalogs, almanacs, hospital reports, etc., some typed, some mimeographed, caused the staff to question whether they were not acquiring and retaining too 321 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE much. Rogers organized a symposium "The Acquisition Policy of the National Library of Medicine," held April 12, 1956, in which a panel of six persons from different fields discussed the subject from the viewpoint of library technology, clinical medicine, research, history, and strategic intelligence. The symposium did not provide slick solutions but, as Estelle Brodman said, "It did give us assurance that we were proceeding along the right lines, and it provided us with important voices to combat any complaints we might have received about our decisions on scope and coverage. Politically and emotionally, therefore, it had important results."27 Shelf-listing, Classifying, Cataloging, Recataloging The Library surveyors had emphasized the necessity of recataloging and cataloging. Jones sought for a competent person to supervise the operation and finally persuaded M. Ruth MacDonald to leave her post as chief cataloger of Detroit Public Library and come to Washington. During the summer of 1945 the first shelf-listing project was completed, resulting in an inventory of 126,860 monographs.28 Librarians then began to sort more than 71,000 pamphlets stored in 1,300 boxes and 215 packages in the basement. Dust had been accumulating on these containers for decades, and the workers had to wear surgical masks, rubber gloves, and smocks. Approximately 42,000 pamphlets were shelf-listed, the remainder (theses, journals, documents, and other publications) being transferred to other collections or set aside for exchange. The shelf-list index cards were photographed on a V-mail machine, printed in long rolls, cut and trimmed. Almost 200,000 photoprint cards were alpha- betized and placed in the card catalog trays, in front of the old catalog cards. During December 1945 and January 1946 the shelf-listers again donned smocks, masks and gloves and inventoried old, stored serials. Other holdings were also inventoried. In the spring of 1946 the shelf-listing team finished the work started 2 years earlier, completing one of the initial tasks in modernizing the Library. Before the shelf-listing was started the development of a new shelf classi- fication for the Library was begun by a committee appointed by Jones and financed by the Rockefeller Foundation.29 The group considered basing the classification on the Library of Congress schedule for medicine because this would have advantages to both institutions but concluded reluctantly that re- vision was not practical. Instead they decided to devise new schedules for medicine and allied sciences using the letters W and QS-QZ (the LC classifi- cation was retained for nonmedical works, as dictionaries, encyclopedias). The classification tables were compiled during 1944, '45, and '46 by Mary Louise Marshall of Tulane with advice of specialists in different fields of medicine. While the classification was being developed, descriptive cataloging of ac- quisitions was done in a brief form and subject cataloging was done using the old system.30 Catalogers started to apply the new classification on October 1, 1946, preparing author and subject cards for the new public catalog. The Library 322 modernizing the library began to prepare the classification for publication in 1947 and distributed copies to other libraries in 1948. An abridged form of the classification prepared by Marshall was adopted by the Veterans Administration libraries.31 After the cataloging program was well under way, it became apparent that the classification schedules were overly detailed. On instructions from Mc- Ninch, Rogers prepared a cut-down version of the W schedule and catalogers began to use his revision on November 1, 1949. This brief classification along with simpler cataloging rules allowed the catalogers to proceed much more rapidly. After being tested for a year the revised Army Medical Library Classification was prepared for publication and issued in April 1951. Thereafter the classi- fication was revised and reissued periodically, being kept up-to-date between revisions by lists of "Additions and Changes." Recataloging books that had been in the Library started in October 1946, simultaneously with the cataloging of new arrivals. The bio-bibliographical collection was recataloged first, then reference books in the reading room, followed by monographs in the stacks. The latter project was not completed until June 1952. This was one of the largest, if not the largest, recataloging programs ever undertaken by an American library. Thereafter the recataloging of serials and other groups of publications proceeded slowly and intermittently depending upon priorities of library services and operations.32 Cooperation With Library of Congress Cooperation between the Army Medical Library and Library of Congress in areas of mutual concern was desirable from the viewpoint of efficiency and to avoid duplication of work. In 1946 the Library of Congress agreed to print and distribute catalog cards prepared at the Army Medical Library.33 Cards turned out by catalogers from October 1946 to March 1948 were published by LC in a series known as the MED series. The Library of Congress sold these cards to libraries willing to subscribe to a year's output; there were not many subscribers. The cards contained subject headings and classification notations according to both LC and AML systems, so that other libraries could follow the system they preferred. The cards were reproduced later in A Catalogue of Books Represented by Library of Congress Printed Cards, Supplement, 1942- 1947, and in Library of Congress Cumulative Catalog, 1948. This cooperation between LC and AML permitted a centralized distribution of catalog cards without duplication of work. On April 1, 1948, the Library suspended its cooperative catalog agreement with LC, because of the decision to revise the AML classification. Instead it sent mimeographed copies of its cards to LC where they were filed in the National Union Catalog and published as a supplement to the Cumulative Catalog of Library of Congress Printed Cards under the title Army Medical Library Author Cards (April-December 1948). In 1949 LC published the cards as a supplement to its author catalog under the title Army Medical Library, 323 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Author Catalog, 1949. In 1950, its major cataloging and recataloging difficulties overcome, the Army Medical Library resumed its cooperative agreement with Library of Congress. Main entries, added entries, and cross-references were typed on mats and sent to LC where they were printed in card sets for sub- scribers. At the end of each year the cards were reproduced in book form under the title Army Medical Library Author Catalog. The two libraries continued to issue catalog cards, annual volumes and 5-year cumulated volumes until 1965. End of the Index-Catalogue Prospective resumption of publication of the Index-Catalogue, suspended during part of the war, raised old arguments over the value of this bibliography. From the viewpoint of researchers and physicians in search of up-to-date in- formation on a subject the Index-Catalogue was not satisfactory as a finding aid. Since it was published in a cycle of about 20 years, only about 5 percent of references in each volume were current, the remaining references being from 2 to 19 years old, or often even older. The fault was not in the indexing but in the "dictionary" arrangement that required 20 or more years for the Catalogue to run through the alphabet and start over. Furthermore, the indexing process created a backlog of unpublished ref- erences. Every year the backlog grew. In 1920, after a half century of indexing, a million references had lain in the files waiting to be printed. During the 1920's and 1930's the total increased. After World War II the rate of accu- mulation accelerated. The number of unprinted references was expected to reach two million by 1951, three million by 1960. There was no practical way of reducing the ever-growing backlog of un- printed references. The Index-Catalogue could not be published more fre- quently or in larger format because of the expense—volume 10 of the fourth series cost approximately $175,000, or $175 a volume for each of the 1,000 copies printed.34 Every Librarian from the time of Champe McCulloch, during whose tenure (1913-1919) the backlog reached enormous size, had puzzled over the disad- vantages of the Index-Catalogue, begun before they were born and seemingly destined to go on forever. Finally McNinch decided to seek advice from phy- sicians and librarians about the matter. He persuaded Surgeon General Bliss to appoint a committee "to study the indexing requirements of modern medical science and the publications of the Army Medical Library as devices to satisfy these requirements." Named the Committee of Consultants for the Study of the Indexes to Medical Literature published by the Army Medical Library, this group met 12 times, the first on September 24, 1948, the last on May 1, 1952.^ General Bliss also contracted with Sanford Larkey, librarian of Welch Medical Library, to undertake research for the committee. Larkey assembled a staff and provided assistance to the committee from November 1, 1948, to September 30, 1953.36 The Larkey group undertook two major studies: one, a 324 MODERNIZING THE LIBRARY survey of world medical serials and the coverage of these serials by indexing and abstracting services; the other, the preparation of printed indexes by au- tomatic punched-card equipment. After the committee was fairly along in its task McNinch, the outgoing Director, and Rogers, the incoming Director, asked the group to concentrate on the critical state of indexing in the Library. Both McNinch and Rogers recommended that the Index-Catalogue be stopped when the series ended, and that a new periodic index be developed out of the Current List.37 The committee considered the fate of the Catalogue for 2 months and then agreed reluctantly that it be ended as soon as possible.38 News of the impending demise of the reference work circulated among medical libraries, and a number of prominent physicians wrote to Surgeon General Bliss protesting the action.39 Rogers did his best to calm the objectors, explaining the reasons for stopping the Catalogue and announcing that the Current List and other publications would take its place.40 On March 31, 1950, the routine indexing of journals for the Index-Catalogue ended. The staff continued to index accumulated journals and to subject-head tens of thousands of references in the Mh-Mz portion of the alphabet for the volume then under preparation.41 In 1954 the last of the Mh-Mz cards were sent to the printer. As typesetting progressed it was seen that the book would be too large if all the references were printed. Rogers recalled 7,000 cards, and the volume closed at Mn instead of Mz. The tome, issued in 1955, was the largest volume of the Catalogue ever produced, with more than 1,500 pages and 110,000 references. Rogers had one section, "Military Medicine," covering 938 pages with more than 30,000 ref- erences, reprinted in a separate volume. While volume 11, Mh-Mn, was being compiled, catalogers selected from the backlog of 1.5 million unpublished references the title, author, and subject entries of monographs. Rogers first planned to publish these references in a five-volume supplement to the Catalogue. Later, to keep the cost down and hasten the work, he reduced the supplement to three volumes, one for titles and authors, two for subjects. This fifth series, as it was named, appeared in 1959 and 1961.42 When the final pages came off the press, the 61 volumes of this massive bibliography had listed 579,566 author titles, 538,509 book and pamphlet titles, and 2,556,036 article titles. The Index-Catalogue ended 87 years after Billings began indexing and after it had been slaved over by four generations of conscientious editors, surely something of a record. Development of the Current List of Medical Literature After the Current List became an official government publication in August 1945, Director Gardner and editor Ignatius McGuire decided on a number of changes.43 The subject index would be published monthly instead of semian- nually, the price would be decreased from $5 to $3, and the List would be 325 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE confined to current publications and therefore not include wartime publications now arriving in large quantity. There was no certainty that the List, born at the beginning of the war period and successful during abnormal times, would be judged worthwhile by readers and survive in normal times. But scientists and physicians found the little periodical so convenient and useful that its circulation jumped from 1,500 to 5,000 in 2 years, and its existence was secure. Editor McGuire prepared Current List by himself. He was overwhelmed by the task, and in October 1947 he resigned and moved to California. The Acting Librarian Scott Adams recruited Mildred Kuch, who had at one time been with Quarterly Cumulative Index Medicus, as the new editor. She pro- duced the List but because she was poor in health the monthly indexes for 1947 and '48 fell behind. She died of cancer in January 1949. By the spring of 1949 the indexes were 11 months in arrears. At the Medical Library Association meeting in Galveston in April 1949, librarians complained to Rogers that delays in the indexes were handicapping their readers. McNinch gave first priority in the Library to bringing the indexes up-to-date. Several employees were shifted from other duties to assist with the indexes, and two numbers were prepared by outside librarians under contract.44 By October 1949 the indexes were again current. By this time McNinch, the outgoing, and Rogers, the incoming Director had decided that the Index-Catalogue would be replaced by other indexes, primarily a larger Current List. The new List would be issued monthly instead of weekly and contain a monthly and a cumulated index. Journals would be arranged in alphabetical order instead of being grouped by subject. With suggestions from other libraries, 1,225 journals were chosen for in- clusion. Fifty-seven percent of these were in non-English languages. Titles of articles in foreign periodicals would be given in the vernacular and in English translation. It was expected that a score or so of journals would be added each month. On the recommendation of M. Ruth MacDonald, McNinch appointed Sey- mour Taine, a young cataloger, as the new editor.45 Taine proved to be an excellent planner, able to foresee the details that arose in a new operation and to overcome obstacles. He was ingenious, as for example in devising (with the aid of an officer in the Prosthetics Research Laboratory at Walter Reed) a hand stamp to number citations for the List and in constructing an inexpensive layout board instead of purchasing an expensive commercial model. In March 1950 the nucleus of the new List staff moved into Tampa Hall and began to expand. Equipment was acquired. Indexing began in May and for the next 2 months the staff learned, mostly by experience, how to turn out a large monthly index periodical. To produce the List the Library adopted the "shingle" method developed by Ralph Shaw at the Department of Agriculture Library. Indexers scanned articles, writing subject headings on forms provided for that purpose. These 326 MODERNIZING THE LIBRARY Slips of paper bearing citations for Current List of Medical Literature being shingled by Hertha E. Bishop. and the journals were passed to typists who skimmed through articles typing citations, authors' names, and subjects in precise positions on rolls of paper 5 inches wide, perforated every 3 inches for tearing into slips. Strips of these slips were filed under journal titles until the cutoff date for the publication of an issue of the List. At that time the slips were numbered in sequence with all slips for a given article assigned the same number; the strips were then separated into slips. The citation slips were laid on boards in numerical order and held by tape sticky on both sides so that they overlapped vertically, or were "shingled," in three columns to make a page. The pages were then photographed for photo-offset printing by a commercial firm. After the citation slips were all paged and photographed, the subject and author slips were alphabetized and then treated in the same manner. Author and subject slips were kept and interfiled with the succeeding months' slips. Twice a year ac- cumulated author and subject slips were shingled to produce cumulated in- dexes. The first number of volume 19 of the new Current List went to press on July 10. Production improved during the remainder of 1950, more and more 327 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE journals and articles being covered. In 1951 the Library experimented by producing one volume for the year instead of two volumes. But it took only 1 year for the staff to learn that it was not practical, and in 1952 they switched back to two volumes a year. In February 1953 the Bureau of the Budget began to question the Library's authority to publish the List. Rogers did not learn of this until October, when the Adjutant General ordered the Library to suspend publication. Rogers and the Surgeon General objected strenuously, and in December the Bureau re- lented, agreeing to allow the List to continue until October 1, 1954, provided that no more than $19,500 be spent on printing, no more than 4,100 pages be set up, and no more than 1,800 copies be distributed to government agencies or sent for exchange. To stay within the page limit Rogers and Taine decided to switch from a three- to a four-column format, losing legibility but gaining 50 percent more references per page and volume. The February 1954 issue, already half com- posed in a three-column format, was torn down and remounted in four columns. To stay within the $19,500 limit they reduced the number of copies for official use from 700 to 500, and for exchange from 1,400 to 1,000. With the List on the verge of extinction Rogers bombarded his superiors with cogent reasons for continuation. Finally the Bureau of the Budget granted the Library authority to publish the index for 3 years, until 1957, and increased the limit on funds to $28,000 annually. Medical Subject Headings Needing a subject heading authority list for books, catalogers began a file of subject cards, making a card for each book cataloged, giving the source or authority for the subject, cross-references, and a scope note if necessary.46 The Library sponsored a symposium on medical subject headings in December 1947 to open the undertaking to discussion by other medical librarians.47 By 1950 the file contained 20,000 cards. The file was examined systematically while the subject indexes of the Army Medical Library Author Catalog were being edited in 1950 and '51. The compilation of a list of standard subject headings for articles became necessary in 1950 when Rogers changed the format of Current List.48 Taine, Rogers, and their associates modified the subject heading list of Quarterly Cumulative Index Medicus to draw up the first of several provisional lists for CL. Ideas for categories came from the studies of the research group assisting the Committee of Consultants on the Study of Indexes. As indexers referred to this list they revised it, adding terms to make the list more precise and assist users to locate articles. In 1954 the Library published the compilation for the use of other libraries and information specialists under the title, Subject Heading Authority List Used by the Current List Division Armed Forces Medical Li- brary. It seemed to Rogers that a single list for books and articles would be pref- 328 MODERNIZING THE LIBRARY erable to separate lists. A single list would be simpler for users, save time, and be more economical for the Library. With much labor and thought on the part of Taine, Rogers, and others, one list of standard headings and subheadings was drawn up for articles and books. Subheadings had been reserved tradi- tionally for indexing articles, but now Rogers decided to use them also in cataloging books. The work was published in 1960 as National Library of Medicine Medical Subject Headings. Main Headings, Subheadings, and Cross References Used in the Index Medicus and the National Library of Medicine Catalog, and revisions were issued periodically thereafter.49 Bibliographies The Index-Catalogue was replaced, in part, by bibliographies on specific subjects. The first of these was compiled between April and December 1950 by librarians who sifted through myriads of unpublished Index-Catalogue cards and other sources to produce The Pituitary-Adrenocortical Function: ACTH, Cortisone and Related Compounds, a 366-page volume containing more than 3,400 references. This was followed in 1951 by Plasma Substitutes; N15 in Biological Research; Intravenous Injection of Fats and Oils for Nutritive Pur- poses; Lower Nephron Nephrosis; Fibrinolysin, Profibrinolysin, and Antifibri- nolysin; in 1952 by Pathology and Physiology of Burns, 1942-1951; Psycho- pathology of Aging; Medical Photography and Radiography; Fat Embolism; Bibliography of Military Psychiatry; Gas Gangrene and Gas Gangrene Orga- nisms, and in subsequent years by many additional bibliographies. During meetings of the Committee of Consultants for the Study of the Indexes to Medical Literature, Chauncey Leake commented a number of times about the need for the publication of critical reviews of scientific and medical literature, particularly for scientists entering new areas. Scott Adams, the ex- ecutive secretary of the group, agreed with Leake's reasoning. Later Adams suggested to Director Rogers and Seymour Taine that an index of reviews be started. This led Rogers and Taine to establish the Bibliography of Medical Reviews as a by-product of Current List. The first annual volume, covering 1955, appeared in March 1956. A bibliography of a different kind, one that had been wanted for a third of a century, was a catalog of the Library's incunabula.50 Fielding Garrison, Felix Neumann, Champe McCulloch, Claudius Mayer and others had hoped to do this, but for various reasons had stopped short and published lists.51 In 1944 after the History of Medicine Division had been established and Max Fisch had arrived, the idea of bibliography was revived and Fisch started to study and catalog the early printed works. Later that year Dorothy Schullian joined the division and took over the cataloging. Francis Erich Sommer of the John G. White Collection, Cleveland Public Library, was engaged as a con- sultant to catalog Oriental manuscripts. Sommer, a rare linguist, familiar with 81 or 94 languages, according to different authorities, worked part-time at the branch for 3 years.52 329 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE In September 1946 Fisch asked Henry Schuman, an antiquarian bookseller and publisher, if he would be interested in bringing the book out. Schuman agreed. Rising costs of printing forced Schuman later to request a subsidy, which the Honorary Consultants provided. A Catalogue of Incunabula and Manuscripts in the Army Medical Library by Schullian and Sommer, describing 490 incunabula, 35 early Western manuscripts, and 137 Arabic, Persian, Turk- ish, Singhalese, and Hebrew manuscripts, appeared in 1950. Providing Service The greatest increase in service to readers came about through the use of photography. During 1945 the Library obtained equipment from V-mail surplus and adapted it to produce inexpensive photoprints, 8 inches wide instead of the V-mail 5-inch width. Since these photoprints did not require a viewer, many readers preferred them to microfilm. During 1946 188,000 pages of photoprint were produced; during 1947, 246,000 pages; and during succeeding years larger quantities.53 The policy of providing free microfilm was becoming a bit expensive for a library operating on a small budget, and starting on January 1, 1947, civilian customers were charged for film. Atherton Seidell, who was largely responsible for the introduction of microfilming into the Library, tried to persuade Director McNinch to restore free film.54 McNinch felt that the Library could not afford this, but he compromised with Seidell. Starting in May 1948 the Library pre- sented users with the option of purchasing film or borrowing it for 90 days. Microfilming proved useful in a variety of ways. Security copies were made of incunabula and of 2 million index cards for future volumes of the Index- Catalogue. Positive microfilm copies were made of scarce Russian journals and sold to other medical libraries at cost. Books and journals printed on poor quality, deteriorating paper were filmed for preservation. Service microfilm, from which copies could be produced, was made of frequently used journals in order to reduce wear and tear on the volumes. In conjunction with the State Department and Office of the High Commissioner for Germany, microfilm of medical literature was made for the Institut fur Forderung Offentlichen An- gelegenhalten, Frankfurt/Main, Germany, to enable German scientists, stu- dents, and libraries to obtain access to medical literature destroyed in the war. The spectre of copyright restriction, ignored during the war when the Library began to turn out multiple copies of film, now arose. The question as to whether or not the photoduplication of articles was an infringement of co- pyright and if so how this valuable service could be maintained was debated by librarians here and elsewhere. So many groups were involved—researchers, authors, publishers, students, librarians, professional societies—that the ques- tion could not be answered readily, and it continued to be discussed into the future. An indication of the usefulness of film to patrons may be gained from the quantity produced in 1952, 10 years after Photoduplication Service began, when 330 MODERNIZING THE LIBRARY 15 persons filled 88,000 orders for 1,431,600 frames of microfilm, 1,164,200 photoprints-photostats, plus other reproductions. Microfilm copying amounted to more than half the use of the Library, local reader use being second, and interlibrary loan of volumes third. Aside from advances made in photoduplication, regular loans remained an important function. No other medical library made as many interlibrary and individual loans. Volumes were sent to all sections of the country but mainly to the mid-Atlantic and southeastern regions. The majority of loans were made to other government agencies, as the National Institutes of Health and Naval Medical Center. None were made outside of the United States, microfilm being sent instead. Photographs and portraits were also loaned. By 1955, more than 37,000 loans were being made each year. The number of requests for information increased greatly. During the war many military and civilian scientists had learned that they could depend on the Library for rapid answers to queries and for compiling bibliographies on medical subjects. After these men returned to their peacetime pursuits, they continued to call on the Library for assistance. Back in the 1930's only a fraction of the time of two or three librarians was required to answer a few hundred questions and compile a few dozen bibliographies each year. Now several persons worked full time answering thousands of mail, telephone, and oral queries (11,453 in 1952) and compiling hundreds of bibliographies (475 in 1954) annually. About one-quarter of the questions and one-third the requests for bibliographies came from military personnel, the remainder from civilians. Questions came from every state, from Latin-America, Africa, Asia, Europe, and Australia. Because of the large size and special character of its collections, the Library was frequently the court of last resort, the only place, practically speaking, where certain information was available. Because of the increase in the size of the staff, the Library was now able to assist other institutions on a larger scale than previously. Estelle Brodman, chief of the Reference Division, advised the National Institutes of Health on the development of its library.55 M. Ruth MacDonald, chief of the Catalog Division, spent 3 months in Germany in 1952-53 by invitation of the State Department serving as consultant to the new American Memorial Library in Berlin. Rogers assisted in the survey of Department of Commerce libraries for the Secretary of Commerce and in 1954 surveyed Korean medical libraries for the Korean Ministry of Health. Kanardy Taylor consulted with the Post Office Department on its new library. Harold W. Tucker, a reserve officer, came from his position as head of the Gary, Indiana, library system to spend a year and a half at the AML and, with Estelle Brodman, make a detailed survey of the Army Medical Service field libraries. The Library also supervised two branch libraries; one, the Army Surgeon General's Reference Library, the other the Air Force Surgeon General's Library.56 The tradition of exhibits dated back to the 1870's, but heretofore they were set up only on special occasions. Now the Library emphasized them. Three 331 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The stack of the reading room, about 1917. On the left is the first public card catalog. On the right series 1 and 2 of the Index-Catalogue are lined up on a catalog desk. types were prepared, one for showing at meetings of medical and library so- cieties, one for medical schools, and one for use in the Library. The first and second types were not successful, and they were discontinued. The frequency of exhibits within the building increased until they were being changed monthly. The latter were usually arranged by a volunteer interested in some special subject.57 The Association of the Honorary Consultants to the Army Medical Library During the decade from 1945 to 1955 the Library was aided by two volunteer groups, the first of which was the Association of Honorary Consultants, orga- nized in 1944. The association held its first postwar meeting in October 1945 at the Allen Memorial Medical Library in Cleveland. Thereafter it met every October in Washington at the Library or Walter Reed or a hotel. Between meetings the members were kept informed of events through the monthly Army Medical Library News, started in August 1945 by Jones.58 On January 24, 1947, the members incorporated their organization in the District of Co- lumbia as the "Association of the Honorary Consultants to the Army Medical Library."59 332 MODERNIZING the library A third of a century later the stack end of the reading room looked like this on an average day. Membership hovered between 90 and 100, the latter number being the maximum set by Jones. A few members died each year and were replaced by new members nominated by the Library Director and appointed by the Surgeon General. In the association were members of the Committee on Medical Research of the National Research Council. There were members who had been asso- ciated with other research organizations. These persons had become conscious of the deficiencies in the Library through its inadequate response to requests for literature during the war, and when they became consultants they supported wholeheartedly the implementation of the survey report by Librarians Jones and McNinch. Most of the deliberations went on in standing committees, of which there were five; executive, building, endowments and grants, acquisitions, and his- tory of medicine. A temporary committee existed in 1945 to explore the pos- sibility of starting a journal or annual for scholarly articles written by employees. The acquisitions and the history of medicine committees met periodically with appropriate Library employees for briefings. The endowment and grants com- mittee had two goals: one, to persuade individuals, firms, and societies to 333 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The window end of the reading room, about 1917, photographed from the left end of the card catalog. On the left are exhibit cases. At the center left is the back of the catalog desk. present gifts to the Library; two, to obtain money to pay the expenses of the Association of the Honorary Consultants. They succeeded in obtaining funds from a few firms (Sharp-Dohme, Ciba) and individuals (Chauncey Leake, John Fulton, among others), and one association (American Pharmaceutical Con- vention). The building committee kept abreast of the deliberations going on in the Army over the site and legislation for the proposed building. Some con- sultants, acting individually, pressed officials, legislators, and Medical De- partment advisors to provide funds for the building. In the early 1950s when the Defense Department began the slow process of transmuting the Army Medical Library into the Armed Forces Medical Library, it signaled the end of the Honorary Consultants. Having been ap- pointed by the Army Surgeon General, they could not appropriately represent a library in the charge of three Surgeons General. The executive committee of the consultants took steps to disband their group. The U.S. District Court of the District of Columbia issued a decree on December 9, 1952, dissolving the corporation. During its 8 years of existence the Honorary Consultants assisted the Library in several ways: paying a debt of approximately $400 owed by Current List in 1945 (the List, at that time, was still being financed by the old Friends orga- nization); paying costs of printing the Army Medical Library News from No- vember 1945 onward; publishing Proceedings of their meetings in pamphlets and in the Bulletin of the Medical Library Association; and encouraging and subsidizing publication of the important Catalogue of Incunabula and Manu- 334 MODERNIZING THE LIBRARY The window end of the reading room photographed a third of a century later. scripts in the Army Medical Library, by Dorothy M. Schullian and Francis E. Sommer in 1950. They contributed in an intangible way by giving employees recognition for good work, encouraging employees to progress, and by influ- encing military officers, civilian officials, and legislators to upgrade the insti- tution. Friends of the Armed Forces Medical Library Before the consultants disbanded, Rogers planned the formation of a new volunteer organization to be called the Friends of the Armed Forces Medical Library in imitation of the Friends group that had existed from 1940 to 1945. The Friends would be open to anyone in contrast to the consultants, mem- bership in which had been by invitation from the Surgeon General.60 Rogers made arrangements for a combined dinner-organization meeting of potential members at the Willard Hotel, October 24, 1952. Through Wilbur Davison, president of the Honorary Consultants, Rogers invited former con- sultants and other persons to attend. Thirty-five men and women showed up. Davison, presiding temporarily, explained the reasons for ending the consult- ants and beginning the Friends. Copies of a proposed constitution and bylaws, 335 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE prepared by Rogers, were discussed, modified and adopted, officers were elected, Rogers talked for a few minutes, and the Friends were in business. Secretary Robert Stecher sent letters to librarians and physicians, inviting them to join the group. Within a few months 200 persons had become members. The organization held a business-dinner meeting once a year in Washington. The executive committee met occasionally when necessary. Members were kept informed of events through the monthly Armed Forces Medical Library News. Money came into the treasury from dues ($2 a year), gifts, and dinner meeting tickets. It was used to pay the cost of dinner meetings, postage and other administrative costs, printing the AFML News, and a few other expenses. The latter included $55 to reimburse Seymour Taine for materials to build two boards used in pasting up Current List, thereby saving the Library approxi- mately $1,000 the boards would have cost from a manufacturer. In 1956 Rogers, through chairman Benjamin Spector, sent to a number of the Friends copies of the Hill-Kennedy bill to transform the AFML into a National Library of Medicine. He also sent speeches, editorials, and other information, and asked members to use their influence with journals, news- papers, and legislators to support the bill. After the Hill-Kennedy measure became law, Rogers recommended that the Friends disband. The executive committee obtained the assent of the approximately 300 members by a mail poll. On December 10, 1956, the committee met at Welch Library, transferred $767.35 remaining in the treasury to the Director of the AFML for whatever purpose he saw fit, and the Friends ended. The time from 1942 to 1956 was a transition period in the life of the Library, perhaps the most momentous period since it moved out of Ford's Theatre in 1887. During these years the "ownership" of the Library passed from military to civilian control. The Library expanded from half of a building into the whole building and portions of other buildings. A new home, desired since World War I, was close to reality. The Index-Catalogue was discontinued and replaced by other finding aids. Through a committee of consultants the Library began to determine system- atically what, how much, in what way it should index, and in what form it should provide indexes to the public. Through a contractor it started to de- termine the possibility of using machines to assist in the preparation of indexes. A new classification was devised and the publications recataloged. A new public card catalog and an annual printed author catalog were provided for readers. The scope and coverage of the Library was defined for the first time. Early publications were segregated into a History of Medicine Division. The "art" collection was revitalized. The collecting of documentary medical moving picture films was begun. In 1956 the staff was more than six times larger than in 1942, the number 336 MODERNIZING THE LIBRARY of acquisitions more than ten times, the funds spent for publications almost four times, the amount of binding two times, circulation within the library several times, exchanges many times, and photoduplication thousands of times. At no time since the early Billings era were the changes in the Library so large and significant. Notes 1 H. W. Jones, Report of an interview with the Surgeon General, Major Norman T. Kirk, ... 7 Dec. 1946: MS/C/148. 2 Biographical information on Gardner may be found in: Army Register; Edgar E. Hume, Ornithologists of the United States Army Med- ical Corps (1942), pp. 150-160, with port.; di- rectories of the American Medical Association. Information was also provided by Johns Hopkins University. 3 During Gardner's term he gained the impression that the title "Director," used in the Library since July 1944, was being restricted to chiefs of certain War Department staffdivisions, and he requested the Surgeon General to change his title to "Commandant." This was done on Nov. 14, 1946, by Army Regulation 40-405. The title was used for only a few months before being changed back to Director. 4 Information on the disagreements between the Director and the Librarian may be found in: Records of the Honorary Consultants, MS/ C/148; letter, Wyllis Wright to Wyndham Miles, Feb. 1, 1979, NLM; recorded autobiography of Maj. Gen. Joseph H. McNinch, Nov. 30, 1976, NLM; W. Wright, Report on the progress of the survey recommendations, pp. 9-10, file Sur- vey Library MS/C/309; Scott Adams, Tape-re- corded autobiography. . ., July 18,1979; NLM. 5 McNinch felt that the title "Commandant" was not appropriate for the head of the Library and he requested the Surgeon General to change it back to Director (memo, McNinch to Surgeon General, June 2, 1947; file Directorship, MS/ C/309). The Surgeon General obliged on July 3, 1947 (change 1 to Army Regulation 40-405, July 3, 1947). The Historical Division, SGO, was trans- ferred to the Library's Table of Organization in January 1947 but remained in the Pentagon. It was transferred to Walter Reed Hospital on Dec. 1, 1951. McNinch was designated Commandant of the AML pursuant to letter from the Adjutant's Office, Dec. 23, 1946. 6 Letter, Wright to Wyndham Miles, Feb. 1, 1979; Scott Adams, Tape-recorded autobiog- raphy . . ., July 18, 1979: NLM. 7 Notes by McNinch, May 1979: NLM. 8 Memo, McNinch to the Surgeon General, sub: final report on administration of the Army Medical Library, Aug. 26, 1947; with attached correspondence: file AML September 1947: MS/ C/205. 9 Notes by McNinch, May 1979: NLM. 10 Biographical information on McNinch may be found in Army Register, Who's Who in America, and tape recorded autobiography, November 1976: NLM. 11 Among the members of the Committee were J. H. McNinch, H. W. Jones, and Luther Evans. 12 Rogers was a major when he entered on duty at the Library, and reached the rank of colonel. He resigned, effective July 31, 1960, and on Aug. 1 became a member of the Public Health Service with rank of medical director. 13 Tape-recorded autobiography of Kanardy Taylor: NLM. Kanardy Leslie Taylor, born in Peoria, 111., 1910, attended Eureka College, University of Illinois Library School and University of Chi- cago Graduate Library School. From 1934 he rose through successive positions of responsi- bility in Illinois State and John Crerar libraries and came to AML as assistant to the Director, Oct. 1, 1950. His title was changed to Librarian in 1951. After leaving AML in 1956 he was with the Northwestern, Air University, and DHEW libraries, retiring from the latter as Department Librarian in 1973. He was an officer in several professional societies, and wrote a number of articles and chapters on library matters. See biographical data in Manuscript Collection and tape-recorded autobiography of Taylor. 14 Biographical information may be found in tape-recorded autobiography of Rogers, 1977: NLM. 15 Information on acquisitions may be found in: annual reports of the Library; Army Medical Library News; files IDC on Acquisition of For- eign Publications, Acquisition Division F. Y. Activities, Acquisition Division Procurement, Disposition of Publications, MS/C/301; S. Ad- ams, "Sources of Acquisitions," Bull. Med. Lib. Assoc. 36: 178-83 (1948); S. Lazerow, "The 337 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE National Medical Library: Acquisition Pro- gram," Bull. Med. Lib. Assoc. 42: 427-53 (1954); records Hon. Consultants, MS/C/148. Scott Ad- ams, Tape-recorded autobiography . . . July 1979: NLM. 16 Letter, Surg. Gen. N. Kirk to Eileen Cun- ningham, Feb. 14. 1946: file Other Medical Libraries: MS/C/309. 17 Letter, McNinch to Chief, Public Health and Welfare Section, Supreme Commander for the Allied Powers, sub: Army Medical Library Mission to Japan, Mar. 3, 1948; file Activities of AML: MS/C/309. 18 Wilson, 1884-1963, attended Western Reserve (A.B.), Northwestern (A.M.), Garrett Biblical Inst. (S.T.B.), and Harvard (S.T.M., Ph.D.). He taught Greek at Iowa Wesleyan, Greek and Latin at College of the Pacific, Eng- lish at East Washington College of Education. From 1927 to 1929 he studied Greek manu- scripts in Europe. At Library of Congress, 1929- 1941, he directed the compilation of Catalog of Latin Vernacular and Alchemical Manuscripts in the United States and Canada, supervised the Annotated Bibliography of American His- tory, and collaborated with de Ricci. During World War II he was a historian in the Office of Price Administration. He was chief of HMD from June 13, 1947, to Aug. 31, 1954. For an obituary see Library of Congress Information Bulletin, 22: no. 42, 565-6, Oct. 21, 1963. Ap- preciative remarks about Wilson and a charac- terization of him by F. B. Rogers, Director of the Library, are in taped autobiography of Rog- ers: NLM. An Army officer who made the annual in- spection of the History of Medicine Division in 1950 recommended that all volumes published before 1925 be microfilmed, the microfilm be retained by the Library, and the original vol- umes sold "since, reportedly, . . . the subject matter held thereby has found little practical use by Department of the Army personnel." Wilson suggested humorously that by the same reasoning the United States could sell for fab- ulous sums the originals of the Declaration of Independence and Constitution. See report of the U.S. Army Inspector General, 1950: NLM. 19 File HMD Fiscal Year Activities, MS/C/ 309; annual reports of the Library; Wilson, "Historical Libraries, New Style," College Re- search Libraries, 54-68 (1950); "A Plan for a Comprehensive Medico-Historical Library," Lib. Quart. 21: 248-65 (1951); "Plans for Collecting 16th Century Sources," Bull. Med. Lib. Assoc. 39: 110-7 (1951). 20 Wilson, "The Bookbuyer and the Catalog of Holdings," Bull. Med. Lib. Assoc. 42: 10-14 (1954); "Bookbuying with a Portable Catalog," Armed Forces Med. Lib. News 8: 1^4 (Aug. 1953); annual reports of the Library. 21 Information on the prints and portraits collection may be found in annual reports of the Library; Army Medical Library News; records in the collection; Helen H. Campbell, "The Picture Collection in the Army Medical Li- brary," Bull. Med. Lib. Assoc. 37: 52-8 (1949); M. R. MacDonald, "Cataloging at the Armed Forces Medical Library, 1945-1952,"J. Cata- loging Classification 9: 69-75 (1953). 22 For information on the bindery during this period see: annual reports of the Library, par- ticularly 1955, pp. 44-49; Proceedings of the Honorary Consultants; Army Medical Library News; file HMD F.Y. Activities: MS/C/309. 23 For binding during the postwar period see: M. R. MacDonald, "Cataloging at the Armed Forces Medical Library, 1945-1952,"/. Cata- loging Classification 9: 58-78 (1953); annual re- ports of the Library; Army Medical Library News; Catalog Div. F.Y. act., MS/C/309. 24 Information on scope and coverage may be found in: Army Medical Library, Policy on Scope and Coverage, (processed), 1951, and subsequent published editions, copies in Ar- chival Coll.; J. Groesbeck, "Some Problems of Scope and Coverage," Bull. Med. Lib. Assoc. 38: 97-101 (1950); Acquisition Policy of the Na- tional Library of Medicine, proceedings of a symposium held 12 April 1956, (processed) 1957, copy in Archival Coll.; file, Acquisition Division F.Y. Activities, MS/C/309; S. Lazerow, "The National Medical Library: Acquisition Pro- gram," Bull. Med. Lib. Assoc .42:447-53 (1954); S. Adams, "Weeding as an Art," Bull. Med. Lib. Assoc. 42: 30-1 (1954). 25 Memo, Rogers to Brodman, et al., Nov. 17, 1947, establishing a Committee on Scope: copy in Report of Comm., Oct. 20, 1950, in Arch. Coll. 26 Titles of books withdrawn from the col- lections may be found in a series of drawers labeled "Withdrawal file" in the public card cat- alog. Unfortunately in the 1950s some volumes on science were withdrawn from the main col- lection without consultation with the History of Medicine Division, then located temporarily in Cleveland. HMD wishes those volumes were still in the Library. 27 Letter, E. Brodman to W. Miles, Mar. 6, 1979: NLM. 28 Inforamtion on shelf-listing may be found in: file Catalog Div. F.Y. Activities, and other files in MS/C/309; M. R. MacDonald, "Catalog- ing at the Armed Forces Medical Library, 1945- 1952," /. Cataloging Classification 9: 58-78 (1953). 29 On the committee at various times were 338 MODERNIZING THE LIBRARY Keyes Metcalf, Andrew Osborn, Janet Doe, Mary Louise Marshall, Francis R. St. John, Helen Norris, Herman Henkle, David Haykin, Wvllis Wright, M. Ruth MacDonald, and M. Irene Jones. Information on the development of the clas- sification may be found in: annual report of Li- brary activities for 1945, p. 44-45; file Consol- idated FY Activities and other files in MS/C/ 309: preface to Army Medical Library Classifi- cation, hectograph edition, 1946: preface to Calssification, preliminary edition, 1948: M. R. MacDonald, "Cataloging at the Armed Forces Medical Library, 1945-1952," /. Cataloging Classification 9: 58-78 (1953); E. R. Hasting, "Use of Serial Shelving Numbers in the National Library of Medicine," Lib. Resources Tech Services 3: 62-63 (1959); M. F. Tauber, Report on the recataloging program of the Armv Med- ical Library, June 1949, MS/C/186; M"! Irene Jones, "The Army Medical Library Classifica- tion," Proceedings Fourth Annual Meeting of the Association of Honorary Consultants, 1947, pp. 45—47. A copy of the classification in each stage of development, and a copy of each published edition, is in the Archival Collection. 30 Information on cataloging may be found in: M. F. Tauber, Report on the recataloging program of the Army Medical Library, June 1949, MS/C/186; file Catalog Division F.Y. Activities, MS/C/309; F. B. Rogers. "Cataloging and Clas- sification at the Army Medical Librarv," Bull. Med. Lib. Assoc. 39: 28-33 (1951); M. R. MacDonald, "Cataloging at the Armed Forces Medical Library, 1945-1952," /. Cataloging Classification 9: 58-78 (1953); Army Medical Library News. 31 The Army Medical Library Classifiction: an Informational Outline. (Distributed by Spe- cial Service, Library Service, VA, Mar. 1947). 15 p. Copy in Archival Collection. 32 The progress of recataloging may be fol- lowed by reference to annual reports of the Li- brary, 1950's and 1960's. 33 Information on the cooperation between AML and LC may be found in: introduction to Armed Forces Medical Library Catalog, 1950- 54, vol. 1, Authors; Army Medical Library News; M. R. MacDonald, "The Army Medical Library Author Catalog, 1950," Bull. Med. Lib. Assoc. 39: 102-4 (1950); F. B. Rogers, "Cataloging and Classification at the Army Medical Librarv," Bull. Med. Lib. Assoc. 39: 28-33 (1951). 34 The Superintendent of Documents sold volumes for $4.25. Therefore the government subsidized each volume by $170. 35 Surg. Gen. Bliss appointed this commit- tee on July 7, 1948. The minutes of the committee with related documents and a photo of the members is in the Archival Collection, NLM. Members of the committee at various times were: Lewis H. Weed (first chairman), Chaun- cey Leake (chairman), John Fulton, Sanford Larkey, William S. Middleton, Ebbe C. Hoff, Eugene W. Scott, Mortimer Taube, Ralph Shaw, Janet Doe, Basil G. Bibby, Verner W. Clapp, Morris Fishbein, David E. Price, Austin Smith, Joseph McNinch, Frank B. Rogers. 36 The original contract, with extensions, ran from Nov. 1, 1948, to Jan. 31, 1951. The second contract ran from Feb. 1, 1951, thru Sept. 30, 1953. Reports of the work done under contract by the Larkey group are in the Archival Col- lection. Members of the research group were: San- ford Larkey, Williamina A. Himwich, Eugene E. Garfield, Helen G. Field, John M. Whittock Jr. The research group assisting the Committee of Consultants on the Study of Indexes experi- mented with the production of subject heading lists using sorters, collators, and other business machines with punched cards. The group de- veloped the idea of sorting headings into cate- gories. The ability to manipulate cards and make lists of various categories for study turned out to be a fruitful way of producing a subject head- ing authority list. The method was used later to produce the categories in Index Medicus. In the estimation of Frank B. Rogers, the Director at that time, this was the most important contri- bution of the group (Frank Rogers, Tape-re- corded comments on Index Committee . . ., Mav 24, 1979). 37 Memo, McNinch to committee chairman, Oct. 20, 1949, in minutes Indexing Committee, p- 121-123. Rogers statement in minutes, p. 124-139. Information on the production of the Index- Catalogue during this period may be found in files including Index-Catalogue Div. F.Y. Ac- tivities, in MS/C/309; annual reports of the Li- brary. 38 Minutes, pp. 217-220, 229-232. 39 Excerpts from these letters are in min- utes, pp. 257-264. 40 See, for example: F. B. Rogers, Scott Ad- ams, "The Army Medical Library's Publication Program," Texas Rpts. Biol. Med. 8: 271-300 (1950). 41 Claudius Mayer, editor of the Catalogue from vol. 10, 3 series, 1932, up to this time, left the Library on Sept. 10, 1954. His arguments for the continued publication of Index-Cata- logue are in MS/C/42. 339 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 42 The printing of series 5 is discussed in annual reports of the Library, 1960, 1961. 43 Editors of the List were: Ignatius McGuire, who had been head indexer for Index-Cata- logue, August 1945 until his resignation from the Library. Oct. 31. 1947; Mildred Kuch, a librarian of long experience who came from the Department of Commerce, from November 1947 until her death on Jan. 7, 1949; Seymout Taine, acting editor, August-October 1950, editor Oc- tober 1950 to 1959. Information on the List may be found in: annual reports of the Library; records Hon. Consultants; records Advisory Group; Current List, covers; files in MS/C/309; minutes of the Committee to Study the Indexing Require- ments ... of the Army Medical Library; S.I. Taine, "New Program for Indexing at the Na- tional Library of Medicine," Bull. Med. Lib. Assoc. 47: 117-123 (1959); F. B. Rogers, S. Adams, "The Army Medical Library's Publica- tion Program," Texas Rpts. Biol. Med. 8: 271- 300 (1950). 44 Helen Bayne, New York University Belle- vue Medical School, and Mary Louise Marshall, Tulane University Medical School, compiled the May, June 1948 indexes. 45 Seymour Irving Taine, A.B., B.S., began his library career at University of California, Berkeley, after serving in the Army during World War II. He came to NLM in 1949, edited Cur- rent List, Bibliography of Medical Reviews, and Index Medicus, and occupied several responsi- ble positions. In 1964 he went to NSF, then to WHO, NASA, NIH, NLM, and finally in 1973 to WHO as chief librarian and chief, Office of Library and Health Literature Services. He wrote many articles and in 1962 received the Ida and George Eliot Prize. 46 Information on the Authority List may be found in: S. Taine, "Notes on the Subject Ap- proach to Medical Periodical Literature," Bull. Med. Lib. Assoc. 39: 118-21 (1951); F. B. Rog- ers, "Report from the Army Medical Library," same, 290-4; S. Taine, "The Subject Heading Authority List of the Current List of Medical Literature," same, 41, 41-3 (1953); M. R. Mac- Donald, "Cataloging at the Armed Forces Med- ical Library, 1945-1952,"/. Cataloging Classi- fication 9: 58-78 (1953); Minutes of symposium on medical subject headings, in file Activities of AML, MS/C/309; file Catalog Div. F.Y. Activ- ities, MS/C/309; minutes of Committee of Con- sultants for the Study of Indexes to Medical Lit- erature; records AFML Advisory Group; Frank B. Rogers, Tape-recorded comments on Index Committee, Welch Medical Library Research . . . May 24, 1979: NLM. 47 Articles by Sanford Larkey, David Hay- kin, Janet Doe, Claudius Mayer, and Estelle Brodman, Bull. Med. Lib. Assoc. 36: 69-107 (1948). 48 For the change in Current List see later in this chapter. 49 Preface to National Library of Medicine Medical Subject Headings (1960). 50 Information on incunabula may be found in: records Hon. Consultants; correspondence ofF. H. Garrison, MS/C/166; files including In- cunabula Catalogue, HMD FY Activities, in MS/ C/309; correspondence of Osier, Klebs, Schul- lian, Schuman, Fulton and others, 1915-1958, at NLM. ™Ann. Med. Hist. 1: 301-15 (1917); Bull NY. Acad. Med. 6: 365-453 (1930); Index-Cat- alogue 3 s., 10, pp. 1415-36, (1932). 52 Sommer was born in Germany in 1890. He was precocious with languages, inventing an "Indian" play language when he was a boy. He learned Persian while he was an adolescent and picked up Sanskrit and Swedish during school vacations. An import-export firm in Antwerp, consulates in Russia, and the Red Cross utilized his linguistic talents. In 1922 he and his wife came to the United States, and in 1926 he found his true home in the John G. White Collection, Cleveland Public Library, where he remained until 1965. One account credited him with knowing 94 languages. Another with speaking 14 fluently, reading 22 easily, and having a working knowledge of 45 others. He wrote an occasional article or note, and several pamphlets on the learning of Russian, Arabic, German, and Chinese. Sommer died Dec. 6, 1978. See clip- pings, other documents, and obituary in Cleve- land Plain Dealer, Dec. 9, 1978, in NLM. 53 Information on service may be found in annual reports of the Library; Army Medical Library News; Army Medical Library Bulletin; files on Exhibits, Translation, Reference Serv- ice, Photoduplication Service, and other topics in MS/C/309; records Hon. Consultants; records Advisory Group; Eleanor Coffyn, "Medicine's Information Please!," Proceedings Fourth An- nual Meeting of the Honorary Consultants 1947, pp. 39-44. 54 When McNinch arrived at the Library to assume the post of Librarian in January 1947, his first visitor was Seidell campaigning for free film. Later, Seidell tried to persuade the AFML Advisory Group to sanction free film: see Sei- dell's Memorandum on the Role of Microfilm Copying in the Armed Forces Medical Library [1952], inProc. U.S.A.F.M.L. Advisory Group. 55 Brodman, Survey of National Institutes of Health Library, Bethesda, Md. (processed), 1951. Estelle Brodman, born in New York, June 1, 1914, received her B.A. degree from Cornell, 340 MODERNIZING THE LIBRARY B.S., M.S., and Ph.D. from Columbia, and hon- orary D.Sc. from Illinois. She began her library career at Cornell and then moved to Columbia, where she was an instructor of Frank B. Rogers, at whose invitation she left New York and came to the National Library of Medicine as head of the Reference Division. From 1960 to 1961 she was also associate director for extramural plan- ning. Brodman left NLM to become librarian and professor of medical history at Washington University School of Medicine in 1961. She also taught at Catholic University, Keio University in Tokyo, and University of Missouri. She has served on several commissions, held office in societies, been president of the Medical Library Association, and was a member of the Presi- dent's National Advisory Commission on Li- braries. She has written two books, many arti- cles, and received the Marcia C. Noyes Award for Distinguished Librarianship and the Murray Gottlieb Award for Medical History. A curric- ulum vitae, other biographical information, and a tape recorded interview with Brodman are in HMD. 56 The Army Surgeon Generals Reference Library was set up during World War II. Estelle Brodman described it thus: "It was staffed by an old lady who had been mailroom clerk when she was put in charge of the collection (which was housed in whatever building the Surgeon- General's office was placed at the time); con- sequently the catalog was of an individualistic nature, to say the least; the collection was hap- hazard and unbalanced; the systems for circu- lation or fiscal accounting of the most primitive nature. The Library was placed under the Army Medical Library [in the spring of 1947] a year or two before I came to Washington and until the old lady retired (about 1950 or so) was only handled by weekly visits from the Chief of the Reference Division or someone designated by her as liaison, and by sending over duplicates of some medical books received at the main AML. When the old 'librarian' retired a regular li- brarian from the AML was assigned to the SGO Library and a real reorganization took place. The scope of the collection was changed to fit the needs of the officers at the SGO, books were purchased without regard to the main AML col- lection but cataloged by the Catalog Division at NLM. Gradually, especially under Mary Alice Jackson, a very nice, small medical library which gave good service amid comfortable surround- ings evolved. When AML became the NLM, control of that library was, of course returned to the Army." (letter, Brodman to W. Miles, April 12, 1979: NLM). The Air Force Surgeon General's Library was started and a librarian, Jacqueline L. Cham- bers, supplied by the AML in June 1950. This branch library was housed in the Pentagon. It was transferred from the Library to the Air Force on July 1, 1953. 57 Annual reports of the Library contain lists of the exhibits. Programs of some exhibits are in the Archival Collection. 58 This publication was first titled the Army Medical Library Newsletter and was mimeo- graphed on cheap, poor quality paper. In No- vember 1945 the title was changed to Army Medical Library News and was printed on better paper. 59 Correspondence, minutes of meetings, le- gal documents, and other records of the con- sultants are in MS/C/148. Information is also in the AML News, 1945-1952, and in the annual Proceedings of the association. Several of the proceedings were published in Bulletin of the Medical Library Association, two were pub- lished as pamphlets, and one was issued as a typescript. Articles by staff members and much information about the Library is tucked away in the proceedings. Complete bound volumes of the News and Proceedings are in the Aichival Collection. Officers of the consultants were: president, John Fulton, 1944-46, Chauncey Leak, 1947- 49, Wilbur Davison, 1950-52; vice president, Leake, 1944-46, Davison, 1946-49, Henry Viets, 1950-52; secretary/treasurer, Harold Jones, 1944- 47; treasurer, Jones, 1948-49, Robert Stecher, 1950-52; secretary, Joseph McNinch, 1948-49, Thomas Keyes, 1950-52; executive committee, Clyde Cummer, Wilbur Davison, Morris Fish- bein, Viets, Stecher, George Lull, Reginald Fitz, at various times. Lists of members are in the Proceedings for 1944, 1945, 1948, 1949. 60 Information on the Friends may be found in records of the organization, MS/C/158, and in the Armed Forces Medical Library News, financed by the Friends. Officers of the Friends were: chairman pro tern, Wilbur Davison, 1952; chairman, Henry Viets, 1952-54, Benjamin Spector, 1954-56; secretary/treasurer, Robert Stecher, 1952-54, Mrs. Breed Robinson, 1954-56; executive com- mittee, Edward Cushing, E. B. Krumbhaar, Atherton Seidell, 1952-54, Sanford Larkey, Tom Jones, Henry Viets, 1954-56. 341 xsx The Army Medical Library Becomes the National Library of Medicine The Museum Moves and the Library Occupies the Entire Building BY 1945 the Library had been divided among four buildings; the main building, Fisheries Building, Fisheries Annex, and Allen Library in Cleve- land. In the autumn of that year it seemed, for a time, that the Cleveland volumes could be brought back to Washington. The Librarian of Congress consented to house the material in the LC Annex for 5 years (when, it was assumed, a new AML building would be ready) if the Army Library would erect steel shelves in an empty annex deck. But the Architect of the Capitol ruled that the War Department did not have authority to pay for the stacks, the Library of Congress had no money to purchase them, so the annex space remained empty and the volumes remained in Cleveland.1 By 1947 the main building was again bulging with publications. This time space was obtained from the Library's old partner the museum, which the Medical Department moved temporarily into Chase Hall, a wartime barracks nearby on Independence Avenue. The Museum's offspring, the Armed Forces Institute of Pathology, continued to occupy a portion of the building for several years, but the Library now had room to expand. Director McNinch had the walls of Museum Hall painted, shelves erected, and then moved the Acqui- sition, Catalog, and Index-Catalogue Divisions into the area. Documents were moved from Fisheries Annex onto the Museum Hall balcony, and other col- lections were shifted around. In the autumn of 1948 the Library was permitted to use part of Tampa Hall, a temporary wartime structure across the street at 7th Street and Independence Avenue. Tampa's basement floor was concrete and could bear the weight of stacks, but the first and second floors were wooden and not designed to carry heavy loads. Book cases were placed around the perimeter of the rooms where the supports were strongest, but the floors shook when librarians walked. The flammability of the building also caused uneasiness. Another crisis over space was averted in 1950 when Cleveland Medical Library Association consented to extend for 5 years the lease on the rooms 343 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Old photograph of Museum Hall, crammed with exhibits of the Army Medical Museum. occupied by the History of Medicine Division. But soon HMD became over- saturated as Director Rogers shipped 20,000 monographs of the 1801-1850 period to Cleveland in order to reduce overcrowding in the main building. To make a place for the arrivals HMD withdrew more than 10,000 out-of-scope U.S. government documents from its collection and returned them to the issuing agencies or the United States Book Exchange. It also moved about 15,000 little-used items into a warehouse. When the second lease expired it was renewed for 5 more years by the library association. In 1952 government housing officials decided to move the National Park Service into Fisheries Annex and recompense the Library by permitting it to use Escanaba Hall, a temporary building at 9th and Independence. Collections had to be rearranged, some volumes being sent from Fisheries to Cleveland, some to Tampa Hall, and the 1850-1920 volumes to Escanaba Hall. Escanaba, like Tampa, was liable to the risks of fire, floor overloading, and poor security, but the Library utilized every bit of space and managed to shelve more than 110,000 volumes in the structure. Lack of space for publications, librarians, and readers was not the only thing wrong with the main building. Parts of the structure were wearing out, some from age and some from lack of proper maintenance, the latter resulting from insufficient appropriations. During heavy rain, water came in around windows, 344 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE Museum Hall about 1948, after the Museum had moved out and the catalog, acquisition, and index-catalogue divisions of the Library had moved in. accumulated in puddles on the floor, and caused paint to peel off the walls. It leaked through the skylights in Library Hall and dripped into wastebaskets and buckets placed around the floor and on tables. Tarpaulins had to be thrown over catalog cases, desks, and card files had to be moved, work was disrupted, and books and journals were damaged. Each range of stacks was protected by a roof of copper so that water leaking through the skylights would land on the roofs and run off onto the aisles instead of dripping on books. A drain in the concrete basement floor, over which a wooden floor had been laid, became clogged. Water 2 feet deep collected under the floor providing a breeding place for insects. Joists rotted until some 2 by 10s were reduced to 2 by 4's. The floor settled almost 2 inches before the damage was discovered and rectified.2 A downspout enclosed in the front wall corroded, allowing water to seep through the wall and raise and rot the floor in the Librarian's office. Finally all the downspouts in the walls had to be capped and replaced by exterior downspouts. Certain renovations were desirable to improve the original characteristics of the building. The ceiling of Library Hall was 47 feet high; therefore the 345 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE room was drafty and practically impossible to heat comfortably in the winter, although additional radiators were installed. Conversely, some rooms and stack areas became unbearably warm and humid in the summer. A few exhaust fans and window type air conditioners were installed in the 1950s. Originally there was no way to move books from the third or second tier of stacks to the main floor of Library Hall except by carrying them or using a small hand-pulled dumbwaiter. There was no way of moving book trucks from one floor to another. Volumes had to be carried up or downstairs from rooms or tiers to the interlibrary loan office, photoduplication office, loan desk, or other locations. The large increase in service rendered by the Library during the war made the slow movement of publications by manpower intolerable. As soon as conditions permitted, in the autumn of 1945 Director Gardner re- quested that an electric elevator be installed in the stack area. A short time later he asked that it be run to the basement where publications were received and dispatched. Not only would an elevator speed all services, but it would pay for itself in decreased personnel costs in a few years. After much discussion at various levels within the Public Buildings Administration, the Military Dis- trict of Washington, and the Corps of Engineers over the expense of the elevator Waste paper baskets and tarpaulins catching water leaking through the roof after a heavy rain on the night of March 25, 1953. 346 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE and the limited life of the old building, in the spring of 1946 the Library was promised an electrically controlled dumbwaiter and a new stairway. This did not satisfy the next Director, McNinch, and he renewed the pleas for an elevator. Permission was finally granted in 1947 and the elevator erected against the outer wall of Library Hall in 1948.3 The original gas lights had given way long ago to electric lights, but the combination of electric and natural lighting was not adequate in many areas. Flashlights were still used in the stacks in Library Hall until fluorescent lamps were installed. Desk lamps finally arrived in the 1950's. The building did not have a canteen or cafeteria. This was not owing to a gap in the original plans, for in the 1880's such facilities had not been placed in public buildings. Later, the interior became so crowded that no space could be spared for dining. The first canteen, operated by the Washington Society for the Blind, was installed in a small open space at the foot of the cellar stairs in 1948. The Library had the dubious distinction of being the only Federal building in Washington with an outhouse. In Billings' day it may have been thought desirable to place toilet facilities in a separate building but it was inconvenient, particularly in the winter. Toilet facilities were installed on the third floor of the main building in 1950, but the outhouse remained in use as long as the Library remained. In 1951 Congress appropriated funds to construct a building for the Armed Forces Institute of Pathology, which had remained when the museum departed. The Institute forecasted that it would move during the summer of 1954 and promised to bequeath all of its space in the old building to the Library. The Institute underestimated by only one-half year and started to transfer its equip- ment and furniture to its new building in February 1955. As the Institute departed Rogers began to have the entire structure reno- vated. Following a plan that had taken a year and a half to prepare, all collections and work units were relocated. Every volume in the Library, more than three- quarters of a million, pieces, was shifted. Four and nine-tenths shelf miles of serials were moved. One hundred and thirty thousand volumes were transferred from Escanaba Hall; fifty thousand from Tampa Hall. During the reshelving librarians discovered that the cast iron stacks in Library Hall were buckling from the immense weight of books that they had supported for two-thirds of a century. The stacks had to be shored up with channel steel beams. Finally after years of separation all book collections and work groups, except those in Cleveland, were reunited. Since 1942 the Library had been divided, incon- veniencing readers and librarians. Much money and time had been spent moving collections and divisions, money which could have been saved or used more profitably had a new building been erected for the Library as planned during the 1930's. Even after all the renovations of the mid-1950's had been completed, parts of the structure continued to break down. The worst water damage to publi- 347 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE A clogged drain dammed water to form this pool under the wooden floor in the basement. Astonished at the mess is Joseph McGroarty of the Library, center, and two employees of the Public Building Service. cations in the life of the structure occurred one rainy night in September 1957 when a drain pipe above the cellar stacks backed up and began to leak. The next morning Robert Austin entered the area and saw a torrent of water pouring over books of the 1801-1850 period.4 Employees rushed to move the books 348 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE and stacks, and carry more than 400 soaked volumes to the bindery, where other employees spent the day interleaving pages with paper towels while electric fans blew air over open books to evaporate the water. Books were even hung on clotheslines to dry. About 25 volumes were damaged so badly they could not be salvaged while others had to be repaired or rebound. Birds entered through holes in screens and unscreened windows and then flew wildly about Library Hall trying to escape. A starling was found down in the basement stack. Readers were amused by pigeons roosting and clucking on the card catalog. Bats were found hanging from pipes. An employee felt something on her shoulder, turned her head, and saw a bat perching there. Rats and mice found entrance to the building. In the winter of 1957 em- ployees discovered that rats were coming up through holes in the floor of the east basement stack area and nibbling starch-filled bindings of folios and foreign theses. Exterminators discovered that the rat holes went down beneath the foundation to the remnants of the old Tiber Creek. The Tiber, which had flowed from its source near the White House toward Capital Hill and along Canal Street to the Anacostia River, had been filled in early in the 19th century and the east end of the building had been erected near the bed of the ancient waterway. Windows fitted so loosely that cold air penetrated easily. During an unu- sually cold, blustery spell in the spring of 1958 Library Hall became so chilly that public service had to be suspended for a day, the first time on record. Dirty windows could not be washed conveniently because the wood frames were so deteriorated that they would not hold hooks from window washers' belts. Chunks of plaster fell from the ceiling of a room. As though to top off the deterioration, a cornice came loose and had to be removed before it fell and perhaps killed someone. New Name, New Parent, New Building While librarians were shifting collections around in the old building and its satellites, trying to make space for acquisitions and to allow persons to work comfortably and efficiently, the campaign for a new building was progressing slowly. Plans for the interior had been redrawn to accommodate the Library alone, as a result of Surgeon General Kirk's decision to provide a separate building for the museum and AFIP. In 1946 the Medical Department requested money for construction, but the military establishment, retrenching and re- organizing after the war, had problems more important than the AML, and the Surgeon General could not push his request through the upper levels of the Army.5 By 1947 the estimate of space needed in the proposed building had risen considerably over the 1941 estimate. Because of the skyrocketing cost of ma- terials, labor, and land, and the increase in size of the structure, the estimate of the cost of the land and the building reached $15 million, as compared with $4,750,000 in 1941. The director of service, supply and procurement in the 349 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Defense Department vetoed the Army's request for legislation to appropriate $15 million. Instead he pointed out that the Library was used much more by civilians than by military personnel and therefore ought not to be financed by military funds. He suggested that the Library be transferred to some other agency such as the Public Health Service or Library of Congress. The presence of a large research library in the armed forces began to perplex civilian officials who were trying to make the financial and business part of the military establishment as efficient as possible. The Library was a minor problem but only because its cost was small compared with the sums being spent on ships, planes, and other military items. The Library thus became the subject of study by several committees. The Commission on Medical and Hospital Services of the Armed Forces (frequently called the Hawley Commission after its chairman Major General Paul Hawley) considered the Library in 1948 and recommended, among other things, that it remain in the armed forces, be renamed the Armed Forces Medical Library, be budgeted for by the Army Department, and receive a new building. Off on the side the first Hoover Commission on Organization of the Executive Branch of the Government was recommending that the Library be transferred to the proposed Department of Health, Education, and Security (eventually established as the Department of Health, Education, and Welfare) and be given a new building. Director McNinch saw that one way out of the dilemma was to have the Army categorize the Library as a "civil function." The budget for the AML would then fall under the Department of the Army Civil Functions Appropri- ation Act rather than the Military Appropriations Act. Through 1947 and '48 the idea wended its way upward to the Secretary of the Army. In the summer of 1949 the Secretary of Defense adopted the idea by requesting the General Services Administration to include the building in that agency's legislative program.6 Within the Defense Department, Comptroller William J. McNeil had dis- agreed with the Hawley report and suggested that the library be transferred from the Army to the Federal Security Agency or, if that were not possible, that it be budgeted for by the Army as a civil function. McNeil's recommen- dation and the Hawley report were considered by the Medical Advisory Com- mittee to the Secretary of Defense. This committee, influenced by McNinch and Michael De Bakey, recommended that the Library remain in the Army as a civil function and be given a new building. The Library was also looked at by another group, the Defense Department's Management Committee, chaired by General Joseph McNarney, set up to find ways of reducing the department's budget. It was estimated that the Library was costing the Army approximately $1,180,000 a year, thus the committee's concern. In the summer of 1950 this committee suggested that the Library be transferred to the proposed Department of Health, Education, and Security or be placed in the Library of Congress or be set up as an independent agency under supervision of the Joint Congressional Committee on the Library. 350 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE The Medical Advisory Committee disagreed with the Management Com- mittee and set up a subcommittee on the Library. This subcommittee, com- posed of Edward Cushing, John Fulton, Henry Viets, Chauncey Leake, McNinch, and De Bakey recommended that the institution be made a civil function of the Defense Department and that the National Research Council's Division of Medical Sciences study the question. Secretary of Defense Louis Johnson agreed to the latter in the summer of 1950. By the spring of 1951 the NRC Committee on the Army Medical Library, chaired by George W. Corner, concluded, among other things, that the Library had become in the fullest sense the National Medical Library, it should continue under the military, have a governing board to direct its policy, and be given a new building.7 By this time, however, because of the Korean War and un- settled world conditions the Defense Department had to defer action on the Library. This was a period when officials were trying to unite military agencies. A proposal was made to place the Library under the aegis of the Navy, Air Force, and Army and have the directorship rotate among medical officers of the three services. While the proposal was being debated and moving forward, Rogers labored to persuade his superiors that it would be a step backward to rotate the directorship every few years instead of continuing the policy of having a permanent Director.8 His view on this point finally prevailed, and when Robert A. Lovett, the Secretary of Defense, signed a directive transforming the Army Medical Library into the Armed Forces Medical Library on March 4, 1952, there was no mention of rotation.9 The Library now had a new name.10 Henceforth the Director was to be an officer of the Army, Navy, or Air Force appointed by the Secretary of the Army with approval of the Secretary of Defense. It was to have ah advisory group composed of the Director, a representaative from each service, and up to five civilians appointed by the Director. And it was to have a civilian Librarian, appointed by the Director. Rogers continued on as Director of the renamed institution, Kanardy Taylor continued on as Librarian, and the advisory group was set up a few months later.n During these years when the Library's future was being discussed by high level officials, officers, and committees, the location of the proposed building was being debated anew. The possibility of an atom bomb attack on Washington in a future war caused civil defense planners to object to the erection of new government buildings in the center of town. In addition a building on the perimeter of the town would cost perhaps $2 million less than a building on Capitol Hill, displace fewer persons and businesses, cause no demolition of houses, not contribute to traffic congestion, and allow free parking of auto- mobiles. Director McNinch opposed a site on Capitol Hill because he feared that the Library of Congress would eventually absorb the AML if it were placed there. He came to favor Bethesda where the large Naval Medical Center and expanding National Institutes of Health were close together on opposite sides 351 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE of Wisconsin Avenue.12 On the other hand some other Army officers opposed Bethesda because they felt that if the building were erected there, the Library would be absorbed by the Navy or Public Health Service. Many officers and civilians preferred a site at Walter Reed, but as time passed more and more of them came to favor Bethesda. By 1949 Surgeon General Raymond Bliss had decided on Bethesda. In March 1953 Secretary of Defense Charles Wilson told the Secretary of the Navy to plan, budget for, and construct the building at the Naval Medical Center. The Navy gave Commander John A. Oley the task of preparing plans for the building and stationed him at the Library in April 1953 as a special assistant to Rogers. After attending a summer course in medical librarianship at Emory University and visiting several new library buildings throughout the country, Oley began to chart the flow of operations in the AML, survey all jobs, estimate the space that would be required in the future, and draft diagrammatic plans. Rogers thought his plans were excellent and showed them to Keyes Metcalf, the AFML's consultant and one of the most knowledgeable persons in the United States in regard to library structures. Metcalf said of them: "I think these are one of the best statements of requirements for a library building that I've ever seen." The Navy used Oley's data in making sketches and estimating the cost of the building.13 Commander Oley retired in September 1955. The following year Robert W. Severance, formerly librarian at Baylor and more recently deputy director of the Army Library, came to AFML as Rogers' assistant to do further work on the plans, act as liaison with architects and contractors, draw up a list of equipment for the new structure, and plan the move. In the summer of 1955 Congress appropriated $350,000 for the preparation of plans and specifications of the building.14 Later that year Wilson reviewed the apportionments of appropriated funds and decided that, because of the size of the defense budget and need for funds elsewhere, the Library would have to be deferred again. Therefore the $350,000 was not spent. By this time many members of the staff had given up hope of ever seeing a new Library. They had been disappointed so many times that they had come to feel that they would work forever in the old, grimy, run-down structure. The Director's spirits may have been lowest on the day Major General Elbert DeCoursey, who had obtained his building for the AFIP, sat along side of Rogers on a Pentagon bus and remarked sadly, "Rogers, you're never going to get that building, you're never going to get it."15 Meanwhile earlier in February 1955 the Task Force on Federal Medical Services of the second Hoover Commission released a report recommending that the Armed Forces Medical Library be designated the National Library of Medicine and be transferred to the Smithsonian Institution as a semiauton- omous agency with an adequate budget and building.16 The Defense Depart- ment and Bureau of the Butget opposed transfer to the Smithsonian because 352 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE President John F. Kennedy greeting members of the Second International Congress on Medi- cal Librarianship, Washington, DC, 1963. funds had been appropriated for plans and they doubted the wisdom of placing the Library within the Smithsonian group. Nevertheless the plan appealed to some congressmen. Senators Joseph McCarthy and H. Alexander Smith, along with three representatives, introduced identical bills between June 20 and July 21 to implement the task force proposal. Thus in the summer of 1955 the Library's future was proceeding along two lines, one stemming from the Hoover Commission aimed at converting the Library into a semi-independent agency within the Smithsonian Institution, the other, from the Defense Department, intending to retain the Library in the armed forces with a new building at Naval Medical Center. At this juncture Senators Lister Hill and John Kennedy, both influential in health legislation, became interested in the Library. In September members of their staffs began to develop legislation that would unite the Library with the medical exhibits of the Smithsonian into an independent agency to be named "The National Library and Museum of Health." Director Rogers received a draft of the bill in early 1956. He opposed it for several reasons. He felt that the proposed Library-museum would have a difficult time as an independent agency (as, for example, the National Archives had before it was absorbed into the Federal Security Agency); the museum ought to be the subject of separate legislation, and the best course \vcy*kl be to attach the Library to the Public Health Service and give it a buildiflrg~on the NIH grounds in Bethesda. The bill was rewritten and introduced by Senator Hill on March 13, 1956. Under the terms of the bill the Library would become an independent agency named the National Library of Medicine governed by a Board of Regents 353 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE composed of the 4 Surgeons General, the Librarian of Congress, and 12 other knowledgeable individuals appointed by the President. The Board would have the responsibility of acquiring a site, erecting a building, advising the Director, and carrying out other duties.17 Several years previously Surgeon General Leonard Scheele of the Public Health Service had been asked if his organization would harbor the Library. Scheele was enthusiastic about the idea but laid down the policy that the service would accept, not fight for, the institution. Between 1949 and 1955 the majority of Army officials wrestling with the problem of the Library came to favor the PHS as the Library's new home if the Army were to relinquish it. Even before the Hill-Kennedy bill was introduced sentiment was swinging from the Library as an independent agency toward the Library as a PHS agency. Senator Hill preferred that the Library be independent but was willing to see it enter the PHS. Scheele obtained permission from the Secretary of HEW to bid for the Library and directed his staff to draft a bill for the purpose.18 The bill was well received. Rogers, after considering it, preferred the placement of the Library in the PHS to other alternatives. In hearings on the Hill-Kennedy, McCarthy, and Smith bills before the Senate Subcommittee on Health, April 10 and 11, 1956, Scheele presented a strong case for the PHS, reinforced by arguments from the Bureau of the Budget and prominent medical librarians. On the other hand Leonard Carmichael of the Smithsonian gave reasons why his Institution did not want the Library. During the following month the committee redrafted the Hill-Kennedy bill to transfer the Library to the PHS, and on June 11 the Senate passed the measure. The bill specified that the building be erected in or near the District of Columbia. Earlier an editorial writer in the Chicago Sunday Tribune had praised Hill and Kennedy's efforts to assist the Library and had suggested that the building be erected in Chicago where there were universities, fine libraries, five medical schools, plus the headquarters of the American Medical Association and several other medical societies.19 This started a campaign by civic leaders and physicians to persuade Congress to place the Library in that city. Chicago newspapers ran editorials calling their town the Nation's number one medical center. Mayor Richard Daley appointed a 19-person National Medical Library Committee. Chicago's Medical Center Commission offered, free, 9 acres of ground valued at $500,000 for the site. Chicago's council passed a resolution endorsing the campaign. Eleven representatives and one senator from Illinois introduced bills identical to the Hill-Kennedy bill except that they ^notified Chicago as the Library's new home.20 On June 19 the bill introduced by Illinois Representative O'Brien was the subject of hearings by the House Administration Committee. Mayor Daley, Senator Paul Douglas, Morris Fishbein, and 16 other prominent Chicagoans traveled to Washington and argued persuasively for their town. Thirteen phy- sicians, librarians, educators and administrators appeared a few days later in favor of the Washington area. 354 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE The House Committee voted to take no action on the O'Brien bill, and thus on its companion bills. This paved the way for the House to take up the Hill- Kennedy bill introduced by Representative Percy Priest.21 The House Com- mittee on Interstate and Foreign Commerce, to whom the Priest bill was referred, avoided a fight over the site by removing the words "in or near the District of Columbia" from the bill and leaving the selection to the proposed Board of Regents. The House passed the measure on July 23. The Senate agreed to the House amendments, and President Eisenhower approved the bill on August 3. The armed forces had supported the Library to the best of its ability, but the military's primary job was the defense of the United States and it needed the funds it could obtain from Congress for guns, ammunition, food, pay, and everything else required by the infantry, artillery, air force, and other units. It was probable that the Army would never have been able to pass along sufficient funds to enable the Library to rise to its full potential as the Nation's medical library and center of biomedical communications. The act of 1956 raised the status of the institution from that of a departmental to that of a national library, it reinforced the Library's management by the addition of a knowl- edgeable, influential Board of Regents; but most importantly it moved the institution into the mainstream of American medicine by placing it in the Nation's primary health organization, the Public Health Service. There the Library rounded out research, prevention of disease, and all the other health- related activities of the service. During the years when the future of the Library was being debated by civilian and military committees and officials, McNinch and Rogers were aided by a number of prestigious physicians, men who knew from experience how valuable the Library was to the medical profession and who believed that it should be enlarged, given greater support, and be housed in a modern building. They had served on committees and subcommittees, acted as consultants and advisors, and they championed the cause of the AML in meetings where the Library seemed of relative unimportance compared with other items. Among the most active were John Fulton, Chauncey Leake, Michael De Bakey, Worth Daniels, and Alan Gregg. De Bakey supported the Library in committees and the Hoover Commission. Daniels swayed congressmen, including Represent- ative Percy Priest, to vote for the institution. Alan Gregg of the Rockefeller Foundation worked quietly behind the scenes. The assistance rendered by these persons is immeasurable but was significant. After the act was passed the Bureau of the Budget and Department of Defense arranged to transfer the Library's property, funds and personnel from the Army to the Public Health Service. On October 1, 1956, the Armed Forces Medical Library became the National Library of Medicine, approximately 80 years after John Shaw Billings began calling it by that name. In the months that followed President Eisenhower appointed regents. The Board held its first meeting on March 20, 1957. The chief topic was the selection 355 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE of a site for the building. The majority of regents favored the Washington area, and they spent half a day considering 10 locations that had been suggested including Capitol Hill, the Mall, Naval Medical Center, Soldiers Home, Naval Observatory, and National Institutes of Health.22 During the second meeting, April 29, the members visited proposed sites, discussed and rejected the Chi- cago offer, and voted for a site on the old Glenbrook Golf Course located on the southeast corner of the campus of the National Institutes of Health.23 Construction of the Bethesda Building Neither the President nor the House had requested funds to erect a new building, and for a time it seemed that the planning that had been going on for 40 years would continue indefinitely.24 But Senator Hill, chairman of the subcommittee responsible for the Library, convinced the full Senate Appro- priations Committee to add $6,950,000 to the Department of Health, Educa- tion, and Welfare's appropriation.25 Congress agreed to the amendment. Pres- ident Eisenhower signed the act on August 1, 1958.26 The Second Supplemental Appropriation Act of 1956 had appropriated $350,000.27 Therefore $7,300,000 was now available to plan, construct, and equip a new building. Under contract the New York firm of Robert B. O'Connor and Walter H. Kilham, which had designed library buildings for Princeton, Colgate, Louis- ville, and other schools, recommended that new plans based on Oley's state- ment of requirements be prepared. The firm estimated the cost of a building as $8,774,000 compared with the 1955 cost of $5,150,000. The Bureau of the Budget was unhappy with the increase in cost; it wanted the cafeteria and an auditorium to be deleted from the plans, and it urged that the structure be placed closer to existing NIH buildings. The Bureau limited the cost to $7,300,000 and reduced the planned area to 230,000 square feet of space, but it later withdrew its objections to the location of the building and to the inclusion of a small cafeteria. On June 24, 1957, the General Services Administration contracted with O'Connor and Kilham to develop preliminary plans for the building. The Public Building Service approved the plans on January 30, 1958, but the Bureau of Budget objected because the floor area was 5,000 square feet larger then the approved figure. The Bureau finally compromised at 232,200 square feet. The architects reached this footage by transferring mechanical equipment from the mezzanine to C level, shortening the bay module in one dimension from 21' 4" to 21' 1", and by eliminating areas of the mezzanine to the north and south cantilevered over the hall below. Through 1958 plans were developed, many staff members presenting sug- gestions that were used. Keyes Metcalf gave advice. Bids were accepted for contracts in 1959, the Arthur Venneri Company being the lowest of 17 con- struction bidders at $4,370,000.M During the afternoon of sunny, warm June 12, 1959, a groundbreaking ceremony was held on the site to mark the start of construction. Senator Hill 356 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE Senator Lister Hill shovels the first spadeful of earth at the groundbreaking ceremony for the new Library building, June 12, 1959. Looking on, from left, are Surgeon General Leroy Burney, chairman of the Board of Regents Champ Lyons, Congressman Melvin R. Laird, and Arthur Flemming, Secretary of the Department of Health, Education, and Welfare. dug the first earth while former Surgeon General Leroy Burney, Representative Melvin R. Laird, Senator Gordon Allott, Secretary Arthur S. Flemming, and other distinguished persons looked on. A few days later on June 17 machines and men began to excavate in earnest. The digging went well until September when the excavators unexpectedly encountered hard rock. The rock formation had to be blasted, which increased the cost by almost $200,000, infuriated neighbors who claimed their homes were being damaged by shock waves, and slowed the work. Unusually cold, snowy, winter weather delayed the work further. By mid-1960 construction was 4 to 5 months behind schedule, and the contractor began employing two shifts of men to speed the job. By December 1961 the building was about 90 percent completed. Stacks were being installed in one level and the other two levels were almost finished. On the afternoon of the 14th of the month, dedication ceremonies were held in the main reading room. Secretary Abraham Ribicoff and Senator Hill spoke, 357 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Main reading room, shortly after the Bethesda building opened. and Greek Ambassador Alexis S. Liatis presented a cutting from the plane tree on the Island of Cos, the tree under which, according to tradition, Hippocrates taught students.29 More than 1,200 guests attended the dedication. Letters and telegrams of congratulations came from all over the world. The following morn- ing a special symposium, "Books and Medicine," was held. When completed, the building sat on a knoll facing the main traffic tho- roughfare, Wisconsin Avenue. Measuring 276 by 192 feet, constructed of rein- forced concrete faced with limestone, the structure was topped by a roof having an eye-catching hyperbolic paraboloid form. Within was 231,560 square feet of floor space, and a quarter million linear feet of space for shelves with an ultimate capacity of 1.5 million volumes. Half of the structure was below ground, a precaution against the kind of atom bomb attack envisioned by civil defense planners of the 1950's. The defensive planning led to the insertion of narrow, recessed windows on the main floor and a secondary use of the building as an air raid shelter. Containers of food, medical kits, and other civil defense emer- gency supplies were stored against the walls on the lower levels for many years. The top floor, the mezzanine, contained offices. The main floor held reading rooms, the card catalog, the history of medicine reading room and offices, and 358 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE Public card catalog area. The mural around the mezzanine was the work of Frans Wildenhain. A model of a section of a deoxyribonucleic acid is on ex- hibition . large rooms for indexers, catalogers, and reference librarians. The bottom three levels, underground, provided stack and work space.30 The Library Moves to Bethesda While the building was being constructed two staff members, Ray W. Grim and William H. Kurth, were planning the movement of literature, furniture, and equipment from the main building, the temporary buildings, and the Allen Memorial Library in Cleveland. They identified furniture and equipment to be retained and pieces to be discarded; figured out special handling procedures for certain items; selected and ordered new equipment; drew sketches of floors of the new building showing phones, power sources, and placement of furniture for use of movers; notified the book trade and library profession of the coming change in address; instructed staff members who would participate in the move; determined the order of priority for moving sections of the Library in such a way that operations would be disrupted as little as possible; and tried to foresee every other thing that would have to be done.31 A survey indicated that the degree of insect infestation in the building was low, particularly considering the age of the structure, but to kill any bugs that might otherwise be moved with the books a team of exterminators visited the 359 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Library on three successive Friday evenings and sprayed insecticide mainly in the basement. When the move began the books on book trucks on the loading dock were dusted with low pressure compressed air before being placed in moving vans. Ten firms looked through the old building and then submitted bids to move the Library to Bethesda; Davidson Transfer and Storage Company's was the lowest. Davidson trucks begain to transport books on March 3, 1962. In Cleve- land the History of Medicine Division, separated from the Library for 20 years, was loaded into four vans and driven to Bethesda, guarded by a Pinkerton detective in each cab and insured in transit by Lloyd's of London for $6 million. On April 6, halfway through the move, the building was turned over to the government, and the first staff members moved in. Hundreds of minor and a few major deficiencies were being corrected, and breakdowns expected in any new large building occurred. Two of the three elevators stopped running. Heat stopped flowing to one section of the building during cold weather, forcing librarians to wear overcoats. Filing cabinets for the Director's office were a sixteenth of an inch too large to fit into their allotted space. Despite precautions, pieces of ancient furniture from the old building turned up, some of it of unidentifiable use. On the whole the move proceeded very well, and the doors were opened to the public on the morning of April 16. The last book was removed from the old building on the Mall at 12:17 p.m. on May 3 and shelved in Bethesda by Rogers at 5 p.m. It had taken 60 days to move the largest medical library in America, but so well had the transfer been planned that scarcely any interruption occurred in service. Death of the Building on the Mall After the Library moved, a decision was made to preserve the building. It was one of the oldest structures in the country designed specifically as a Library and museum; the country's first true postgraduate medical school was estab- lished there in 1893; many famous scientists had researched there (Walter Reed and James Carroll on yellow fever, Frederick Russell on typhoid vaccine, George Callender on wound ballistics, to name a few); many noted librarians and scholars had labored there; many great bibliographies had been born there. The General Services Administration rehabilitated the structure. The Armed Forces Institute of Pathology, now in its own building at Walter Reed, planned to install some of its histopathology laboratories. In 1962 the museum moved back after being lodged in temporary structures for 15 years. The museum had always attracted tourists and after it returned to its old home it was visited by hundreds of thousands of persons annually. In 1964 the National Survey of Historic Sites and Buildings studied the building and, upon its recommendation, the Secretary of the Interior approved it as a Registered National Historic Landmark.32 It was described as "a massive structure, carefully designed and executed. Tasteful terra cotta ornamentation helped to make the building attractive as well as useful." Along with the Wood- 360 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE Reading room of the History of Medicine Division. On the right is the glass- enclosed incunabula room. row Wilson House, Clara Barton House, and Naval Observatory, it was one of eight structures in the Washington area in the National Landmark Registry. But hardly had the museum settled down when President and Mrs. Johnson persuaded Joseph H. Hirshhorn to give his collection of sculpture and paintings to the United States. The Smithsonian Institution, under whose umbrella the collection would be placed, wanted the site upon which the museum stood for the Hirshhorn Museum, and it wanted the medical museum collection. S. Dillon Ripley, secretary of the Smithsonian, told a House committee: "[the building] is not in my estimation a distinguished architectural edifice, though it may have sentimental value."33 Voices were raised in protest against the destruction of the building. Ken- neth M. Brinkhous, professor of pathology at the University of North Carolina, testified in a Senate hearing: "I have great respect for history, and where important things are done ... It was a good example of the late last century governmental buildings and for what was done in it I think it ought to be preserved. ..." Frank M. Townsend, former director of the Armed Forces Institute of Pathology, said: "... I can't understand why the Smithsonian Institution insists on this exact side on the Mall for the Hirshhorn Museum. There is more space on the Mall than is necessary for both these buildings . . . we need not destroy a national historic landmark in order to provide for a new museum. ..." Elbert DeCoursey, another former director of the Institute of Pathology, remarked in a House hearing: ". . . as a physician I am a humanist also, and I hate to see this building a historical site one year and the next year 361 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE see it torn down." Senator Daniel K. Inouye noted: ". . we have been re- ceiving a lot of letters from constituents for and against and most of the letters opposing the establishment of the Hirshhorn Museum at this location have come from people who are sympathetic with the medical profession and sug- gesting that one of the major reasons for not moving [the medical museum] is that this present AFIP is a historical landmark."34 The forces that desired the land for the location of the Hirshhorn Museum were too strong, and the decision was made to raze the structure. On the evening of October 4, 1968, the Medical Department began a ceremonial closing of the building. After listening to speeches and music the guests took a final stroll through the rooms. At 10 o'clock the muffled drums of the United States Marine Band echoed throughout the building and the drum major led a procession down the stairs to the front door. As the strains of Auld Lang Syne filled the halls the curator locked the door to the public for the last time. Notes 1 Information on buildings used by the Li- brary may be found in: Space Information, Old Building Restoration, and other files in MS/C/ 309; Army Medical Library News; Henry, Armed Forces Institute of Pathology; annual reports of the Library; reports of U. S. Army Inspector General filed in HMD. 2 Information on repairs and renovations may be found in Army Medical Library News, Army Medical Library Bulletin, and annual reports of the Library. Employees, among them Howard P. Drew, Jr., Stella Schehl, and Joseph Mc- Groarty, also provided information. 3 File Elevator Project History: MS/C/309. 4 Robert Burdette Austin was born in Sher- idan, Wyo., Nov. 10, 1905. He attended at var- ious times George Washington University, Co- lumbia University School of Law, and Western Reserve University School of Library Science. He came to the Library in September 1928 and served in various capacities until September 1961. Thereafter he was associate librarian at Wash- ington University School of Medicine until Oc- tober 1967 and administrative assistant at the Francis A. Countway Library of Medicine, No- vember 1967 to September 1968. In the 1940's Austin became interested in early American medical publications. He slowly and laboriously compiled bibliographical information on those that appeared before 1820. His useful, author- itative book on the subject, Early American Medical Imprints: A Guide for Works Printed in the United States, 1668-1820, was published in 1961. 5 Documents providing information on the proposed Library building, 1945 onward, are in MS/C/309, MS/C/47, MS/C/345 and MS/C/205. See also records Hon. Consultants and records Advisory Group. 6 Chronology of correspondence regarding civil functions for AML, May 1947 to 1950: file Transfer of AML: MS/C/309. 7 Report of NRC Comm. to Secretary of Defense, May 25, 1951. 8 Correspondence in NLM, including memo, Rogers to Gen. Hays, sub., Plans for the Armed Forces Medical Library, Oct. 30, 1951. Former Director McNinch, now stationed in Japan, opposed the plan of rotating the di- rectorship. He believed so strongly that the best course for the Library was to continue under a permanent director, Rogers, that he offered to return to the United States to argue against the proposal. See notes by McNinch: NLM. 9 DOD Directive 20.33-3, May 4, 1952: copy in AML News, April 1952. 10 The date was May 9, 1952, when DA Gen- eral Order 49 redesignated the Army Medical Library as the Armed Forces Medical Library. 11 Papers and Proceedings of the Armed Forces Medical Library Advisory Group, 1952- 1956: copy in Archival Collection. 12 For Director McNinch's views favoring a location in Bethesda see letter, McNinch to M. Cummings, Mar. 5, 1974, and notes by Mc- Ninch in NLM. 13 Oley, "Basic Elements in the Planning of a New Building for the Armed Forces Medical Library," Bull. Med. Lib. Assoc. 42:454-7 (1954). See also annual reports of the Library regarding 362 THE ARMY MEDICAL LIBRARY BECOMES THE NATIONAL LIBRARY OF MEDICINE Oley's activities. Sketches of the proposed new building based on Oley's work are in NLM. 14 84th Cong., P.L. 219, Aug. 4, 1955. 15 Tape-recorded autobiography of Rogers: NLM. 16 Report is reprinted in 84th Cong., 2d sess., Hearings before the Subcommittee on Health . . . on S.3430, pp. 52-54; also in minutes of meeting of AFML advisory group, Oct. 28, 1955. 17 84th Cong., 2d sess., bill S.3430, "To pro- mote the progress of Medicine and to advance the national health and welfare by creating a National Library of Medicine." The composition of the Board was changed slightly as the measure progressed. 18 Committee Print, Proposed Legislation on the National Library of Medicine, May 18, 1956. Committee Print No. 2, May 22: Hearings be- fore the Subcommittee on Health ... on S.3430, pp. 28-31. 19 Editorial, "A medical treasury threat- ened," Apr. 1, 1956. 20 Copies of many Chicago newspaper clip- pings are in NLM. : 84th Cong., 2d sess., Bill H.R. 11524, in- troduced May 29. See Theodore G. Klumpp, "How Congress Almost Aborted the National Library of Medicine," Med. Times 101: 40-51 (December 1973). 22 Information of the Regents' meetings is from the Minutes: copies in Archival Collection. 23 The golf course was owned by NIH but operated by Montgomery County. It remained open until Mar. 31, 1959. 24 The progress of the planning, construc- tion, and equipping of the building may be traced through minutes of staff conferences, MS/C/295; minutes of the Board of Regents; NLM News; NLM Bulletin; annual reports of the Library. 25 Senate Report No. 1719, pp. 37-8. H.R. Bill 11645, p. 33. 26 P.L. 85-580. 27 P.L. 84-219, Aug. 4, 1955. 28 It was said that Arthur Venneri spent much time personally overseeing construction of the building, was proud of the results, and regarded it as his monument in the Nation's capital. 29 The tree was planted in a brief ceremony near the Library on May 11, 1962. 30 Building Data and Floor plan, National Library of Medicine: PHS pamphlet, (1961). Foster E. Mohrhardt, "A Building for the Na- tional Library of Medicine," Libri 12: 235-9 (1962), lists several articles about the structure. 31 Kurth and Grim wrote a book to assist others who would need advice in like situations: Moving a Library (1966). 32 Letter, A. Clark Stratton, Acting Dir., Nat. Park Service, to Stephen Ailes, Secretary of the Army, Jan. 14, 1965: copy at AMM. 33 House of Representatives, Report of Pro- ceedings, Hearings before Subcommittee on Public Buildings and Grounds, H.R. 15121, H.R. 15122, H.R. 15123, H.R. 15312 to provide for the establishment of the Joseph H. Hirshhorn Museum and Sculpture Garden, and for other purposes. June 5, 1966. Copy at AMM. The team of librarians who examined the Library in 1943 noted; "The fact that the build- ing has been in use for over fifty-six years is ample indication that it was well-planned for its time. As far as the surveyors can learn, no other great research library in the United States still occupies a building completed as early as 1887 and not materially added to since": Keyes D. Metcalf, et al., The National Medical Library: Report of a Survey of the Army Medical Li- brary, p. 5. "Dr. Billings must have had a good deal to do with the planning and should be given credit for the basic strong points which characterize the building. Today, 73 years after construction, it is the oldest library building housing a great research collection in the United States. The University of Pennsylvania Library was com- pleted four years later, early in 1891; it is now being replaced by a new library. The Cornell University Library was completed in October, 1891; a new central library for Cornell is now under construction, and the old building after gutting and complete rebuilding, except for the sturdy stone walls, will be retained as an un- dergraduate library. The Newberry Library, the fourth oldest, was completed late in 1893, and detailed studies are now being made in regard to its future. In many ways the Army Medical Library was a better planned building than either of the university libraries listed." Keyes D. Metcalf, "Housing the Library," Bull. Med. Lib. Ass. 49:379 (1961). 34 Joseph H. Hirshhorn Museum and Sculp- ture Garden. Hearings before the Subcommit- tee on Public Buildings and Grounds, United States Senate, 89th Congress, Second Session, on S.3389, a Bill to provide for the establish- ment of the Joseph H. Hirshhorn Museum and Sculpture Garden. June 3, 1966. 363 Evolution of Computerized Bibliographies WHEN Billings began to develop the Index-Catalogue in the 1870's he unwittingly converted the Library into a publishing house, half or more of whose employees would spend their working hours year after year preparing annual bibliographies. The manual indexing, arranging, and editing for the Catalogue continued for seven decades, diverting the staff from other important library operations. Not until the 1940's did the situation change as directors and editors seized new techniques for processing and transmitting information. Development of a Mechanized System for Producing the Library's Publications The repetitive sorting, filing, and photographing that occurred every month during the production of Current List of Medical Literature suggested that much of the work could be done by machines. During the 1950's as the number of journal articles continually increased, straining the facilities of the Library to publish Current List, editor Seymour Taine had many discussions with Director Rogers about the possibility of mechanizing the operation. He ex- amined equipment being used by business firms and government agencies to process data and concluded that the methods and machines could be applied in the Library. He drew up a plan to abandon the "shingling" procedure for producing the List in favor of punched cards which could be sorted by machines and photographed by an automatic high-speed camera to make a photo-offset negative. Since the system would be made up of data processing equipment, Rogers and Taine hoped that it could also be used for the selective retrieval of bibliographical data.* Rogers was unable to obtain appropriated funds to buy or rent machines, but at a meeting of the Board of Regents members suggested that he apply for a grant from the Council on Library Resources. Rogers did this, and on April 16, 1958, the council allotted $73,800 for the Library to undertake the work.2 In order to understand more fully the potentialities of available equipment Taine and other staff members attended courses on data processing at the International Business Machines school in Endicott, New York. A room in the Library building was soundproofed, air-conditioned, and otherwise prepared to accommodate equipment. Consultants were engaged to assist. An advisory 365 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Listomatic Camera photographing citations for Index Medicus being oper- ated by Tyrone Ferguson, right. Pages being spliced together by Donald Dod- son, left. committee was appointed. Various tape operated typewriters, tabulating equip- ment, and other machines were evaluated for use, and the most satisfactory were ordered. The heart of the system was to be an Eastman Kodak Listomatic camera capable of photographing 230 punched cards a minute while adjusting its aperture to accommodate one, two, or three lines of text imprinted across the top of the cards. Early in the experiment it was decided that the arrangement of citations in Current List would be changed. The grouping together of titles of all articles in a journal was almost a necessity for the "shingle" method of production, but here it would be preferable to place one complete citation on each punched card. The final publication would contain two sections; one would list citations under subject headings in alphabetical order, the other would list authors in alphabetical order. There were a number of possible ways of arranging the flow of work, and much thought went into the development of the best system. Finally Taine settled on seven stages, starting with an indexer who scanned articles, translated foreign language titles, assigned subjects and subheadings, and typed this in- formation on a form; an indexing assistant who added authors' names, other bibliographical information, and machine codes to the form; an input typist who turned out a proof copy and a coded punched paper tape; a key-puncher who punched subject and author cards; and an operator who ran tapes and cards through output typewriters to produce imprinted cards. The cards were sorted and interfiled by machines, then collated with cards bearing headings, subheadings, and cross-references. After corrections were made, the deck was 366 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES interfiled with a "program" deck containing the page numbers of the pages to be printed and other information. This complete deck was run through the camera, the film developed, cut into columns, the columns taped together into pages, and the pages sent to the printing firm. Through the spring of 1959 Taine and his associates perfected the mecha- nized system, adjusting one part or another, replacing inferior components by better, removing bottlenecks and improving procedures. In May 1959 citations for the fourth volume of the Bibliography of Medical Reviews were typed on cards and filmed as a test of the new system. The published work, received from the printer in August, was quite satisfactory. The team then began to index for the first number of Current List to be published by the new system.3 While Rogers and Taine were happy with the success of the new publication system they were disappointed because it was not practical as a retrieval system. The fastest machine obtainable could sort 1,000 cards a minute. At that rate it would take 12 Vfe hours to sort a 5-year accumulation of 750,000 cards, much too slow. Also, there were risks that the massive decks of cards might be mixed if they were disturbed before cumulation. Before the Library had the opportunity to publish the first issue of Current List using the new system, the List metamorphosed into the Index Medicus. The transformation came about this way. Since 1950 Rogers had sought to find a way in which the Library and the American Medical Association could co- operate in publishing bibliographies. The Library's Current List and the AMA's Quarterly Cumulative Index Medicus together indexed about one-half of the world's medical literature, but they overlapped, so that about one-third of the citations in the List were duplicated in the Index. One of Rogers' suggestions to the AMA had been to divide the indexing of the world's literature with the Library, the AMA indexing all publications from the Western Hemisphere and the Library indexing everything from the rest of the world. Another suggestion was that the Library index all articles in foreign languages, the AMA all those in English. For various reasons none of the proposed methods of cooperation was acceptable. After the mechanization experiment began Rogers saw another way by which the two organizations could cooperate. The Library could prepare the monthly index and the AMA could produce the annual cumulation. Every December the Library could alphabetize its accumulation of cards, photograph them, and send the film to Chicago, where the AMA could use it to publish the cumulation. The Library would benefit by not having to publish a cumulated volume, the AMA would benefit by not having to publish monthly volumes, libraries would benefit by having to purchase, handle, and shelve only one index instead of two, and readers would benefit by having to scan one index instead of two. In June 1959 the AMA board of trustees and house of delegates endorsed the plan. The following month the Public Health Service and AMA signed an agreement under which the Library would publish a monthly bibliography, named Index Medicus, superseding the Current List and Quarterly Cumulative 367 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Index Medicus, while the AMA would publish an annual volume titled Cu- mulated Index Medicus.4 The first number of the new Index Medicus appeared almost on schedule in late January 1960. Through the year the monthly issues became larger and more current as the team became more skillful in operating the mechanical equipment. By early January 1961 the cards from the monthly batches had been cumulated, interfiled, photographed, and the film shipped to Chicago. Some portions of the film were found to be defective and the work had to be done over, but even at that the three-volume Cumulated Index Medicus cov- ering the year 1960 came from the AMA presses in April 1961. MEDLARS During the 3-year period in which Taine, Rogers, and their associates were using data processing equipment to prepare Index Medicus, they learned much about an alternative means of storing and retrieving information then being developed and installed in government agencies and business firms, namely the first generation of commercial electronic computers. Even before the mech- anization project proved itself, Rogers was familiarizing himself with computers by reading, talking to experts, and attending courses in symbolic logic, com- puter operations, and related subjects at the Department of Agriculture Grad- uate School. While computers held the promise of filling the Library's needs, they were expensive in relation to the Library's funds (NLM's appropriation was approx- imately $1.5 million in 1960). But it so happened at this time that the Council of NIH's National Heart Institute had become concerned over the problem of bibliography in the field of cardiovascular diseases. A subcommittee of the Council studied the matter. There were vigorous debates in the Council about the methods of gaining control over the literature. James Watt, director of the Institute, and Rogers had several discussions about the possibility of using a computer to store and retrieve information. The Heart Council decided that computer retrieval of information was feasible and that it had the authority to support the development of a computerized bibliographic system in the Library. They offered to finance the work if, in return, NLM would give some priority to literature on cardiovascular diseases when the system was completed. In November 1960 the Library engaged an analyst to draw up specifications for a system that Rogers and Taine named MEDLARS, the acronym for medical literature analysis and retrieval system.5 The preliminary specifications were so unsatisfactory that Rogers discarded them and, with Taine, rewrote them. The heart of MEDLARS was to be a digital computer. Information representing the indexing done by the staff was to be fed into the system, converted to magnetic tape, and manipulated in the computer. The processed magnetic tape would be used to activate a high-speed composing device capable of producing photographic masters for printing Index-Medicus and other publications. 368 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES NLM desired a system that would permit an increase in the number of journals indexed in Index Medicus, reduce the time required to prepare the monthly issues of 1M from 22 to 5 days, produce for publication bibliographies similar to IM in format devoted to special fields, permit a search of the data base and retrieval of bibliographies for patrons upon request, include citations from books and other nonjournal sources, and reduce the need for duplicate literature screening operations at other libraries and information centers. The development of MEDLARS was planned to take place in three phases, each under a separate contract. During phase I the contractor would make a preliminary design of the system, evaluate equipment available on the market, and select the equipment. In phase II all the engineering would be completed to ready the system for operation, major programs would be written for the computer, final specifications for equipment would be written, and operators would be trained. During phase III, which would overlap phase II, equipment would be ordered and installed. The entire system was to be ready for operation in the fall of 1963. In February 1961 NLM sent invitations to bid to more than 45 firms that designed computer systems. Publicity about the project led other firms to ask for information, and Rogers extended the deadline. As replies from firms ar- rived, Rogers and Taine, later assisted by representatives of DHEW, Depart- ment of Defense, National Bureau of Standards, and Central Intelligence Agency evaluated them. Rogers hoped to have the contract for phase I of the project signed in June, but because of delays August arrived before it was signed, with General Electric Company. A very competent General Electric team, composed on the average of six persons headed by Richard F. Garrard, began work on August 14. Taine acted as project director for NLM. For weeks thereafter the GE team, working with NLM employees assigned to the project, studied and amplified the MEDLARS requirements, determined possible system and subsystem configurations, and recommended various machine configurations. Important basic decisions were made, among them the decision to continue using the Library's medical subject heading list, MESH, instead of natural language or other indexing approaches; to index each article only once, for both publication and retrieval purposes; to train specialists to retrieve information for patrons; to use serial magnetic tape files for storing citations rather than random access devices; to segment com- puter programs into self-contained modules for ease of maintenance and system changes; and to develop a rapid, high-quality photocomposition device for preparing copy for Index Medicus. They decided that only commercially available equipment would be used, with exception of the photocomposer. Eighteen different computers were con- sidered. Seventeen were eliminated because they were too large, too small, too slow, or for other reasons, leaving the Minneapolis-Honeywell 800 as the survivor. A MH 800 was already in use in NIH, and the GE-NLM team considered the possibility of sharing this computer. But a study indicated that 369 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE sharing was not practical, and that the money saved would not be sufficient to justify the inconveniences and problems that would arise with joint usage. During the design phase Rogers assigned to Deputy Director Scott Adams the task of considering secondary objectives for the system. Consulting with GE, Adams proposed several, one of which was the "decentralization" of MED- LARS. A national network of MEDLARS centers was to be set up, each with a search capability and duplicate copies of the master tapes. Searches could then be made locally instead of being made in Bethesda, and the number of searches that could be run daily would be increased tremendously. Other objectives were: the storage and retrieval of text images on microfilm, per- mitting copies of text to be provided to searchers, probably through a separate device linked to MEDLARS; the use of on-line and remote input and output facilities such as data inquiry and display stations; and the processing of internal library transactions, such as acquisition procurement control, interlibrary loans, inventory control, and other requirements of a similar nature. The preliminary design phase of MEDLARS was completed on January 31, 1962. The contract for the next step, the detailed design phase, was not signed by GE until the summer, but work continued nevertheless. During phase II specifications were laid out for equipment, operators were trained, develop- ment was begun of composing equipment that would print Index Medicus, and the computer system was developed to the point where it would operate. An idea of the magnitude of the task may be visualized by noting the time required for programming, 30 man-years. The program was tested and "debugged" on a computer at Army Map Service until the Minneapolis-Honeywell 800 arrived at the Library in March 1963. The computer room had been carefully designed, and the computer was installed and tested without major problems. GE had provided on-the-job training for operators of the system. After the computer was installed the operators kept it busy an average of 12 hours a day debugging, modifying, and integrating program modules. The Library assumed responsi- bility for maintaining the system in February 1964. In operation the new system began with indexers, each of whom was as- signed a number of journals every day. Starting with the first article in a journal an indexer typed the author's name and other bibliographic data on a printed form. Because of the large number of articles scheduled for citation in Index Medicus, the indexers did not have time to read every word in an article but used a rapid scanning-reading method of deciding what each article was about and selecting the subject headings and subheadings to be cited, using terms on NLM's medical headings subject list. Approximately nine subject headings were assigned to the average article, editorial, letter, or other item. The indexer typed these terms on the form, placing an X along side of those destined for publication in Index Medicus, leaving the unmarked terms to be inserted into the computer for retrieval during searches. The indexer also checked on the form preprinted terms appropriate to the article, such as the age of a person discussed in the article. The form was attached to the article, and each suc- 370 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES The Honeywell computer, workhorse of MEDLARS I, was responsible for processing over 10 years of Index Medicus, Cumulated Index Medicus, Current Catalog, and numerous other bibliographies used throughout the world. It processed thousands of demand searches during the years before on-line search- ing took over. The system was also instrumental in providing data which led to the development of its own successor MEDLARS II. ceeding article in the journal was indexed in the same manner. The journals were passed to a reviser who checked the form against the article quickly to confirm the indexing. After revision the information was typed on paper tape in machine-readable form, proofread, the tapes spliced into batches and fed into the computer. Through the computer's input program the information on the paper tape was recorded on reels of magnetic tape, edited, and incorporated into data files. On the retrieval end of the system the process began with a patron's writing his request on a special form and mailing it to the Library. There a librarian, using the medical subject headings list vocabulary, coded the request into a form acceptable to the computer. In MEDLARS, as with most of the computer systems developed at the time, the entire file of magnetic tapes had to be searched in sequence in order to retrieve all of the citations on a given subject. In 1964 it took about 40 minutes for the computer to read all of the tapes. Therefore it was not practical to process only one search at a time. Instead a batch of requests was inserted into the computer which retrieved citations for all of them in one sweep and sorted them at the end. The retrieved list of citations was reviewed by the specialist who had coded the request and mailed to the patron. As might be expected with large new systems, the development of MED- LARS did not proceed altogether smoothly. One problem was the revision of the medical subject headings list, MESH. The existing MESH list, developed during the previous decade for NLM publication, contained 4,500 headings and 67 topical subheadings. Winifred Sewell and her associates worked hard 371 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE integrating 1,400 new headings, eliminating subheadings and some old head- ings, and producing a list of 5,700 subjects. Inconsistencies and deficiencies were noted, and changes were made. Decisions had to be made as to which subject headings would be used in Index Medicus, and which would be placed in the computer only for searching. Other troubles occurred during 1963 when the Library was switching from the old method of producing Index Medicus to the new, forcing indexers to process journal articles twice, once using the old MESH list to index articles for the current issues of Index Medicus and once using the new MESH list to index articles for a computer test tape. The double processing caused the production of citations to proceed slowly. By the end of 1963 the regular production of Index Medicus had been maintained, but only 45,000 citations had been stored in the test tape instead of the 150,000 that had been expected. This so-called "conversion" tape was useful in testing MEDLARS, but it con- tained so many inconsistencies that it was not used for searching after 1965. It had been foreseen that the development of the output system that would print Index Medicus might present more problems than the development of the computer segments. The intention was to link the computer to a device that would compose the text of Index Medicus, perhaps a mechanized line- printer of the type commonly used with computers or a mechanical photocom- position device or a cathode ray tube device. A study of the existing printers showed that none was satisfactory; they were too slow or had a poor typograph- ical appearance or possessed other drawbacks. Seymour Taine had persuaded Rogers to include in the MEDLARS re- quirements one for a fast photocompositor. General Electric arranged a sub- contract with Photon Company to develop a new phototypesetter that would operate at high speed, using a magnetic tape input following computer trans- position and editing. This device was first named GRAC (graphic arts composer) but this sounded somewhat like a monster in a science fiction movie and was changed to the felicitous GRACE (graphic arts composing equipment). GRACE was scheduled for delivery in May 1963 to allow time for testing before being used to print Index Medicus. The engineering problems involved were difficult, and their solution took longer than expected. Several of the Library's knowledgeable visitors were very pessimistic about the slow progress of GRACE. Finally in the summer of 1963 Rogers was faced with a major decision, to delay the inauguration of MEDLARS or to find another way of printing IM. He decided to follow the schedule as closely as possible, and he ordered the system be placed in operation in January 1964. Martin Cummings, who succeeded Rogers as Director in January 1964, closely monitored the construction of GRACE. He exerted pressure on the contractor and subcontractor to achieve the high quality they had promised, and he had everything in readiness for production when the machine arrived during the summer. In the meantime a conventional computer printer, loaned 372 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES by Documentation, Inc., composed the issues from January through June, and an IBM printer with a more attractive font turned out the July issue. GRACE began to produce Index Medicus in August. GRACE accepted input from a magnetic tape that had been coded by the computer. The machine contained a matrix of 226 characters etched on a glass plate; these characters were in several fonts, with a complement of diacritical marks. Behind each character was a high-speed flash tube. The circuitry of GRACE timed the flashing of these lights. Between the matrix plate and a 9- inch wide roll of film was a mirror and reciprocating lens, constantly moving back and forth, photographing a line of characters, character by character, across the width of the page, at a speed of 1.7 seconds per sweep. The exposed film, in 100-foot-long rolls, was developed automatically in another machine, cut into page size strips and sent to the printer. At the time GRACE was the fastest computer-driven photocomposer in the United States. It operated at a speed of 3,600 five-letter words a minute, more than 25 times the speed of previous phototypesetters. The August issue of Index Medicus contained 13,733 different citations and approximately 1.8 million five- letter words. GRACE needed only 16 hours to set and compose the type. GRACE continued to phototypeset publications until 1969 when, overtaken by age, it was replaced by an improved, faster commercial model Photon Zip 901, and sent to rest at the Smithsonian Institution. It was estimated that during its active life, from August 1964 until March 1969, GRACE composed 165,000 pages for Index Medicus and other bibliographies. During the break-in period of MEDLARS, 1964, imperfections became evident in the analysis and retrieval system. There was need for improvement in the practices and techniques of indexing and for the recruitment and training of persons capable of carrying on the rigorous in-depth indexing necessary to prepare information for insertion into the computer. There was need for a method of evaluating the relevance of citations retrieved from the computer upon request and of estimating the percentage of citations missed during re- trieval. There was need for computerization of the Library's technical activities, such as cataloging. There was need for further refinement and modification of the medical subject headings list. The latter was particularly important; the high quality of Index Medicus, of the proposed recurring bibliographies, and of individual searches depended upon MESH. Director Cummings acted quickly to improve the list. He set up a MESH group headed by Peter Olch, a pathologist whom he brought from National Institutes of Health. Through the efforts of Olch's group MESH was expanded and developed further logically. Subheads were reinstated, the number of cross references was increased, and hierarchical or tree structures were developed for a number of categories. The MESH section received advice on special terminology from several professional groups, among them representatives of the epidemiology section of the American Public Health Association, the American 373 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Dental Assocation, Journal of Medical Education, American Journal of Nursing, and Chemical Abstracts Service. Cummings maintained a close watch on MESH, placing it under the care of Norman Shumway after Olch left. Despite the problems of the inaugural year, MEDLARS performed well. Indexers, revisers, computer operators, search specialists, and others associated with MEDLARS gained the practical experience necessary to operate the sys- tem efficiently and to make full use of the capabilities of the system to store and retrieve information and to produce copy for printing bibliographies. Within a relatively short time they reached a high level of competence and produced work of whose quality they were proud. The cost of development of MEDLARS, some $3 million, was high but reasonable. At the time of the completion of MEDLARS there was no other The first Photon ZIP Series 900 high speed computer phototypesetter, GRACE, installed in 1964, being op- erated by Donald Dodson. GRACE operated at a speed of 3600 words a minute, several times faster than pre- vious phototypesetters. 374 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES publicly available fully operational electronic storage and retrieval system of its magnitude in existence. Not all of the objectives that Rogers and his staff had hoped for were attained, but on the whole the system was one of the largest and most successful library automation projects. It provided the medical profes- sion of the United States, and later of other countries, with the most powerful bibliographic tool in the world. The original computer configuration served NLM well from the time it began to operate in January 1964 until its successor replaced it in January 1975. Its success marked a milestone in the evolution of modern libraries. And the development of the MEDLARS printer, GRACE, yielded a by-product, an advancement in the art of electronic typography. Recurring Bibliographies It was not intended that Index Medicus be the only bibliography produced by MEDLARS. Rogers, Adams, and Taine foresaw a stream of periodical bib- liographies, ultimately perhaps as many as 50, issuing from the system. Once the citations to articles had been placed on the computer tapes, those in any field of medicine could be retrieved rapidly. Bibliographies covering the recent literature of any specialty could be produced without difficulty. There would be no necessity for any medical organization or agency to compile bibliographies for its members, it could be done by MEDLARS. Indeed, it would be a wasteful duplication of MEDLARS' mission to produce bibliographies by other means. As the system approached completion Adams and Director-Elect Cummings discussed the policy that would be followed in producing these specialized lists of citations. They decided that the Library would not publish them itself, but only in cooperation with government agencies or nonprofit medical organiza- tions. NLM would carry on the tradition of free service by supplying bibli- ographies without charge to the organizations, and the organizations would then have the bibliographies printed and distributed. The Board of Regents approved this policy in December 1963. During 1964 under the direction of Taine and his successor Leonard Karel the Bibliographic Services Division formulated a number of experimental searches to obtain information on the construction of recurring bibliographies. By July 1964 the tests were completed. The first work printed from film composed by GRACE was Cerebrovascular Bibliography, under the sponsporship of the Joint Council Subcommittee on Cerebrovascular Disease of the National In- stitute of Neurological Diseases and Blindness and the National Heart Institute. The first recurring bibliography processed by MEDLARS from inception to retrieval was Index to Rheumatology, sponsored by the American Rheumatism Association with assistance from a grant provided by the National Institute of Arthritis and Metabolic Diseases. A pilot issue of the Index was printed in November 1964, and volume 1, number 1, was published on January 15, 1965. Generally a recurring bibliography originated with a proposal from a health organization. If NLM concluded that the proposed bibliography would not duplicate any other publication and that it would help advance the subject, the 375 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Library moved ahead. Representatives of NLM and the organization planned the format, frequency of publication, and specifications of contents. They de- fined the subject field using the terms in MESH, and then tested and developed the search strategy until the experts and searchers were satisfied. The Library produced a sample issue of the bibliography for review by experts in the field. Further modifications were made based on their criticism. Finally the Library produced a camera-ready copy for the organization to publish and distribute. Many months passed between the beginning of negotiations for a bibliography and publication of the first issue. The Library and sponsoring organization benefitted mutually from the col- laboration. The sponsor gained a current, thorough bibliography of primary importance to workers in its field while the library received expert advice on the literature needs of persons in the field and suggestions concerning termi- nology. On occasion NLM gained indexing assistance; the American Dental Association provided two indexers to the NLM staff to assist with the Index to Dental Literature, and the American Journal of Nursing Company added an indexer to help with the International Nursing Index. Recurring bibliographies were quite successful. Within 6 months of the appearance of the first compilation, the Bibliographic Services Division was producing seven and was planning seven others. Organization after organization negotiated agreements with the Library, and each year two or three new titles appeared. By the end of a decade NLM was producing copy for 28 different recurring bibliographies.6 Demand Searches The second major type of bibliography produced by MEDLARS was not intended for publication but for the use of a person carrying out research. These lists of citations were retrieved from the system by a "demand search." While MEDLARS was nearing completion in 1963 trained search specialists began to make experimental demand searches to test the computer's ability to provide relevant bibliographies on specific subjects. As might be expected the operators found "bugs" in the system. They had difficulty preparing search formulations and procedures. This led them to evaluate items that influenced the search and the adequacy of terms used in formulations. They devised a new card input program to simplify search formulations, reduce processing time, and diminish the number of searches rejected for format error by the computer.7 Improving the search procedure took time. Finally in March 1964 the Library began to accept requests for searches. The early searches were made for physicians, researchers, health officials, and teachers who agreed to evaluate the bibliographies produced by MEDLARS for completeness and relevance so that the staff could improve the procedures. The service was limited at first because only a few operators were sufficiently familiar with the system to process searches, give demonstrations, and train associates. The demand for MEDLARS bibliographies increased rapidly. By mid-1964 376 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES the operators had processed more than 600 searches. During fiscal year 1965 they successfully processed 1,623 out of 1,757 requests submitted to them. Most requests came from researchers and teachers. About 95 percent originated in the United States, the remainder in other countries. During this period Director Cummings received a visit from Cyril Clev- erdon, librarian of the College of Aeronautics, Cranfield, England. Cleverdon had evolved ideas for evaluating the efficiency and effectiveness of information systems by determining their recall and precision ratios. He explained his ideas to Cummings, who saw in them an opportunity for the Library to find out how satisfactory were the bibliographies produced by MEDLARS and to learn where improvements might be made. Upon Cleverdon's recommendation the Director engaged F. Wilfrid Lan- caster in December 1965 to evaluate MEDLARS. He retained Cleverdon as a consultant and appointed a committee of six knowledgeable computer spe- cialists to review the test procedures and the analysis of results. In making his test Lancaster sent forms requesting information to a selected group of persons who had asked for and received lists of citations retrieved from MEDLARS. Each person was asked his opinion of the usefulness, to him, of each of the articles on his list. From the replies returned by 302 persons Lancaster was able to tell, in each case, whether the system had retrieved informative articles, or relatively worthless articles, or some proportion of the two; and whether it cited sufficient articles or too few. He found failures at- tributable to lack of specificity in medical subject headings, variations in the exhaustivity of indexing, lack of specificity in indexing, failure of the requester to be specific in wording his request, and other causes. He recommended improvements in several areas, including the user-system interaction, index language, indexing, and search strategy. He suggested that NLM begin con- tinuous quality control of MEDLARS searches. Lancaster's study was useful in and out of the Library. Outside, the report was of interest to organizations with computers because of the diversity of subject areas that it covered and because it was the first large-scale evaluation of a major operating information system. In the Library Cummings ordered that Lancaster's recommendations be adopted, and he set up a quality control unit to check the effectiveness of every search requested by a patron. Later the designers of MEDLARS II benefited from this evaluation of MEDLARS. Certain bibliographies produced by a demand search were, in the opinion of the staff, of interest to many persons and deserved a wide circulation. In June 1966 NLM began to reprint such bibliographies, christened "literature searches," announce them through various journals, and mail copies to patrons who requested them. The first literature search was titled "Anterior Pituitary Insufficiency due to Postpartum Necrosis, 1949-1965," and comprised 77 ci- tations. By 1976 the Library had published 356 different searches and distrib- uted between 30,000 and 40,000 copies. 377 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Decentralization of MEDLARS When MEDLARS was being designed the staff looked ahead to the time when the system would be completed, and they saw that search specialists would eventually be overwhelmed by requests for computer searches. The staff and the GE team considered several ways of preventing this. The Library could open branches in other sections of the country, each with its own computer facility and employees; it could open branches whose operators would send searches to, and receive bibliographies from, NLM via data communication equipment; it could make copies of MEDLARS tapes for other libraries which would then provide search service for users in their areas. The last option was selected because it was relatively inexpensive to duplicate tapes and because the establishment of search centers in other libraries would stimulate the growth of those libraries, relieving some of the pressure on NLM. The Library soon found that this decision appealed to the medical community; within a short time 35 institutions requested duplicate tapes in order to provide service to their clientele.8 The decentralization of MEDLARS began in 1964 when NLM awarded a contract to University of California in Los Angeles to serve as a search center. The UCLA and NLM computers were different, and one of the purposes of the agreement was to learn what difficulties libraries might face in reprogram- ming MEDLARS tapes. The reprogramming took longer than expected, and UCLA did not process tapes during the life of the contract. The second search center was University of Colorado, awarded a contract in 1965. The University arranged with the Denver Federal Center for use of a computer identical to the NLM computer, and within a reasonable time it began to provide service to physicians in its area. The following year a com- mittee of the Board of Regents considered applications from other institutions and recommended that contracts be awarded to University of Alabama, Uni- versity of Michigan, and Harvard. Ohio State and Texas Medical Center ob- tained permission from the Library to establish MEDLARS centers using their own funds. Further decentralization of MEDLARS in the United States came about through the Medical Library Assistance Act of 1965. This law authorized the granting of funds to medical libraries in various regions of the United States to enable them to provide services similar to, though on a smaller scale than, those provided by the National Library. Between 1967 and 1970 there were established 11 regional libraries, each of which became a MEDLARS center. Operators came from all MEDLARS centers to Bethesda to learn how the system operated and to formulate searches. After returning home the operators formulated search requests from local patrons and mailed the formulations to NLM for processing. Centers continued to send formulations to NLM until they became fully operational and were capable of processing searches them- selves. 378 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES Institutions in Europe showed interest early in gaining access to MEDLARS so that they could provide service to physicians and libraries within their countries. Even before MEDLARS was perfected the Library received requests from abroad for services and data bases. In 1965 informal discussions between Director Cummings and physicians in Great Britain and Sweden led to an agreement: the Library would provide tapes to an institution in each of those countries and train operators for them if the institutions would evaluate the service and would index for NLM. Both countries complied and sent trainees to the Library. After these operators completed their training and returned home the British MEDLARS center began to operate in 1966 and the Swedish in 1967. To guide the establishment of future MEDLARS centers abroad and to provide for cooperation between all foreign centers and NLM, Cummings laid down these policies. The Library would not select the institutions that would become centers, this would be done by governments or by organizations within the countries using standards suggested by NLM. The Library would provide access to MEDLARS and would train operators for the centers if in return the centers would index a reasonable number of articles monthly for MEDLARS. No funds would change hands, there would only be an exchange of service. The success of the first European centers led the Office of Science and Technology and the State Department to suggest that NLM offer MEDLARS to the Organization for Economic Cooperation and Development. For 2 years Deputy Director Scott Adams endeavored to bring about a multilateral agree- ment with the organization leading to the setting up of a center to serve OECD countries, but the countries could not agree on a consortium. The Library finally decided to seek agreements with individual countries. Mary Corning, the Director's special assistant for international programs, negotiated agree- ments with institutions in several nations, among them Institut National de la Sante et de la Recherche Medicale in France, Deutsches Institut fur Med- izinische Documentation und Information in West Germany, The National Library of Australia, and Canada Institute for Scientific and Technical Infor- mation in 1970; Japan Information Center of Science and Technology, and World Health Organization in 1972; Iran in 1975; Mexico and South Africa in 1976; Italy in 1977; and Switzerland in 1980. The Library and its partners collaborated on policy and technical matters through an International MED- LARS Policy Advisory Group, which first met in 1972. One disadvantage of the demand search service was its slowness. The time from the submission of the request, through the formulation of the request by an analyst at NLM and the processing in the computer, to the review and mailing of the bibliography to the patron, was usually 3 to 6 weeks. Therefore when MEDLINE, the Library's on-line retrieval service, became available in December 1971 patrons turned to it. They could obtain lists of citations within minutes. As the on-line system grew the centers sent fewer and fewer requests 379 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE to NLM, and the Library discontinued the demand search service in January 1973. FY 1965 '66 '67 '68 '69 '70 '71 '72 1,623 3,035 3,135 2,500 3,182 3,550 3,889 2,401 1,580 5,173 8,231 10,737 14,180 10,806 1,225 2,698 4,062 6,453 5,648 5,808 5,958 10,371 15,475 20,740 23,717 19,015 Searches NLM U.S. Centers Foreign Centers Totals Selection of Journals for the Library The Library did not have sufficient funds to index every article in every medical and related journal in the world. Nor did it wish to cite articles that would have little value for most users. Its aim was to index as much of the world's substantive medical literature as possible while avoiding the indexing of periodicals of lesser value.9 The selection of journals for the Library's collection, and particularly the selection of journals whose articles were cited in Index Medicus, was very important. In the early days one person, Billings, had chosen the journals. After he built up the subscription list it was used year after year. New journals that came to the attention of Billings, Fletcher, or later editors of Index-Cat- alogue, were added for trial. Journals that went down hill were dropped. Wars killed journals and played havoc with the list. Business depressions forced journals out of buisness. The serials on the subscription list of 1960 were far different than those on the list of 1870, but they were still essentially the choice of a few persons within the institution. On the whole the editors had chosen wisely, and there was no criticism of their lists; still the volume of periodical literature kept increasing, the Library was broadening its scope, and Director Cummings felt it would be wise to seek advice from persons outside the Library. In 1964, he appointed a Committee on Selection of Journals for Index Medicus which evolved into a less formally constituted group of consultants for the selection of literature for MEDLARS. These groups were composed primarily of non-NLM persons, including scientists, medical librarians, and physicians. The original- committee, chaired by Leonard Karel, reviewed ap- proximately 2,300 journals being indexed for, and others suggested for, Index Medicus, basing its decision on the quality of the journals in research, clinical applications, or education. Members found it easy to segregate the few hundred unquestionably superior periodicals out of the more than 15,000 titles acquired then (the number increased annually), but difficult to select 1,500 to 2,000 other journals of lesser importance, especially those in unfamiliar languages. Finally the committee, often with advice from specialists in certain subjects, recommended the addition of 466 titles to, and deletion of 324 from, the Index Medicus list. Each year thereafter the group's recommendations changed the character of IM slightly, with the aim of presenting to users an index to the most useful articles published throughout the world. 380 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES COMPUTER-AIDED CATALOGING It had been hoped, during the early planning, that MEDLARS would be able to publish the Library's book catalog data in Index Medicus. The latter would then be a catalog of books, serials, and theses, as well as an index to articles. It would be reminiscent of the old Index-Catalogue in its universal coverage. In 1963 when MEDLARS was being programmed for the production of Index Medicus, General Electric and NLM made several attempts to satisfy the needs of the catalogers, but technical limitations in the programs prevented the publishing of cataloging data in acceptable form. Finally in October 1963 NLM decided to postpone the inclusion of book entries in Index Medicus.1() In February 1964 an analysis was begun of the procedures used by the Technical Services Division in selection, citation searching, acquisition, cata- loging, and serial record keeping in order to obtain the information needed to design a computer system linking all of these functions. Several other libraries were consulted about their procedures, and librarians were asked for advice. While the analysis was going on NLM informed the medical library profession of its intention to publish a catalog with the help of MEDLARS and asked for preferences. On the basis of replies NLM decided to issue a biweekly serial that could be used by other libraries for cataloging and for selecting books for purchase. The design of the system was completed in October 1965. Priority was given to the cataloging phase of the operation. Rather then write new programs the NLM staff modified several programs, adapting the MEDLARS input module to the specific requirement for displaying cataloging data. In January 1966 NLM began publication of the biweekly National Library of Medicine Current Cat- alog, one of the first regularly recurring, completely automated book catalogs in the world. The first issues listed by author and title the books and serials that had been acquired by the Library from December 1965 to January 15, 1966. Cumulations were issued quarterly and annually. After 1966 biweekly issues included only material published during the current and preceding 2 years. NLM also produced catalog cards, containing approximately the same information as the printed catalog. The Library estimated that American med- ical libraries could save a total of $4 million a year if they adopted the Current Catalog for use in procurment and cataloging. After a few years' experience NLM concluded that a monthly catalog would better serve the profession than a biweekly. It discontinued the biweekly issue at the end of 1969. Some libraries, however, still felt the need for biweekly lists. Beginning in July 1970 the Medical Library Association arranged to receive proof sheets twice a week from NLM, print copies, and distribute them to subscribers. Later the semiweekly gave way to weekly proof sheets. The Library began the monthly catalog in January 1970. The monthly was short-lived owing to the development of an on-line bibliographic retrieval sys- tem named AIM-TWX which led to MEDLINE and to CATLINE. The latter 381 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE possessed a base of catalog data that could be searched by libraries through computer terminals, starting in 1973. The monthly issue of the Catalog was then superfluous and it was discontinued at the end of 1973, leaving the quart- erly and annual issues. Indexing by Contractors When indexers began to prepare citations for MEDLARS, they assigned many more subject headings than for the old Index Medicus. As a result they indexed fewer articles per hour, and a backlog of unindexed articles began to pile up. The Library hired additional employees, it asked indexers to work overtime, and it modified the procedure. These steps increased production, but still the backlog grew. Although the number of articles indexed rose from 144,057 in fiscal year 1964 to 168,310 in FY 1967, the backlog jumped from approximately 12,000 to about 70,000.u Indexers had to have an excellent knowledge of science, be very intelligent, be nearly fluent in foreign languages, and have good judgment. It was difficult for the Library to recruit persons with such unusual abilities because salaries were too low. NLM had set up a training program for indexers, but this did not fill vacancies. The Library, therefore, considered the possibility of having some of the indexing, done under contract. A pilot study in 1966 showed that the idea was practical. The following year NLM contracted with Keio University in Japan to index articles in Japanese, the editor of the Israel Journal of Medical Sciences to handle articles in Slavic languages, and the Parkinson Information Center at Columbia to index certain domestic journals. To make sure that the work was done properly the Library trained the contractors' employees, reviewed the indexes, and when necessary, revised them. During 1967 12,300 indexed citations, less than 8 percent of the total, were produced outside of NLM, but the following year commercial contractors at home and MEDLARS partners abroad began to contribute a large proportion. The backlog shrunk and dis- appeared, and soon all articles were being indexed currently. In 1969 the number of articles indexed by U. S. contractors and foreign MEDLARS centers outnumbered the articles indexed at NLM. By 1976 only 15 percent of all articles, or 38,400 out of 255,000, were indexed in the Library. Thereafter, on orders from the Director, 25 percent of all indexing was done at home. In 1976 about 100 indexers and revisers, most of whom were employed by contractors or foreign partners, produced citations for the MEDLARS data base. This was more than 10 times the number of persons who indexed for the Indexed articles FY 1968 '69 70 '72 '74 76 U. S. contractors 59,000 76,200 75,500 120,700 74,000 100,000 MEDLARS centers abroad 22,000 34,900 43,600 72,800 106,200 116,600 NLM 112,000 99,400 90,900 39,900 44,100 38,400 Totals 193,000 210,600 210,000 233,400 224,300 255,000 382 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES old Index-Catalogue and Index Medicus from the 1880's to the 1920's. One monthly issue of IM in 1976 contained more citations (approximately 25,000) than the entire first volume in 1879 (approximately 18,000). The Library as Publisher of Cumulated and Abridged Index Medicus In 1959 the Library and the American Medical Association had begun to publish the Cumulated Index Medicus as a joint venture. The Library, at the time, was using data processing equipment and an automatic camera to produce copy for printing the journal. This publication system was as primitive, com- pared with a computerized system, as the horse and buggy was to the auto- mobile. When NLM ascended out of the mechanized stage into the computer stage, it had the potential to publish many more bibliographies each year.12 Among the ideas for new bibliographies was the thought that the Library could easily relieve the American Medical Association of the burden of com- pleting each volume of the Cumulated Index Medicus. Director Cummings wondered if the AMA would not prefer to divest itself of its share of the work rather than expend part of its energies in completing, handling, and selling the volume. Finally in the summer of 1965 he met with Hugh H. Hussey, Jr., director of the division of scientific activities of the AMA and a Regent of NLM, and volunteered to assume responsibility for the entire production of CIM. Hussey agreed tentatively. Shortly thereafter Morris Fishbein, associated with the AMA publications for many years, visited the Library and completed the arrangements. Beginning with volume 6, 1965, NLM became sole publisher of the massive reference work. The four-volume set of 5,697 pages was proc- essed in 120 hours over a period of 2 weeks utilizing the computer and GRACE. The concept of an abridgement of the Index Medicus was another of the ideas that arose. Scott Adams recommended an abridgement containing ref- erences to articles on clinical medicine of interest to practicing physicians. The Library offered to publish an Abridged Index Medicus jointly with the AMA. In January 1965 Leonard Karel and his staff in the Bibliographic Services Division compiled a sample issue of the proposed journal containing 166 subject pages and 88 author pages, listing 3,660 citations from 216 journals. The as- sociation examined the sample, gave suggestions for improvement, and agreed to appoint a committee to draw up specifications for an abridged IM. But by this time MEDLARS was operating, the Library was having difficulty maintaining its schedule, indexing was falling behind, operators were being trained, and the computer group had more than enough work turning out Index Medicus, Cumulated Index Medicus, and recurring bibliographies. The staff had to suspend work on the abridged IM. In 1969 Clifford Bachrach, successor to Karel, and later editor of Index Medicus, returned to the abridgement. After much study to determine which high-quality periodicals would be most useful to practicing physicians, the staff and consultants selected 100 English-language journals from 2,300 journals being indexed in Index Medicus. Using MEDLARS they produced a pilot issue 383 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE in August 1969. The American Medical Association conducted a market survey and concluded that there would not be sufficient subscribers to warrant pub- lication. But Bachrach was more optimistic and went ahead to prepare the first regular monthly issue of Abridged Index Medicus in January 1970. The AIM attracted sufficient subscribers to justify continued publication. Each year ap- proximately 33,000 articles were listed in AIM, about 13 percent of the number in Index Medicus. MEDLINE and Other Lines In 1967 Director Cummings engaged the nucleus of a new group whose mission was to study the ways by which modern methods of communication could be applied in the Library. The group shortly became the Lister Hill National Center for Biomedical Communications. Ralph Simmons of the center set up facilities for experimenting with computer on-line retrieval systems. This led to the development by a contractor, System Development Corporation, of a practical on-line bibliographic system named AIM-TWX, from Abridged Index Medicus, used as a data base, and Teletypewriter Exchange Network, the communication system. AIM-TWX was opened to a select group of users across the country in June 1970. During a trial period of several months users became enthusiastic over the speed with which it supplied bibliographic information. Guided by experience gained during the test, Davis McCarn of the center and the contractor planned an on-line system that would accommodate 10 times as many searches as MEDLARS each year at one-tenth the cost. For the data base they selected citations to articles in 1,200 of the approximately 2,200 journals that were covered by Index Medicus. These citations amounted to about 60 percent of the total number, they included those most frequently sought, and provided a manageable base. The operation of AIM-TWX had indicated that the cost of communication between the terminal and computer might be twice as much as the cost of the computer search, and that the communication cost would increase as the dis- tance to the terminal increased. The staff were concerned that the expense might prevent many potential customers from using the new system. In order to make the data base as accessible to as many libraries as possible, NLM decided to subsidize the basic communication network. With assistance from the National Bureau of Standards, the staff sought the cheapest means of com- munication. For the first few months of operation they depended upon the Western Union Datacom System supplemented by phone lines leased from American Telephone and Telegraph Company. They then contracted with Tym- share for use of that firm's commercial communications network of high speed transmission lines connecting more than 50 cities in the United States and Europe. Libraries paid only the cost of telephone service to the nearest Tym- share city, from which they were connected to the contractor's computer in Santa Monica, California. The new service named MEDLINE, from MEDLARS onLINE, began trial 384 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES runs in the Library on October 18, 1971, and was opened to a selected group of institutions in December. Among the original users were NLM's regional medical libraries and large medical school libraries. Later other schools, re- search institutions, hospitals, clinics, and independent medical libraries were admitted to the system. Libraries did not have to pay for use of the new bibliographic service, but in return for free access to MEDLINE they had to agree to provide service to persons who were not among their usual clientele. As had been anticipated the new on-line system was used much more extensively than the MEDLARS demand search service. It provided bibliog- raphies within a few minutes, in contrast to the demand search which took 3 or more weeks. The MEDLINE terminal showed the patron his citations, and thus gave him the opportunity to modify his request if he wished to obtain references more pertinent to his need. A year after MEDLINE began 150 institutions were connected to the system. Twenty-five libraries, on the av- erage, were using it simultaneously, making 10,605 searches a month, or ap- proximately 140,000 a year. About two-thirds of the patrons were satisfied with the bibliographies that appeared on their terminals; the remainder desired long bibliographies (more than 100 citations) which were printed off-line at NLM and mailed to them. In February 1973 the Library stopped using the SDC computer in Santa Monica and provided MEDLINE service from Bethesda. The following month NLM arranged with the State University of New York at Syracuse, SUNY, to provide MEDLINE service through the Tymshare network. The SUNY com- puter could handle 40 searches simultaneously, nearly doubling the capacity of MEDLINE and assuring that the service would be maintained if the NLM computer shut down for some unforeseen reason. Initially the MEDLINE data base was a selected bibliography designed for the majority of users, and it omitted a large proportion of the references in Index Medicus. To satisfy researchers who wanted every citation on a subject, NLM placed the Index Medicus references that had been left out of MEDLINE into a new data base called COMPFILE, from COMPlement FILE. Into COMPFILE were also inserted citations from Index to Dental Literature and International Nursing Index. COMPFILE was made available to searchers in February 1973. By that time the on-line system was receiving so much use that the Library had to restrict access to COMPFILE to 2 days each week. COMPFILE was eliminated in 1974 when all the citations in Index Medicus were placed in MEDLINE. To keep the MEDLINE file relatively current, containing only articles published within 2 or 3 years, NLM periodically removed older citations and placed them in BACK files, as BACK 66, holding the references from the period January 1966-December 1968. The back files were accessible for search- ing off-line. The Library found that some users of MEDLINE were interested in only the most up-to-date articles in their field. Lister Hill Center therefore devel- 385 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE oped a data base containing citations from the forthcoming monthly issue of Index Medicus. Each month users could receive citations weeks before the issue was printed and distributed by the Government Printing Office. This data base named SDILINE, from Selective Dissemination of Information onLINE, was made available in September 1972. The on-line retrieval system was so successful that the Library staff incor- porated all manner of useful data into computer files. By 1976 almost 3.5 million citations were in the data bases. Scope Citations to audiovisual teaching packages used in health sci- ences education from 1974 on. References and abstracts of articles on cancer from 1963 on. Originally called CANCERLINE. Descriptions of projects in cancer research for the present and preceding 2 years. Reference to books and serials cataloged at NLM from 1965 on. Chemical dictionary containing names and information on hundreds of thousands of substances. Citations and abstracts of articles on epilepsy in Excerpta Medica, from 1947 on. A computer-assisted instruction program used in teaching persons to operate NLM's on-line system. Citations to articles and selected books from January 1978. MEDLINE citations from January 1975 to December 1977. MEDLINE citations from January 1972 to December 1974. MEDLINE citations from January 1969 to December 1971. MEDLINE citations from January 1966 to December 1968. Medical subject headings file, used for indexing, cataloging, and searching. Authority list of names and companies, used by NLM catal- ogers. Registry of toxic effects of chemical substances, an on-line quarterly compilation of data starting in 1976. The hard copy version was prepared by the National Institute for Occupational Safety and Health. MEDLINE citations for the current month. Bibliographic information on all serials ever cataloged by NLM Citations and abstracts of published studies relating to toxi- cology, from 1977 on. TOXLINE citations from 1974 through 1976. TOXLINE citations from 1965 through 1973 plus citations from the private file of W. J. Hayes. Patrons referred to the MEDLINE file far more frequently than any other file, communicating with it approximately 71,000 out of 77,000 connect hours the system was in use during 1976. CATLINE was the second most frequently Name AVLINE CANCERLIT CANCERPROJ CATLINE CHEMLINE EPILEPSYLINE MEDLEARN MEDLINE BACK 75 BACK 72 BACK 69 BACK 66 MESH VOCABULARY NAME AUTHORITY (MEDNAM) RTECS SDILINE SERLINE TOXLINE TOXBACK 74 TOXBACK 65 386 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES used file, but most of its usage occurred within NLM. TOXLINE was second only to MEDLINE in outside usage. As more and more libraries hooked onto the bibliographic network, the Library purchased faster and larger computers. The IBM 360/50 used initially was replaced by a 370/155, this by a 370/158, and followed in 1977 by a twin 370/158 multiprocessor. These improvements permitted NLM to give the best service possible, to make additional files available, and to allow more libraries to search simultaneously. Paralleling improvements in the computer system was the upgrading of the retrieval program. Extracting citations from the MEDLINE and other data bases was far dif- ferent from obtaining them from the old Index-Catalogue, Index Medicus and Current List. The person sitting at the terminal and desiring citations from MEDLINE needed to know the procedure, which could be learned in a short time, and the strategy of locating citations indexed under the Library's medical subject headings list, which required, for proficiency, many hours of training and experience. From the opening of the MEDLINE system, NLM offered a course of 3 weeks duration for librarians. The course provided intensive training in the content of the data bases, the use of MESH, indexing practices, cataloging practices, and the use of the name authority file. The student spent approxi- mately one-third of the time searching the bases gaining practical experience. The course for TOXLINE operators was shorter, generally of 3 days length. In 1976 NLM developed a brief self-instructional course named MED- LEARN for beginning operators to study before coming to Bethesda for training. MEDLEARN required only half a day or less for completion, yet instructors found that it greatly increased the effectiveness of the main course. By 1977 the Library had trained approximately 750 operators to use MEDLINE, and almost 600 to use TOXLINE, CHEMLINE, and related files. As in earlier days the Library had shared with institutions in other countries its printed Index-Catalogue, and in recent times its MEDLARS tapes, so now it invited its international partners to utilize the on-line system. By 1980 Canada and Mexico in North America, France and Italy in Europe, Iran in the Near East, and South Africa far away in the Southern Hemisphere linked themselves to the NLM computer in Bethesda through commercial communication lines. France extended the on-line service into Spain, Belgium, and Switzerland. Japan and Australia placed MEDLARS data bases on their own computers and provided on-line service to institutions in their own countries. Sweden, Ger- many, and United Kingdom also used their own computers and stretched the service into the Scandinavian countries, Poland, Netherlands, East Germany, Austria, and Belgium. An important difference between cooperation earlier and in the 1970s was speed. In Billings' day at least 1 or 2 years elapsed between the time an article was indexed at the Library, the citation published in Index-Catalogue and the latter shipped to a European agent and distributed to users. If the citation had to wait in the file, because of the place of its subject heading in the alphabet, 387 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 15 or 20 years could elapse before it reached a user. Now the average length of time between the arrival of a journal and the appearance of the citation in the data base ready for users was only 80 days. From the beginning of its existence the Library had given its services as freely as its resources would allow. It developed the MEDLARS demand search sen ice and the MEDLINE system, and made them available to qualified users without charge. But the Library's funds were limited, and it could not continue to pay all the expenses indefinitely. After discussions in meetings of the Board of Regents about funding, Director Cummings ordered that users be billed for a portion of the communication costs. Beginning in August 1973, users paid $6 per terminal connect hour, and 100 a page for off-line prints. The cost was raised to $8 an hour in February 1975. On July 1, 1975, the Regents changed the rate structure to $15 an hour for service between 10 a.m. to 5 p.m., and $8 an hour from 5 to 8 p.m., and 3 to 10 a.m. Physicians, nurses, researchers, other health workers, and students learned quickly of the great convenience, usefulness, and speed of NLM's on-line service after it became generally available in 1972. The number of searches increased from an estimated 22,000 in fiscal year 1972 to approximately 165,000 in FY73, 278,000 in FY74, 402,000 in FY75, and 579,000 in FY76. By the end of 1976 approximately 550 institutions were linked to the Library's computer. In 1978 NLM provided a million searches from all data bases, more than half of all the searches made in the United States in all fields of science and edu- cation. MEDLINE was the first large-scale successful on-line library-based bibliographic system, and the first international telecommunications-based sci- ence information network.13 MEDLARS II Computer firms were continually improving their products. By the time MEDLARS went into operation it was evident that it would be obsolete within a few years. In the summer of 1966 Director Cummings contracted with Auer- bach Corp. to draw up specifications for a new system, MEDLARS II, that would outperform MEDLARS, and in addition would accommodate elements of the cataloging process and the keeping of serial records, permit on-line retrieval of citations, include a drug information module, and store and retrieve graphic images. Cummings appointed a task force composed of NLM, NIH, and other government agency employees to assist in determining the Library's needs.14 In 1967 the Library requested proposals from industry. The Library's spec- ification described what the new system should do. Firms were to state how the system would be developed, recommend a computer, and estimate the cost of developing the system. Seven firms delivered proposals. On June 11, 1968, Cummings contracted with Computer Sciences Corp. to design, develop, and support the programming of MEDLARS II for $2,037,505 (this did not include the cost of an IBM computer that NLM planned to pur- 388 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES chase). Development of the system was to take place in three phases and be completed by December 1971. The heart of the new system was to be a set of interrelated computer programs called COSMIS, computer systems for medical information services. As the months passed by the contractor was unable to keep up to the schedule. Furthermore costs escalated. In the spring of 1969 the Board of Regents Subcommittee on Research and Development, whose function was to advise Cummings, met with the contractor's staff to try to locate the problem. Receiving the subcommittee's report, Cummings persuaded the contractor to change the MEDLARS team. Ralph Simmons, who had been overseeing the development of NLM's on-line retrieval system, spent weeks working out the provisions of a new contract which Cummings signed with CSC on June 20, 1969. The new contract stated explictly the roles and interactions of the NLM and contractor teams, it gave new cost estimates, and contained penalties for cost overruns. Cummings set up a small unit to monitor the project and placed Simmons at its head, with authority to report directly to him. Still the contractor fell behind the planned schedules. Simmons became pessimistic about the contractor's ability to meet deadlines. Regents Alfred R. Zipf, of the Bank of America, and Bruno W. Augenstein, of Rand Corp. received critical reports from members of their firms' computer staffs, whom they asked to check on the project. Cummings met with top management of the contractor to persuade them to hasten the work. But MEDLARS II proceeded slowly and on April 19, 1971, Cummings cancelled the contract. In the meantime the System Development Corp. under contract had de- veloped the Library's experimental on-line bibliographic retrieval system, AIM- TWX. A test of the system was to be started shortly. On June 9, 1971, Cummings contracted with System Development Corp. to complete MEDLARS II. The plan was to design the system around the structure and logic of AIM-TWX, adding an improved file generation and maintenance system and a new set of programs for photocomposition. The scope of some of the earlier objectives was reduced. Over a span of 3Vz years the contractor designed and developed the system. When completed in 1974 MEDLARS II contained a seven-level vocabulary (MESH) file, a journal file, current citation file, MEDLINE file, and other files. Davis McCarn and the computer staff tested the system during the latter months of 1974 and accepted it on behalf of the Library on January 3, 1975. The new system possessed all the capabilities of the original MEDLARS, it was faster, it was cheaper per unit cost of processing, it permitted higher standards for data, and it was more responsive to interactive searching and retrieval. New files with different record formats could be designed and im- plemented without interfering with other activities. The scope and variety of data bases and publications could be amplified more readily, and components of the system could be installed easily in other libraries. In the summer of 1979 Director Cummings appointed Joseph Leiter to lead 389 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE a team whose task it would be to prepare specifications for a new computerized system, MEDLARS III, capable of managing and delivering a wider range of bibliographic information, data, and documents, faster and more rapidly than MEDLARS II. Eventually MEDLARS II would follow the original MEDLARS into oblivion, after years of service as the backbone of medical communication in the United States. Notes 1 In 1947 Scott Adams, then The Acting The Librarian, organized a meeting of librarians at the Pentagon to discuss the conflict in subject headings in the Quarterly Cumulative Index Medicus, Current List, and Index-Catalogue. During lunch, Director McNinch mentioned to the group that the Statistical Department of the Surgeon General's Office was using IBM ma- chines, and he wondered if it was possible for such equipment to be used in medical indexing. He took the group to see the keypunch, card sort, and other machines in operation. Mc- Ninch's suggestion and the tour of the Statistical Division may have been one of the roots pf the mechanization of Current List. The conclusions of the Welch Medical Li- brary Indexing Project, 1948 to 1953, also sug- gested that some of the operations could be done using business machines. 2 The Council on Library Resources, Inc., was organized in September 1956 as a nonprofit body. The establishment of the council was made possible by a grant from the Ford Foundation of $5 million to be expended over a 5-year pe- riod for "aiding in the solution of the problem of libraries generally, and of research libraries in particular." A copy of the Library's Proposal is in MS/C/295. 3 Information on the mechanization project may be found in: "The National Library of Med- icine Index Mechanization Project; July 1, 1958- June 30, 1959," Bull. Med. Lib. Ass. 49: Part 2 of number 1, Jan. 1961, 1-96; records of the Board of Regents, Sept., 1957-Apr. 1961; Out- line of a Proposal Made by the National Library of Medicine to the Council on Library Re- sources, Inc., Feb., 1958: MS/C/47; annual re- ports of the Library, 1957-1961; Frank B. Rog- ers, Tape-recorded comments on Index Committee . . . May 24, 1979: NLM. 4 Correspondence between Rogers and of- ficials of the AMA, a copy of the agreement between the PHS and AMA, and other perti- nent documents are in MS/C/295. See also an- nual reports of the Library, 1961-1963. 5 A medlars is a fruit that resembles a crab apple and may be used in preserves. In earlier times it was used in medicine, according to Thomas Cogan's Haven of Health (London, 1584): "Medlars are cold and drie in the seconde de- gree; they streine or binde the stomacke, and therefore they are good after meales, especially for such as bee over laxative, being much eaten they engender melancholie, and bee rather meat than medicine, as Galen saith. Yet of the stones or kernelles of Medlars, may be made a very good medicine for the stone, as Matthio writeth. The stones of medlars made in powder, driveth out the stone of the reynes, if you take a spoo- nefull thereof in white wine wherein the rootes of perselie have bene boyled." Information on the development of MED- LARS may be found in many sources, among them: General Electric Co., Final technical re- port for MEDLARS preliminary design, Jan. 31, 1962; Archival Coll. NLM: The Principles of MEDLARS (NLM, 1970): The MEDLARS Story at the National Library of Medicine (NLM, 1963): Charles J. Austin, MEDLARS, 1963-1967 (NLM, 1968): NLM News: records of the Board of Regents: articles, including F. B. Rogers, "The National Library of Medicine's Role in Improv- ing Medical Communications," Amer. J. Med. Electronics 1: 230-41 (July-Sept. 1962); S. I. Taine, "The Medical Literature Analyses and Retrieval System," Bull. Med. Libr. Ass. 51: 157-67 (1963); Winifred Sewell, "Medical Sub- ject Headings in MEDLARS," Bull. Med. Libr. Ass. 52: 164-70 (1964); S. Adams and S. I. Taine, "Searching the Medical Literature, "JAMA 188: 251-4 (April 20, 1964); L. Karel, C. J. Austin, M. M. Cummings, "Computerized Biblio- graphic Services for Biomedicine," Science 148: 766-772 (1965): Tape recorded reminiscenses of Frank B. Rogers, May 24, 1979, and of Winifred Sewell, Mar. 12, 1979; NLM. Information about the financing of MEDLARS by the National Heart Institute was obtained from James Watt. 6 A list of recurring bibliographies, with names of sponsoring organizations, may be found in each issue of Index Medicus and Monthly Bib- liography of Medical Reviews. Information on the bibliographies may be found in NLM News, annual reports of the Library, and records of the 390 EVOLUTION OF COMPUTERIZED BIBLIOGRAPHIES meetings of the Board of Regents. Charlotte Kenton, "The Recurring Bibliographies Pro- gram of MEDLARS," Bull. Med. Libr. Ass. 54: 135-7 (1966). S. Adams, "MEDLARS and the Library's role as publisher," National Library of Medicine Programs and Services, F.Y. 1976, pp. 5-10. Information was also obtained from Scott Adams and Clifford Bachrach. 7 Information on the demand search service may be obtained from writings by the NLM staff, including F. Wilfrid Lancaster, Evaluation of the MEDLARS Demand Search Service (1968); "Evaluating the Performance of a Large Com- puterized Information System, "JAMA 207:114— 120 (1969); and, with Grace Jenkins, "Quality Control Applied to the Operation of a Large Information System," /. Amer. Soc. Informa- tion Sci. 21:370-71 (1970). Data was also ob- tained from annual reports of the Library, and persons associated with MEDLARS. Lists of subjects of some early demand searches are in NLM News, July through November 1964. Ti- des of literature searches are listed in the monthly issues of Index Medicus, 1967 onward. Policy is in the records of the Board of Regents. 8 Information on decentralization of MED- LARS may be found in records of the Board of Regents, NLM News, and annual reports of the Library. 9 Statistics on journal acquisition and selec- tion may be found in annual reports of the Li- brary. Leonard Karel, "Selection of Journals for Index Medicus," Bull. Med. Lib. Ass. 55: 259- 78 (1967), contains many references to pub- lished and unpublished sources. Information was also obtained from Clifford Bachrach, editor of Index Medicus. Policy is in the records of the Board of Regents. 10 Statistics on cataloging may be found in annual reports of the Library. Narrative infor- mation may be found in articles by NLM catal- ogers, NLM News, and Emilie Wiggins' unpub- lished manuscript, "Cataloging at the National Library of Medicine." Information was also pro- vided by Carolyn Davis. See also records of the Board of Regents. 11 Information on difficulties in indexing and on indexing under contract was obtained from Stanley Jablonski and Lloyd Wommack, both of whom were project officers on contracts. Sta- tistics were obtained from annual reports of the Library. Policy statements are in the minutes of the Board of Regents. 12 Information on the CIM and AIM was ob- tained from Martin Cummings, Scott Adams, and Clifford Bachrach. 13 For the development of AIM-TWX see the chapter on the Lister Hill Center. Infor- mation on MEDLINE and other data bases may be found in articles by members of the staff, records of the Board of Regents, NLM News, on-line services reference manuals, and Library network/MEDLARS technical bulletins. Statis- tics may be found in annual reports of the Li- brary. Information was also obtained from Grace McCarn, Scott Adams, Lloyd Wommack, Don- ald Hummel, George Cosmides. 14 Information on MEDLARS II may be found in: Auerbach Corp., Functional system speci- fications for the National Library of Medicine . . ., July 1, 1967 (copy in archival collection); records of the Board of Regents; NLM News; annual reports of the Library; and articles, in- cluding: Robert V. Katter, K. M. Pearson, Jr., "MEDLARS II, A Third Generation Biblio- graphic Production System"/. Libr. Autom. 8; 87-97 (1975); Davis B. McCarn, J. Leiter, "On- line Services in Medicine and Beyond," Science 181: 318-24 (1973); D. B. McCarn, "National Library of Medicine-MEDLARS and MED- LINE," in Belzer, Holzman, and Kent, Ency- clopedia of Computer Science and Technology, v. 11, pp. 116-52 (N. Y. 1978). The on-line serv- ices reference manuals and Library network/ MEDLARS technical bulletins contain much detail. Information was also obtained from Mar- tin Cummings, Ralph Simmons, and Joseph Leiter. 391 XXH The Library's Program for Awarding Grants Martin Marc Cummings, Director 1964— FOLLOWING the resignation of Frank Bradway Rogers from the direc- torship on August 31, 1963, Surgeon General Luther Terry asked Scott Adams to accept the post of Acting Director and to sit on a committee to nominate a new Director.1 The committee, chaired by James Hundley of the PHS, considered nine persons from within the service and 19 from without. It finally selected Martin Marc Cummings, chief, Office of International Re- search and associate director for research grants, NIH. Terry appointed Cum- mings as the new Director of the Library. After accepting the post Cummings remained at NIH finishing his work while spending considerable time at the Library overseeing the final stages of the MEDLARS publication system. He became Director officially on January 1, 1964. Cummings was born in Camden, New Jersey, on September 7, 1920. He received his B.S. degree from Bucknell in 1941 and M.D. degree from Duke in 1944. At Duke he became interested in diseases of the chest, particularly tuberculosis. This led him to accept a Public Health Service internship. He was assigned to the Boston Marine Hospital where, during his second year, he received a commission in the service and was placed in charge of the Tuber- culosis Section. In 1946 the PHS provided Cummings with specialized training in bacte- riology and tuberculosis at the Michigan State Health Department, and overseas at the State Serum Institute of Denmark. It then assigned him to the Com- municable Disease Center, Atlanta, to establish a tuberculosis research labo- ratory. At the neighboring Lawson Veterans Administration Hospital he had the opportunity to treat tuberculosis in veterans, and in 1949 he joined the staff to head the Tuberculosis Service and organize a laboratory for tuberculosis studies. Concurrently he taught medicine at Emory University School of Med- icine. The Veterans Administration asked Cummings to move to Washington in 1953 to become director of research services. Concurrently he lectured on microbiology at George Washington University School of Medicine. He also represented the Veterans Administration in meetings of the National Advisory 393 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Martin Marc Cummings, ap- pointed Director of the Library in 1964. Health Council and thus became acquainted firsthand with the operations and administrators of the National Institutes of Health. Wishing to return to research, in 1959 Cummings accepted the position of professor and chairman of the department of microbiology at University of Oklahoma. With assistance with grants from NIH he upgraded the department, but before long was lured back to Washington by James Shannon, Director of NIH, to head NIH's Office of International Research. Upon assuming the directorship of the Library, Cummings moved rapidly to improve the scientific quality of MEDLARS, and have the recently developed computerized bibliographic system utilized and evaluated nationally and in- ternationally. He began to broaden the Library's mission. Within a few years he obtained legislation for a grants program, inaugurated a research and de- velopment program, obtained authorization for a new building, organized a toxicology information program, directed the acquisition of a medical audio- visual organization, changed the Library's role in continuing education from passive to active, and encouraged broadening of the mission of the History of Medicine Division. He attracted experienced, intelligent and energetic asso- ciates to manage the new programs. He was successful in his relationships with his superiors in higher echelons of the Department and in the legislative branch, who respected his leadership of the Library. He served as Director of the Library longer than anyone other than his hero, John Shaw Billings. Cummings' work in the Public Health Service, Veterans Administration, and University of Oklahoma was reflected in 68 articles and chapters he wrote 394 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS on tuberculosis, sarcoidosis, microbiological technique, and other medical top- ics. He also coauthored a text, Diagnostic and Experimental Methods in Tu- berculosis. From the National Library of Medicine he wrote on a variety of subjects, including NLM programs, library operations, biomedical communi- cations, history, and administration. Among the honors bestowed on Cummings for leadership in library affairs were six university degrees, the Superior and Distinguished Service awards of the Department of Health, Education and Welfare, the Distinguished Service Award of the College of Cardiology, an honorary fellowship in the College of Physicians of Philadelphia, an honorary membership in the Academy of Med- icine of the Institute of Chile, and the Rockefeller Public Service Award, the most prestigious recognition that a Federal civil servant could receive. Beginning of the Grants Program It was inevitable that the Library would become involved with grants after it became a part of the Public Health Service and closely associated with the National Institutes of Health. The NIH had begun to award grants to assist research with a tiny sum of money in 1938. After World War II Congress increased the funds astronomically, from less than $1 million in 1946 to $63 million in 1956 to $177 million in 1958. Every institute in NIH awarded grants for stimulating and supporting research in its area. In 1959 the Library's Board of Regents learned that NIH was considering granting funds to two medical schools for the purpose of training librarians. During the Board's first meeting in 1960 Michael De Bakey, Surgeon General Leroy Burney, Director Rogers, and other members discussed the possibility of NLM's awarding grants for training librarians, research in history of medicine, preparing special bibliographic reviews, and other purposes. Rogers then de- cided to have plans drawn up for a program under which NLM would assist other medical libraries to improve their facilities and services.2 In the summer of 1960 Rogers asked the General Counsel of the Department of Health, Education, and Welfare if the Public Health Service Act permitted the Library to award grants.3 The counsel ruled that the act did not, and Rogers started on the long road that would lead to authority and funds.4 He had been looking for a person to become deputy director to assist with the management of the current work; now he also needed the deputy to plan "extramural" activities. He brought Scott Adams back from the National Science Foundation to the Library in this position, and assigned Estelle Brodman as Adams' as- sociate. After Brodman resigned in 1962 to become librarian of Washington University Medical School, Daniel Bailey assisted Adams. While facilities for medical research, education, and health care had been greatly expanded and improved since the mid-1940's, most medical libraries had been ignored by the schools and institutions they served. Federally spon- sored research in the Veterans Administration, National Institutes of Health, universities, and institutions had created a continuing overload on libraries in 395 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE the 1950's. Libraries had not had sufficient funds to acquire, process, and store the large amount of books and journals wanted by users. Libraries had not been planned with sufficient storage space. Many were overcrowded, and some had had to store publications in warehouses, whence it took hours for retrieval. There was a shortage of professional medical librarians. Relatively few libraries were able to serve efficiently and rapidly as conduits for the transmission of information between researcher and applier. A Senate document in 1960 re- ported that all medical schools needed urgently an "improvement of their libraries, which are essential to the functions of education, research, and good medical care."5 Adams and Brodman had no difficulty in identifying deficiencies in libraries. They outlined a program to support traditional publication media (journals, reviews, and translations), to assist abstracting and indexing services, to further the training of medical librarians, and to strengthen the facilities, resources, and services of medical libraries through which information was made available locally to researchers. They also proposed support of investigations into the principles on which new and improved systems of communication might be built. To accomplish these goals, they drafted programs in the areas of publi- cations and translation; fellowships, library facilities and resources; education and training; and research and development. The Board of Regents approved the scope of the program in November 1960, and a request for funds was included in the preliminary budget for fiscal year 1963.6 Adams and Brodman continued to compile information to reinforce the Library's request that it be given authority and funds to assist other medical libraries. They wrote reports and articles, and Brodman arranged a contract with Harold Bloomquist of Harvard Medical School to survey medical libraries and to describe what improvements were needed.7 Translations In the meantime events at the National Institutes of Health resulted in the transfer of a small grants program to the Library. In July 1956, directed by the Senate Committee on Appropriations to make "available to American scientists the full findings of Russian scientists," the National Institutes of Health in cooperation with the National Science Foundation set up the Russian Scientific Translation Program. Scott Adams, librarian of NIH at the time, directed the program under which Russian medical and related publications were translated, reviewed, and abstracted in English. The work was done in Poland and Israel, some of it financed by grants and contracts, some by funds available through Public Law 480, the Agriculture Trade Development and Assistance Act of 1954, amended in 1958. Under this law foreign currencies that accrued to the credit of the United States from the sales of surplus agricultural commodities could be used to "collect, collate, translate, abstract, and disseminate scientific and technological information." Adams left the NIH library in 1959 to take charge of the National Science 396 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS Foundation's foreign science information program. His departure led to a de- bate by NIH, PHS, and NLM about the future of the Russian scientific trans- lation program. The portion of the program financed by Public Law 480 funds was transferred to the Library in August 1959; the portion paid for by grants was retained by NIH with the expectation of transferring it when the Library moved to its new building in Bethesda. But before the move took place the transfer was made on July 1, 1961, even though the Library did not have legislative authority to make grants.8 Director Rogers felt that the use of grants to finance translations was not proper, and in 1962 he directed that they be replaced by contracts. Progress Toward a Law The grants for translation had no effect on the efforts to obtain authority. Adams and Brodman drafted and redrafted specifications for legislation, and compiled supporting documents. Surgeon General Luther Terry, a member of the Board of Regents and a supporter of the program, approved the specifi- cations, but then there arose in his office a disagreement over the scope of the PHS's mission in medical communications. Legislation needed by the Library could not be written until Terry's staff felt they were on firm ground. Fur- thermore, it appeared that some of the Library's proposed plans might duplicate or impinge on missions of other organizations within the service. The National Institutes of Health, in particular, was entering the field of science commu- nication and might limit the Library's activities. To obtain the views and ideas of all the organizations in the service on communications, the Surgeon General convened a conference on the subject.9 Finally Terry's staff defined the activities in which the PHS could engage. They drew a line between the work of NLM and NIH and pointed out the areas in which the Library could give grants under authority of the Public Health Service law. On March 29, 1963, Terry delegated authority to the Library to support training, research fellowships, and research grants.10 But the Surgeon General's staff was still not completely satisfied about the limits of the authority that the service, and thus the Library, possessed to give grants in the field of medical communication. At last the Secretary of HEW asked the Comptroller General of the United States for his interpretation. On March 4, 1964, the Comptroller ruled that the PHS law permitted the Surgeon General to delegate authority to the Library to make grants for activities relating to the communication of results of medical re- search. n In the meantime Rogers had retired and been succeeded by Martin Cum- mings, who believed strongly in a grants program. In January 1964 Cummings and Surgeon General Terry talked with Senator Lister Hill about their hope of gaining such a program for NLM. Senator Hill liked the concept and asked Cummings to have specifications drafted for the legislation. Two months later, following the Comptroller's decision, Cummings began to mobilize a staff to develop and manage a full grants program. He recruited Marjorie Wilson from 397 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE NIH, Carl Douglass from the National Institue of Arthritis and Metabolic Diseases, and Mary Corning from the National Science Foundation, as the nucleus. He reorganized the Library's divisions into two groups, one headed by Wilson to operate the Extramural Program, or EMP as it was frequently called, one headed shortly thereafter by Joseph Leiter to operate the Intramural Program. He set up a Publications and Translations Division, headed by Corn- ing, and a Research and Training Division, headed by Douglass, and placed them in the former. He placed the traditional library divisions and a new Data Processing Division in the latter.12 The Publications and Translations Division was to make contracts, grants, and Public Law 480 agreements for translation and publication of medical writings overseas and in the United States. The Research and Training Division was to make contracts and grants for research in the management of biomedical literature, for training librarians and other specialists in the communication of medical knowledge, and for providing scholarships in history of medicine and other fields. The only part of the Extramural Program that functioned was the Publications and Translations Division, continuing the work that had begun several years before financed by appropriated and PL 480 funds.13 The other part of EMP remained in the planning stage, waiting for funds that the staff hoped would be appropriated soon. Grants for History of Medicine Money and authority for the first grants awarded by the Library arrived unexpectedly. On February 28, 1964, Cummings appeared before a House Subcommittee on Appropriations to testify on the PHS appropriation bill. Rep- resentative John Lesinski wondered if it might not be possible to rediscover forgotten, useful remedies by delving into the past, and he suggested that funds be given to the Library to undertake research into history of medicine.14 John B. Blake, chief of the History of Medicine Division, quickly planned a program of in-house and grants activities that could be carried out for $180,000. The Committee on Appropriations added this sum to the Library's budget.15 Congress passed the appropriation bill, and the President signed it on Sep- tember 19. The Library allotted $120,000 of the appropriation to history grants, and $60,000 to programs of the History Division. The Library set up procedures to process grant applications and arranged to accept applications in the history of life sciences from NIH, which had been administering them. The Secretary of HEW on October 2 designated the appointed members of the Board of Regents as the Advisory Council to review and recommend applications. The Library now awarded its initial grants; six for research, one for a fellowship, and two for training programs, all in history of medicine.16 The Medical Library Assistance Act The Library still did not have authority to award grants in all areas needed by medical libraries. The Bureau of the Budget and the Office of Science and 398 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS Technology opposed new legislation because they did not think it was necessary. They wanted NLM to apply its authority as a part of the Public Health Service to award grants, and they wanted the Library to use pending legislation which would be administered by the Office of Education, designed to assist libraries in general. The legislation that ultimately gave NIH authority to award grants began in early 1964 when Cummings talked with Senator Lister Hill about NLM's hopes to assist other libraries. Senator Hill asked Cummings to visit him in Alabama during the congressional Easter recess to discuss the plans in detail. Cummings and Wilson spent two and a half days with Hill at the University of Alabama Medical School going over the proposed extramural program. The Senator liked the conception. He asked Cummings for a draft of a bill, and he suggested that he enlist the aid of Representative Oren Harris. During much of the remainder of 1964 Wilson, Douglass, and their asso- ciates continued to develop the program, working with representatives of med- ical schools, dental schools, pharmacy schools, hospitals, and government health agencies to catalog the deficiencies and needs of medical libraries. They drew ammunition from the report of Harold Bloomquist, from the report of the President's Commission on Heart Disease, Cancer, and Stroke, and from con- ferences on the importance of libraries in research, training, and the everyday practice of medicine.17 Wilson also spent considerable time with Elizabeth Chase, a DHEW at- torney, outlining a bill. In the autumn of the year a series of meetings was held in the Surgeon General's office to coordinate the terms and conditions of the proposed Medical Library Assistance Act with all other segments of the PHS. In December Senator Hill called Cummings and Wilson to his office and informed them that he intended to introduce the legislation in the next session of Congress. He did this on January 19, 1965. Representative Harris and later Representative John Fogarty introduced parallel bills.18 Rarely did legislation receive such wide and unanimous support in the health professions. Medical, dental, pharmaceutical, veterinary, optometry, library, and specialized organizations testified in favor of the proposed law at Senate hearings in June and House hearings in September. Medical schools, univer- sities, the American Public Health Association, American Association of Col- leges of Pharmacy, American Nurses' Association, American Hospital Associ- ation, and other groups sent messages of support to congressional committees. James Shannon, Director of NIH, had pessimistically estimated that it would take 4 years for passage of legislation, but Cummings, Wilson, and Douglass were so persuasive that the legislation moved through Congress without dif- ficulty and was signed by President Johnson on October 22, 1965.19 The Grants Programs After enactment of the law Wilson, Douglass, and David Kefauver collab- orated with the PHS General Counsel in writing regulations to implement the legislation. The staff drafted and published informational materials, policy 399 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE guidelines, and application forms and other necessary documents. The Board of Regents appointed a Subcommittee for Extramural Programs to facilitate review of the policy and regulations. The Board approved the drafts on March 21-22, 1966, the PHS and DHEW followed, and the Federal Register published them on July 13. Wilson and her associates developed a budget, planned for short- and long- range programs, established advisory committees, recruited employees, ap- pointed consultants, and carried out all the other activities necessary to prepare for the award of grants. They drew up agreements with the Association of American Medical Colleges to establish functional guidelines for the construc- tion of health service libraries, and with the Institute for the Advancement of Medical Communication to develop objective standards based on the services to users by which to measure library performance. They held many meetings with representatives of institutions planning to apply for grants. The law specified that a Medical Libraries Assistance Advisory Board be established to review and approve grants. The Surgeon General designated the Board of Regents as this Advisory Board. The Board was aided in its deliber- ations by reports of committees, appointed by Director Cummings, that pro- vided initial review of applications. The Medical Library Assistance Act of 1965 had a life of 5 years. It authorized an appropriation of $105 million for programs to finance construction of medical libraries, train librarians and other information specialists, expand and improve medical library resources, stimulate research and development in medical li- brary sciences, support biomedical publications, establish regional medical li- braries, and set up branches of NLM if necessary.20 The staff began implementing the provisions of the act with one exception: the construction of medical libraries. The Bureau of the Budget was not con- vinced that the Library's estimate of the need for construction was realistic. It asked the Office of Science and Technology to prepare an independent estimate. The office hired a contractor to design a national library network and information system, which was more than the Bureau had asked for. When the contractor completed its report the Library and Regents agreed with some portions but disagreed with the concept, which called for an expensive, federally operated system of medical libraries. The Bureau, satisfied with the Library's viewpoint, released the funds for construction. For the construction of libraries the act authorized an expenditure of $10 million each fiscal year from 1967 to 1970, or a total of $40 million. Congress appropriated only $11.25 million. With this money NLM provided funds to nine medical schools, to Auburn University School of Veterinary Medicine, and to Southern College of Optometry. Grants to medical schools ranged from $536,331 to Brown University to $1,765,636 to Jefferson University. The 11 schools acquired 334,121 square feet of library space having a capacity of 1,305,000 volumes. While 11 schools were helped, NLM estimated that from 25 to 40 other institutions needed funds to improve their library facilities. 400 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS Library of Wayne State University Medical School, a regional medical library erected with assistance from a construction grant. The Library did not retain management of the construction program very long. On April 1, 1968, NLM was transferred from the PHS Surgeon General's Office to the National Institutes of Health. James Shannon, Director of NIH, on October 3 appointed a task force to consider the advisability of placing all of NIH's construction grant programs in one NIH division. The task force recommended that this be done. On December 26 Shannon delegated authority for medical library construction grants to NIH's Bureau of Health Manpower. This action removed the everyday operation of the construction grants from NLM, but the latter still participated in the program. It defended the budget for library construction grants, it provided the Bureau with technical guidance, and the Board of Regents cooperated with the Bureau's National Advisory Council in reviewing and approving all NIH construction grants involving li- braries. For research and development in the library field Congress appropriated $6 million of the authorized $15 million. The Library grouped proposals for R&D grants into three categories: library services, operations, and manpower; biomedical communications; and history of life sciences. Two million dollars were awarded for 14 projects in the first category, $3 million for 43 projects in the second, and $1 million for 46 projects in the third. A wide variety of endeavors were financed, among them the development of an on-line computer serials control system, a study of communication patterns among researchers, development of standard nomenclature, evaluation of self-instruction materials, and language analysis for information retrieval. Resource grants were designed to help medical libraries acquire needed publications and equipment, process library materials, and adopt new tech- nologies. It had been estimated by Cummings that the Nation's medical libraries 401 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE needed $100 million for these purposes. The act authorized the expenditure of $15 million to provide grants, but Congress appropriated only $11.8 million. These grants were looked upon as a means of stimulating private support for libraries. To accomplish this the act provided a formula for determining the amount of each grant, the amount depending upon the funds that the institution had been devoting to its library. The NLM also adopted a policy of giving priority to libraries that served the most users. Because of these two criteria, the largest grants went to the largest libraries, since these had the largest resources and the most customers. Assisted by resource grants were 402 li- braries, 192 of which were in hospitals, 93 in medical schools, 29 in pharmacy schools, 16 in dental schools, 16 in societies, 7 in veterinary medical schools, and the remainder in other kinds of institutions. The grantees spent approxi- mately one-half of the resource money for publications, one-quarter for em- ployees, one-sixth for equipment, and the remainder for other purposes. Congress authorized $5 million but appropriated only $4.5 million for train- ing grants. The Library awarded grants to library interns who needed funda- mental training, to established librarians who desired training in modern tech- niques of communication, and to persons who wanted to pursue advanced training in library science. Grants supported candidates for master's degrees in biomedical communication and candidates for doctor's degrees in health information research. One specialized program that received support provided instruction for editors of medical publications. Approximately 350 persons ben- efitted from these grants, receiving training that enabled many of them to step upward into key positions in libraries. The Library dispensed an appropriated $2.3 million, $2.7 million less than authorized, to assist biomedical publications. These funds supported 43 projects for the preparation and publication of monographs, critical reviews, histories of medicine, and works dealing with libraries and biomedical communications; for the compilation of secondary literary tools such as atlases, catalogs, and bibliographies; for the translation of foreign medical books; and for temporary support of journals with innovative approaches. The act authorized $2.5 million to support physicians, dentists, and other health professionals while writing definitive works needed in medicine and related fields. The Library received less than one-tenth of this, $200,000, to underwrite these "special scientific projects," as they were called. The Library used these funds to award grants to 10 fellows, who prepared studies on topics such as the discovery, regulation and use of drugs, and interorganizational aspects of urban community health. The most revolutionary grant was for the establishment of regional medical libraries. The Library was authorized to award funds to a number of institutions in return for their assistance in serving patrons within their regions. This provision was placed in the law as a result of ever-increasing demands for NLM services during the previous two decades. The number of requests for inter- library loans, for example, had become so voluminous NLM either had to 402 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS The Regional Medical Library Network. expand or persuade other libraries to share the load. The latter could be done by offering funds to strategically placed large libraries if they would agree to provide service to patrons and to smaller libraries within their own and neigh- boring states. The idea of regional library cooperation was not unique to NLM staff mem- bers, but they saw the need for such cooperation early, and they developed the concept into a practical, nationwide system. The Regional Medical Library system as it finally evolved, was composed of four tiers of libraries. The first tier was made up of thousands of community hospital libraries, junior college libraries, and other local libraries that would provide primary service. NLM would help hospitals establish and strengthen libraries through its grants pro- gram. The second tier was composed of approximately 125 resource libraries, generally medical school or society libraries, that would assist local libraries when the latter did not have books or journals requested by patrons. The third tier was composed of 11 regional medical libraries with extremely large col- lections and facilities, capable of reinforcing the resource libraries in their areas. The fourth tier was NLM, the library of last resort, ready to supplement the collections and services of regional libraries. Initial planning of the system, both regionally and nationally, was difficult because of the dearth of information about resources and services. With the assistance of medical associations NLM collected statistical data for each state, including the number and percent of professional health workers, distribution of health schools, facilities of medical school hospitals, and resources of major medical libraries. Tentative plans for possible systems were then drawn up. It was estimated that funds available under the MLA act were sufficient to 403 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE support only 10 regional libraries (NLM also acted as a regional library). There- fore each regional library would have to serve a relatively large proportion of the Nation's health workers. The Francis A. Countway Library of Medicine, of the Boston Medical Library and Harvard University, submitted the first application for a regional grant. In October 1967 NLM awarded $104,872 (more later) to Countway to enable it to service the New England region, composed of Maine, New Hampshire, Vermont, Massachusetts, Connecticut, and Rhode Island, through local medical libraries. Almost 3 years later, in July 1970, NLM awarded the final grant to the Health Sciences Library of the University of Nebraska Medical Center to enable it to serve the midcontinental region, comprising Colorado, Kansas, Missouri, Nebraska, South Dakota, Utah, and Wyoming. Each of the 11 libraries managed and coordinated services within its region and participated with other regional libraries and with NLM on continuing plans for the entire system. Congress authorized an expenditure of $12.5 million for regional libraries but appropriated only 38 percent of that sum. Grants to libraries ranged from $1.02 million to Countway, serving New England, to $178,000 to the University of Texas Southwestern Medical School serving users in five states. All-in-all, between FY 1966 and FY 1970 Congress appropriated a total of $40.8 million for the grants program, approximately 39 percent of the authorized $105 million. With those funds the Library was able to assist 604 projects for the improvement of biomedical information, but there were scores of other worthy projects that could not be aided. The grant program was an experiment. For the first time the government, through NLM, helped medical libraries develop themselves, and form and cooperate in a national network. The trial was successful. The health professions were unanimous in asking Congress to renew the legislation, and Congress did not hesitate to do so. Extensions of the Medical Library Assistance Act Through experience the extramural staff expected that some parts of the program would be improved if the Library were given authority to award grants on a different basis or for different reasons. In 1969, when Cummings requested Congress to extend the life of the act, these improvements were considered by those who drafted the new legislation. The program had been successful in upgrading medical libraries, and several Congressmen willingly sponsored bills to prolong the law. One bill proposed to continue the act for 3 years, without changes in the provisions. Three other bills would have extended the act for different lengths of time, with changes. The Administration recommended an extension of 1 year in order to allow the Department of Health, Education, and Welfare an opportunity to review all grant programs, as directed by President Nixon, in order to determine whether it would be more economical or efficient to consolidate closely related programs. But both Houses of Congress preferred and passed a 3-year extension with a 404 the library's program for awarding grants few changes. The President approved the Medical Library Assistance Extension Act of 1970 on March 13, 1970.21 The Extension Act of 1970 provided modest increases in authorized funds for medical library construction, manpower development, resource grants, and regional libraries. It authorized appropriations of $23.5, $25.5, and $27.5 million for the first, second, and third years, compared with $21 million per year under the original law. The total authorized for the 3-year period was $76.5 million; Congress actually appropriated $19,506 million. The act gave Director Cum- mings leeway to finance desirable projects that might arise unexpectedly by permitting him to transfer 10 percent of the funds from one program to a different program, as long as the amount transferred did not exceed 20 percent of the amount in the receiving category. Before the Extension Act of 1970 had run its course, Cummings requested that the law be renewed again. He suggested an extension of 5 years and minor modifications in the provisions. In 1972 Congressmen introduced bills on behalf of the Library, Senator Edward Kennedy sponsoring a measure to renew the law for 1 year. Witnesses who testified at hearings recommended that the grants program be continued for periods ranging from 3 to 5 years. The Senate sub- committee handling the legislation compromised on an extension of 4 years. The Senate passed a bill in September 1972, but Congress adjourned before the House had time to vote, and the measure expired.22 In the spring of 1973 several representatives and senators introduced bills designed to carry on the Extramural Program. Both Houses of Congress agreed on legislation and the President signed the Health Programs Extension Act of 1973 on June 18, 1973. This law continued the Library's authority to award funds for all programs, except construction, for 1 year, through June 30, 1974. The act authorized an appropriation of $8,442,000, Congress gave $7,029,000, and NLM awarded $6,649,808 to grantees.23 To prevent the act from expiring in the short span of a year, Cummings quickly asked for another continuation. In January 1974, with 5 months re- maining, the House passed Representative Paul Rogers' bill to extend a number of health laws, among them the MLA act. The Senate passed an amended version of the bill in May. The House and Senate versions differed in the amount of appropriation, length of extension, and other provisions, but the branches of Congress compromised and passed the Health Services Research, Health Statistics, and Medical Libraries Act of 1974, signed by the President on July 23, 1974.M This law extended the grants program for 2 years, and it included a provision that the program would continue for a third year unless Congress decided otherwise. It repealed authority for construction. The law authorized appropriations of $17.5 million for FY 1975, $20 million for FY 1976, and $20 million for FY 1977. It included an important new provision that gave the Director more flexibility in the use of funds by merging all appropriations into one and permitting him to allocate funds among the various grant programs as circumstances warranted. 405 a history of the national library of medicine Progress of the Grants Programs, 1970-1976 In the renewal of the MLA legislation, Congress permitted the Library to broaden the scope of research and development grants by awarding funds to finance the cost of exhibiting and evaluating new devices or methods under operating conditions, so that practical ones could be recognized and adopted quickly by libraries. Desiring to focus research on promising areas, NLM set up review groups in 1974 and 1975 to discuss trends in information science and establish desirable goals for researchers. The participants believed that computers would be utilized more and more in transferring information. But- tressed by this opinion the Extramural Program thereafter encouraged projects that would lead to improvements in the storage and retrieval of biomedical information and to the rapid communication of data from biomedical researchers to physicians and educators. From the beginning of the Extramural Program to June 30, 1976, NLM awarded $11,150,000 to support 339 research projects. Of these sums, $5,150,000 was awarded for 263 projects under the extension acts, 1970 to 1976. Under the extension acts the Library adopted the philosophy of awarding resource grants primarily to strengthen or establish community hospital li- braries, particularly to make them active participants in the regional medical library network. Under the original act funds could be awarded only for the purpose of improving or expanding libraries: the extension act permitted funds to be awarded to create libraries. Under the original act the amount of a grant awarded to a library depended upon the size of that library's operating budget for the previous 3 years; the more a library spent the more it could receive. This provision funneled more money to the well-endowed libraries, less to the poor. The extension act repealed this provision, allowing small, poor libraries to be benefitted. All institutions that received grants had to promise to help support themselves with other funds. The extension act set up two types of resource grants, the resource im- provement grant and the resource projects grant. The former was a 1-year, non-renewable grant of $3,000, awarded to institutions, such as community hospitals, to enable them to establish libraries. It was also awarded to small institutions to help them acquire books, journals, and other materials. The resource projects grant was a 1- to 3-year grant ranging from $1,000 to $200,000 a year, to stimulate libraries to improve or expand services. Recipients used these grants for a variety of activities, including the development of automated systems for library technical services, and the setting up of learning resource centers containing audiovisual materials, computer-assisted instruction pro- grams, self-teaching modules, and other new devices. By the end of June 1976 the Library had awarded 2,588 resource grants with a value of $23,605,000. Of these 2,223, totaling $11,805,000, were awarded under the MLA extension acts. The first extension act, 1970, increased the authorized appropriation for construction grants to $11 million for FY 1971, $12 million for FY 1972, and 406 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS $13 million for FY 1973. It also modified provisions of the original law. But the erection of libraries was expensive, austerity had arrived, and no money was appropriated for the purpose. The second extension act, 1973, did not continue NLM's authority to provide grants for construction, and the extension of 1974 repealed the authority. The first extension act authorized NLM to support regional libraries with contracts as well as grants. Director Cummings had requested this change because the Library staff had learned, after starting the regional library network, that it was difficult with grants to bring about uniform practices, such as the formulation of MEDLARS searches and delivery of documents and photocopies, in 10 different institutions. The use of contracts permitted NLM to divide the funding of regional libraries into a service component, funded by contracts, and a research and development component, funded by grants. Under contracts all 10 libraries provided similiar services under uniform policies, while simul- taneously using grants they enjoyed considerable freedom in developing their resources and facilities. Furthermore contracts permitted NLM to coordinate the planning of the network. At first some regional libraries were unhappy over the switch from grants to contracts, but within a year or two they came to prefer contracts for support of services. After the initial extension act was passed, NLM began to phase out grants for financing traditional education in librarianship. The Library decided to do this after surveys indicated that the shortage of medical librarians had decreased but that advanced training of librarians was desirable. Instead the Library began to assist health scientists to receive instruction in the use of computers in medical research, education, and health care. The first grants under this policy were awarded in 1972. Scores of institutions expressed interest in the new training grants program. Up to the end of fiscal year 1976 NLM awarded grants totaling $9,256,000 for the training of 650 persons. Approximately half of this, $4,756,000 was awarded under the MLA extension laws for the training of 300 persons. Under the extension acts the Library continued to support health scientists in preparing scholarly book-length works on subjects of broad interest. The works of the grantees covered a wide range. Some of the topics were: the pathophysiology of respiratory disease; the causes and treatment of infectious diseases in humans; a systems analysis of health systems; a study of graduate education in occupational medicine; the development of medical education in the United States; and analysis and interpretation of the worldwide literature on malignancies occurring in the generation system or resulting from the re- productive process. By June 1976 NLM had awarded $691,000 to assist 28 scholars. The extension acts contributed $491,000 to 21 scholars. The largest category of publications supported from 1965 to 1976 was sec- ondary literature aids, such as atlases and bibliographies. The second largest was works on history of medicine. In 1974 the EMP shifted emphasis in as- sistance from secondary literature aids to critical reviews and biomedical mon- 407 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE ographs which identified the current state of research or practice in a certain field. At the same time the EMP decided to give priority to small grants and to writings requiring only publication costs. More grants were awarded for publication under the extension acts than under the original MLA act. By June 1976, 238 grants in the amount of $5,191,000 had been awarded since the beginning of the program, 195 valued at $2,891,000 under the extension acts. The legislation that served as the foundation of the Library's grants program was referred to more than once as a "landmark."25 "The act was well conceived," stated one librarian, "and in the short time of its existence, the beneficial effect is everywhere apparent."26 The president of the American Optorrietric Asso- ciation commented: "The Medical Libraries Assistance Act has been of immense benefit to schools and colleges of optometry, as well as other repositories of health and medical resources material."27 The initial decade of the Library's effort to aid other medical libraries was an outstanding success. "The National Library of Medicine has made remarkable progress in its efforts to bring the Nation's medical library resources up to desirable levels," wrote a witness to the events.28 A prominent dentist stated: "The programs of assistance for re- search, regional medical libraries, library resources, scientific publications, and training of personnel for the new technologies in the fields of bio-medical communication and information sciences have assisted immeasurably in im- proving the critical situation with regard to information handling and dissem- ination."29 By 1976 thousands of hospital, medical school, society, and other health libraries had been strengthened, but many still waited for aid to improve themselves so they could provide the most rapid, complete service to users. From the beginning of the program until the end of fiscal year 1976, the Library awarded grants as follows: Program Construction Training Special Scientific Projects Research Publications Resource Regional Medical Library* Totals "Includes funding by contract. Notes 1 Adams was born on November 20, 1909. idence, Rhode Island, Public Library. In 1945 After graduating from Yale in 1930 he taught for he came to the Army Medical Library as chief a year and then entered the book trade. From of acquisitions, in January 1947 was promoted 1939 to 1942 he attended Columbia University to the post of The Acting The Director (surely School of Library Science and also supervised the oddest title ever in AML), and in October the acquisition division of the Teachers College 1949 became assistant to the Director. He went Library, Columbia. From 1942 to 1945 he su- to the National Institutes of Health as librarian pervised the order-catalog department of Prov- in 1950, where he also organized and managed Number Amount 11 $11,250,000 148 10,309,000 28 691,000 339 11,150,000 238 5,191,000 2,625 23,605,000 89 18,714,000 3,478 $80,910,000 408 THE LIBRARY'S PROGRAM FOR AWARDING GRANTS the Russian Scientific Information Program, to the National Science Foundation as director of the Foreign Science Information Program in 1959, and returned to NLM as deputy director for Extramural Programs in 1960. After retiring from NLM in 1970 he worked for the Interna- tional Council of Scientific Unions and the For- eign Secretary, National Academy of Sciences, as their representative on the Joint ICSU/ UNESCO UNISIST study. He then assisted Unesco, the National Science Foundation, and the Department of State on a variety of assign- ments relating to the initiation, development and management of the UNISIST program. He also served as chairman of the Committee on International Scientific and Technical Informa- tion Programs of the National Academy of Sci- ences during its efforts to define national inter- ests in the international exchange of scientific information. He participated in bilateral activ- ities through the academy, and the Agency for International Development relating to the de- velopment of national scientific information policy in Latin America, Taiwan, USSR, and Egypt. 2 Information on the NLM grants program may be found in tape-recorded recollections of Martin Cummings, Frank B. Rogers, Scott Ad- ams, Marjorie Wilson, and Carl Douglass. In- formation was also obtained from Jeanne Brand, Mary Corning, and Arthur Broering. Annual reports of the library, and NLM News contain data on the programs. The most informative documents are those of the Board of Regents, particularly the transcripts of meetings. 3 Memo, Director NLM to Surg. Gen., July 28, 1960, sub: Request for opinion of General Counsel on legislative authority for proposed programs of National Library of Medicine. 4 Memo, Director NLM to Surg. Gen., Oct. 8, 1960, sub: Legislative authority for extra- mural programs, NLM. 5 Federal Support of Medical Research. Re- port of the Committee of Consultants on Med- ical Research to the Subcommittee on Depart- ments of Labor and Health, Education, and Welfare of the Committee on Appropriations, United States Senate, 86th Cong., 2d sess., 1960. This report recommended that aid be extended to medical libraries. For deficiencies in medical libraries see J. E. Deitrick and R. C. Berson, Medical Schools in the United States at Mid-century (N.Y., 1953): Scott Adams, "Medical Library Resources and their Development,"/. Med. Educ. 38: 20-27 (1963); "Medical Libraries are in Trouble," Libr. J. 88: 2615-21 (1963); "Hospital Libraries: Underdeveloped Base for Continuing Educa- tion," Hospitals 38: 52-4 (June 16, 1964). 6 Records of the Board of Regents, particu- larly the meeting of Nov. 5, 1960, in which Ad- ams discussed his and Brodman's proposed grants programs. The National Library of Medicine Proposed Extramural Program, Mar. 29, 1961. F. B. Rogers, "The National Library of Medi- cine's Role in Improving Medical Communi- cation," statement to the Subcommittee on De- partments of Labor, and Health, Education, and Welfare of the Appropriations Committee, U. S. House of Representatives (1962): copy in MS/ C/295. "The National Library of Medicine and the Library Component in Communication," a report prepared for the House Committee on Interstate and Foreign Commerce (March 1963): copy in MS/C/295. Also, Rogers' statement in 87th Cong., 2d sess., Departments of Labor, and Health, Education, and Welfare Appropri- ations for 1963, part 2, pp. 746-58. 7 H. Bloomquist, "The Status and Needs of Medical School Libraries in the United States," /. Med. Educ. 38: 145-63 (1963). 8 Memo, Acting Surg. Gen. to Bureau and Division Chiefs, PHS, July 1, 1961, sub: Trans- fer of responsibility for Russian scientific trans- lation program. 9 Surgeon General's Conference on Health Communications, November 1962 (DHEW, PHS, 1963). 10 PHS Delegation of Authority No. 40, Mar. 29, 1963. 11 Letter, Joseph Campbell, Comptroller General of the United States, to Secretary DHEW, Mar. 4, 1964. Letter, Martin Cum- mings to F. Ellis Kelsey, Special Assistant to the Surgeon General for Scientific Communi- cation, May 13, 1964. Records of the Board of Regents. 12 Associate directors for the Extramural Program were: Marjorie P. Wilson, March 1964- January 1968; David F. Kefauver, January 1968- March 1970; Leroy L. Langley, March 1970- February 1973; Ernest M. Allen, March 1973- 13 Details of the Scientific Activities Over- seas (Special Foreign Currency Program), in which several segments of the Public Health Service, among them the Library, were in- volved may be found in the annual hearings of the PHS before the House Subcommittee on Appropriations. Information on the Library's role may also be found in the parts of the hearings devoted to the Library. Titles of works translated and published under the Foreign Currency Program may be found in annual reports of the Library. 14 Representative Lesinski's remarks may be found in 88th Cong., 2d sess., Hearings before a Subcommittee of the Committee on Appro- priations . . . Department of Health, Educa- 409 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE tion, and Welfare, Part 2, Public Health Serv- ice, np. 599-602. »» 88th Cong., 2d sess., Bill H.R. 10809, making appropriations for FY 1965, introduced Apr. 10, 1964, pp. 34-35. Report 1316, to ac- company H.R. 10809, Apr. 10, p. 37. Blake's program may be found in the hear- ings cited in the previous note, pp. 600-602. 16 A list of the nine initial awards are in the annual report of Library for FY 1965. 17 President's Commission on Heart Dis- ease, Cancer, and Stroke, A National Program to Conquer Heart Disease, Cancer, and Stroke (GPO, vol. 1, 1964, vol. 2, 1965). Among other influential reports was the Surgeon General's Conference on Health Communications, No- vember 1962 (DHEW, PHS, 1963). 18 89th Cong., 1st sess., Hearings . . . on S. 597, June 14and 15, 1965. Hearing. . . on H.R. 3142 and H.R. 6001, Sept. 14, 1965, Serial 89- 23. 89th Cong., 1st sess., Bill S. 597 "To amend the Public Health Service Act to provide for a program of grants to assist in meeting the need for adequate medical library services and facil- ities." Bill H.R. 3142 introduced by Harris Jan. 19. Bill H.R. 6001 introduced by Fogarty, Mar. 19. Senate Report 756 to accompany S. 597. House Report 1026 to accompany H.R. 3142. 19 Public Law 89-291, An act to amend the Public Health Service Act to Provice for a Pro- gram of Grants to Assist in Meeting the Need for Adequate Medical Library Services and Fa- cilities. Usually referred to as the Medical Li- brary Assistance Act of 1965. 20 The authority to set up branches of NLM was placed in the law by the House to make certain that states, as Alaska and Hawaii, that might not be served by a regional library could be served by an NLM branch library. For an excellent assessment of the grants programs see Martin Cummings and Mary Corning, "The Medical Library Assistance Act: an analysis of the NLM Extramural Programs, 1965-1970," Bull. Med. Libr. Ass. 59: 375-91 (1971). 21 91st Cong., 1st sess., Bill H.R. 11223 in- troduced by Harley Staggers, May 13, 1969. Bill S. 2549, providing for a 5-year extension, intro- duced by Ralph Yarborough, July 7, 1969. Bill H.R. 11702, for a 1-year extension, introduced for the Administration by Harley Staggers, May 27. Bill S. 2239, for a 1-year extension, intro- duced for the Administration by Peter Dom- inick, May 23. House Report 91-313, June 17, 1969, to accompany H.R. 11702. Senate Report 91-180, Oct. 16, 1969, to accompany H.R. 11702. See debates in Congressional Record. Legislative History of the Medical Library Assistance Extension Act of 1970, P.L. 91-212, contains bills, reports, excerpts from Congres- sional Record; and the law: NLM. 22 Bill S. 3752 introduced June 26, 1972, passed by the Senate, Aug. 16, passed again as an amendment to S. 3716, Sept. 20. Senate Report 92-1004 to accompany S. 3752. 23 93d Cong., 1st sess., Serial 93-33, 1973. Health Programs Extension Act of 1973 Hear- ings . . . Committee on Interstate and Foreign Commerce, House of Representatives ... on H.R. 5608 and S.1136 (and all identical bills), Bills to extend through fiscal year 1974 the ex- piring appropriations authorizations in the Pub- lic Health Service Act, the Community Mental Health Centers Act, and the Developmental Disabilities Services and Facilities Construction Act, and for other purposes, Mar. 27, 28, 29, 1973. Programs for Health Services Research, Health Statistics and Medical Libraries. Hear- ings . . . on H.R. 7274... and H.R. 6387, H.R. 6586, and H.R. 6590 . . . May 10, 11, and 14, 1973. Serial 93-32. Health Programs Extension Act of 1973. Public Law 93-15. 24 93d Cong., 2d sess., Bill H.R. 11385, to amend the Public Health Service Act to revise the programs of health services research and to extend the program of assistance for medical libraries. House Report 93-757 to accompany H.R. 11385. 93d Cong., 2d sess., Bill S. 2996. Health Legislation, 1974; Hearing . . . Subcommittee on Health . . . Committee on Labor and Public Welfare, United States Senate ... on S. 2996 ... H.R. 10957, Feb. 19, 1974. Senate Report 93-764 and Report 93-768 to accompany Bill H.R. 11385. House Report 93-1170, the conference re- port to accompany H.R. 11385. Public Law 93- 353, Title II. 25 See, for example, statement by Robert C. Berson, executive director, Assoc. Amer. Med. Colleges, in House of Representative hearings on the MLA Act, Serial 91-93. 26 Ursula H. Anker, librarian, Albany Med- ical College, quoted in reference above. 27 Communication by Robert E. Day, pres- ident, Amer. Optometric Assn., in Senate Re- port 93-764. 28 Ernest B. Howard, executive vice presi- dent, Amer. Med. Assoc., quoted in House of Representative Hearings, Serial 91-93. 29 Letter by C. Gordon Watson, executive director, Amer. Dental Assn., in Senate Report 93-764. 410 XXII The Specialized Information Services The Drug Literature Program THE rapidly increasing literature about drugs in the years following World War II, the difficulty that researchers and physicians faced in obtaining data quickly on new medicines or on compounds tested as medicines, and the need for immediate warning about harmful drugs such as thalidomide, con- vinced Senator Hubert Humphrey, among others, that some means, perhaps a "National Drug Information Clearinghouse," was needed to collect, organize, and disseminate information on the subject. The director of Humphrey's sub- committee, visited the Library several times to discuss the matter with Director Rogers, Winifred Sewell and others. Deputy Director Adams spent much time at the Senate Office Building assisting the staff. In 1962 Humphrey asked Rogers to prepare a study on "The Nature and Magnitude of the Drug Literature." Sewell, who had been librarian of Wellcome Research Laboratories and Squibb Institute for Medical Research before coming to NLM, and was editor of Un- listed Drugs, wrote the report which emphasized the wide dispersion of material on drugs. Senator Humphrey, who had been a pharmacist before entering public life, used this report to buttress his proposal for the establishment of a special program in the Library to cope with the literature. The following year the President's Commission on Heart Disease, Cancer and Stroke also rec- ommended that a National Drug Information Clearinghouse be established in NLM.1 Elsewhere the chief proponent for a drug information center was F. Ellis Kelsey of the Public Health Service. Kelsey, whose wife Frances O. Kelsey had helped keep thalidomide off the U.S. market, helped evolve a plan for the collection, organization, and dissemination of data on drugs. The plan advocated a division of work between the Food and Drug Administration, NIH, and the Library. The FDA would collect and disseminate information on unpublished work, NIH would support research and development to improve methods of handling chemical and biological data, and the Library would be responsible for published literature. Kelsey hoped to be placed in charge of the Library's program, with a large staff and considerable funds. But the amount of money and number of employees eventually allotted were considerably less than Kel- 411 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE sey expected. He died suddenly, and the leadership of the emerging program passed to others. In the autumn of 1964 the Administration placed funds in the 1966 budget to establish a coordinated system for collecting, organizing, and disseminating information on drugs within the Department of Health, Education, and Wel- fare. One million dollars was allotted to the Library for development of a drug information clearinghouse, $2.5 million was pinpointed for the Food and Drug Administration, and $1.5 for NIH. Informed of the approaching appropriation, Director Cummings placed Sewell in charge of the program. She drew up plans to extend the level of NLM's activities in drug literature, using approximately two-thirds of the ap- propriation for development of an in-house program and the remainder for grants and contracts. Six functions were anticipated: collection of all published literature on drugs; expansion of the number of publications covered by MED- LARS in the drug field; improvement of drug terminology in MESH so that articles on drugs could be indexed more accurately; expansion of reference and search services to researchers and to those engaged in regulatory work; pro- viding of abstracts, translations, and bibliographies of articles about drugs; and research in communication of information on drugs to the biomedical com- munity. When funds became available Sewell began to engage a staff of pharma- cologists, biochemists, medicinal chemists, and information specialists. She made arrangements for the Library to acquire more drug literature, particularly that supplied by card and microfilm services which had been previously ex- cluded by the acquisition policy, and to subscribe to drug information services oriented primarily toward industry. Drug journals published throughout the world were examined to determine which should be added to the journals already being indexed for MEDLARS. Pharmacological terminology in MESH was improved so that drug articles could be indexed more precisely. Professional societies cooperated in the development of MESH by appointing panels of specialists to give advice on terminology. The American Hospital Formulary Service and the Library agreed to employ the same terminology insofar as feasible. At NLM's suggestion the Pharmaceutical Manufacturers' Association sent librarians to assist in the development of the Library's drug information program in exchange for access to MEDLARS, which at the time was available only to nonprofit organizations. The DLP desired to index articles on drugs in a much more detailed manner than the usual medical article, so that regulatory agencies, researchers, phar- macists, physicians, and others who needed precise information about thera- peutic use, pharmacologic action, and chemical composition of a compound could obtain it quickly. Moreover, it was important that the indexing be related to a specific chemical entity. At the time, Chemical Abstracts Service, under contract to National Science Foundation, was endeavoring to place on computer tape the registry numbers and detailed chemical descriptions of the millions 412 THE SPECIALIZED INFORMATION SERVICES of compounds indexed in Chemical Abstracts. Since the Cancer Chemotherapy National Service Center, the Food and Drug Administration, and the Drug Literature Program were all interested in a subset of this data base, the three groups agreed to extend the funding for this contract and have Chemical Ab- stracts Service register selected drugs and chemicals found in specific sources designated by the three groups. The tape, delivered in 1968, covered about 31,000 compounds in the fields of drugs, cosmetics, food additives, and other products. The data were also produced as Desktop Analysis Tool for the Com- mon Data Base (six volumes), distributed by the National Technical Information Service. It had been the intention of the Drug Literature Program to use the Chem- ical Abstracts data for synonym matching, to aid NLM indexing, and possibly to assign chemical class terms for MESH automatically. Computer programs for an auxiliary chemical module were partially written to enable this name matching process to proceed, but they were never completely tested and im- plemented owing to the redirection of emphasis during the development of MEDLARS II. The Drug Literature Program's first bibliography was a monthly compilation of information on the adverse effects of drugs for the FDA. In July 1966 the DLP turned to MEDLARS to produce a pilot issue of Toxicity Bibliography, a list of reports on toxicity studies, adverse drug reactions, and poisoning in man and animals compiled from approximately 2,500 journals. After receiving suggestions for improvement of the bibliography from toxicologists, pharma- cologists, pharmacists, and clinicians to whom the publication was sent for review, DLP modified the format and produced a second pilot issue in the spring of 1967. Following further modifications, the Library published the bibliography on a regular quarterly basis from 1968 until 1978. The Toxicology Information Program While the Drug Literature Program was evolving in the Library, the related subject of toxicology was receiving much publicity throughout the United States. Reports of harmful effects of chemicals in food, water, and the environment, along with the publication of articles and books such as Rachel Carson's Silent Spring aroused the public's interest and alarm. In 1964 James A. Shannon, Director of NIH, convened a group of NIH's pharmacologists to study the effects of environmental chemical contaminants upon life. The President's Sci- ence Advisory Committee, impressed by the NIH study, recommended the establishment of a National Toxicological Information System.2 President Lyn- don Johnson accepted the recommendation and assigned to the Department of Health, Education, and Welfare the responsibility for developing a computer- based file of toxicological information. From the Secretary of DHEW the re- sponsibility passed down to the Surgeon General and finally to the Library.3 Director Cummings was concerned that NLM did not have the funds and specialized manpower to develop the large information service visualized by 413 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE his superiors in NIH, PHS, and DHEW, but he accepted the responsibility with the understanding that the Library would receive adequate resources. The Surgeon General transferred funds and four positions from his office to NLM to enable the program to begin. In December 1966 Cummings appointed Charles N. Rice, a chemist with industrial, academic, and governmental ex- perience, to organize the program. Rice prepared a plan that was implemented after approval by a DHEW Departmental Toxicological Information Coordi- nation Committee. Because the activities of the Drug Literature Program were similar to the new Toxicological Information Program, the former was placed under Rice's supervision on May 17, 1967. The name Specialized Information Services was coined to cover both units. The DLP had focused primarily on acquiring, indexing, and compiling drug information. Since these activities overlapped ongoing library operations, some members of the staff were gradually transferred to sections of the Library responsible for these activities. Finally in 1970 the DLP was abolished leaving the Toxicology Information Program as the major element in the Specialized Information Services. Development of the Toxicology Information Program Shortly after the Toxicology Information Program was established, Cum- mings requested the National Research Council-National Academy of Sciences to form an advisory committee, generally referred to as TIPCOM. Composed of several scientists prominent in toxicology and related fields, TIPCOM pro- vided advice on the scope and priorities of the program. Since the number of persons in TIP was small, much of the development, compiling, arranging, and other work had to be done by contractors, leaving the staff free to plan and manage. Rice negotiated contracts with University of Pittsburgh, University of Pennsylvania, and commercial firms to obtain several products, among them a directory of toxicology information resources in gov- ernment agencies, industrial companies, and universities; a roster of experts in the various areas of toxicology; a data bank of user needs of toxicological information and data; and the design of a computerized data storage and on- line retrieval system for toxicology. Director Cummings had expected to receive an increase in funds and po- sitions each year to build the large program envisioned by the originators. However within a year or two it became apparent that the increase would not materialize:4 Fiscal Year 1967 '68 '69 '70 '71 '72 '73 '74 '75 '76 Anticipated funds 0.5 2.3 5.9 Obligations, millions 0.051 0.586 1.380 1.240 1.311 1.315 1.533 1.747 1.881 1.9 Anticipated personnel 20 41 57 Actual personnel 10 18 18 18 17 17 16 17 17 17 Therefore, the ongoing broad program covering many facets of toxicology could not be continued. The Library had to choose narrower but attainable goals that 414 THE SPECIALIZED INFORMATION SERVICES would allow TIP to function within its limited resources and to perform useful services as quickly as possible. Under Henry M. Kissman, a pharmaceutical chemist and information specialist, who arrived from the Food and Drug Admin- istration in June 1970 to direct TIP, the primary objectives became: the op- eration of services to provide toxicological information and data to the scientific community; an increased collaboration with other government agencies which possessed data and information relevant to TIP's subject area or could use the services of TIP; and a continuation of the development of computerized toxi- cological data banks. TIP provided services through publications, query-response, and the op- eration of a variety of on-line retrieval files and systems. The first of TIP's publications was a Directory of Information on Resources in the United States: General Toxicology (1969) prepared by the National Referral Center for Science and Technology at Library of Congress. Others included Drug Interactions, an Annotated Bibliography with Selected Excerpts, prepared by Paul de Haen, Inc.; Index to the Report of the Secretary's Commission on Pesticides and their Relationship to Environmental Health, prepared by Sharon Valley using a whole text data processing system; Abstracts on Health Effects of Environmental Pollutants, a monthly abstract journal initiated by TIP and published by Bios- ciences Information Service of Biological Abstracts. The query-response service was brought about by an agreement between the Library and the Atomic Energy Commission to establish the Toxicology Information Response Center at the Oak Ridge National Laboratory. The center drew on the resources of the Library and Oak Ridge to provide answers to questions from users. The answer generally consisted of a bibliography compiled by computer searching of on-line files such as MEDLINE and hand searching of conventional sources like Chemical Abstracts, Biological Abstracts, and Sci- ence Citation Index. Some of the queries received by the response center required considerable time and labor to answer. The Board of Regents approved Kissman's recom- mendation that searches completed within 2 hours be free, but those over 2 hours be charged $15 for each additional hour, the money reverting to the Oak Ridge Laboratory to help offset the cost of the service. Some of the bibliog- raphies compiled by the center were considered to be of such wide interest that they were published. The Library's first whole text computerized search system was developed under the direction of Donald J. Hummel in TIP using Health Aspects of Pesticides Abstracts Bulletin and the facilities of a contractor, Mead Data Cen- tral Corp.. This served as a prototype for a nationwide retrieval service named TOXICON, developed with the aid of a contractor, Informatics, Inc.. TOXI- CON, an acronym for toxicology information conversational on-line network, was demonstrated by Specialized Information Services in April 1972. Regular service to subscribers was inaugurated on October 1 through the commercial Tymshare network. TOXICON at first contained citations from Toxicity Bib- 415 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Several of the publications provided to scientists working in the fields of pharmacology, toxicology, environmental pollution, and related disciplines by the Library's Specialized Information Services. liography, Health Aspects of Pesticides Abstracts Bulletin, Chemical-Biological Activities, Abstracts on Health Effects of Environmental Pollutants, and a pri- vate collection of citations on pesticides compiled by Whalen J. Hayes. Later, citations from other files and services were introduced into the system. In 1973 the name TOXLINE, for toxicology on-line, replaced the name TOXICON. The following year the system, which had been operated by a contractor outside of the Library, was brought inside since NLM could now handle whole text search capabilities. 416 THE SPECIALIZED INFORMATION SERVICES Following the successful establishment of TOXLINE, Bruno M. Vasta began to develop a companion file, the toxline chemical dictionary, based upon the Chemical Abstracts Service registry numbers contained in TOXLINE. This file contained chemical identification data extracted and reformatted from data supplied by Chemical Abstracts Service, including generic and trivial names, registry numbers, and molecular formulas. These data, considered proprietary by CAS, required royalty payments based upon use. The file was tested as a prototype while running with TOXLINE in the National Aeronautics and Space Administration RECON satellite system and later was improved and renamed CHEMLINE when the service was offered directly from the Library. In 1974 Michael Oxman and the TIP staff began to develop an on-line interactive computer-based data retrieval system that would provide access to chemical, physical, toxicologic, pharmacologic, use, and manufacturing data on hundreds of selected chemicals. The toxicology data bank, as the compilation was named, became available to U. S. subscribers of the Library's on-line computer services in November 1978. TIP collaborated with Federal agencies and NIH Institutes in designing and developing other on-line bibliographic and data files. These included CAN- CERLIT and CANCERPROJ, with the staff of the National Cancer Institute; EPILEPSYLINE, with the staff of the National Institute of Neurological and Communicative Disorders and Stroke; and RTECS (registry of toxic effects of chemical substances) with the staff of the National Institute for Occupational Safety and Health. The most widespread collaboration of the Specialized Information Services occurred in the Toxicology Information Subcommittee of the DHEW Com- mittee to Coordinate Toxicology and Related Programs. This committee, or- ganized by the Assistant Secretary for Health, was composed of representatives of 13 organizations within DHEW and liaison representatives from 13 other Federal agencies. Headed by Kissman, the information subcommittee drew a list of desirable projects to be undertaken by TIP. When the Assistant Secretary was able to obtain funds, TIP began the most urgent project. One of these was the laboratory animal data bank, LADB, a computerized repository of evaluated baseline data on many strains and species of animals such as mice, rats, rabbits, dogs, and monkeys used in research. Battelle Columbus Laboratory collected the data under contract from institutions throughout the United States, and the Library made the data available through an on-line retrieval and statistical analysis system designed for use by scientists, breeders, and managers of lab- oratory animal research. Formal training in computer retrieval logic was not necessary for use of this system. Another important project was a periodical that provided news of toxicity tests being carried out or considered by com- panies, universities, and government agencies. TIP collected the information and sent it to National Technical Information Service, which published it in a monthly bulletin titled Tox-Tips (from toxicology testing-in-progress). In a third project, reports about planned and ongoing research in toxicology were ex- 417 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE tracted from the data bank of the Smithsonian Science Information Exchange and published through NTIS as the monthly Toxicology Research Projects Directory. In the 1960s when the Library was given responsibility for the Drug Lit- erature and Toxicology Information programs, Director Cummings expected to receive authority to hire the relatively large number of professional em- ployees and to receive the large annual appropriations envisioned by those who conceived the programs. Instead he was given authority to hire only a few scientists, and he received only a relatively small amount of money for the work. As a result, the Specialized Information Services had facilities and per- sonnel to carry out only a fraction of possible worthwhile projects and at times was able to undertake an important proposal only by obtaining funds and borrowing positions from collaborators. The staff of the service demonstrated ingenuity and skill in accomplishing so much with limited resources. Notes 1 Information on the Drug Literature and Toxicology Information programs may be found in records of the Board of Regents, annual re- ports of the Library, NLM News, and articles published by members of the staff. Information was also obtained from Martin Cummings, Win- ifred Sewell, Charles Rice, George Cosmides, Henry Kissman, Donald Hummel, Sharon Val- ley, Arthur Wykes, and Donald Walker. 88th Cong., 1st sess., Committee Print, Drug Lit- erature. Report prepared for the Study of "Interagency Coordination in Drug Research and Regulation" by the Subcommittee on Re- organizations and Internal Organizations of the Senate Committee on Government Operations. A factual Survey on "The Nature and Magnitude of Drug Literature" by the National Library of Medicine. Aug. 30, 1963. 2 Handling of Toxicological Information. A Report of the President's Science Advisory Com- mittee (Washington, The White House, 1966). 3 Memo, Philip Lee, Asst. Sec. for Health and Scientific Affairs to Sec. DHEW, Sub: De- velopment of Toxicological Information System, Jan. 31, 1967. 4 Obligations and personnel are from annual reports of the Library. Anticipated funds and personnel are from memo, Surg. Gen. William Stewart to Sec. DHEW, sub: Development of toxicological information system, Dec. 12, 1966. 418 Ill The Lister Hill National Center for Biomedical Communications Research and Development in the Library FROM the time of Director Cummings' early days in the Library he was captivated by the idea of converting the institution from a traditional medical library into an active information center. He felt that rapid commu- nication involving radio, television, telephone systems, computers, and other devices was the way of the future in libraries; that research ought to be carried out to test new networks for communicating biomedical information and to evaluate information retrieval techniques, graphic storage and retrieval, com- puter software for information retrieval, and other devices and systems. He was given an opportunity to express his views in 1965 when Surgeon General Luther Terry, concerned about the role of communications among the many new health programs, asked the Board of Regents for a statement of the Library's policy. The policy, drafted by members of the staff and the Board, stated that the Library should, among other things "support experimental programs, both intramural and extramural, to test multiple approaches to meeting the needs for biomedical information ... be a national resource for information systems research and development relevant to human health . . . serve as a clearing- house and coordinating agency for information systems R and D within the Public Health Service. "J While the policy was being drafted, the Department of Health, Education, and Welfare asked all of its agencies to draw up their plans for the next 5 years, fiscal years 1966 through 1970. In its forecast the Library outlined the task it hoped to accomplish through the establishment of a Center for Biomedical Communications, housed in a new building, staffed by scientists carrying out research and development in information systems, and developing and dem- onstrating methods for the continuing education of workers in the health profes- sions. In the meantime Cummings talked to Representative John Fogarty and Senator Lister Hill, whom he knew, about the possibility of obtaining authority and facilities to carry out research. They encouraged him to seek permission 419 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE from Congress, and Fogarty promised to support a bill to appropriate funds if authority were obtained. At Fogarty's suggestion Cummings conferred with Representative Paul Rogers about the need for research, and also met with members of the pertinent subcommittee staff. As a result of these discussions the House Subcommittee on Reorganization issued in 1966 a report recommending that the Library establish a research center in biomedical communications, coordinate all health communication activities in the Public Health Service, establish a national biomedical infor- mation clearinghouse and referral service, and have transferred to it the Medical Audiovisual Branch, at that time a part of the PHS's Communicable Disease Center in Atlanta, Georgia. And most importantly the House and Senate Sub- committees on Appropriations recommended that NLM receive $118,000 and four new positions to begin R&D. With the funds Cummings engaged Ruth Davis of the Department of De- fense as the Library's associate director for research and development. She arrived on April 24, 1967, and for a while worked alone, laying the foundation for the program. During the second half of 1967 she recruited several engineers and scientists to serve as the nucleus of the R&D staff. She and her associates began to draft plans for a biomedical communications network, to be developed over the following 5 years. The Lister Hill National Center for Biomedical Communications Parallel with Cummings efforts to gain authority and funds for a R&D program was his attempt to obtain a building to house a research staff, facilities, and employees hired within recent years. In the interval since the Library building had been occupied in 1962, NLM had expanded its activities. It had acquired the computer-based MEDLARS system, a grants program, a drug literature program, and a toxicology information program. Three hundred and forty employees were squeezed into space designed for 250. Areas in the stacks intended to house books had been converted into offices. Space for the Extra- mural Program staff had been rented in a structure in Bethesda. The R&D employees that Cummings hoped to hire would have overflowed from the Library building. In early 1967, after Congress had indicated that it would appropriate funds for research, Cummings engaged the firm of O'Connor and Kilham, designers of the Library building, to draw up a preliminary plan for an annex to house the Library's recent activities. And since the Library's interior had been mod- ified from the original design by the installation of computers and other equip- ment, the firm was also asked to plan a renovation of the existing structure, when and if an annex were built. The architects presented three possibilities; an annex the height of the Library building, one with a tower 15 stories high, and one with a tower of medium height. The annex would be close to but not against the south side of 420 THE lister hill national center for biomedical communications the Library, be connected at the underground levels, and have underground parking. Following the transfer of the National Medical Audiovisual Center to NLM on July 1, 1967, Cummings asked O'Connor and Kilham to prepare another feasibility study that would explore the alternatives of providing space for the center in the annex, or expanding the center's facility in Atlanta, Georgia. The following year Senator Lister Hill closed his long career in public life. After coming from Alabama to Washington as a Representative in 1923, he had served in the House until 1938 and then in the Senate. He had sponsored more influential health laws than any legislator in this century, including the Hospital and Health Center Construction Act, the Comprehensive Health Planning and Public Health Services Act, the National Library of Medicine Act, the Medical Library Assistance Act, the Regional Medical Programs Act, and the Hill-Harris Act of 1963.2 Learning of Senator Hill's decision to retire, Cummings suggested that he be remembered for his role in improving health care by having the annex named in his honor. Through Joseph F. Volker, a friend and a constituent of Hill, his suggestion was relayed to Senator John Sparkman, Hill's colleague, and to Alabama Representatives. They were enthusiastic about the idea. A short time later on June 20, 1968, the NLM staff, Board of Regents, Secretary Wilbur Cohen, Senators, Representatives, and friends held a recep- tion for Senator Hill in the Library. Senator Sparkman, the main speaker, emphasized the fitness of naming the annex the Lister Hill National Center for Biomedical Communications, "to perpetuate the name of the man who has done so much for the health of the nation, who has exhibited an abiding concern for . . . libraries in general and the National Library of Medicine in particular." Upon Senator Sparkman's suggestion Cummings and Scott Adams drafted a resolution embodying the sentiments expressed at the reception, and Senator Sparkman introduced this into Congress as a joint resolution on July 19. It was passed unanimously by the Senate, passed unanimously by the House on July 24, and signed by President Johnson on August 3.3 Cummings "redesignated the Library's R&D program as the Lister Hill National Center for Biomedical Communications. Secretary Cohen of HEW assigned to the center its functions, the most important of which were: to design, develop, construct, and manage a biomedical communications network; to apply advanced technology to improve biomedical aspects of biomedical communications, information systems and networks; and to represent DHEW in biomedical communication activities.4 Planning the Biomedical Communications Network In drafting the development plan the R&D group obtained advice from medical societies, professional associations, the Library's Board of Regents, and consultants to determine the needs of the medical community and establish priorities. It tried to envision the ways in which television, satellites, films, 421 A history of the national library of medicine computers, lasers, and other devices could be applied to medical communi- cations. It supplemented its own thinking with surveys made under contract by research institutes and university groups. When completed in June 1968 the plan outlined the logical, orderly pro- duction of a biomedical communication network during the next 5 years. It envisioned a national network composed of Library, Specialized Information Service, Specialized Education Service, Audio and Audio-Visual Service, and Data Processing and Transmission components. The network was to be managed by a staff of 64 persons with a budget of $16 million by fiscal year 1974. But Congress never appropriated funds for such a network; by 1974 the staff com- prised 20 persons and the budget $2,931,000, and by 1976, 24 persons and $ 1,475,000.5 Under the circumstances the only policy the Library could follow, dictated by relatively low funds, was to have the Lister Hill Center manage the research and development of parts of the network, with much of the work being done by contractors, and, after the systems had been demonstrated and evaluated, turn them over to others for operation. During its formative years the center staff engaged in a variety of tasks. They compiled an inventory of all the projects sponsored by DHEW involving the use of communication and information science technology. They set up a DHEW Scientific and Technical Information Publication Data System. They compiled a data bank, the medical resources file, containing all manner of statistics of use to Federal agencies, the biomedical community, and for use in planning the biomedical communications network. They were given the re- sponsibility of evaluating the decentralization of the MEDLARS system. They monitored the Library's contract with the Interuniversity Communications Council, the purpose of which was to determine how biomedical information might best be distributed over a network to physicians, hospitals, and schools. They helped evaluate the proposals for development of MEDLARS II. They pioneered in the development of individualized biomedical communication modules, containing a projector-viewer and tape recorder, for use in the ed- ucation of students and the continuing education of physicians. But during the first decade their major activities became the development of a time-shared, on-line retrieval system for searching data bases of citations to medical litera- ture; the illustrative application of biomedical communications to education through the development of an interactive television network and a computer- assisted instructional network; and the demonstration of the usefulness of sat- ellite communication in medical education and treatment. AIM-TWX The technology that permitted persons at a distance from a computer to communicate directly with the computer had been worked out only a few years before the Library began research in biomedical communications. As Davis and her associates drew up the Lister Hill Center's technical development plan, 422 THE LISTER HILL NATIONAL CENTER FOR BIOMEDICAL COMMUNICATIONS they included in it an on-line bibliographic retrieval system that would make the MEDLARS data file available to physicians nationally through the use of remote terminals. To work on this system Davis brought from the Defense Intelligence Agency Ralph Simmons, who had been in charge of the devel- opment of an on-line system for the Air Force. Simmons assisted with Lister Hill Center's development plan, but his main task was setting up a Remote Information Systems Center, a room containing terminals connected to data bases on computers in other locations. In the center MEDLARS operators familiarized themselves with the equipment and techniques for querying other data bases. Simmons and those associated with him used the terminals to learn about various data banks, models, programs, and programming languages of possible use to NLM. Using the computer of one contractor, System Devel- opment Corporation, located in Santa Monica, California, and the firm's on- line, time-shared retrieval system named ORBIT, the staff experimented with a small data base of citations to neurology articles and books:6 Simmons was certain that a system could be developed that would permit researchers, educators, librarians, and practicing physicians to communicate with MEDLARS. But the questions were, could it be done with the relatively small amount of money that was available, and would the benefits be worth the cost and time. The staff estimated the potential benefits by an analysis of the use of other systems, particularly the system opened by the State University of New York at Syracuse, SUNY in December 1968 using a MEDLARS data base. These estimates convinced them that MEDLARS would be searched by many more users if an on-line system were available. But as valuable as a system might be for NLM patrons, it had to be developed at a low cost or not at all. A relatively cheap communication link between the computer and terminal had to be found. Existing remote access systems communicated with their computers through special terminal equipment connected to leased telephone lines or teletypes and telephone lines. These communication methods were too expensive for NLM. The staff decided that the Teletypewriter Exchange System, TWX, could be utilized in place of telephone lines. TWX terminals had been installed in more than 500 libraries for transmission of interlibrary requests, and these could also be used for retrieval without purchasing addi- tional terminal equipment.7 Other remote access systems had tried the TWX network as a communications link, but in such a way that users had to lease new equipment or special devices to place on their teletypewriters. The MEDLARS data base contained more than 1 million citations, too many at that time for use in an available remote access system. An analysis of the Abridged Index Medicus base, containing approximately 100,000 citations from the most widely used journals in clinical medicine, indicated that it would be manageable and useful, particularly if supplemented by citations from additional journals. The AIM base was chosen for the proposed on-line system. The AIM data base and the TWX network provided two components of an 423 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE experimental system. The third component, the computer, was chosen after consideration of three alternatives. One alternative was a contract with SUNY to provide access to its computer system through the TWX network. NLM discarded this idea because it felt that the system could not be used over the entire nation unless it were improved substantially. Another alternative was to move the ORBIT or SUNY system to the Library and use the Library's com- puter. But transfers of the system would have been expensive, and operation within the Library would have interfered with the operation of MEDLARS. The third alternative was to provide service through System Development Corporation in Santa Monica, using the corporation's time-sharing computer, the TWX communication system, and the AIM data base. A contract with SDC would also give NLM a head start, for the corporation had already accumulated considerable experience with remote access systems while developing one for the Air Force. In the autumn of 1969 the Library engaged SDC to provide an experimental on-line retrieval system called AIM-TMX that would enable NLM to test the feasibility, use, and acceptance of such bibliographic service. The bibliograph- ical information published during the preceeding 5 years in over 100 journals of clinical medicine was stored in SDC's computer in California. The retrieval program was named ELHILL, for Lister Hill. NLM selected a group of hosp- tials, medical libraries, MEDLARS search centers, NIH institutes, and other users willing to cooperate in the experiment. The Library inaugurated the service in June 1970. Users could call the computer each day between 11:30 a.m. and 3:30 p.m. Eastern time from TMX terminals or from computer ter- minals connected to telephone lines. As many as 18 searchers could use the system simultaneously. The users paid the cost of calling the computer; NLM paid other costs. The Library kept the AIM-TWX data base available for users until Nov. 22, 1972 and then replaced it by a much larger data base, MEDLINE. The Experimental Computer-Assisted Instructional Network The success of the AIM-TWX network, which linked institutions all over the country to the Library's computer through economical communication lines, suggested to the LH staff that the same kind of network could be used for other purposes. One of these was a network of educational institutions joined through telephone lines and Tymshare to a computer in which instructional programs would be stored.8 A few institutions had already written programs for their students. Mas- sachusetts General Hospital employed its computer to teach students by sim- ulating disease syndromes, biomedical models, and clinical encounters. The Ohio State College of Medicine computer courses assisted first- and second- year medical students, nurses, nursing students, optometry students, graduate students, and physicians in community hospitals. The University of Illinois Medical Center's computer programs offered simulated clinical encounters which 424 THE LISTER HILL NATIONAL CENTER FOR BIOMEDICAL COMMUNICATIONS allowed free vocabulary entry and an interactive file of multiple choice ques- tions. In 1972 Harold Wooster, the LH project officer, contracted with these three institutions to permit other schools to connect with their computers and employ their courses. Arranging for the. teaching computers and the communications network, Tymshare, was only half of Wooster's task. The other half was pub- licizing the experiment and finding institutions willing to try computer-assisted instruction, CAI. Lister Hill paid for the use of computer facilities, the users bore the cost of communication to the nearest Tymshare city and provided their own terminals. Massachusetts General Hospital opened its computer to the network on 8 a.m., July 1, 1972. Ohio State connected its computer in September, and Illinois in January 1973. By February 1973 students in 45 institutions were learning various subjects with the help of computers. In May the Lister Hill Center held a meeting of users to evaluate the experiment and determine the direction it should take. Institutions were almost unanimous in their enthusiasm for the network. It was estimated that 70 percent of the audience were medical stu- dents, 5 percent were physicians, and the remainder were nurses, dental stu- dents, and other health workers. Through 1973 LH financed the cost of the computers and the Tymshare network. At its peak the network provided 3,000 connect hours a month to 100 users. Wooster calculated that the Library was paying $18.77 for each connect hour. The ever increasing cost became so great that the Library felt compelled to ask users to share the expense. Beginning in February 1974 institutions were charged $2.50 for each connect hour. In July the charge was increased to $5. The intention of Lister Hill had been to start and test the utility of CAI, not to operate an instructional network indefinitely. The experiment completed, Lister Hill prepared to close the network on May 30, 1975. Users had found CAI so valuable that they begged Lister Hill to continue financing it, but the Library did not have the funds—it had already paid $677,494 to Massachusetts General, Ohio State, and Illinois. Fortunately on June 1 users were able, with further assistance from LH, to start managing and financing their own health education network. The New Hampshire-Vermont Medical Interactive Television Network By the time the Lister Hill Center came into existence, educational tele- vision, ETV, was well established. Approximately 120 stations were operating in the United States. The Lister Hill staff saw the potential usefulness of ETV in medicine, and it entered the field by contracting with Rand Corporation for a study of costs of ETV stations and the percentages of physicians within reach of those stations. In the meantime an event took place that led LH to sponsor a large-scale 425 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Speech therapy session on the New Hampshire Ver- mont Medical Interactive Television Network (Interact). test of ETV in medicine. In 1968 NIH's National Institute of Mental Health financed a two-way closed circuit television hookup between Dartmouth Med- ical School and Mary Hitchcock Memorial Hospital, Hanover, New Hampshire, and Claremont General Hospital, 30 miles away, to see how effectively psy- chiatrists in a medical school could examine patients in a distant small com- munity hospital. The system was interactive; that is, persons at both ends communicated with each other. The experiment worked so well that Dean Seibert, assistant dean of community affairs of Dartmouth, talked with Ruth Davis about the possibility of LH's financing a network to explore the uses and benefits of interactive television in the rural areas of New Hampshire and Vermont. Since this fitted into the center's plans, and the Board of Regents had requested that priority be given to the application of biomedical com- munications in education, Davis agreed and placed Harold Wooster in charge of the project.9 Lister Hill engaged a research firm to study the proposed network, even- tually named Interact. After the firm reported that Interact was technically feasible, the LH staff had to decide what proportion of their relatively small funds they should allot to the project. This amount was not sufficient to finance the entire network, but it was enough to test a smaller system involving four 426 THE LISTER HILL NATIONAL CENTER FOR BIOMEDICAL COMMUNICATIONS types of institutions: medical schools, hospitals, community colleges offering courses in health care, and prisons. Construction of a four-station duplex network, with three mountain relay points, began in 1971. In the network were Dartmouth Medical School, Uni- versity of Vermont Medical School, Claremont General Hospital, Central Ver- mont Hospital, Rockingham Memorial Hospital, Claremont Vocational Tech- nical College, and Windsor State Prison. The stations began operating in 1972 and were augmented by other facilities in 1973. Practicing physicians used Interact to continue their medical education and to seek advice on diagnostic and patient care problems. Professors at the medical schools taught student nurses in the hospitals and students in health care courses at the Vocational Technical College. Physicians in community hospitals participated in surgical rounds and conferences at university hospitals. Participants benefited from a variety of programs presented over the network approximately 40 hours a week. Lister Hill provided funds until' the concept had proved practical and then withdrew in 1975, leaving the operating network in other hands. Medical Assistance and Education via Satellites The responsibility of Lister Hill to improve biomedical communication by means of advanced technology was carried out, as funds permitted, mainly through the use of satellites. The National Aeronautics and Space Administra- tion launched the first communication satellites in 1960. They were spheres 100 to 135 feet in diameter, circling the earth at altitudes of 600 to 6,700 miles, with reflective surfaces that bounced radio signals back to sending stations. These "passive" communication satellites were followed by craft that contained receiver and transmitters, powered by solar cells, that amplified and returned radio signals. In 1963 NASA sent aloft the first satellite to relay a live television program from Europe to America. The round satellites were soon replaced by cylinders, orbiting at higher altitudes, remaining in a stable position by spinning. They relayed telephone, teletype, and television transmissions across the ocean. A further improvement was a spin-stabilized machine in an orbit approximately 22,000 miles high traveling at a velocity that kept it over a certain area of the Earth. Satellites at this altitude could see about one-third of the globe. In 1966 NASA sent into a 22,300 mile high orbit the first of the Application Technology Satellites, ATS- 1. The ATS satellites were geostationary, hovering over a spot instead of an area, and their antennas maintained a fixed orientation toward the Earth, al- lowing radio beams to be directed with precision. During the planning of the Library's research and development program the Lister Hill staff considered satellites to be one of the means by which medical information would be disseminated over a large geographical area. The staff visualized a satellite communications system that could be utilized for the education of medical students, the continuing education of physicians, and even the education of the public. This system would be composed of a national 427 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE The Native Health Clinic, Galena, Alaska. ATS-1 antenna at left. network, regional networks, and interconnections between regional networks. The Library asked Comsat Corporation to estimate the cost of designing and developing the system. Comsat replied that it would cost about $6 million, not counting yearly operating expenses. Since the total Lister Hill budget at that time was only about one-sixth of this sum, the scale of the plans had to be reduced drastically. Lister Hill carried out its first experiment in satellite communication in April 1970. With the assistance of ATS-1, LH tested a four-way voice conference network joining the Library, University of Wisconsin, University of Alaska, and Stanford University. This satellite network was also used to demonstrate the transmission of electrocardiograms, the sending of photographs by means of a photo facsimile system, and the relay of questions to and answers from a computer.10 These tests prepared the way for the development of a communication network for supplying medical information to remote villages in Alaska. By means of the ATS-1 satellite, equivalent to a transmission tower 22,000 miles high, two-way conversations were made possible between a physician in the Indian Health Service hospital in Tanana and health aides in 26 remote villages. The aides, who had been trained to provide primary health care in their com- 428 THE LISTER HILL NATIONAL CENTER FOR BIOMEDICAL COMMUNICATIONS munities, were supplied with VHF transmitters and receivers. With this equip- ment they were able to talk to the physician daily to report on or obtain advice about the treatment of sick villagers. In emergencies the aides used the system to call for a plane to carry patients to a hospital. This satellite network was also shown to be useful for teaching medicine to students, nurses, and health aides in remote locations, as well as permitting physicians, separated by long distances, to consult with each other. Satellite communications were a major improvement over shortwave radio in arctic regions since radios were inoperable much of the time because of ionospheric disturbances. In May 1974 NASA launched ATS-6, a much more complex, versatile and powerful satellite. The ATS-6 enabled two-way television communication to be carried on between the Tanana hospital and village aides. The aides were supplied with simple and relatively inexpensive ground terminals capable of receiving and sending video and audio signals. A physician at Tanana could now see patients through television, diagnose their illnesses, and give instruc- tions to the attending health aides. In May 1975, with the Alaska health ex- periment proved to be practical and valuable, Lister Hill withdrew, and the state took over maintenance of the network. Satellite ATS-6 was also utilized to set up a network for medical instruction in the states of Washington, Alaska, Montana, and Idaho. The area of these four states comprised 22 percent of the territory of the Nation but were pop- ulated by only about 6 million people. In 1971 the University of Washington Medical School had begun an experiment in decentralized medicine in this region. Named WAMI, from the initials of the states, the program had several objectives in health care and education, among them an increased opportunity for medical education without the construction of additional medical schools. In 1973 the Lister Hill Center contracted with the University of Washington to explore the use of satellites in the WAMI program. Courses taught at Uni- versity of Washington Medical Center in Seattle were beamed to the univer- sities of Alaska, Montana, and Idaho for an audience of first-year students. Upon completion of the year the students enrolled at University of Washington for the remaining 3 years. Clinical instruction was transmitted from the medical center to third- and fourth-year students in clerkships at the Family Medicine Clinic in Omak, Washington. The WAMI project demonstrated the possibilities of sharing educational facilities within a large area. The two-way video, audio, and data communication network allowed instructors and students separated by long distances to participate in a coordinated medical education program. In January 1976 NASA launched the Communications Technology Satellite, CTS, developed by Canada and the United States. At that time CTS was the world's most powerful and versatile communications satellite. In addition to industrial firms and universities, it was used by several agencies of the Public Health Service, including the Library, for medical education, dental education, teleconferences, training seminars, and health consultations. CTS permitted 429 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE expansion of the WAMI program, provided the Lister Hill staff with an engi- neering laboratory for experiments and demonstrations, and had other uses. For the Library's CTS network the Lister Hill staff designed, developed, and installed six sophisticated Earth terminals at locations as far apart as Fair- banks, Alaska, and Bethesda, Maryland. This network operated for 818 days, logging 2,083 broadcast hours before making its final telecast on June 27, 1979. During the course of its operations more than 16,000 persons appeared before the cameras. The June telecast ended a decade of satellite experiments by the Lister Hill Center, demonstrating the wide range of health communications services that could be offered by this medium. Construction of the Lister Hill National Center for Biomedical Communications In the spring of 1970 Congress appropriated $900,000 for architectural and engineering designs of the Library's annex, the Lister Hill National Center for Biomedical Communications, but the Office of Management and Budget would not release the funds until 2 years later, January 1972. The General Services Administration negotiated a contract with the firm of Carroll, Grisdale and Van Alen which, over the next 2 years, produced plans for a 10-story annex with three underground levels containing approximately 200,000 gross square feet of space for 428 employees.11 Each year at budget time Cummings asked for money for construction, and each year he came away empty handed. Other buildings needed by NIH, PHS, and DHEW received priority. He became pessimistic about the Library's chances of ever receiving an appropriation. Slowly, however, he was gaining support. Members of the Board of Regents, very knowledgeable about Library affairs, lost patience with the pace of events and asked Congressmen from their states for help. Mrs. Frances Howard, sister of Senator Hubert Humphrey, who knew about the shortage of space from personal observation, introduced Cummings to several Congressmen to whom he explained the need for an annex. Rep- resentatives Paul Rogers, Robert Michel, and Daniel Flood; Senators Hum- phrey, Edward Kennedy, Warren Magnuson, and Norris Cotton, all influential in health legislation, were coming to the rescue of the Library. Not knowing that funds were on the verge of being appropriated, Cummings became very discouraged. Feeling that he could not contribute further to the development of the institution he decided to retire from the Federal service. He notified the staff and his superiors of his intention of leaving and had tidied up his official business when he received word that Congress was going to appropriate funds. Pleasantly surprised, he cancelled his retirement party and looked forward to the construction, completion and occupancy of the Lister Hill building. Congress appropriated $26 million in January 1976 for construction of the center and renovation of the Library building. During the spring and summer of 1976 the National Capital Planning Commission approved the architects' 430 THE LISTER HILL NATIONAL CENTER FOR BIOMEDICAL COMMUNICATIONS The Communications Research and Development Facility of the Lister Hill National Center for Biomedical Com?nunications. plans, the Library met the requirements of the National Environmental Pro- tection Act, and the General Services Administration awarded the contract to George Hyman Construction Company on a low bid of $13 million. Excavation of the site and construction took place without unusual incidents or delays, and the building was ready for occupancy in May 1980. The staff of the extramural program moved from a rented office building in Bethesda, employees of the National Medical Audiovisual Center moved from their quar- ters in Atlanta, and the Lister Hill group, Toxicology Information Program, and other units shifted from the Library building. The Lister Hill National Center for Biomedical Communications was dedicated on May 22 with Senator Hill in attendance. Notes 1 Information on the LHNCBC may be found in publications by staff members, fact sheets, records of the Board of Regents, annual reports of the Library, and NLM News. Information was obtained from the above, and from Martin Cum- mings, Harold Wooster, and Harold School- 2 Some account of Senator Hill's activities in sponsoring legislation on behalf of medicine may be found in Congressional Record, Oct. 8, 1968, pp. S12254-S12259; Oct. 9, S12325; Oct. 12, S12735-S12754; Nov. 1, E9565. 3 NLM News, August 1968. Senate Joint Resolution 193. Public Law 90-456. Directors 431 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE of the center have been: Ruth Davis, August 1968-November 1970; Davis McCarn (Acting Director) November 1970-May 1971; Albert Feiner, May 1971-September 1974; Robert Bird, September 1974-December 1976; Kenneth M. Endicott (Acting Director) January 1977-June 1977; Lionel Bernstein (Acting Director) July 1977-July 1978, Director August 1978. 4 F. R. Doc. 68-13778, Nov. 14, 1968. s Fiscal Year Obligations millions Personnel, June 30 Source: Annual reports of the Library. 6 Information on the development of AIM- TWX may be found in records of the Board of Regents, articles by members of the staff, Li- brary network/MEDLARS technical bulletins, On-line services references manuals, and NLM News. Information was also provided by Ralph Simmons. 7 NLM acquired TWX facilities in the spring of 1966 to cooperate with the Medical Interli- brary Communication Exchange System, MICES, in servicing interlibrary loan requests. 8 Information on the CAI network may be found in records of the Board of Regents, arti- cles by members of the staff, annual reports of the Library, and H. Wooster, "The LHNCBC Experimental CAI Network, 1971-1975: an Ad- ministrative History," in Edward C. DeLand, ed., Information Technology in Health Science Education, 119-42; see also publications cited in this article. Tape-recorded autobiography of Harold Wooster, Feb. 23, 1979. 9 Data on the New Hampshire-Vermont medical TV network may be found in records of the Board of Regents, NLM News, annual re- ports of the Library, articles by staff members, and Dean J. Seibert, Interact—a Decade of Experience Using Two-way Closed Circuit Tel- evision for Medical Care and Education: Con- tract no. 2-LM-4-4704, April 1977. 10 For details of the satellite experiments see annual reports of the Library, records of the Board of Regents, articles by members of the staff, NLM News, contractor's reports, and Lister Hill Center reports. George Thoma also pro- vided information. 11 Information on the events leading up to the appropriation for the Lister Hill Building were obtained from Martin Cummings. 1967 68 69 '70 71 '72 '73 '74 '75 '76 0.828 0.911 1.366 1.883 1.949 2.931 2.234 1.475 1 10 12 10 14 15 17 20 22 24 432 XXIV The National Medical Audiovisual Center The National Medical Motion Picture Archives THE National Medical Audiovisual Center was a child of World War II. During the conflict the Public Health Service set up in Atlanta, Georgia, an organization called the Office of Malaria Control in War Areas, whose task was to suppress malaria around military bases and war industry plants.1 The office grew, became very good at its job, and was given responsibility for controlling other diseases. To reflect the increased responsibility the Public Health Service changed the office's name to Communicable Disease Center, and later to Center for Disease Control. At the beginning, the Office of Malaria Control had to train the men it hired, all unfamiliar with the methods of suppressing the disease. It acquired a cameraman-director to make instructional films showing the techniques of larviciding, ditchdigging, dynamiting, and other control measures. This means of teaching proved so useful that the organization hired additional motion picture makers. Eventually the small film company evolved into a Medical Audiovisual Branch, producing filmstrips, videotapes, and other audiovisual materials for the entire Public Health Service.2 It was through motion pictures that the Library first became associated with the center. At least as early as 1944 the Library considered collecting medical motion pictures, but the institution was being modernized, and there were other tasks much more important to be carried out. The idea of a movie col- lection arose occasionally thereafter, but no action was taken until 1953 when Director Rogers initiated a survey of the subject. He discovered that no or- ganization in the United States collected old medical motion pictures. The earliest films had already disappeared, either thrown away or disintegrated, and those produced within the last generation or two would eventually be lost if they were not harvested and preserved. The Library did not have equipment, space, and employees for proper maintenance and operation of a movie collection; nevertheless Rogers thought it was important to begin acquiring films for the experience to be gained thereby. He laid down the following policies. The Library would act as a central repository for documentary medical movies, but it would not produce, distrib- 433 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE ute, or evaluate them. Films would be available to individuals who came to the Library, but the Library would not act as a theater, showing movies to groups of persons. Reference service would be provided. Films would not circulate. Rogers appointed Muriel Weins film curator. He also appointed an advisory committee for the first year of operation. The Library circularized its intention of establishing a movie archives, and gifts of film began to arrive from medical organizations, pharmaceutical firms, government agencies, film producers and distributors, and individuals. One hundred and twenty-one reels were acquired in 1954 and 311 in 1955. During the first 5 years of collecting NLM purchased only two films, one on Harvey's discovery of circulation of blood, the other on cardiac surgery. By 1961 there were more than 600 items in the collection, now named the National Medical Motion Picture Archives, and there were promises of many others. During these years NLM found out that it had greatly underestimated the resources needed to maintain a film collection. Old movies had been made on nitrate base film that deteriorated with age and could ignite spontaneously. NLM had no place to store dangerous film and had to borrow space in the Library of Congress' film vault at Suitland, Maryland. For the proper operation of the archive special equipment was needed for editing, cleaning, splicing, and rewinding film, for transferring 35 mm to 16 mm film, and for transferring images from nitrate to safe acetate base film. NLM did not have funds for the equipment and to hire personnel. Rogers sensed a growing interest in the application of audiovisual materials to medicine, but he did not want the Library to be drawn into this field willy- nilly. He felt that the institution had its hands full with the development of MEDLARS, the move to the new building, the advent of an extramural pro- gram, and in trying to control published literature. During the summer of 1961 he visited the Public Health Service's Communicable Disease Center and reached an agreement with the Director to transfer NLM's films to the CDC's Audiovisual Branch, soon renamed the National Medical Audiovisual Facility. The collection of 665 films was sent south in January 1962. The Library and movie archives remained apart for several years, then began to come together. The reunion started in 1966 when a House subcom- mittee examined the organizational structure of the Public Health Service. James Lieberman, Director of NMAF, desired to transfer his agency to some other part of the PHS, where it could obtain a larger appropriation and broaden the scope of its program. A subcommittee staff member asked Director Cum- mings if it would be logical to place the facility in the Library. After several conferences it was agreed that the work of the organization could dovetail with the programs being carried on in Bethesda. As a result the Secretary of DHEW ordered the transfer to take place on July 1, 1967, and changed the name to National Medical Audiovisual Center. 434 THE NATIONAL MEDICAL AUDIOVISUAL CENTER The NMAC motion picture staff shooting a training film. The National Medical Audiovisual Center At the time of its transfer to the Library,3 the center included the largest medical motion picture studio in the United States, a completely equipped television production center, a studio for the production of graphic and pho- tographic art useful in medical teaching and communication, a repository for still pictures, and an international center for distribution of motion pictures and other audiovisuals. It was staffed by approximately 130 persons and had operating funds of more than $2 million.4 About half of NMAC's funds were channeled into the production of motion pictures, television programs, and other audiovisuals. Some of these were made for such government agencies as the Communicable Disease Center, National Center for Air Pollution Control, National Institute of Neurological Diseases and Blindness, and National Center for Urban and Industrial Health, which used them for education and dissem- ination of information. Some were made to be sold or loaned to schools of medicine, dentistry, osteopathy, podiatry, veterinary medicine, pharmacy, nursing, and to hospitals for use in teaching. A large proportion were on subjects of everyday health, such as the importance of brushing teeth, and were aimed at the general public and high school audiences. 435 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE An NMAC television workshop in which students were instructed in the art of designing audiovisual products. About one-fifth of NMAC's resources were spent acquiring, distributing, and cataloging audiovisuals, and providing reference service. The center main- tained the International Index of Medical Film Data, the centralized source information bank on audiovisuals in the field. This index contained information on more than 26,000 citations and was growing by several thousand each year. The center published the National Medical Audiovisual Center Catalog and catalogs in special fields as heart disease, cancer, and stroke. It loaned more than 73,000 audiovisuals in 1967, and this number increased annually. It main- tained a still picture collection of more than 100,000 items: in 1967 more than 8,400 searches were made in this collection for patrons. NMAC continued to acquire old movies for the National Archives of Medical Motion Pictures: in 1967 the Archive contained 1,500 films. Approximately 6 percent of NMAC's funds were devoted to studies of and development of the application of audiovisuals to education. The center pro- vided instruction for a group of students enrolled in a graduate program in biomedical communication offered by Tulane University in association with other colleges. The staff gave advice on the effective use of audiovisuals to U.S. and foreign hospitals, health organizations, and schools of medicine, dentistry, 436 THE NATIONAL MEDICAL AUDIOVISUAL CENTER veterinary medicine, and nursing. Members of the staff lectured at meetings, seminars, and symposiums. The center conducted workshops and conferences in Atlanta and elsewhere to encourage medical organizations and schools to produce and use audiovisuals. Staff members visited schools that asked for advice on the design of classrooms in which audiovisuals were to be employed. They prepared conceptual designs of classrooms and audiovisual departments for institutes intending to construct such facilities. NMAC also carried on special programs, the most important of which was the community medical television system, CMTS. This was a prototype closed circuit system for the Atlanta area, developed by the center in cooperation with a dozen hospitals. Live and taped programs were televised, and several grand rounds and conferences were presented weekly. Redirecting NMAC to the Goals of the Library Shortly after NMAC became a part of the Library, Director Cummings sent a small task force of consultants and staff members to Atlanta to examine the operations of NMAC in detail and advise him how they could be coordinated with those of NLM. Believing that the operations of NMAC should be directed mainly toward the support of education in the health sciences, Cummings appointed an advisory group of educators to help develop plans. At his request the chairman of the Board of Regents appointed a subcommittee to give advice on policies, programs, and priorities. The Regents also authorized the estab- lishment of a committee to provide NMAC with technical advice. To this committee Cummings appointed experts from various fields, among them Mar- garet Bourke-White, noted photographer, and Gerald G. Graham of the Ca- nadian National Film Board. Following the recommendations of the committees, Cummings drew up certain guidelines for the audiovisual center: all programs should be directed toward professional health education, including continuing education; emphasis should be given to the acquisition, cataloging, and distribution of audiovisuals; production should be deemphasized; NMAC indexing and cataloging should be coordinated with that of NLM; fundamental research and development would be the responsibility of the Lister Hill Center, research in the application of audiovisuals would be the proper area for NMAC. And since the community medical television system was now fully developed, it should no longer be financed by NMAC but transferred to a local medical group as soon as possible (Emory University Medical School volunteered to become the operator of the system). The audiovisual center was slow in realigning itself as instructed by Cum- mings' guidelines. By 1969 the Board of Regents subcommittee had become concerned, particularly about the continued high level of production of films, filmstrips, and videotapes. Furthermore funds were not sufficient to maintain high production and also handle the increasing number of loans, up from 2,404 in 1948 to more than 100,000 in 1969. Following recommendations of the Board, 437 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Cummings ordered a drastic reorganization, shifting emphasis from the pro- duction of audiovisuals toward acquisition, distribution, training, consultation, research, and development. Reorientation was practically complete by mid- 1970 and the center was headed in the direction desired by the Director and Board of Regents. Finding it difficult to coordinate the activities of two organizations more than 600 miles apart, Cummings considered moving NMAC to Bethesda. But this would have caused hardship for many families of employees, forcing them to leave their homes in Atlanta and find new homes in the Washington area. He compromised by postponing the move until the anticipated Lister Hill building would be constructed adjacent to the Library. This delay of several years duration (funds had not yet been appropriated for the building) gave employees ample time to seek positions elsewhere in Atlanta if they wished to do so, and it gave the Georgia Congressional delegation time to attempt to delay or rescind the move. The Learning Resources Program In May 1971 Cummings arranged a joint venture with Kenneth M. Endicott, director of NIH's Bureau of Health Resources Administration, to form the Office of Audiovisual Educational Development, later renamed the Learning Re- sources Program. To the partnership the Bureau contributed funds and ex- perience while NMAC contributed facilities and the services and expertise of its staff. Working together the two partners were able to accomplish much more than each could have done singly. Within a year the collaboration had proceeded to the point where almost half of NMAC's capabilities were directed toward Learning Resources Program projects. The learning resources projects were conceived by schools or organizations, not by NMAC or the Office of Audiovisual Educational Development. NMAC and OAED financed the projects through contracts and, upon request, gave advice. Priorities for projects were set by an NMAC-OAED priority review committee. Among the contractors was the New York University School of Medicine, which developed instructional materials for an interdisciplinary cur- riculum in forensic pathology; the Pacific Medical Center School of Medical Science, which developed self-instructional materials for an undergraduate medical curriculum in ophthalmology; and the Tissue Culture Association, which de- veloped basic curriculum definition and prototype instructional materials in cell biology. NMAC Activities and Products The National Medical Audiovisual Center alone and in cooperation with the Learning Resources Program undertook many projects, but despite their diversity these fell into several general areas: clearinghouse, evaluation, dis- tribution, media development, advisory service, workshops and seminars, and applied research. 438 THE NATIONAL MEDICAL AUDIOVISUAL CENTER Audiovisuals being available through many outlets, NMAC set up a clear- inghouse of information and of products. Under sponsorship of the Library, the Association of American Medical Colleges collected data on approximately 6,000 audiovisual educational materials, chiefly motion pictures currently in use and available nationally. Likewise, the American Association of Dental Schools provided data on about 1,500 items. The evaluation of these audiovisuals was important in directing teachers and students toward the best. Even though produced with good intentions, not all audiovisuals possessed high instructional value. The quality of movies and other AV's made by medical schools, hospitals, medical organizations, government agencies and commercial firms ranged from excellent to poor. Just as critics evaluate plays, novels, television programs, concerts, and other artistic products for general audiences, so did NMAC scientific referees evaluate audi- ovisuals for their specialized audiences. The technical quality and instructional design of audiovisuals were evaluated by the NMAC staff. Under the leadership of Harold Schoolman, the content was evaluated by panels of experts from various health professions provided by national organizations and schools. In 1973 NLM contracted with the Association of American Medical Colleges and American Association of Dental Colleges to choose the hundreds of reviewers, organize them into panels, and oversee the evaluation process. While the clearinghouse and evaluation activities were going on, NMAC published a list of the materials. Led by Schoolman, the Library's staff began to prepare a system named AVLINE, from audiovisuals on-line, for storage and retrieval of the information. Thousands of motion pictures, videotapes, and slide/sound sets were evaluated. Hundreds were approved for inclusion in AVLINE and were cataloged, indexed, and entered into the computer. The Library also set up a computerized file named AVPROC, for audiovisuals in process, containing thousands of titles waiting for review. A 4-month test of AVLINE began on May 1, 1975, with a limited data base of 260 citations in the neurosciences. Each item had been assessed for technical quality, validity of content, and instructional design, and was available nation- ally. Thirty-one institutions made demand searches during the test period. Several months later several hundred titles were made available to teachers, students, and physicians, and thereafter between 100 and 200 titles were added to AVLINE each month. In addition to providing information through its clearinghouse, NMAC be- came a national distribution center. Each year it produced movies and other audiovisuals for sale or loan to medical schools, libraries, and organizations. Learning through its evaluation and clearinghouse activities of the existence of high quality audiovisuals that were not widely distributed, NMAC acquired the items and made copies available. Audiovisuals produced or acquired by NMAC were distributed in three ways: movies were loaned for short periods; videotapes were duplicated free for users, the user providing blank tape; slide sets, filmstrips, instructional packages, and many movies were sold at low cost. 439 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE During fiscal year 1976 the center received approximately 60,000 requests, almost all for motion pictures, and loaned about 53,000 items. NMAC also became an advisor to those who wished to produce or utilize audiovisuals. Schools knew the value of teaching aids but seldom had experience in designing facilities wherein students could study audiovisuals or faculty members could make them. In 1971 the center installed a demonstration area in which there were different types of carrels, student learning stations, and recommended audiovisual systems. By examining and trying the different fa- cilities visitors could decide what equipment, furniture, and work areas could be afforded by or was best suited for their institutions. During the decade after NMAC became a part of the Library, hundreds of representatives of American and foreign institutions came to Atlanta to inspect the demonstration area and to consult with staff members. Representatives of NMAC visited hundreds of schools, hospitals, and organizations to give advice on the design and operation of audiovisual systems, to assess facilities and recommend improvements, and to help plan and produce programs. The center presented many workshops and conferences in Atlanta and other cities each year. Hundreds of teachers and librarians attended to learn how to manage audiovisual collections, to design learning spaces for users, to produce audiovisuals, and to become familiar with other facets of the subject. In 1970 the center began to sponsor an annual Conference of Directors of Biomedical Communications, attended by scores of persons. The center developed and encouraged the development of instructional audiovisuals for use in health fields. Some of the work was carried out in-house, some was done in collaboration with schools and organizations, but most was done by schools and organizations under contract. NMAC learned by experi- ence and advocated the value of teams in designing and developing items, each team consisting of a subject matter specialist, an education specialist, and an audiovisual specialist. The center rounded out its activities by undertaking research into educa- tional methodology as it applied to audiovisual media. The staff undertook a number of projects, among them comparisons of various methods of instruction, experiments with different formats of visual abstracts of audiovisual materials, studies of learning styles and methods for accommodating these styles to stu- dents, the development of learning packages based on problems, and a study of instruction management procedures and associated cost factors. During the first decade that NMAC was associated with the Library audi- ovisuals had an increasing influence in making health sciences education more responsive to the needs of students and practitioners. It was too early to judge the changes that would take place when the use of audiovisuals would become routine, but indications were that education would become more of an indi- vidual experience, that students would have greater flexibility scheduling their 440 THE NATIONAL MEDICAL AUDIOVISUAL CENTER studies, and would learn at their own pace and in their own manner. The textbook and lecture, the monograph and journal, used by students and prac- titioners during the first century and a half of the Library's existence was slowly being joined by new educational media. Notes 1 A history of the early years of the Com- municable Disease Center may be found in: Mary H. McClanahan, The Origin and Administrative Development of the Office of Malaria Control in War Areas, Masters thesis, Emory Univ., 1958. 2 Information on NMAC may be found in publications by staff members, NLM News, an- nual reports of the Library, fact sheets, records of the Board of Regents and Board of Regents Subcommittee on NMAC. Information was also obtained from Martin Cummings, Charles Bridgman, Charles Herbert, Harold School- man, and Robert Sumpter. 4 The amount of obligations and number of employees were: 3 Directors of NMAC were: James Lieber- man, July 1967-June 1970; Jerome Barnett (Act- ing Director), June 1970-October 1970; Charles Bridgman, November 1970-September 1973; George Mitchell, September 1973-September 1977; Myron Adams, October 1977-February 1979; Charles Farmer, March 1979-February 1980; William Cooper (Acting Director), March 1980-October 1980; James Woods, November 1980-. 71 72 '73 '74 '75 '76 2.295 3.235 3.453 4.518 4.049 3.567 105 105 103 100 101 101 Fiscal Year 1968 '69 70 Obligations millions 2.255 2.350 2.320 Personnel June 30 127 122 109 Source: Annual reports of the Library. 441 XXV Extensions of Traditional Library Services THE additions of MEDLARS, the Lister Hill Center, the grants program, the National Medical Audiovisual Center, and the Specialized Information Services to the basic library structure were the major events within the National Library of Medicine during the 1960's and 1970's, but other important activities occurred during this period. The Library strengthened its resources in subjects allied to medicine in order to improve its ability to render services to all health practitioners. An increased emphasis on dental literature was catalyzed by two regents: George W. Teuscher, dean of the School of Dentistry at Northwestern, and Russell A. Dixon, head of the School of Dentistry at Howard. Teuscher and Dixon height- ened Cummings' awareness of the needs of the dental profession, and in July 1965 he recruited Kenneth C. Lynn, a PHS dental officer, as NLM's coordinator for dental affairs. Lynn helped define the scope and coverage of the dentistry collection, made arrangements for the American Dental Association to coop- erate in refining the MESH terminology, assisted in organizing conferences on continuing education in dentistry, represented the Library at dental meetings, reviewed NLM publications relating to dentistry, and furthered the interests of the dental profession in other ways. The new emphasis on the subject also benefitted from the advice of Dixon, whom NLM retained as consultant-in- residence on dental affairs. Through its agreement with the American Dental Association, NLM was provided with the services of two dentists, Faith Stephan and Raquel Halegua, who indexed for Index Medicus and Index to Dental Literature and developed the dental vocabulary for MESH. Within a relatively short time the Library was providing greater support than ever before for the dental profession.1 Improvements in the collection of veterinary literature were stimulated by James Steele, the chief veterinary officer of the Public Health Service. Steele, talking to Cummings, emphasized the importance of NLM to his profession, and pointed out that neither NLM nor the National Agricultural Library com- pletely satisfied its needs. Cummings conferred with Foster Mohrhardt of the Agricultural Library, and the two agreed that their institutions would cooperate in developing the scope and coverage of their veterinary health sciences col- lections, so that between them they would cover the subject completely, with 443 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE minimum duplication. Cummings recruited Fritz P. Gluckstein as coordinator of veterinary affairs. Gluckstein, a veterinarian, who had been chief of the Microbiology Branch, Science Information Exchange, Smithsonian Institution, came to NLM in January 1966. He brought to the Library a philosophical point of view that permitted the institution to serve veterinary medicine without becoming involved in subjects properly belonging to Agriculture, and he made a careful study of the scope and coverage policy, differentiating the literature that the Library of Medicine and the Agricultural Library should each acquire. The Library set up a panel on veterinary medicine composed of representatives of NLM, the National Agricultural Library, and the American Veterinary Med- ical Association to develop an authoritative, precise vocabulary of veterinary terms for use by both libraries and for MESH. As the Library's support of the veterinary profession improved, more and more veterinarians came to rely on NLM for information.2 To accommodate writers, historians, literature researchers, and others who needed library facilities for long periods of time, Cummings in 1964 expanded the offices set aside for them in the stacks. This had been desirable earlier but not possible because of lack of space in the old building. Among the first to use the facilities were Stanhope Bayne-Jones, writing about the history of preventive medicine in the Army during World War II; James P. Leake, re- vising manuals on smallpox and vaccination; Bess Furman Armstrong, compiling a popular history of the Public Health Service; and Robert Pollitzer, the WHO expert on plague. A few years later the Library established a formal Scholars- in-Residence Program. Appointments were made by the Board of Regents. Researchers were provided with offices and reference assistance. The first scholars were Fred L. Soper, epidemiologist, former director of Pan American Sanitary Bureau and WHO Regional Office for the Americas, studying the evolution of international health; and Harry F. Dowling, former professor at George Washington University and University of Illinois medical schools, au- thor of works on drugs, researching the history of drug regulations.3 The continued expansion of the mission, personnel, and facilities of the Library made necessary major and minor changes in its organizational structure. Molded by Rogers in 1960 into five operating divisions and an Office of the Director, the structure was revised again in 1962 following recommendations of the Study Group on Mission and Reorganization of the Public Health Service. In 1964 as a result of a decision of the Comptroller General and the opening of MEDLARS, the staff rewrote NLM's functional statement and divided the operations among seven divisions. The following year a management analysis, requested by Cummings, led to a major reorganization; the five service divisions were grouped into an Intramural Program (later Library Operations) and three new grants divisions in an Extramural Program, each program under an as- sociate director. In 1967 the two programs were joined by the Toxicology Information Program (later Specialized Information Services), the Research and Development Program (later the Lister Hill Center), and the National Medical 444 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE Audiovisual Center, all under associate directors. On April 1, 1968, the Library, which had been under the Office of the Surgeon General of the Public Health Service since 1956, was made a component of the National Institutes of Health. The five programs, along with the Office of the Director and Office of Computer and Communications Services, remained the basic units of the organization, alterations thereafter consisting of shifts and regroupings, additions and dele- tions of groups, and changes in name.4 Continuing Education Before midcentury county medical societies and hospital staffs played the major role in stimulating the continuing education of physicians although large medical societies such as the American Medical Association, American College of Surgeons, and American College of Physicians held annual meetings for the purpose. In the 1950's and 1960's medical school facilities increasingly coop- erated in the process of continuing education by presenting courses for prac- titioners. In 1955 the Council on Medical Education established an advisory committee on continuing medical education, which later reviewed programs on continuing education and accredited organizations that presented them. Like every other medical library, NLM played a passive role in continuing education by providing literature to health workers keeping up with advances in their professions. Cummings took steps to change the role to an active one. He sought advice from those who had given thought to the subject, including Bernard V. Dryer, who had recently written Lifetime Learning for the Phy- sician. In August 1965 he appointed a committee, headed by Carl Douglass, to consider the ways in which NLM could assist physicians, dentists, nurses, dietitians, medical librarians, and other health professionals desiring to further their education. A short time later he created a new position, continuing ed- ucation officer, and brought Burnet Davis from the Public Health Service to fill the post. In November the interest of William Hubbard, Jr., and other Regents was reflected in a recommendation that NLM should develop and support, directly and through regional and local medical libraries, research, experiments, and demonstrations to improve techniques for the continuing education of health workers. To obtain suggestions for a program, Douglass and Davis organized a meet- ing of leaders in medical education in January 1966. Following this meeting NLM moved ahead internally and externally. Within, it began to arrange con- ferences with professional societies, and it installed facilities for self-instruction in the main reading room. The first of these was an audiovisual carrel equipped with rear-screen motion picture projectors and earphones. The collection of audiovisuals was broadened and placed in the carrel. A year later a television set with earphones was installed, and videotapes, including those from the Network for Continuing Medical Education, were made available. The area was finally enlarged to contain three soundproofed carrels where patrons could study using the latest audiovisual equipment and a wide variety of instructional 445 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE One of the Library's learning resource carrels, in which patrons could view and listen to a wide variety of medical and audiovisual materials, including 35 mm slide/audiotapes, video cassettes and 16 mm films. materials. These carrels not only served local users, they provided NLM with experience and served as demonstration models for other libraries. While facilities in the Library motivated health workers in the Washington area to continue their education, encouragement to persons elsewhere was rendered through the grants program. Grants for resources stimulated libraries of community hospitals, professional societies, and medical schools to acquire audiovisual programs, microfiche readers, slide projectors, microfilm readers, tape recorders, and other equipment and materials for regular and continuing education. Grants for research enabled medical institutions to develop tech- niques for reaching the practitioner through visual materials, programmed instruction, and other means.5 Grants for training permitted staff members of libraries to seek instruction in the use of new learning materials and equipment, to serve practitioners better. Each regional library that was assisted under the grants program was expected to support continuing education within its region.6 In addition to awarding grants to encourage medical libraries to assist in continuing education, NLM also provided materials for, and it demonstrated the usefulness of modern communications systems in, continuing education. Through the National Medical Audiovisual Center it cooperated with profes- sional societies, medical schools, and the Association of Professors of Gyne- cology and Obstetrics in developing audiovisual courses. It provided instruction in the production of high quality courses. It produced audiovisuals for distri- 446 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE bution at reasonable prices, and it compiled catalogs to assist users in locating appropriate instructional materials. The Lister Hill Center cooperated with schools and organizations, among them the Universities Associated for Research and Education in Pathology, in creating materials and models for regular and continuing education.7 It demonstrated the use of a computerized instructional network linking schools, hospitals, and organizations. It applied satellites and broadband television in regular and continuing education. It developed the Knowledge Base Research Program, an interdisciplinary research program in- volving the design, demonstration, testing, and evaluation of computerized knowledge bases in specialized areas to achieve a more rapid transfer of new medical information to health professionals, particularly physicians. Continuing education cut across most of the divisional lines in NLM's or- ganizational structure. Therefore to oversee the program Cummings enlisted Ralph P. Christenson as successor to Burnet Davis, and in 1970 he appointed Harold M. Schoolman, former director of the Veterans Administration Edu- cation Service, as a special assistant and later as deputy director for research and education. Schoolman provided liaison between NLM and outside orga- nizations and between NLM divisions in matters of continuing education. Continuing education was in its infancy when the Library began its efforts to assist health professionals who desired to learn in their homes, offices, hospital libraries, or local medical libraries at their own pace, at times con- venient to them. The Library attempted to respond to and to stimulate the recognition of the importance of the information component of all continuing medical education activities. It was the unresolved problems of continuing medical education that made the results of NLM's efforts less than was hoped for.8 International Cooperation From the 1950's onward the institution was to render much more technical assistance to medical libraries in other countries than ever before. This was owing to several circumstances, among them the policy of the United States in assisting other nations, the development of rapid communication that brought countries of the world closer together, and the policy of the Library, from its infancy, to cooperate with and assist other libraries at home and abroad as far as its resources would permit. Relationships with other countries grew so nu- merous, diversified, and important that Cummings established the position of special assistant to the director (later assistant director) for international pro- grams in October 1967, and appointed Mary Corning to the post. Corning carried out subsequent negotiations for the establishment of MEDLARS and MEDLINE in other countries and assisted in planning, developing, and co- ordinating NLM's international activities.9 Members of the staff assisted institutions in many countries with technical advice. In accordance with President Johnson's commitment to the government of South Korea, Scott Adams and two members of the Board of Regents, William 447 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE N. Hubbard, Jr., and Alfred A. Gellhorn, visited medical schools in Korea in May 1966 to survey library resources for an expanded program in medical education. Adams also visited Vietnam to review with officials of the Agency for International Development the implementation of plans for an enlarged medical library at University of Saigon. At the invitation of Mexican authorities Cummings flew to Mexico City in October 1967 to make a survey of facilities in preparation for the establishment of a national medical library. NLM helped by training Mexican librarians in MEDLARS operations and the latest tech- niques of document handling, and it provided materials and information not available in Mexico. In 1976 Secretary of Health Gines Navarro Diaz de Leon and Cummings signed a memorandum of understanding for cooperation be- tween NLM and the recently created Centro Nacional de Informacion y Doc- umentacion en Salud. With the cooperation of NLM there was developed in South America a regional library of medicine. This began in 1965 when the Pan American Health Organization Advisory Committee on Medical Research recommended the es- tablishment of a regional medical library under sponsorship of PAHO and the Pan American Federation of Associations of Medical Schools. The Biblioteca Regional de Medecina, BIREME, was set up at the Escola Paulistade Medicina, Sao Paulo, Brazil, with funds from Brazil, PAHO, Commonwealth Fund, and Kellogg Fund. NLM donated literature from its own resources and through its credits with the U. S. Book Exchange, it trained BIREME's staff in modern library management and technical operations. It detailed Leonard Karel to the center in 1967 as interim director and provided Loren R. Newburn of NLM's Bibliographic Services Division as deputy director. By 1978 BIREME had a staff of 71, and it provided reference service, interlibrary loans, special bibli- ographies from a subset of the MEDLARS data bank, and training to Latin American medical libraries. Thus through the technical assistance of NLM groundwork was laid in South America for a major regional biomedical and health information resource. Among other countries with which NLM cooperated were Iran, whose authorities were assisted by Corning in setting up a national library, and Aus- tralia, visited by Cummings to advise on the feasibility and design of a proposed life sciences information network. The Library became an active participant in international organizations. Cummings served as a special consultant to the World Health Organization. Cummings and Corning represented NLM at meetings of the Pan American Health Organization Scientific Committee for BIREME. NLM Deputy Direc- tor Melvin S. Day served as the U. S. member of the UNESCO/UNISIST Advisory Committee of the UN Environmental Program International Referral Service and chairman of the Organization for Economic Cooperation and De- velopment Environmental Information Panel. The Library became a member of the International Council of Scientific Unions' Abstracting Board, with Corn- 448 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE ing as its representative, and it hosted the 1976 meeting of the board in Be- thesda. From the 1880's when the Library had become prominent internationally through the distribution of Index-Catalogue and Index Medicus, it had re- sponded to requests for services from institutions in other countries. The vol- ume of services rendered abroad increased greatly until 1969 when, faced with severe limitations of funds and personnel, the Library was forced to restrict delivery of services to foreign countries. Two years later it resumed delivery of two services, the providing of audiovisual materials and photocopies of ar- ticles, but with charges of fees to cover costs. The Library provided services to developing countries, where modern med- ical knowledge was scarce owing to the lack of facilities and resources, under an agreement with the State Department's Agency for International Devel- opment. Beginning in 1964 NLM undertook to deliver up to 30,000 services a year to AID's Washington staff, mission staff, and approximately 50 developing countries in Africa, Latin America, Asia, and the Near East. In some years NLM provided more than 20,000 services to AID nations, including photo- copies of articles, reference services, MEDLARS bibliographies, and subscrip- tion to Index Medicus, NLM Current Catalog, recurring bibliographies, and other publications. The Library continued these services until 1978 when AID's funds for the purpose were exhausted. The Library sought exchanges of medical literature with institutions in other countries much more vigorously than ever before, with the result that the number of exchange partners increased several fold. By the mid-1960's NLM was sending publications to almost 900 institutions in approximately 80 coun- tries, including AID nations. NLM contributed Index Medicus, NLM Current Catalog, recurring bibliographies and other material, receiving in return thou- sands of books, periodicals, and theses, written in many lanugages, some of which would have been otherwise difficult to procure. An increasing number of library administrators, physicians, study teams, and official delegations came from other countries to NLM for information, advice, and tours. In 1969, 35 countries were represented among visitors. In 1973, 225 persons from foreign nations passed through the doors. In 1975 more than 1,000 arrived, including groups from Japan, Sweden, Pakistan, Germany, Algeria, Iran, Mexico, USSR, Trinidad and Tobago, and Egypt. The Special Foreign Currency Program In the late 1950's NLM began to participate in a different kind of inter- national cooperation brought about by the enactment of Public Law 480, the Agriculture Trade Development and Assistance Act of 1954. This law authorized the sale of surplus farm commodities to friendly nations for currencies that had to be spent within those nations. In 1958 an amendment to the act authorized U.S. government agencies to spend these currencies in having scientific and 449 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE technical information translated or abstracted in English. In 1959, through an Executive Order, the National Science Foundation was given the responsibility of developing a translation program. The Foundation negotiated contracts with scientific organizations in Poland and Israel to translate works for several gov- ernment agencies. Each agency was allotted a certain number of pages: NLM's quota was approximately 3,350 pages each year. Estelle Brodman, in charge of NLM's segment, and members of the Library staff, with advice from scientists, physicians, and librarians, chose the books and journals to be translated. Initially, the NLM program was devoted primarily to the translation of Russian literature. After the translations were completed, published (not all translations were published), and shipped to the United States, NLM distributed copies to several hundred libraries. Other copies were offered for sale through the Department of Commerce. Soon after receiving the program the Library added Yugoslavia to the countries providing transla- tions. Beginning with fiscal year 1962, the Library received its own Public Law 480 funds. These amounted to an equivalent of $732,820 in FY 1962, and between $500,000 and $600,000 a year from FY 1963 to FY 1966. The Library continued to cooperate with the National Science Foundation, transferring funds to the Foundation for contracting overseas. In 1965 Corning renegotiated the agreement with the Foundation so that the Library could negotiate directly with contractors if it desired. Originally the program was concerned with the translation of foreign lan- guage biomedical literature into English and the distribution of the translations to American libraries. In 1964 Mary Corning became head of the program and began to broaden its scope to include abstracting, indexing for MEDLARS, publication of conference proceedings, collaborative medical audiovisual dem- onstration projects, and the preparation of handbooks, dictionaries, histories of medicine, and critical reviews. .Eventually the Special Foreign Currency Program came to relate to all functions and missions of the Library. One of Coming's first acts was to arrange for European scientists to prepare digests of articles on drug research appearing in foreign language journals. The work was done by a team of scientists headed by Leo Wislicki at Hadassah Medical School, Israel, and the digests were published in a trial periodical Drug Digests from the Foreign Language Literature from 1965 to 1968. In cooperation with the Food and Drug Administration, NLM also contracted with Wislicki's group to abstract articles on drugs from journals not covered by the FDA's Clinical Experience Abstracts. The abstracts were published in the FDA journal from 1965 to 1971. In addition the Library obtained the services of Ino Sciaky and other dentists at Hadassah School of Dental Medicine to abstract articles from foreign dental journals, the abstracts being published in the American Dental Association's Oral Research Abstracts, from 1965 to 1971. Corning also reached an understanding with the Polish Ministry of Health 450 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE and the Principal Medical Library, Warsaw, for the preparation of critical reviews by Polish physicians. Critical reviews, as conceived by NLM, were thorough analyses of scientific fields written by leaders in the fields describing the current state of the fields and suggesting areas of research. The first reviews, The Application of Metabolic and Excretion Kinetics to the Problems of In- dustrial Toxicology by Jerzy K. Piotrowski, and Myoplastic Amputation and the Use of an Immediate Prosthesis by Marian Weiss and associates, were published in 1971. The Library had to overcome several problems in arranging programs with physicians and scientists in countries with different environments and political systems thousands of miles away. One problem was funding. In 1966 NLM began to use "bloc" financing for activities in Israel. Instead of administering and financing each project individually, Corning arranged with Moshe Pyrwes, editor of Israel Journal of Medical Sciences, to act as prime contractor or principal investigator and oversee all projects in his country for a certain period of years. Bloc funding possessed several advantages; it decreased administrative and paper work, relieved NLM of the problem of locating competent scientists in Israel, provided continuity in the projects, and provided stable funding over a long period of time. In 1971 after several years of negotiation, Jeanne Brand, Coming's successor, negotiated a bloc agreement in Poland, Janusz Jeljaszewicz of the Coordinating Commission for Polish-American Scientific Collaboration serving as principal investigator. During the early years only three countries were involved in the program, Poland, Israel, and Yugoslavia. Corning, Brand, Leroy L. Langley, and G. Burroughs Mider of the Library, as well as William G. Anlyan, Robert H. Ebert, William N. Hubbard, Jr., Morris Tager, Stewart Wolfe, Alfred A. Gel- horn, and Max Michael of the Board of Regents visited health officials and scientists in these countries, seeking to improve ongoing projects and looking for opportunities for new projects. Library emissaries also visited other coun- tries, inviting health officials to cooperate in projects of mutual benefit. In 1972 Brand negotiated research agreements in Egypt, and broadened the translation and printing activities in Tunisia, Pakistan, and India. In some of the nations the special funds used for the programs eventually ceased to be available. When this occurred, the programs did not die but were continued under the auspices of joint cooperative agencies. In 1973 P.L. 480 funds for Israel were depleted but were replaced for 6 more years by funds from the United States-Israel Binational Science Foundation. In 1973 P.L. 480 money also became exhausted in Yugoslavia, but financial support was provided by the United States-Yugoslavia Joint Board on Scientific and Technical Co- operation. In 1974 Egyptian P.L. 480 funds ended, but the program continued first under sponsorship of the Joint Working Group on Medical Cooperation and in 1975 under an agreement on health cooperation between the govern- ments of Egypt and the United States. In 1976 P.L. 480 funds ran out in 451 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Poland, but the program was extended until 1985 under auspices of the Marie Sklodowska-Curie Joint Fund of the United States-Polish Joint Committee for Cooperation in the Field of Health. Through FY 1976 the equivalent of $8.5 million was obligated for NLM's Special Foreign Currency Program. The Library's partners produced 47 books (original writings and translations), 72 chapters and aticles, thousands of ab- stracts, and engaged in other activities. The program was valuable in dissem- inating information which would not otherwise have been accessible in the United States because of language limitations and communication gaps.10 Upholding the Right of Scholars to Copy Writings The Library had started to microfilm articles for patrons in 1937, but the demand did not become large until World War II. Then, as the number of microfilmed articles climbed into the thousands, and as copies of entire journals were filmed, there arose a concern about possible violation of copyright laws, even though copying was necessary to assist research and medical care in the ArmecuForces and to provide all the information the Allied Forces requested. Director Jones drew up the following rule to protect the Library:11 Except when the order is accompanied by the written permission of the copyright owner, the Army Medical Library will not reproduce books protected by co- pyright or entire periodical issues, nor will it reproduce excerpts from periodical issues within 6 months of their publication date. After the war was over the demand for film dropped for a time, then began to rise. When Joseph McNinch became Director in 1946 he gave no thought at first to the legal questions involved in microfilming and photocopying pub- lished material. "It was not long," he recalled, "before I became aware of this most difficult problem. It was brought to a head when it was discovered that we had copied not a few pages but a complete copyrighted book."12 McNinch learned that the Library of Congress was thinking of approaching publishers for the purpose of arranging agreements covering photoduplication and he considered doing this with publishers of medical literature. He did not follow through for two reasons: first, the Judge Advocate's office told him that steps were being taken to permit firms to bring suit against the government in the Court of Claims for copyright infringement, but there would be little likelihood of suit because damages would be negligible; secondly, Morris Fish- bein, chairman of the Honorary Consultants Committee on Copyright, pressed the viewpoint that circulation of the so-called "Gentleman's Agreement" among medical publishers would be more effective than trying to secure releases.13 Through McNinch's term, 1946-1949, and Rogers' term, beginning in 1949, the amount of copying increased. The old V-mail equipment, used since World War II, became obsolescent. In the meantime commercial machines capable of producing high-quality prints rapidly had been developed. After looking over models on the market, Rogers in the spring of 1957 rented a Copyflo machine that replicated 32 pages of text a minute from microfilm by a xerographic 452 extensions of traditional library service The Copyflo machine producing a long roll of photocopied articles from microfilm. Frank Shiflet, right, and Daniel Calloway operate the machine; Louise Goins cuts a roll of photocopies into pages. process. Representatives of the Joint Congressional Committee on Printing and Binding came to the Library to see the Copyflo perform and approved the rental, later the purchase, of the machine. After the institution was designated by Congress as a national library, Rogers made a thorough examination of the interlibrary loan and photoduplication services, and decided to rationalize and codify the loan policy. The Library would no longer lend publications to individuals, only to other libraries. It would not lend volumes of journals, instead it would provide photoprints of articles without charge. It would continue to lend books to other libraries, and the borrowing institution would have to pay only return postage. These new regulations would force readers in other areas to patronize their local medical libraries, leaving NLM to provide publications not obtainable locally; it would encourage the growth of local libraries; it would save wear and tear on volumes of journals; it would retain journals in the Library where they would always be available for the use of other readers and for copying purposes; the cost would be no greater than the cost of maintaining fiscal accounts on purchases of photoprints; it would reduce the expense of the borrowing library. After much discussion among the staff and Board of Regents, Rogers initiated the new policy on September 1, 1957. In promulgating the new policy Rogers laid down the following rules: the Library would copy no more than one article from an issue or three from a volume of a journal; it would not copy an article longer than 50 pages; it would 453 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE not make multiple copies of an article; it would copy no more than a few pages from a book. Exceptions to the regulations would be made only by approval of the Director or Librarian. Each photocopy would contain this statement in the margin: "This is a single photostatic copy made by the National Library of Medicine for purposes of study or research in lieu of lending the original." Thus the Library attempted to formulate policy with due regard to the pro- visions of the copyright law. Rogers hoped that the regulations would lessen risks of infringement, but he also felt that eventually there would come a test of the issues in the courts.14 After the policy had been in effect for a few years William H. Kurth made a survey of the interlibrary loan operation through June 1961, a period of almost 4 years. During this period there were 325,262 loans, 301,528 or 93 percent of which were articles satisfied by photocopies. Utilizing punched cards Kurth examined the borrowing libraries in terms of geographic location, type, and frequency of borrowing. He gathered statistics on the frequency of requests for certain periodicals, the relationship of photocopied articles to citations in Index-Medicus, and the age of the periodicals. His data indicated that the interlibrary loan operation was successful in meeting a large proportion of loan needs across the country. It reinforced the Library's decision to divide the serial collection in the new building by shelving older, less-used periodicals on the lowest stack level, and the recent, frequently used journals in a readily accessible area on the highest stack level. It .presented data useful to the staff in other ways.15 Endeavoring to reduce the time from the arrival of a loan request to the dispatch of a photoprint or book to a minimum, the staff studied the flow of work. It sought new equipment to hasten and improve the quality of photo- graphing, developing, and printing. A major innovation was the development of a moveable camera for use in the stack area of the new building. Originally in the copying operation, volumes containing articles to be photographed were brought from the shelves to a centralized group of microfilm cameras. These volumes were temporarily out of circulation, and furthermore there was con- siderable labor involved in moving, sorting, and reshelving them. Rogers and Scott Adams decided to move the camera instead of the books. With assistance of technicians from the National Bureau of Standards and other agencies, a camera, bookholder, lights, controls, and an operator's chair were installed in a little cubicle on wheels that could be pushed back and forth along an aisle. Electricity to operate the lights and controls came through an extension reaching to metal rails on the ceiling. Shortly after the Library moved into the Bethesda building five movable cameras were put into operation. Journal volumes con- taining articles to be copied were placed on a special shelf at the end of each range within reach of the camera operator. The operator picked the volume off the shelf, photographed the article and replaced the volume on a second shelf for reshelving. The movable cameras made photocopying cheaper, faster, and less laborious than the old procedure. 454 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE The moveable camera developed to overcome the disadvantages of trucking books from the stacks. The camera housing was designed by the National Bureau of Standards. George Queen operates the filming unit, a Kodak Recordak Micro-file. 455 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE In the meantime the book industry was showing increasing concern over the amount of photocopying being done in libraries. The American Text Book Publishers Association held a meeting in New York City to which Adams was invited to present data from NLM. Using figures from Kurth's survey, Adams demonstrated that only two book publishers owned any of the 100 most heavily photocopied journals on Kurth's list. These data tended to show the divergence between commercially oriented and scientifically oriented sponsors of publish- ing. Subsequently Adams invited the vice president of Williams & Wilkins, publishers of medical journals, to the Library to explore grounds of common interest and to demonstrate the degree of controls that NLM had voluntarily adopted. Soon after, William N. Passano, president of the firm, visited the Library and talked to Director Cummings about photocopying. In Passano's view the Library was infringing on his firm's copyright by photocopying articles from Williams & Wilkins journals, but he offered to permit the practice to continue if a royalty of 2 cents per page per copy were paid. Cummings pointed out that the "Gentleman's Agreement" had generally been accepted as a basis for permitting libraries to make single copies of articles for scholars and that no royalty was required by law or custom. Cummings also felt that although NLM could probably afford to pay the royalty smaller libraries could not. And finally he was concerned that the demand for royalties might escalate from 2 ce,nts to 5 cents or 10 cents per page. On February 27, 1968, Williams & Wilkins filed a petition in the United States Court of Claims against the government, alleging that the National Library of Medicine and the library of the National Institutes of Health had infringed on the company's copyright by photocopying articles from their jour- nals. The case of Williams & Wilkins Company v. the United States was tried on September 9, 1970, before Commissioner James F. Davis of the Court. The firm was represented by a lawyer very knowledgeable in the subject, Alan Latman, who had prepared the report on "fair use" for the Copyright Office series of studies toward revision of the copyright law. The suit had implications for other programs of the Library. Filming entire works for preservation could constitute infringement, and Cummings consulted with the Library of Congress and National Agricultural Library about the pos- sibility of an amendment to the copyright bill before Congress which would permit the three national libraries to copy publications for preservation. The planned graphic image program, in which publications would be filmed, the film stored, and printed out for interlibrary loan purposes could be affected. Facsimile transmission of publications might not be permissible. Computer- based information systems and audiovisuals might run into trouble. Cummings, Adams, Albert Berkowitz of NLM, and Seymour Taine of the NIH Library were among the witnesses for the United States. The government claimed that NLM had the right to copy any document that reported research paid for by public funds (a portion of the copied articles described research 456 EXTENSIONS of traditional LIBRARY SERVICE supported by Federal grants). But the government's defense relied chiefly on the judicially-created doctrine of "fair use." Commissioner Davis presented his report to the Court of Claims on Feb- ruary 16, 1972, recommending that the case be decided in favor of Williams & Wilkins. The government filed an exception to Davis' report. The publisher then approached libraries with a plan that called for an increased institutional price and with it a license to make single-copy reproductions of all articles. In addition the publisher asked for a 5 cents fee for each page copied for interlibrary loan. The Library was willing to pay the increased institutional price but without reference to license or royalty. On November 27, 1973, the Court of Claims overturned Commissioner Davis' report by the narrow margin of four to three and ruled that the making of a single photocopy of a journal article did not violate copyright laws. The court believed that research would suffer if photocopying were banned, since "the supply of reprints and back numbers is wholly inadequate," and it was "unrealistic to expect scientific personnel to subscribe regularly to large num- bers of journals which would only occasionally contain articles of interest to them." As expected Williams & Wilkins appealed the verdict to the U. S. Supreme Court. The Court listened to arguments in the case on December 17, 1974. On February 25, 1975, eight justices (one recused himself) rendered a split decision, four to four, thereby affirming the decision of the Court of Claims. In this long legal battle NLM championed the rights of every noncommercial library in the nation. Some members of the staff worked an extraordinary number of hours compiling data to reinforce the Library's position and in acquainting lawyers with library traditions, techniques and operations. To Cum- mings it was the most trying event during his term as Director. For years he devoted half of his time to the case. It sapped more of his energy than all other problems combined, and he felt that it triggered the heart attack that sent him to the hospital in 1973. The Library won this ground-breaking case by the narrowest of margins. The Court of Claims emphasized the complexity of the litigation stating, "the issues raised by this case are but part of a larger problem which continues to plague our institutions . . . how best to reconcile on the one hand the rights of authors and publishers under the copyright laws with, on the other hand, the technological improvements in copying techniques and the legitimate public need for rapid dissemination of scientific and technical literature ... our hold- ing is restricted to the type and context of use by NIH and NLM as shown by this record." This suit emphasized the need of revision of the copyright law. In the opinion of the Court of Claims the decision was a "holding operation" in the period before Congress passed a law covering photo and mechanical reproductions made possible by recent technology.16 The Supreme Court decision was followed approximately 2 years later by a new copyright law that revised the old law of 1909. This general revision had 457 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE begun in 1955, had been the subject of a bill introduced in the House and Senate in 1965, and had been the subject of extensive hearings before being enacted by both houses and signed by President Gerald R. Ford on October 19, 1976.17 The new law recognized the principle of "fair use" as a limitation on the exclusive rights of copyright owners and established general standards to be applied to the interpretation of "fair use." The new law confirmed the practices that NLM had been following since it began photocopying in the late 1930's. Microfilming Books and Journals for Preservation The cost of preserving perishable literary works has bothered librarians ever since libraries began. At times it has seemed as though some librarians were more concerned about preserving the books and serials entrusted to their care than in seeing them well used. Yet it is important that librarians, particularly the librarian of a national library, make certain that scarce writings, at least, be preserved for posterity.18 The National Library of Medicine possesses many works, copies of which are held by few or no other libraries in the country. Unfortunately a large proportion of these publications have been deteriorating. This was owing to repeated handling, interlibrary loan transit, and photoduplication; to the dry heat and dust in the old building; to sulfur dioxide in the atmosphere around Washington from the combustion of coal and oil; and to the nature of the paper itself. Mass produced chemically digested woodpulp paper entered commerce around 1870. Almost all of the books and journals published after that time were printed on woodpulp paper. This paper is inherently weak because of the short fibers in wood pulp and because of residual acid from the manfacturing process. Within a short period, in terms of human existence, a very large proportion of NLM's publications will disintegrate. For years the librarians had been thinking about preserving the text of fragile publications by microfilming but had held back because of the expense. In 1954 Director Rogers asked his division chiefs to survey the collections to ascertain the books and journals most in need of preservation. The following year he instructed the photoduplication staff to begin photographing deterio- rating publications when they were not making photocopies for interlibrary loan. For several years thereafter microfilming for preservation proceeded at an uneven pace, decreasing as the number of interlibrary loan requests in- creased and vice versa. Usually, some hundreds of thousands of pages, mostly serials, were filmed each year. In 1964 members of the staff inspected the collections to ascertain the degree of deterioration. They estimated that the shelves held 350 million pages, 325 mi ion of which had been printed after 1870 on woodpulp paper. Thirty-seven mrlhon pages were considered to be fully deteriorated, and this number would increase to 262 million by 1989. Deterioration was proceeding faster than microfilming. 458 extensions of traditional library service Director Cummings asked the National Bureau of Standards for advice to enable NLM to improve the quality of microfilming. Edward Forbes and Thomas Bagg of the Bureau inspected the Library's equipment and procedures. They recommended improvements and drew up specifications for preservation film- ing.19 Cummings requested funds to enable the Library to increase the pace of preservation microfilming. The administration removed the item from his budget, but sympathetic Congressmen added money for the purpose to NLM's appro- priation for fiscal year 1966. ^ The Library accelerated the pace of microfilming in its own building, and it contracted with commercial firms to assist, the first firms being University Microfilms and Microcard Corporation. By 1976 NLM and its contractors had microfilmed approximately 18 million pages. Since the Library at that time received approximately 18 million pages each year, the rate of filming could not catch up with the backlog of deteriorating publications. However, the future of textual preservation may not be as gloomy as the above figures indicate. Earl Henderson and George Thoma of the Lister Hill Center saw the possibility of assisting preservation and interlibrary loans through electronic technology and began development of a system that would elec- tronically transfer textual and graphic images onto high density optical disks, from which the images could be retrieved on a viewer or on paper. This system will provide the opportunity to investigate the extent to which optical disks may be employed to preserve the texts of NLM's perishable books and journals and to assist NLM's interlibrary loan service. Collecting Modern Manuscripts John Shaw Billings and the Directors who succeeded him occasionally pur- chased or were given manuscripts of historical value. The manuscripts, shelved among the books, were listed in the Index-Catalogue under the names of the author or compiler and were followed by the notation MS. Billings also knew the usefulness to historians of the correspondence of noteworthy physicians— he tried unsuccessfully to purchase the letters of John Morgan, founder of the first medical school in the colonies—but he and his successors had too little money, too few assistants, too many publications to acquire, and too much service to render, to seek and collect correspondence systematically. No sep- arate collection of manuscripts, except that of early Western and Oriental writings, existed in the Library until the 1960s.21 The foundation of the modern manuscripts collection was laid in 1961 when John Blake, chief of the History of Medicine Division, presented to Director Rogers a plan for obtaining the personal correspondence, diaries, laboratory notebooks, and other writings of physicians, researchers, administrators, and, in some cases, the records of medical organizations.22 Rogers agreed but could not promise funds to hire a manuscripts librarian for at least 2 years.23 Blake, in the meantime, began to acquire papers whenever the opportunity arose, among them letters and other manuscripts of Chauncey D. Leake, Victor Ro- 459 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE binson, Esmond Long, and Henry L. Coit. These records were stored in the stacks awaiting the eventual arrival of a qualified person for the job. In 1965 Blake received funds to engage a manuscripts librarian, Manfred Waserman. Waserman began to organize, and arrange the documents, remov- ing duplicates and out-of-scope material. He compiled finding aids. He proc- essed new collections. He cataloged hundreds of volumes of lecture notes, recipe books, diaries, journals, commonplace books, and manuscript items that had come to NLM during the past century. He processed the old Library correspondence of Billings and other former directors. One of the larger tasks undertaken was the cataloging of approximately 2,000 individual historical let- ters which had accumulated over the previous decades. Some of these had been given to the Library as gifts, some had been obtained for their autograph value or purchased for their medical history content, and some had been with- drawn, for one reason or another, from the Library's archival collection. In 1966 Peter D. Olch arrived to act as deputy chief of HMD, to begin a systematic effort to acquire the papers of contemporary leaders in medicine, and to start producing and collecting oral histories. A policy was drawn up concerning in general the kinds of persons, out of the hundreds of thousands in the life sciences, whose papers would be sought and preserved for posterity. Among those who responded were William S. Middleton, Stanhope Bayne- Jones, William B. Bean, John B. Youmans, the estate of Alan Gregg, Milton Senn, Lois Murphy, Fred Soper, the Association of American Medical Colleges, Sydenham Hospital of Baltimore, American Association of Thoracic Surgery, Alpha Omega Alpha Honor Medical Society, and Interurban Clinical Club. At first the requests brought reasonable quantities of correspondence and other records. But in 1971 one donor shipped 264 cartons containing approx- imately 120,000 items, many of which did not have any historical value, and which took more than a year to process. It was then decided that the Library would never again take possession of large collections sight unseen but that Olch or Waserman would visit prospects and examine records before accepting them to make certain that the Library would receive only worthwhile material. As medical librarians elsewhere in the country learned of the existence and scope of the manuscript collection, they called on HMD for advice. Waserman assisted with the Lister Hill papers at University of Alabama Medical School, the Bailey K. Ashford papers at University of Puerto Rico, and the archives of the Society for Research in Child Development. Olch and Waserman advised the Alan Mason Chesney Medical Archives of Johns Hopkins Medical Insti- tutions. By 1976 HMD had obtained 236 new groups of records of individuals and organizations. The acquisitions ranged in size from a few items to accumulations filling about 80 manuscript containers stretching over 35 linear feet. As the Library's holding grew historians, writers, students, and editors in increasing numbers used the material to prepare articles, obituaries, book-length biogra- 460 EXTENSIONS of traditional library service phies, and theses; and the Modern Manuscripts Collection came to be one of the attractions of the History of Medicine Division. Recording Autobiographies In 1963 Martin Cummings, at that time director of NIH's Office of Inter- national Research, was interviewed by Harlan Phillips, who was gathering information for a historical study. The questions and answers were tape-re- corded and transcribed, producing an "oral history." Cummings was impressed by the potential usefulness of such interviews to historians, and 2 years later, after he had become Director of the Library, he considered the possibility of introducing oral history into the institution.24 To obtain an overall picture of the utib'ty, scope, and cost of; the facilities and personnel required for; and the technique of producing oral histories, Cummings invited five experienced practitioners of the art to NLM for a con- ference. Afterward he requested John Blake to add an oral history program to the History of Medicine Division. The Library contracted with Harlan Phillips to interview notable physicians and scientists selected by Cummings and his associates. Phillips began by obtaining a lengthy autobiography of Stanhope Bayne-Jones, educator, micro- biologist, and administrator, tape-recorded over a total period of 52 hours. Later Phillips conducted audiotaped interviews with Ward Darley, Lister Hill, Michael Heidelberger, and Albert Szent-Gyorgy. In conjunction with inter- views the staff endeavored to acquire the subjects' correspondence and other papers for the manuscript collection. The Library contracted with historians studying modern aspects of the life sciences, in return for copies of their recordings and transcripts. In this way NLM obtained interviews bearing on the recent development of the Food and Drug Administration, on the contemporary practice of homeopathy, on the history of the child development movement, and on other subjects. The Library obtained other oral histories by gift and purchase. In 1966 Peter Olch took charge of the oral history program. Over the succeeding years he interviewed Albert Baird Hastings, William S. Middleton, Donald D. Van Slyke, Owen Wangensteen, Shields Warren, Emile Holman, and other persons. The steps in the production of an oral history included: preparation for the interview by studying the subjects' career in detail, an interview generally of several sessions, typing the interview from the tape recording, proofreading the typed draft, an editing of the draft by the subject, final typing, indexing, and, in some cases, binding. The entire process was slow, labor-intensive, and expensive. Finally Olch and Blake began to wonder if it would not be preferable to concentrate HMD's limited resources on the collecting and processing of the personal papers of leading physicians rather than on oral histories. In 1975 after much deliberation, an evaluation of the project by consultants, and a 461 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE review by the Board of Regents, HMD discontinued the production of oral histories, except when they would serve to supplement the papers of an in- dividual or organization. At the time the collection comprised about 11,000 pages transcribed from approximately 520 hours of interviews with 140 persons. Cooperation Among Federal Libraries The leaders of the Library of Congress, National Agricultural Library, and National Library of Medicine had consulted and exchanged information for a century, among them Billings with Ainsworth Spofford of Library of Congress, McCulloch and Jones with Herbert Putnam of LC, Jones with Ralph Shaw of National Agricultural Library, McNinch with Luther Evans of LC, and Rogers with Foster Mohrhardt of NAL and with Verner Clapp of LC. Formal relations between the three national libraries increased after midcentury and gradually encompassed other Federal libraries and information groups as cooperation offered the promise of increased efficiency in comparable operations.25 In 1962 the Federal Council on Science and Technology set up an inter- agency Committee on Science Information, later renamed the Committee on Scientific and Technical Information or COSATI. COSATI concerned itself with the coordination of the various programs within Federal agencies. To do this it appointed task forces and panels to study such matters as the assessment of specialized information centers, the funding of the Science Information Ex- change, promulgation of standards for descriptive cataloging of technical re- ports, microfiches for the storage and dissemination of reports, the creation of a clearinghouse for Federal scientific and technical information, and the estab- lishment of a governmental depository library system. In early 1966 the Office of Science and Technology invited Cummings to attend COSATI meetings as an observer. Later that year the Secretary of the Department of Health, Education, and Welfare appointed him as the Depart- ment's representative on the group. He soon found himself on the COSATI steering committee, the COSATI international panel, a panel concerned with establishing policies for. machine-readable information distribution, and a task force on national information systems. Other members of the Library staff were asked to serve on various panels. During this period Cummings was concerned with important innovations in the Library—the starting of the research and development program that was to become the Lister Hill Center, the planning of MEDLARS II, and the development of the grants program and the Toxi- cology Information Program. Because of the inordinate amount of time that he, along with seven of his staff, was spending on COSATI affairs, he asked to be replaced as the DHEW representative. G. Burroughs Mider, deputy di- rector of the Library, took his place on the committee. COSATI provided a useful forum for the exchange of ideas and data among Federal libraries and information groups. In its conception of a national infor- mation system, it proposed that NIM be the agent for the construction of a national medical library network and be designated to coordinate and approve 462 extensions of traditional library service the handling of information within the area of medicine. But COSATI's plans never progressed very far because it had no authority to redirect program emphasis or enforce common standards within agencies. It was disbanded in 1973 when the advisory functions of the Federal council were transferred to the National Science Foundation. The most successful cooperation on a national scale was brought about by the directors of the three national libraries: Quincy Mumford of the Library of Congress, Foster Mohrhardt of the National Agricultural Library, and Cum- mings. They began to meet occasionally in 1964 to discuss the possibility of cooperation and of avoiding redundancy in their operations. In March 1965 they set up the Federal Library Committee, composed of directors of the three national libraries and a librarian representative of each executive department. The committee carried on its work through task forces, the most important of which was the Task Force on Automation and Other Cooperative Services. The major effort of the task forces became the development of a computer-based national serial record data bank, and machine-readable catalog formats. In 1973 the three national librarians reorganized the committee, increased its membership to 41, and set a schedule for regular monthly meetings. The committee's deliberations touched on all areas of interest to Federal libraries, and within these areas they recommended policies and other measures for improvement. It was difficult for three national libraries, each of which had developed along its own lines, to reach unity in their operations, but through the committee they slowly approached this goal. Interns and Associates In the early 1950s Director Rogers became concerned over the national shortage of qualified librarians capable of moving into responsible positions in modern medical libraries. He and his staff drew up plans to offer a year of on- the-job training and intensive academic study to persons holding the master of library science degree. The educational-vocational experience would enable the interns to build careers in medical librarianship and would develop them to hold positions of responsibility in medical institutions. The maximum number of interns that the Library could train annually was three. This would provide fewer qualified medical librarians than was needed, but it was all that the Library, with its limited funds, manpower, and space could accept.26 The Library announced the start of the intern program through its monthly National Library of Medicine News in January 1957. At that time NLM was the only medical library in the United States offering such an education, and many persons leaped at the opportunity of moving ahead in their profession. The three who were selected by a screening committee began their appren- ticeship in September 1957. The program was directed by a committee composed of divisional chiefs and the executive officer, with the Director's assistant serving as chairman. The course, designed to provide interns with a broadly based work experience, 463 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE consisted of rotating assignments in the Library's operating divisions, seminars, lectures, elective projects, attendance at local and national meetings of profes- sional librarians, university courses, and visits to medical and research libraries and information centers. Scores, perhaps hundreds, of medical schools, hospitals, Federal agencies, medical society libraries, and other health libraries needed specially qualified librarians, and NLM's supply of three each year was insignificant compared to the demand. Rogers and the Board of Regents desired to train a much larger group, but there was no money for the purpose. When Rogers placed estimates for funds for intern training in the budget, the items were eliminated at higher levels, and he had to use unexpended personnal funds for the purpose. The Library looked forward to the time when the grants program, then being planned, would provide for the establishment of training programs elsewhere. In addition to the Intern Program the Library offered advanced training for its own employees. They were invited to attend intern lectures in the building. Employees who wished to attend courses in languages, library science, or other pertinent subjects were sent to the Department of Agriculture Graduate School, The Catholic University, and other universities in the Washington area. The development of MEDLARS in the early 1960's brought the first phase of the intern program to an end. At the conclusion of the September 1963- August 1964 session the Intern Program was suspended. Because of need in other libraries for persons capable of working with automated systems, partic- ularly MEDLARS, NLM began to offer training in indexing, searching, MESH, and concepts of information storage and retrieval. Librarians came from other areas of the country and from foreign nations to attend these classes. When AIM-TWX, MEDLINE, and other on-line systems were developed, instruction was expanded to include these. In 1966 NLM resumed a modified Intern Program, naming it the Library Associates Program. The purpose was now to "train personnel in the skills required for effective operation of communication services for the biomedical community." In keeping with NLM's increasing functions the program included instruction in the various operations of computerized bibliographic systems, audiovisual techniques, biomedical communications, specialized information services, and grants. As the program developed members of the Library staff served as training coordinators, the first of whom was Scott Adams, followed by a former intern Maxine Hanke. By this time NLM's grants program was operating, and a number of medical libraries and library schools were receiving funds to present advanced training programs. The annual production of their graduates did much to alleviate the shortage of well-trained librarians for medical institutions. During the first 20 years of the programs (1957-64, 1967-79), 66 persons received advanced training at NLM. The programs carried prestige, and li- brarians regarded graduates very highly. Upon completion of their training the 464 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE graduates had no difficulty obtaining positions in the profession, and rapidly assumed posts of responsibility in library management or systems design. Ap- proximately three-fourths of them remained in the library field, one-half in medical libraries. More than a third elected to remain at NLM for at least a year, many moving into positions of responsibility, as coordinator of the Re- gional Medical Library Program, chief of the Technical Services Division, head of the Acquisition Section, and on-line training coordinator. The Gillmore Bequest During World War I Captain Robert Tracy Gillmore, Medical Officers Reserve Corps, died while serving in the Army at Fort Oglethorpe, Georgia. After his death his wife, Emma Wheat Gillmore, also a physician, joined the Public Health Service for the duration of the war. Some 20 years later Emma Gillmore began to think about the disposition of her estate. The Gillmores had had no children, and she had no relatives. At first she placed $5,000 in a trust fund and willed this to the Library. "It would give me personal pleasure," she told Librarian Jones, "to feel that upon my death this trust fund . . . would be turned over direct to the . . . Library ... [to be] used in whatever way desired, unrestricted in every sense of the word."27 Later she changed her will, ap- pointing the Surgeon General of the Army an executor and bequeathing prac- tically all of her estate to the Library. Emma Gillmore died in Sydenham Hospital, New York City, August 15, 1948. The Government received $23,434.75 in 1951 to be used by the Library "in the name of my late husband, Robert Tracy Gillmore, and myself, Emma Wheat Gillmore." In 1964 Director Cummings arranged with Surgeon General of the Army Leonard D. Heaton to draw on the fund to help provide the building with something greatly needed; a meeting place for societies and for conferences of groups associated with the Library. A large storage room was remodeled into an auditorium and a study, both named in memory of John Shaw Billings. In addition the bequest was used to produce dioramas of the four buildings that had housed the Library since the Civil War, to engage artists to paint portraits of former directors McNinch and Rogers, and to purchase rare books for the History of Medicine Division.28 The latter included two publications from the 16th, 11 from the 17th and 12 from the 18th centuries on medicine or related subjects. The most important work was a unique manuscript by Conrad Gesner, a notebook in which he jotted down his impression of famous physicians, naturalists, and other scientists whom he met between 1555 and 1565, and in which more than 200 of these persons wrote short passages and their autographs. Emma Wheat Gillmore never saw the building in Bethesda, but her gift of furnishings has been appreciated by the tens of thousands of listeners in the Billings auditorium, of the paintings by all who have visited the reading room, and of the books by many scholars. 465 a history of the national library of medicine The Billings and Bicentennial Celebrations In 1965, a century after John Shaw Billings entered the Army Surgeon General's office, his work in transforming the small reference collection of books and journals into a national library was commemorated by the observance of a Billings Centennial. On June 17 members of Congress, officials of the govern- ment, and leaders in medicine, librarianship, and communication met at the Library.29 The afternoon session, scheduled to be held out-of-doors in front of the building, was forced into the main reading room by rain. There Norman Q. Brill, chairman of the Board of Regents, presided. After a welcome by Director Cummings, Surgeon General Luther Terry introduced Representative John E. Fogarty who spoke on "Medical Libraries and Medical Research." Wilbur J. Cohen, Undersecretary of the Department of Health, Education, and Welfare, introduced Representative Leo W. O'Brien who delivered an address on "Med- ical Libraries and Medical Education" on behalf of Representative Oren Harris, who was unable to attend. Anthony J. Celebrezze, Secretary of the Department of Health, Education, and Welfare, introduced Senator Lister Hill who talked about "The Medical Library Crisis-Billings to MEDLARS." Following the speeches guests toured the Library and viewed an exhibit of Billings memorabilia, ranging from diplomas, photographs, books, personal letters, newspaper clippings, literary articles, official documents and lecture notes to the early Hollerith punch card tabulation equipment (the foundation of the International Business Machines Corporation) developed at Billings' suggestion. The evening program, held in the Billings auditorium, featured talks about Billings by Jean A. Curran, professor emeritus of history of medicine at State University of New York; Bess Furman Armstrong, former Washington news- paper correspondent and author of a history of the Public Health Service; and Frank B. Rogers, one of Billings' successors as Director of the Library. As a lasting memento of the occasion the Library issued all of the addresses in a volume, John Shaw Billings Centennial, and published a facsimile copy of an outline of an autobiography that Billings began in 1905 but never completed. In a private ceremony preceding the centennial, a link from the old Library to the new was provided by Colonel Robert Howe Fletcher, grandson of Robert Fletcher, Billings' friend and collaborator in the Library and in the production of Index Medicus for a third of a century. Colonel Fletcher presented to NLM literary manuscripts, articles, and memorabilia of his grandfather, including the medal awarded by the Royal College of Surgeons of England in 1910. Several years after the Billings celebration, it occurred to Mary Corning that the Bicentennial of the United States was approaching, and that it would be appropriate for the Library to contribute to the anniversary. She suggested to Cummings that NLM sponsor a Festschrift assessing 200 years of biomedicine and health, and prognosticating the future. Cummings and she then planned a series of events involving a Colloquium and Festschrift.30 466 extensions of traditional library service The "Colloquium on the Bicentennial of Medicine in the United States" was held on May 6 and 7, 1976. Topics included medical education, public health and preventive medicine, medical care, select specialty areas, biomedical communications, the Federal role in medical education and research, and U. S. medicine as seen from abroad. Several hundred physicians, scientists and educators from the United States and other countries attended; essays were presented, reviewed by a special discussant, and then discussed by the audi- ence. On the evening of May 6, a special Board of Regents dinner attended by 225 guests took place in the main reading room, the first time such a banquet was held in the building. The guests of honor included those who had assisted in developing the Federal health effort and NLM's role in biomedical com- munications. The closing lecture by Philip Handler was presented in the Na- tional Museum of Science and Technology on May 7, and was followed by a reception and buffet. Among the congratulatory messages received by the Library were those from President Ford, and Senators Humphrey, Magnuson, and Kennedy. The colloquium was described as "a great tribute to American medicine." The lectures presented at the colloquium were published in a two-volume set, Advances in American Medicine: Essays at the Bicentennial, by the Josiah Macy, Jr. Foundation in cooperation with the Library. Three special presen- tations not included in Advances were published by NLM in a volume, Epi- logue: Essays at the Bicentennial of Medicine in the United States. The Library also issued a special annual report devoted to its development and history, Communication in the Service of American Health ... a Bicentennial Report of the National Library of Medicine. For more than the first century of its existence the National Library of Medicine was a traditional library, acquiring, cataloging, storing, and lending literature. Then in less than a decade it mechanized and computerized its bibliographic functions, and in another decade it began to utilize television, satellites, and audiovisuals. In years to come, it will use every other means of communication that is available. The Library of the future may be one in which there will be no readers, only literature, equipment, and staff, information being delivered to users in homes, offices, hospitals, laboratories, institutions, and student areas through rapid communications. What John Shaw Billings said a century ago is true today and will continue to be as long as the institution stands:31 I may say that the future prospects of the Library are excellent. It is not de- pendent on the skill or energy, or goodwill, of any one man; it is becoming more and more known to, and more and more used by, the members of the medical profession, and so long as they are interested in it, the necessary ap- propriations will be made and the skilled force employed to increase, preserve, and catalogue it. The service rendered by a number of those employed in the 467 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Library is not a mere matter of money—they are deeply interested in their work and proud of the results, and they can and will carry it on and instruct others who will come after them and do likewise. Notes 1 Information on the Library's increased em- phasis on dental literature was obtained from Kenneth Lynn, Martin Cummings, records of the Board of Regents, and NLM News. The first dentists on the Board of Regents were Basil G. Bibby, professor of dentistry, University of Rochester, 1956-1959, and May- nard K. Hine, dean, School of Dentistry, In- diana University, 1959-1963. 2 Information on the renaissance of veteri- nary medicine in NLM was obtained from Fritz Gluckstein, Martin Cummings, records of the Board of Regents, annual reports of the Library, and NLM News. 3 Information on scholars-in-residence was obtained from John Blake, records of the Board of Regents, NLM News, annual reports of the Library, and records of the program. 4 Information on reorganizations within the Library were obtained from library manuals of operations, Public Health Service manuals, an- nual reports of the Library, and NLM News. 5 See, for example, the article by R. B. Liv- ingston and C. F. Bridgman, "Progress Report on the Neurosciences Study Plan," Trans. Am. Neurol. Ass. 94: 165-7 (1969). 6 R. Q. Marston, W. D. Mayer, "The In- terdependence of Regional Medical Programs and Continuing Education, "/. Med. Educ. 42: 119-25 (1967). 7 The Universities Associated for Research and Education in Pathology produced several publications, among them: K. Brinkhous and J. Johnson, Thrombus, 1972. 8 Information on continuing education was obtained from Harold Schoolman, Martin Cum- mings, Kenneth Lynn, Carl Douglass, and also from NLM News, records of the Board of Re- gents, annual reports of the Library, and arti- cles, including M. K. Schindler, R. K. Gold- stein, J. Port, "Organizing Library Audiovisual Services to Support Continuing Education," Mount Sinai J. Med 46: 357-9 (1979), and "Li- brary Mobilization for Continuing Education," Bull. Med. Lib. Ass. 68: 240-2 (1980), both of which describe a program at Mount Sinai sup- ported by a grant for NLM. 9 Information on international cooperation was obtained from Mary Corning; Martin Cum- mings; James Barry, deputy associate director of library operations; Brenda Swanson, chief of Selection and Acquisition Section; and Galina V. Zarechnak, program officer in international programs. Consulted also were records of the Board of Regents; annual reports of the Library; NLM News, and articles by Corning, especially "International Biomedical Communications . . .," Health Commun. Informatics 6: 212-42 (1980), and "The United States National Library of Medicine's International Relationships," Med Inform. 5: 3-20(1980). 10 Information on the Special Foreign Cur- rency Program was obtained from Jeanne Brand, Mary Corning, documents in the files of the program, records of the Board of Regents, and annual reports of the Library. A list of titles of publications produced from 1974 onward under the Special Foreign Cur- rency Program may be found in annual reports of the Library. A complete list of all publications from 1965 onward may be obtained from NLM. 11 Memo, Jones to Lt. Col. M. Ladd, May 30, 1944, with attachments; memo, Jones to editor, Army Medical Bulletin, June 9, 1944, with attached policy regarding microfilming: NLM. 12 Statement by Joseph H. McNinch, May 1979: NLM. 13 McNinch, Proceedings Fourth Annual Meeting of the Honorary Consultants (1947) p. 13. S. Adams, Report on Six Month Project Schedule, April 19, 1948, p. 2: file Activities of AML, MS/C/309. The so-called "Gentlemen's Agreement" was written in 1935 by the National Association of Book Publishers and the Joint Committee on Materials for Research (representing libraries). It stated in part that a library could make a single photographic reproduction of a part of a volume for a scholar who stated that he desired the re- production solely for research in lieu of a loan of the volume. 14 Board of Regents, 1957. The policy was the subject of the entire June 1957 issue ofNLM News. Information was also provided by Frank B. Rogers. 15 The results of Kurth's pioneering study were presented in a 49-page pamphlet, Survey of the Interlibrary Loan Operation of the Na- tional Library of Medicine (Public Health Serv- ice, 1962). 16 Much was written in journals and news- 468 EXTENSIONS OF TRADITIONAL LIBRARY SERVICE papers about this landmark suit. NLM has a large file of clippings, articles and correspond- ence, and the published papers and documents filed before the courts. Information on this suit was also obtained from Albert Berkowitz, head of the Reference Services Division, who testi- fied in the case, Martin Cummings, and Scott Adams. 17 Public Law 94-553, 90 Stat. 2541. 18 The act that established NLM specified that it had to preserve library materials perti- nent to medicine. Information on preservation may be found in annual reports of the Library, NLM News, and minutes of the Board of Regents. Additional information was obtained from Thomas Bagg, Martin Cummings, and Albert Berkowitz, chief of the Reference Services Division. 19 Edward J. Forbes, Thomas C. Bagg, Re- port of a Study of Requirements and Specifi- cations for Serial and Monograph Microrecord- ingfor the National Library of Medicine, NBS Report 9446, 1966. 20 89th Cong., 1st sess., Departments of La- bor, and Health, Education, and Welfare Ap- propriations for 1966, part 2, pp. 760, 770, 776- 8. 21 Information on the modern manuscript collection was obtained from John Blake, Manfred Waserman, Peter Olch, and documents in HMD. The early manuscripts were described by Dorothy M. Schullian and Francis E. Sommer in A Catalogue of Incunabula and Manuscripts in the Army Medical Library (1950). 22 Memo, Blake to Rogers, Nov. 8, 1961, sub: Establishment of Manuscripts Section. 23 Memo, Director NLM to Chief, HMD, Nov. 13, 1961, sub: Collecting manuscript ma- terials. 24 Information on the oral history program was obtained from documents in the files of the History of Medicine Division, and from Peter Olch, John Blake, and Martin Cummings. 25 Information on COSATI and the Federal Library Committee was obtained from Martin Cummings, James Barry, records of the Board of Regents, NLM News, and annual reports of the Library. A statement of the reorganization and functions of the committee is in Federal Register, vol. 38, no. 106, June 4, 1973, p. 14729. 26 Information on the training programs may be found in records of the Board of Regents, NLM News, annual reports of the Library, and a report by Louise Darling, "National Library of Medicine Library Associates Program in Medical Librarianship and Biomedical Com- munications," (1980). Information was also ob- tained from Frank B. Rogers, Scott Adams, and Maxine Hanke, director of the Mid-Atlantic Regional Medical Library Program. See also Estelle Brodman, "Continuing Education for Medical Librarianship," Bull. Med. Lib. Ass. 48: 408-412 (1960). 27 Letters, Gillmore to Jones, Dec. 6, 1937: MS/C/346. 28 Lloyd B. Embry, Washington, D.C., painted the portrait of McNinch. Frederick C. Trucksess, University of Colorado Department of Fine Arts, painted the portrait of Rogers. The volumes carry this bookplate: National Library of Medicine/Bethesda, Maryland/Pur- chased From The/Robert Tracy Gillmore/and/ Emma Wheat Gillmore/Bequest. 29 John Shaw Billings, an Autobiographical Fragment, 1905; A Facsimile copy of the Orig- inal Manuscript (1965). Catalog of an Exhibit, June 17-30, 1965, John Shaw Billings Centen- nial. John Shaw Billings Centennial, addresses presented June 17, 1965, in commemoration of the 100th Anniversary of Dr. Billings' appoint- ment to head the Library of the Surgeon Gen- eral's Office, U. S. Army. Correspondence, clippings, programs, and other material relating to the centennial may be found in MS/C/261. 30 Information on the bicentennial celebra- tion was obtained from Mary Corning; NLM News, June 1976; and correspondence in the Library. 31 John S. Billings, "The Conditions and Prospects of the Library of the Surgeon Gen- eral's Office, and of its Index-Catalogue," Trans. Ass. Amer. Phys. 6: 251-7 (1891). Boston Med. Surg. J. 125: 344-6 (1891). Med. News (Phila) 59: 350-3 (1891). 469 Appendices For at least half a century, at one time or another, members of the staff thought about compiling a full-scale history of this institution, but some event always intervened to prevent them from doing so. I was fortunate in being asked to write this account, and I am indebted to Martin Cummings, Director, NLM, and to John Blake for being allowed adequate time and support for the task. It may be too much to expect that a history of this scope is free from error, but I trust that my mistakes are not so serious as to be misleading. It is my hope that the publication of this history will coincide with the 25th anni- versary of the passage of the National Library of Medicine Act, a milestone in the affairs of the Institution. Honors Members of the staff of the National Library of Medicine have received many honors, including Department of Health, Education, and Welfare su- perior service awards, citations from associations, honorary degrees, university alumni awards, Public Health Service commendations, medals, certificates, plaques, diplomas, prizes, honorary corresponding memberships in learned societies, and election to the presidencies of professional groups. The Library presents two honors to members of the staff, the Regents' Award and the Director's Award. Regents' Award for Scholarship or Technical Achievement 1970 Jaroslav Nemec for bibliographical scholarship, particularly for publication of International Bibliography of Medicolegal Serials. 1971 Stanley Jablonski in recognition of his outstanding skill as a lexicographer, par- ticularly for publication of Illustrated Dictionary of Eponymic Syndromes and Diseases and their Synonyms. 1972 Thelma G. Charen, for conceiving, developing and implementing the MEDLARS indexing manual and training program. 1973 Manfred J. Waserman for initiative and accomplishments in historical research utilizing unique material in the National Library of Medicine's manuscript col- lection. 1974 Sharon L. Valley for initiative and creativity in developing unique toxicology information products and services. 1975 John Cox for exceptional technical and managerial contributions to the devel- opment and implementation of MEDLARS II. 1976 Myron J. Adams, Jr., in recognition of his originality and creativity in improving the learning process for health professionals. 1977 Emilie V. Wiggins for her efforts in making the NLM catalog file conform fully 471 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE to Anglo-American rules, and for her massive restructuring and modernization of the NLM Classification. 1979 Tamas E. Doszkocs in recognition of his technical creativity in developing two experimental on-line bibliographic search tools. 1980 Mary E. Coming for her book A Review of the United States Role in International Biomedical Research and Communication: International Health and Foreign Policy. Director's Award for Outstanding Contribution to the Library's Programs 1969 Ralph A. Simmons in recognition of his superior handling of the extremely difficult contractual arrangements pertaining to the development of MEDLARS II. 1970 Jerome Barnett for management of the reorganization of the National Medical Audiovisual Center and administration of the center. 1974 Henry M. Kissman, Mary E. Coming, Norman P. Shumway, for exceptional achievements and contributions to the Library. 1975 Melvin S. Day for effective leadership and management. 1976 Albert M. Berkowitz for leadership and administrative skill in serving the diverse needs of the users of the Library. 1977 Mary E. Coming, John B. Blake, Peter D. Olch for their participation in the "Colloquium on the Bicentennial of Medicine in the United States," sponsored by the Josiah Macy, Jr. Foundation. 1978 Clement P. Fowler for the design, direction, and coordination of the exhibit on Health Sciences Communications Technology. 1979 James J. Hartman for his outstanding performance in providing a sound personnel management program for the Library. 1980 Joseph Leiter for leadership in heading the task force developing plans for MED- LARS III. Selected Statistics of the National Library of Medicine Fiscal Year to June 30 1957 1958 1959 1960 1961 1962 1963 1964 1965 Appropriations1 1,315 1,450 1,526 1,566 1,738 2,066 3,335 4,074 3,958 Size of collections2 922,079 938,768 957,345 975,870 992,224 1,009,228 1,021,784 1,039,692 1,058,428 Requests filled for readers in the Library3 33,919 40,275 39,094 39,768 43,510 47,605 70,791 84,267 81,842 Reference services provided4 9,546 8,396 9,588 9,241 10,254 10,345 13,418 20,154 20,931 Requests for interlibrary loans filled 18,735 60,302 73,147 96,042 109,803 113,918 135,344 131,039 149,055 Serial titles received5 11,700 12,862 13,835 14,082 14,875 13,888 15,358 16,557 Recurring bibliographies 6 Authorized staff5 223 225 224 224 224 234 242 268 291 Total Grant and contract awards Instructional media produced by NMAC Audiovisual loans filled 472 APPENDICES Statistics The published annual reports of the Surgeon General's office began to mention the Library's appropriation in 1871, the growth of the collection in 1872, and other information thereafter. Beginning in 1923 statistics on binding were added, in 1925 the number of readers registered, number of interlibrary loans, and number of borrowing libraries. At the end of fiscal year 1944 the Library began to issue its own reports, and eventually to place in them a wide variety of statistics, including acquisitions (number of searches, orders placed, new serial titles added, discontinued serial titles, total current serial titles received, serial pieces processed, other publications processed, obligations for publications, obligations for rare books, duplicate shipments made and re- ceived, duplicate pieces shipped and received, etc.); growth of collections (number of theses, pamphlets, bound serial volumes, microforms, audiovisuals, pictures, and manuscripts added; numbers of books added by era; total volumes; total of nonbook materials, etc.); cataloging (number of catalog cards made, cards filed, volumes shelflisted, volumes withdrawn, pictures cataloged, etc.); binding (number of volumes sent to binder, volumes returned from binder, volumes bound at NLM, volumes repaired at NLM, pictures mounted, obli- gations for binding, etc.); circulation (number of requests received for inter- library loan, loan requests filled by photocopy and by original, requests received and filled for readers in library, requests unfilled for various reasons, etc.); reference services (number of requests received by telephone, by mail, and from readers in library, number of requests from government employees, num- ber of readers registered, etc.); photographic services (number of pages mi- Selected Statistics of the National Library of Medicine (Continued) Sept 30 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 9 685 20 192 21674 18,160 19,573 21,436 24,127 25,150 26,329 28,850 35.637 1,084'932 1,116;565 1,164,633 1,193,299 1,231,612 1,263,881 1,323,394 1,363.694 1,399.852 1,338,667 1.396,924 94,125 94,815 99,009 87,154 82,655 88,302 78,676 76,708 70,980 82,934 126,394 22,718 26,852 26,792 25,857 23,163 22,041 24,535 26,075 29,173 31,286 44,700 152,610 148,942 129,372 119,283 102,596 104,439 121,938 126,051 141,232 175,856 260,178 18,482 19,650 18,459 19,448 20,964 22,161 23,132 23,787 24,642 25,228 18,326 9 352 10 397 11 536 16 470 18 475 23 467 24 469 24 466 24 466 28 458 28 472 56 340 485 478 464 528 450 239 200 155 133 157 81 70 50 50 55 34 71 84 92,731 79,251 72,865 85,000 60,000 64,500 56,000 58,050 53,227 473 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE crofilmed, number of photostats, of glossy prints, etc.); history of medicine (acquisitions, cataloging, volumes bound, pages microfilmed, modern manu- scripts cataloged, reference questions answered, etc.); bibliographic services (number of articles indexed, recurring bibliographies, journals indexed, ab- stracts entered, etc.); number of on-line searches for all data bases; number of off-line prints for all data bases; grants (number of new grants, active grants, allocations for various grants programs, etc.); titles of NLM publications avail- able from the Government Printing Office, and the number of each printed for sale; personnel (ceilings, resignations, transfers, etc.); National Medical Audiovisual Center (number of motion pictures, videotapes, slide series, film- strips, and other materials produced and distributed, etc.); and financial re- sources and allocations. Certain statistics are available elsewhere. Those on the growth of the col- lections may be found in the letters of transmission at the front of each volume of the Index-Catalogue beginning with series 1, vol. 16, 1895, skipping series 2, vols. 1 and 2, and resuming with vol. 3, 1898. The numbers given in the Index-Catalogue are, presumably, as of the date of the letters of transmission; they sometimes differ from those in the annual reports, which are for June 30, the end of each fiscal year. Appropriations may be found in appropriation acts, and in the annual NIH Almanac. The Almanac also lists the number and amount of research grants, number and amount of research contracts, and personnel from 1968 onward; data on the Library Building; general information about NLM; and chronologies of important events and legislation. Notes to Selected Statistics These statistics are copied from the pub- book material. The former comprised bound lished annual reports except those for audiovis- monographs (subdivided into chronological eras), uals, which were supplied by NMAC, and for bound serials, theses, and pamphlets. The non- grants/contracts, supplied by EMP. book material included pictures, modern man- In consulting any annual report to obtain uscripts, microforms, audiovisuals, and other statistics, the reader should also look at the re- forms. The figures given here are for book ma- ports for the following two years because they terial. Each year some pieces were withdrawn may give revised numbers. from the collection, so that the net gain was A transitional quarter of a year, covering the slightly less than the number of volumes added. months of July, August, and September, was The size of the collections for 1961 was re- added in 1976 to make the new fiscal year end vised in 1962, 1968 in 1969, and 1975 in 1976. on September 30. Therefore the figures for 1976 The revised figures are given above. The de- cover a period of 15 months. crease in 1975 resulted from the withdrawal of 1 A breakdown of financial resources, in- almost 60,000 theses from the collection. eluding reimbursements, supplemental appro- 3 Requests filled for readers, 1957-1963, do priations, obligations, and allocations may be not include HMD; from 1964 they include HMD. found in the annual reports for each fiscal year. * Reference services provided, 1963-1965, The appropriation of $21,674,000 for 1968 do not include HMD. included $1,762,000 transferred along with 5 The figures for serial titles received in 1968 NMAC from the Communicable Disease Cen- and 1969 are from the annual report for 1970. ter. 6 The authorized staff refers to the number 2 For statistical purposes the Library's hold- of full-time permanent employees. The actual ings were divided into book material and non- number of persons on duty was almost always 474 APPENDICES lower than the authorized strength. The Library also employed part-time and temporary work- ers. The large increase in the authorized staff during 1968 resulted from the transfer of the National Medical Audiovisual Center to the Library, and augmentation of .the computer staff. In the annual reports statistics for the His- tory of Medicine Division are given separately. I have added the statistics from HMD to those from the other Library Divisions to obtain totals for; requests filled for readers, reference serv- ices provided, and requests for interlibrary loans filled. Name Ismael Almodovar William G. Anlyan Vice Adm. Willard P. Arentzen Bruno W. Augenstein William O. Baker William B. Bean Basil G. Bibby Lt. Gen. Richard L. Bohannon Daniel J. Boorstin Norman Q. Brill Vice Adm. Robert B. Brown Leroy E. Burney Harve J. Carlson Thomas C. Chalmers Members of the Board of Regents Address President, University of Puerto Rico Dean, School of Medicine, Duke University Surgeon General, USN John D. Chase Vice President for Research, The Rand Corporation Chairman of the Board, Bell Telephone Laboratories Professor and Chairman, Department of Internal Medicine, University of Iowa Professor of Dentistry, University of Rochester Surgeon General, USAF Librarian of Congress Professor and Chairman, Department of Psychiatry, University of California, Los Angeles Surgeon General, USN Surgeon General, USPHS Director, Division for Biological and Medical Sciences, NSF President and Dean, Mount Sinai School of Medicine of the City University of New York Chief Medical Director, VA Dates on Board 1978-1982 1968-1972 Chairman: 1971-1972 1976-1980 1967-1971 1969-1973 1957-1961, 1965- 1969 Chairman: 1960-1961 1956-1959 1963-1967 1980- 1961-1965 Chairman: 1964-1965 1965-1969 1956-1961 1962-1972 1978-1979 1974-1978 475 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Eloise E. Clark Vice Adm. J. William Cox Susan Y. Crawford James Crutcher Gwendolyn S. Cruzat Jean A. Curran Vice Adm. Donald L. Custis Worth B. Daniels Eugenie Mary Davie Nicholas E. Davies Vice Adm. George M. Davis Michael E. De Bakey Russell A. Dixon Robert H. Ebert S. Paul Ehrlich, Jr. H. Martin Engle F. Emmet Ferguson, Jr. James C. Fletcher Thomas Francis, Jr. Herman H. Fussier Assistant Director for Biological, Behavioral, and Social Sciences, NSF Surgeon General, USN Director, Archive-Library Department, American Medical Association Chief Medical Director, VA Professor of Library Sciences, School of Library Science, University of Michigan Advisor, Charities Trust of Bigham Associates Fund, New England Medical Center Surgeon General, USN. Chief Medical Director, VA Professor of Medicine, Georgetown University Former Vice President American Heart Association Piedmont Hospital Atlanta, Georgia Surgeon General, USN Chairman, Department of Surgery, and Chancellor, College of Medicine, Baylor University Dean, College of Dentistry, Howard University Dean, Harvard Medical School Acting Surgeon General, USPHS Chief Medical Director, VA Ferguson-Houston Colon- Rectal Clinic, Jacksonville, Florida President, University of Utah Professor of Epidemiology, School of Public Health, University of Michigan Director, University of Chicago Library 1973- 1980- 1971-1975 1978-1979 1980-1984 1956-1959 1973-1976, 1980- 1956-1957; 1961-1962. Chairman both terms 1958-1961 1978-1981 1969-1973 1956-1960 Chairman: 1959-1960 1963-1967 1967-1971 Chairman: 1970 1973-1974 1966-1970 1978-1982 1970-1971 1956-1960 1963-1967 476 APPENDICES Alfred A. Gellhom Henry N. Harkins Lt. Gen. Silas B. Hays Lt. Gen. Leonard D. Heaton Bernice M. Hetzner S. Richardson Hill, Jr. Maynard K. Hine Rear Adm. B. W. Hogan William N. Hubbard, Jr. Hugh H. Hussey, Jr. Edward J. Huth Saul Jarcho Lt. Gen. Hal B. Jennings, Jr. Rear Adm. E. C. Kenney Thomas E. Keys Jack M. Layton Champ Lyons Mary Louise Marshall J. Stanley Marshall Angelo M. May Vice President for Health Affairs and Director of the Center for Biomedical Education, City College of the City University of New York Professor and Chairman, Department of Surgery, University of Washington School of Medicine Surgeon General, USA Surgeon General, USA Professor of Library Science, University of Nebraska Medical Center President, University of Alabama in Birmingham Dean, School of Dentistry, Indiana University Surgeon General, USN President, The Upjohn Company Director, Division of Scientific Activities, American Medical Association Editor, Annals of Internal Medicine New York Academy of Medicine Surgeon General, USA Surgeon General, USN Librarian, Mayo Clinic Dean, College of Medicine, University of Arizona Professor and Chairman, Department of Surgery, Medical College of Alabama Librarian, Tulane University School of Medicine President, Florida State University Physician, San Francisco 1962-1966 1962-1966 1956-1959 1959-1969 1971-1975 1978-1980 Chairman: 1979-1980 1959-1963 1956-1961 1963-1967, 1972-1976 Chairman: 1965-1967, 1974-1976 1960-1964 1979-1983 1961-1965 1971-1973 1961-1965 1958-1962 1969-1973 Chairman: 1972-1973 1956-1959 Chairman: 1958-1959 1956-1958 1971-1974 1971-1975 477 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE William D. Mayer President, Eastern Virginia Medical Authority 1980-1984 Walsh McDermott Professor and Chairman, Department of Public Health and Preventive Medicine, Cornell University Medical Center 1964-1968 John P. McGovern Professor and Chairman, 1970-1974 Department of History of Chairman: 1973-1974 Medicine, Graduate School of Biomedical Sciences, University of Texas Maj. Gen. Joseph H. Chief Medical Director, VA 1963-1965 McNinch and Former Director, NLM John W. Mehl Acting Director, Division for Biological and Medical Sciences, NSF 1973 Doris H. Merritt Dean, Office of Research and Sponsored Programs, Indiana-Purdue University at Indianapolis 1978-1980 Max Michael, Jr. Executive Director, Jacksonville Hospitals Educational Programs, Inc. 1968-1972 William S. Middleton Chief Medical Director, VA 1957-1963 Charles E. Molnar Director, Computer Systems 1980-1984 L. Quincy Mumford Marc J. Musser Lt. Gen. Paul W. Myers Maj. Gen. Oliver K. Niess Maj. Gen. D. C. Ogle Lt. Gen. Robert A. Patterson Lt. Gen. Charles C. Pixley Lt. Gen. Kenneth E. Pletcher Isador S. Ravdin Julius B. Richmond Cecil G. Sheps Laboratory and Professor of Physiology and Biophysics and Electrical Engineering, Department of Physiology, Washington University Librarian of Congress Chief Medical Director, VA Surgeon General, USAF Surgeon General, USAF Surgeon General, USAF Surgeon General, USAF Surgeon General, USA Surgeon General, USAF Professor of Surgery, University of Pennsylvania Surgeon General, USPHS Professor of Social Medicine, University of North Carolina at Chapel Hill 1956-1974 1970-1974 1978- 1958-1963 1956-1958 1972-1975 1977- 1967-1970 1956-1958 Chairman: 1957-1958 1977-1981 1978-1980 478 APPENDICES Kathryn M. Smith Benjamin Spector William W. Stadel Robert M. Stecher Jesse L. Steinfeld William H. Stewart Morris Tager Lt. Gen. Richard R. Taylor Luther L. Terry George W. Teuscher Lt. Gen. Alonzo A. Towner John L. Townsend William L. Valk Theodore Van Dellen Joseph F. Volker Ernest H. Volwiler Frederick H. Wagman Ethel Weinberg Warner L. Wells Kelly M. West Dean, School of Nursing, University of Colorado Professor of Bioanatomy, Tufts University Director, Mental Health Services, San Diego, California Cleveland Metropolitan General Hospital, Cleveland, Ohio Surgeon General, USPHS Surgeon General, USPHS Professor and Chairman, Department of Microbiology, Emory University Surgeon General, USA Surgeon General, USPHS Dean, Dental School, Northwestern University Surgeon General, USAF Chairman, Department of Medicine Howard University Professor and Chairman, Department of Sugery, University of Kansas Northwestern University Chancellor, University of Alabama System, Birmingham Chairman of the Board, Abbott Laboratories Director, University of Michigan Library Associate Dean, Medical College of Pennsylvania Department of Surgery, School of Medicine, University of North Carolina Professor of Medicine and of Continuing Education, University of Oklahoma 1966-1970 1956-1957 1957-1961 1960-1964 1970-1973 1965-1969 1964-1968 1973-1977 1961-1965 1968-1972 1970-1972 1979-1983 1960-1964 1959-1963 1974-1977 1956-1960 1967-1971 1974-1976 1959-1963 Chairman: 1962-1963 1978-1979 Chairman: 1978-1979 479 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE James F. Williams II Martha E. Williams John T. Wilson Stewart G. Wolf, Jr. Barnes Woodhall Alfred R. Zipf Medical Librarian, Vera P. Shiffman Medical Library, Wayne State University Professor of Information Science, College of Engineering, University of Illinois Assistant Director for Biological and Medical Sciences, NSF Regents Professor of Medicine and Psychiatry, Oklahoma Medical Research Foundation Vice Provost, Duke University Medical Center Executive Vice President, Bank of America 1977-1981 1978-1982 1956-1962 1965-1969 Chairman: 1967-1968 1964-1968 1966-1970 Chairman: 1969-1970 Selected Chronology of the National Library of Medicine* 1818 Congress established the permanent Medical Department of the United States Army. Joseph Lovell, appointed Surgeon General, soon began to purchase reference books and journals for his office. Pp. 1 1840 The Library's earliest known list of publications was drawn up, a manuscript notebook entitled "A Catalogue of the Books in the Library of the Surgeon General's Office, Washington City, 1840." Pp. 5 1864 The first printed catalog, a pamphlet, listing 485 titles, including about 50 journals, totaling approximately 2,100 volumes, was issued. Pp. 19 1865-1895 In 1865 Surgeon General Joseph Barnes placed John Shaw Billings in charge of the collection. In 1895 Billings retired from the Army and Library to direct the Department of Hygiene at the University of Pennsylvania, and later the New York Public Library. Pp. 25 1866-1887 The Library and Army Medical Museum were housed in Ford's Theatre, where President Lincoln had been assassinated on April 14, 1865. Pp. 27 1869 The Library published its first bibliographies: List of Works on Cholera in the Library of the Surgeon General's Office . . ., List *This chronology is an expanded version of the one prepared by Manfred Waserman which appeared in Bull. Med. Lib. Ass. 60: 551-8 (1972). 480 APPENDICES 1871 1872 1873-1874 1876 1879 1880 1883 1885 1887 1891 1895 1895-1897 1897-1902 1902 1903-1913 of Works on Yellow Fever . . ., and List of Works on Military Surgery .... Pp. 33 The decision was made to develop the collection into the "National Medical Library." Pp 34 Catalogue of the Library of the Surgeon General's Office. ... In this catalog, listing about 13,000 titles, Billings placed an alpha- betical index of subjects, foreshadowing his monumental Index- Catalogue. Pp 79 The institution was now the largest medical library in the United States. Its catalog required three printed volumes, listing about 50,000 titles. Pp. 86 Billings published the Specimen Fasciculus of a Catalogue of the National Medical Library to show his plan of indexing and cata- loging the collection to librarians, physicians, Army medical offi- cers, and government officials. Pp. 119 Robert Fletcher joined the Library staff. Pp. 123 Index Medicus; a Monthly Classified Record of the Current Med- ical Literature of the World began in January. Compiled under the supervision of Billings and Fletcher (and later, other members of the staff), it continued until 1926 (except 1900-02). Pp. 132 The first volume of the Index-Catalogue of the Library of the Surgeon General's Office was published. Pp. 129 Surgeon General Robert Murray consolidated the Army Medical Museum and the Library into a single entity called the "Museum and Library Division," and placed Billings in charge of the division. Pp. 162 President Chester Arthur approved a bill authorizing a new build- ing "for the safekeeping of the records, library, and museum of the Surgeon General's Office ... to be constructed ... in the vicinity of the National Museum and Smithsonian Institution," on March 2. ' Pp. 164 The Library and museum moved from Ford's Theatre to the newly constructed building on the Washington Mall. Pp. 168 Fielding Hudson Garrison joined the Library staff as a clerk. He remained with the Library until 1930, when he went to Johns Hopkins. Pp. 195 The final volume of the first series of the Index-Catalogue was published. The first series contained 176,364 author entries, 168,557 subject entries for books and pamphlets, and 511,112 subject en- tries for articles. Pp. 176 Lt. Col. David Lowe Huntington, Librarian. Pp. 185 Maj. James Merrill, Librarian. Pp. 186 Maj. Walter Reed, Librarian. Pp. 187 Lt. Col. Walter Drew McCaw, Librarian. Pp. 189 481 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 1912 1913 1913-1919 1919 1919 1919-1925 1922 1925-1927 1927-1932 1927 1932-1936 1933 1936-1945 1937 1940 1941 1942 Fielding Garrison published his list of "Texts Illustrating the His- tory of Medicine . . .," later revised by Leslie T. Morton, A Med- ical Bibliography (Garrison and Morton) . . Pp 196 Fielding Garrison published An Introduction to the History of Medicine, which went through several editions. Pp. 198 Col. Champe Carter McCulloch, Librarian. Pp 219 Col. Paul Frederick Straub, Librarian. Pp- 239 Brig. Gen. Francis Anderson Winter, Librarian. Pp. 241 Brig. Gen. Robert Ernest Noble, Librarian. Pp. 242 The old name "Library of the Surgeon General's Office" was re- placed by a new name, "Army Medical Library," on January 10. Pp. 243 Lt. Col. James Matthew Phalen, Librarian. Pp. 243 Col. Percy Moreau Ashburn, Librarian. Pp- 244 Index Medicus was merged with the Quarterly Cumulative Index, forming the Quarterly Cumulative Index Medicus, published by the American Medical Association with financial assistance from the Carnegie Institution. F*P- 249 Maj. Edgar Erskine Hume, Librarian. Pp 259 The Library received the William F. Edgar bequest. Pp. 276 Col. Harold Wellington Jones, Librarian. At his suggestion the old title "Librarian" was changed to the new title "Director" in May 1944. PP 271 Microfilming of literature for patrons was started in the Library. The camera was provided, and the service managed, by a vol- unteer, Atherton Seidell, a Washington chemist. This "Medico- film" service lasted until 1942. Pp- 279 Atherton Seidell organized "Friends of the Army Medical Li- brary," which existed until 1945. Pp. 279 The Current List of Medical Literature began publication January 1. It was financed and edited by Atherton Seidell, under spon- sorship of the Friends. The List was a rapid finding aid to current articles, microfilm copies of which were available at a nominal cost. The Library assumed publication of the List in September 1945. PP- 281 The government leased a portion of the Dudley P. Allen Memorial Library Building from the Cleveland Medical Library Association, and the Library transported its rare books there for protection during the war. In 1945 the Cleveland Branch was renamed the History of Medicine Division. The Division remained in Cleveland until 1962, when it moved back to the Library. Pp. 296 The library organized its own microfilm operation, named "Pho- toduplication Service." Pp 300 482 1944 1945 1945-1946 1946-1949 1947 1948 1949-1963 1943 The Library was inspected by a team of professional librarians, the cost being borne by the Rockefeller Foundation. Directors followed the team's recommendations, embodied in The National Medical Library; Report of a Survey of the Army Medical Library, in modernizing the institution. Pp. 292 The "Association of the Honorary Consultants to the Army Medical Library" was organized. The association advised and assisted the institution until 1952. Pp. 302 In August the first number of the Army Medical Library Newsletter was published. Later it was renamed the Army Medical Library News, and eventually the National Library of Medicine News. Pp. 332 Col. Leon Lloyd Gardner, Director. Pp. 311 Col. Joseph Hamilton McNinch, Director. Pp. 313 The Army Medical Museum moved from the building, and the Library expanded into the vacant space. Pp. 343 The preliminary edition of the "Army Medical Library Classifi- cation" was produced. The Classification was published in 1951, and subsequent editions appeared periodically. Pp. 322 Col. Frank Bradway Rogers, Director. Rogers was the last of the long line of Army medical officers who directed the Library. Pp. 315 1949 The institution published its first annual catalog, Army Medical Library, Author Catalog, 1949. From 1950 until 1965 the AML and Library of Congress cooperated in producing annual and cu- mulated volumes. Pp. 323 1950 A Catalogue of Incunabula and Manuscripts in the Army Medical Library, by Dorothy M. Schullian and Francis E. Sommer, was published. Pp. 329 1950 The Current List of Medical Literature was revised, enlarged, and changed from a weekly to a monthly periodical in July. Pp. 325 1951 The Library compiled its first policy manual on scope and coverage. Pp- 321 1952 Director Rogers formed the "Friends of the Armed Forces Medical Library," an organization of volunteers. The Friends went out of existence in 1956. Pp. 335 1952 The Secretary of Defense placed the institution under the Army, Navy, and Air Force, and renamed it the Armed Forces Medical Library, on March 4. Pp. 351 1954 The institution published the Subject Heading Authority List used by the Current List Division Armed Forces Medical Library. Pp. 328 1955 The Task Force on Federal Medical Services of the second Hoover 483 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Commission released a report recommending that the institution be designated the National Library of Medicine. PP 352 1955 The Library discontinued the Index-Catalogue with volume 11 of series 4. Citations to monographs were selected from the large backlog of accumulated cards and published in a special three- volume fifth series in 1959 and 1961. Pp 324 The Armed Forces Institute of Pathology moved from the building. The Library now had the entire structure for its use. Pp. 347 The Library began to microfilm deteriorating publications for pres- ervation of the text. Pp. 458 1956 On March 13 Sen. Lister Hill and Sen. John F. Kennedy submitted to Congress Bill S.3430: "to promote the progress of medicine and to advance the national health and welfare by creating a National Library of Medicine." Pp.353 President Eisenhower on August 3 signed legislation transforming the Armed Forces Medical Library into the National Library of Medicine, and placing it in the Public Health Service. Pp. 355 1957 In April the Board of Regents of the Library selected a site on the grounds of the National Institutes of Health in Bethesda as the location for a new building. Pp. 356 Director Rogers initiated a new loan policy stating, partially, that the library would no longer lend to individuals, only to other libraries, and that it would provide photocopies of articles without charge in lieu of volumes. Pp. 453 The Library began its Intern Program designed to give qualified librarians advanced training to enable them to assume posts of responsibility in medical institutions. Pp. 463 1958 Director Rogers and editor Seymour Taine began development of a mechanized system for producing the Library's publications. Pp. 365 1959 A groundbreaking ceremony was held on June 12 to mark the start of construction of the building in Bethesda. Senator Lister Hill dug the first earth. Pp. 356 In July the Public Health Service and American Medical Associ- ation signed an agreement under which NLM would publish a monthly bibliography, Index Medicus, designed to replace NLM s Current List and AMA's Quarterly Cumulative Index Medicus. The first number of Index Medicus was produced by the new mechanized system, and issued in January 1960. Pp. 367 Part of the Russian Scientific Translation Program was transferred from the National Institutes of Health to NLM in August. The remainder was transferred in 1961. Pp. 396 1960 The National Library of Medicine Medical Subject Headings . . . was published. Revisions were issued periodically thereafter. Pp. 328 484 The Library initiated development of a computerized bibliographic system named MEDLARS (medical literature analysis and re- trieval system). Pp. 368 1961 Dedication ceremonies for the new building were held in the main reading room on December 14. Pp. 357 1962 On March 3 the first books were moved from the old building in Washington to the new building in Bethesda. The last book was shelved in the new building on May 3. Pp. 359 The new building opened its doors to the public on April 16. Pp. 359 1964 Martin Marc Cummings, Director. Pp. 393 MEDLARS began regular operations. The first bibliography pro- duced by the system was the January number of Index Medicus. Pp. 372 The Library began to accept requests for demand searches pro- duced by MEDLARS. The service was changed in 1973 to an on- line service, MEDLINE. Pp. 376 The new, high speed phototypesetter named GRACE, graphic arts composing equipment, developed for NLM, began regular operations, producing the August number of Index Medicus. Pp. 373 The old Library-Museum Building on the Mall in Washington was designated as a Registered National Historic Landmark. Pp. 360 The Library began to decentralize MEDLARS by awarding a con- tract to University of California at Los Angeles to serve as a search center. Pp. 378 The Library received the bequest of Emma Wheat Gillmore. Pp. 465 1965 The first recurring bibliography produced by MEDLARS, Index to Rheumatology, was published in January. Pp. 375 The Billings Centennial was celebrated at the Library on June 17. Pp. 466 On October 22 President Lyndon Johnson approved the Medical Library Assistance Act, authorizing NLM to aid the Nation's med- ical libraries in expanding their services to the health community. Pp. 399 The Drug Literature Program was started. Pp. 411 1966 NLM began to publish the National Library of Medicine Current Catalog, one of the first regularly recurring completely automated book catalogs. Pp 381 The Toxicology Information Program was established. Pp. 413 The British MEDLARS center began to operate. This was the first center outside of the United States. Pp. 379 485 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE 1967 The Drug Literature Program and the Toxicology Information Pro- gram were combined to form the Specialized Information Services. Pp. 414 The National Medical Audiovisual Center was transferred from the PHS's Communicable Disease Center to the Library on July 1. Pp. 434 The Library selected the Francis A. Countway Library as the regional medical library to serve the New England states. Count- way was the first of the 11 libraries in the regional medical library network. Pp. 404 Director Cummings established the Library's Research and De- velopment Program. Pp. 419 1968 The old Library-Museum Building was demolished so that the site could be used for construction of the Hirschhorn Museum and Sculpture Garden. Pp. 360 The Library was transferred from the Office of the Surgeon Gen- eral of the Public Health Service to the National Institutes of Health on April 1. Pp. 445 On August 3, President Lyndon Johnson signed Public Law 90- 456 designating the proposed NLM annex as the Lister Hill Na- tional Center for Biomedical Communications. Pp. 420 1970 In January MEDLARS produced the first regular monthly number of Abridged Index Medicus, designed to present citations on clin- ical medicine to practicing physicians. Pp. 383 On March 13 President Richard Nixon approved the Medical Li- brary Assistance Extension Act, extending the original law for 3 years. This was the first of the extension acts, the others being enacted in 1973, 1974, 1977, and 1978. Pp. 404 The Library opened the AIM-TWX on-line retrieval service to a selected group of users in June. This service permitted users to communicate with MEDLARS. It was replaced by MEDLINE in November 1972. Pp. 422 1971 MEDLINE was opened to a selected group of users in December. Pp. 384 1972 TOXICON, the on-line service covering the areas of pharmacology and toxicology, was opened to regular subscribers on Oct. 1. It was the forerunner of TOXLINE, 1973. Pp. 415 1975 The Library accepted MEDLARS II from the contractor on Jan- uary 3. Planning for the second generation of MEDLARS had started in 1966. Pp. 388 On February 25 the U.S. Supreme Court upheld the right of the Library and other noncommercial libraries to provide single copies of articles to scholars. Pp. 457 APPENDICES 1976 The Library celebrated the Bicentennial of the United States of America. Pp. 466 1979 MEDLARS III task force was established, the first step in NLM's objective to develop a coherent library automation program to satisfy NLM's operational and service requests in the future. Pp. 389 1980 The Lister Hill National Center for Biomedical Communications was dedicated on May 22, with Senator Hill and other prominent persons in attendance. Pp. 431 Biographies of Staff Members When I began to write this history I hoped to place in the text or notes a biographical sketch of each person who contributed to the development and excellence of the Library. Gradually I learned that we had practically no in- formation about the first generation of staff members, the ex-soldiers who came from battlefields and hospital posts to operate the Library, or about the second generation, the contemporaries of Fielding Garrison and Albert Allemann. While the early librarians were assiduous in accumulating biographical infor- mation about others, they seldom retained information about their associates. Of Wise, Roehrig, Steigers, Neumann, Tibbets, Israeli, Shaw, Stone, Fogarty, Hall, Bickel, Stockman, and many others who labored conscientiously to as- semble this Library, and to whom all users of its collections and great bibli- ographies are indebted, we know very little. Much of what I uncovered is incorporated into the text or notes. When I reached the recent period I found the situation different. There was adequate biographical information concerning staff members. But there are and have been so many worthy persons associated with this institution during the past third of a century that inclusion of sketches would have turned this history partially into a biographical dictionary. Furthermore I could not have completed this work in a reasonable length of time if I had also written hundreds of biographical sketches. With regret I decided that the biographical information already in print would have to suffice. Data on recent staff members may be found in A Biographical Directory of Librarians in the United States and Canada, American Men and Women of Science, Who's Who in the East, Who's Who in America, other biographical dictionaries, and biographies and obituaries in professional journals. Sources of Information on the History of the Library The earliest correspondence and other records concerning the books and journals purchased for the Surgeon General and officers of the Army Medical Department, the literature that formed the foundation of the National Library of Medicine, are in the National Archives. In the Archives is also the corre- spondence between the Directors of the Library and the Surgeons General 487 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE concerning appropriations, legislation, facilities, Index-Catalogue, personnel, the original Library-Museum Building in Washington, and other library mat- ters. The earliest records in the National Library of Medicine consist almost entirely of letters addressed to, and copies of letters sent by, John Shaw Billings. Some of the copies are complete letters that Billings wrote for his clerks to transcribe and mail. Other copies are abbreviated, sometimes scrawled so rapidly that they are almost undecipherable. I assume the clerks, familiar with Billings style, transcribed these into readable letters. I have not referred to the outgoing as "copies" or "rough drafts," but as "letters" that Billings sent. Fielding Garrison thought that Billings "was a poor letter writer—too busy most of the time ..." (letter, Garrison to George H. Simmons, May 11, 1915: MS/C/166). With deference to Garrison, who had the advantage of a firsthand association with Billings, I have come to a different opinion. Billings letters were intended as communications, not literary productions, and as such they are informative, concise, and unambiguous. Not many records of Billings and his successors remain to tell us of activities in the old buildings from the 1860s to the 1950's. The small group of librarians was too busy operating the institution and providing service to consider the needs of future historians. They saw no reason to maintain and store corre- spondence and other records; and as years passed by there was scarcely space for medical books and journals, let alone space for out-of-date records. Cor- respondence, memos, and other papers were thrown away as soon as they were no longer required for administrative or legal purposes. The records of the Billings era, 1865-1895, fill 28 manuscript boxes in NLM's History of Medicine Division. Billings took his personal and nonlibrary cor- respondence with him when he left Washington, and it remained at the New York Public Library, where he was director, after he died in 1913. Billings' 15 successors at the Library left relatively few records—the total accumulation from 1895 to 1963 fills only 70 manuscript boxes, a few bound volumes, and a run of letterpress books. It is important to remember that the earliest correspondence now in the Library referring to a certain subject, such as interlibrary loans, may not have been the first correspondence on that subject. The first may have been thrown away a century ago, and we only assume that what remains is the first. Billings may have started interlibrary loans and other activities a few years earlier and under other circumstances involving different persons than existing records indicate. The Army Medical Museum and Army Medical Library were closely related in the Surgeon General's Office, in Ford's Theatre, and in the Library-Museum Building in Washington. Some of records of the museum concerned the Library and vice versa. When the museum moved in 1947 it took its early records with it.' These are now maintained in the Otis Archives of the museum, at Walter Reed Medical Center. The Library has a number of its older records, including notebooks listing 488 APPENDICES acquisitions, 1870's-1940's; titles of journals received, starting in 1869; names of recipients of volumes of the Index-Catalogue; orders to booksellers in various years of the 20th century; volumes sent on interlibrary loan for several years; and registers of visitors to the Library, mainly from 1888 onward. The most important modern records are those of the Board of Regents. Minutes of the Board have been prepared for every meeting. Stenographic transcripts have been made of most meetings and tape recordings of some. Documents with background information have been prepared and distributed prior to many meetings. The accumulated records of the Board are available at the Library. Writings from the Library on medical literature, medical bibliography, and a wide variety of other topics, began with Billings in the 1870's. He was in- terested in many things. A list of his publications comprises 171 titles. His own view of his works is reminiscent to all who write: "I am one of those unfortunate scribblers," he said, "who never get an article written to suit them, and when I see one of my papers in print I always see some changes which I wish to make" (letter to T. F. Rodenbaugh, July 22, 1882). Frank B. Rogers, one of Billings' successors, brought many of his articles together in Selected Papers of John Shaw Billings (1965), which also contains a bibliography of Billings' publications. Shortly after Billings died in 1913 his family asked Fielding Garrison to write a biography. Garrison's John Shaw Billings, a Memoir, published in 1915 at the family's expense, is a primary source of information on the Library. But Garrison wrote the book so rapidly that he scarcely had time for reflection, and for this reason the book lacks details of the Library that would interest us, details so easy for him to have obtained but now beyond recall. Many of the books and articles published by Fletcher, Garrison, McCaw, McCulloch, Ashburn, Neumann, Hume, Jones, and other members of the Library family are mentioned in the notes of this present history. Almost all of their writings may be located through Index Medicus and Index-Catalogue. A partial list of writings about NLM is in Manfred Waserman's "Historical Chronology and Selected Bibliography relating to the National Library of Med- icine," Bull. Med. Lib. Ass. 60:551-8 (1972). In 1960 the Library began placing in its annual report a bibliography of writings by staff members. These bibliographies were continued in the annual reports each year with the exception of 1967-1969 and 1972. After the Library became attached to NIH in 1968, a list of writings by NLM employees was also placed in NIH's annual Scientific Directory . . . Annual Bibliography. Articles published by staff members and others after MEDLARS began to produce bibliographies were listed in Literature Search 76-34, "The National Library of Medicine: selected references for the biomedical literature," pre- pared by Leonard J. Bahlman, containing 471 citations, January 1966 through July 1976; and Literature Search 78-21, prepared by Sheila Proudman, 69 citations, August 1976 through July 1978. Information, mostly statistical, about the Library was included in the annual 489 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE reports of the Surgeon General's office from about 1870 onward. In 1944 a separate annual report of the Library was prepared in typescript and kept at the institution. The Library's report for FY 1944-45 was published in Bull. Med. Lib. Ass. No report was prepared for FY 1945-^16. Reports for fiscal years 1947 through 1950, consisting of abridgements of divisional reports, were pre- pared in mimeograph form; copies are in NLM. Beginning in 1950 the Library published annual reports for distribution. The monthly Army Medical Library Bulletin, begun in November 1945, became the Armed Forces Medical Library Bulletin in June 1952, the National Library of Medicine Bulletin in October 1956, and the National Library of Medicine News in January 1964. An index 1966 onward is the publication office. Several works written by persons outside of the Library contain information on various aspects of NLM. Daniel S. Lamb, pathologist of the museum for half a century, produced "History of the United States Army Medical Museum, 1862 to 1917, compiled from the official records." He issued this compilation in mimeographed form, apparently for his friends in the museum and Library. Copies are rare; one is in HMD, NLM. Robert S. Henry's The Armed Forces Institute of Pathology, Its First Century, 1862-1962 (1964) contains information on the Library, particularly on the buildings shared by the museum and Library. George J. Olszewski's Restoration of Ford's Theatre (1963) does not discuss the Library, but it does present an interesting, illustrated account of the build- ing that housed the Library for 20 years. Marilyn Casey Bracken wrote her Ph. D. thesis, "An Analysis of the Evolution of the National Library of Medicine; implications for the development of scientific and technical information net- works," at American University in 1971. This thesis, a copy of which is in NLM, contains statements and views of members of the Library staff. Acknowledgements "There are many things of which the Librarian and certain members of the staff alone know the inside story" (Librarian Harold W. Jones and Index-Cat- alogue editor Claudius F. Mayer, ca. 1944). The accuracy and coverage of this present history has benefitted from having pertinent portions of the "inside story" recounted by these present and former directors and staff members: Scott Adams, Clifford Bachrach, Thomas Bagg, Albert Berkowitz, John Blake, Arthur Broering, Thelma Charen, Mary Corning, Martin M. Cummings, Carl Douglass, Stanley Jablonski, Thomas E. Keys, Joseph Leiter, Frank Libersky, Joseph McGroarty, Joseph H. McNinch, Peter Olch, Frank B. Rogers, Charles N. Rice, Stella Schehl, Winifred Sewell, Ralph Simmons, Norman Shumway, Kanardy L. Taylor, Manfred Waserman, Warner Wells, Emilie Wiggins, Mar- jorie Wilson, Harold Wooster, and Wyllis E. Wright. The following members or former members of the Library staff or Board of Regents cooperated in the preparation of this history by providing assistance, information, or advice; or helped assure accuracy of the text by reading all or portions of the manuscript: Scott Adams, Ernest M. Allen, Robert B. Austin, 490 APPENDICES Thomas Bagg, Clifford Bachrach, James Barry, William B. Bean, Albert Ber- kowitz, John Blake, Jeanne Brand, Charles Bridgman, Estelle Brodman, Arthur Broering, Daniel Carangi, Kenneth Carney, James Cassedy, Thelma Charen, Carol Clausen, Karin Colton, Mary Corning, George Cosmides, Susan Y. Craw- ford, Martin M. Cummings, Carolyn Davis, Melvin Day, Patrick Dore, Carl Douglass, Howard Drew, Max H. Fisch, Debra K. Gilbert, Roger Gilkeson, Robert F. Gould, Fritz Gluckstein, Maxine Hanke, Dorothy Hanks, Earl Hen- derson, Charles Herbert, Williamena Heinwich, Donald Hummel, Betsy Hum- phreys, Stanley Jablonski, Lucinda Keister, Jerome Kerkhof, Thomas E. Keys, Sheldon Kotzin, Peter Krivatsy, Joseph Leiter, Frank Libersky, Senta Low- enstein, I. Nathaniel Markfield, Grace McCarn, M. Ruth MacDonald, Joseph McGroarty, Joseph H. McNinch, Robert Mehnert, Peter Olch, John A. Oley, Frank Poh, Marguerite Pusey, Charles N. Rice, Frank Bradway Rogers, Stella Schehl, Harold Schoolman, Dorothy M. Schullian, Winifred Sewell, Sherry Shiebel, Norman Shumway, Ralph Simmons, Kent Smith, Norman Smith, Gaston St. Denis, Robert Sumpter, Brenda Swanson, Seymour I. Taine, Kan- ardy L. Taylor, George Thoma, Irene Underwood, Sharon Valley, Donald Walker, Manfred Waserman, Warner Wells, Emilie Wiggins, Marjorie Wilson, Harold Wooster, Lloyd Wommack, Wyllis E. Wright, Arthur Wykes, and Galina Zarechnak. Information was also provided by the following persons not associated with NLM: Patricia Garrison Boorman; Lt. Col. Jeffrey M. Cook, USA; Joan Er- ickson, University of Iowa; Michael B. Gregg, USPHS; Joseph E. Jensen, librarian, Medical and Chirurgical Faculty of the State of Maryland; Elizabeth Medinger; Col. Harold P. Tasker, USA; Gerard F. White; L. E. Wikander, librarian, Williams College; Ann Hesslop Zebratt, Army Medical Museum. Abbreviations The following abbreviations have been used in the notes and text. AFIP: Armed Forces Institute of Pathology AML: Army Medical Library AMM: Army Medical Museum CPP: College of Physicians, Philadelphia GPO: Government Printing Office HMD: History of Medicine Division JH: Johns Hopkins, Welch Medical Library LC: Library of Congress LHNCBC: Lister Hill National Center for Biomedical Communications MS/B/-, MS/C/-, MS/fB/-: Manuscript collection call numbers, NLM NA: National Archives NLM: National Library of Medicine NMAC: National Medical Audiovisuals Center NYPL: New York Public Library SGO: Surgeon General's Office 491 Index A Aachen Medical Society, exchanges with, 81 Abadie, Eugene, letter to, 43 Abarbanel, 275 Abbott Laboratories, 479 Abbott, Maude E., loans to, 214 Abel, John J., loans to, 214 Abridged Index Medicus, 383, 384 base, 423 Abstracting Board of International Council of Scientific Unions, 448 Access systems, remote, 423 Accession book, 38 Accession lists, monthly, 205 Accessions, 62 Acquisition division, 291 Acquisition, Finance and Supply Division, 285 Acquisition of Foreign Publications, Interde- partmental Committee for the, 317 Acquisition policy, 321, 322 Acquisition, 317 Acting Librarians, Adams, Scott, 314 Darnall, Carl R., 189 De Witt, Calvin, 187-9 Fletcher, Robert H., 189 Adams, John Quincy, 3 Adams, Myron J., Jr., 441, 471 Adams, Scott, 295, 317, 321, 326, 329, 370, 375, 379, 383, 390, 395, 396, 421, 447, 454 456 464 Acting Director, 393 Acting Librarian, 314 biographical, 408 Deputy Director, 411 Adrianus, 275 Advisory Committee on Medical Research, 448 Affleck, John G., 57 Agency for International Development, 448, 449 Agents, foreign book, 31 Agnew, Cornelius R., 145 Agriculture Bureau of, 33 Department of, 279 Graduate School, 368, 464 Library, 321, 443 Trade Development and Assistance Act of 1954, 396, 449 AID nations, service to, 449 AIM base, 423 AIM-TWX, 381, 384, 389, 422, 424 Ainsworth, Robert, 6 Air conditioners, 346 Air Force Medical Department, 319 Air Force Surgeon General's Library, 331 Air raid wardens, 289 Alabama Medical College of, 145 State Medical Association, 148 University of, 378, 477, 479 Medical School, 460 Alan Mason Chesney Medical Archives, 460 Alden, Charles H., 18 letters to Billings, 46, 59 Aldrich, Representative Will, 145 Alien Property Custodian, 289 Allemann, Albert, 200, 247, 253, 259 biographical, 216 chief editor, 231 coeditor, 248 principal assistant librarian, 235, 248 research for patrons, 214 retired, 256, 262 salary, 209 servicing inquiries, 203 translations, 205 Allen, Dudley P., Memorial Library, 297 319 343, 359 Allen, Ernest M., 409 Allen, Timothy F., 104 Allott, Senator Gordon, 357 Almodovar, Ismael, 475 Alpha Omega Alpha Honor Medical Society, 460 Alphabetical classification, 248 American Antiquarian Society, 45 library, 80 American Association of Colleges of Pharmacv 399 American Association of Dental Schools, 439(2) American Association for the History of Medi- cine American Association of Thoracic Surgery, 460 American Book Center, 317 American Bureau for Medical Aid to China, 300 American College of Physicians, 445 American College of Surgeons, 445 American Dental Association, 373-4 376 443 450 American Documentation Institute, 279 American Eclectic Medical Review, 58 American Heart Association, 476 American Homeopathic Observer, 59 American Homeopathic Review, 59 493 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE American Homeopathist, 59 American Hospital Association, 399 American Hospital Formulary Service, 412 American Institution of Medicine, 256 American Journal of Homeopathic Materia Medica and Record of Medical Science, 58 of the Medical Sciences, 7(2), 8, 17, 114, 117 of Nursing, 375 of Science and Arts, 7, 8 American Laryngological Association, 151 American Library Association, 151, 179, 292, 294 Committee on Aid to Libraries in War Areas, 317 American Library Journal, 105 American Medical Association, 128, 144, 145, 151, 161, 163(2), 168, 174, 196, 198, 248, 251, 256, 263, 264, 317, 354, 367, 383(2), 384, 445, 476, 477 Committee on the Catalog, 127 Committee to petition Congress, 121 Journal of the, 222, 249 Library, 97, 104 American Medical Gazette, 46 American Medical Intelligencer, 7, 54 American Medical Journal, 59 American Medical Journals, List of, 61 American Medical Monthly, 46 American Medical Recorder, 117 American Medical Times, 8, 16 American Memorial Library, Berlin, 331 American Nurses' Association, 399 American Optometric Association, 408 American Pediatric Society, 174 American Practitioner, 145 American Physiological Journal, 48 American Public Health Association, 121(2), 144, 161, 373, 399 Billings president of, 168 American Rheumatism Association, 375 American Surgical Association, 145, 151, 163 American Telephone and Telegraph Co., 384 American Text Book Publishers Association, 456 American Veterinary Medical Association, 444 Amherst, 306 Anderson, E. A., 50(2) Andrews, Edmund, 68 Anylan, William G., 451, 475 Annales d'hygiene, 117 Annals of Internal Medicine, 477 Annals of Medical History, 232 Annex, 420, 430 proposed, 290 Anniversary, 100th, 268 Anterior Pituitary Insufficiency due to Postpar- tun Necrosis, 377 Anthony, Senator Henry B., 123 Anthropological Society of Washington, 192 Application Technology Satellites, 427 Appropriation, 213, 222, 352, 356, 398, 400(2), 401, 402, 404, 405, 420, 473 attempt to reduce the, 154 catalog, passed, 129 increased, 262 Library's, 148 low, 292 reduced, 261 Appropriations, 405(2) Act, Department of the Army Civil Func- tions, 350 Act, Military, 350 for Library and Museum, 96, 149 for literature, 95 House Committee on, 145, 164(2), 212, 283 House Subcommittee on, 398 restricted, 41 Senate Committee on, 148, 396 Arabic manuscripts, 276 medical, 277 Architects plans, 284 Archives, National Medical Motion Picture, 433, 434 Arderne, John of, 191 Arentzen, Vice Adm. Willard P., 475 Arizona, University of, College of Medicine, 477 Arlington Cemetery, 179, 194 Armed Forces Institute of Pathology, 319, 343, 347, 360 Armed Forces Medical Library, 350, 351, 352 Bulletin, 490 Friends of the, 335 News, 336 renamed, 352 Armor, S. G., 56 Armstrong, Bess Furman, 444 Armsby, James, 69 Army hospital magazines, 224 Army Institute of Pathology, 291, 292 Army Medical Center, 265(2), 278, 283 Army Medical Illustration Service, 319 Army Medical Library, 243, 279, 282, 291, 488 branch libraries, 331 Bulletin, 490 Classification, 323 News, 332 NRC Committee on the, 351 Quarterly, 272 report of a survey of, 294 Army Medical Museum, 16, 21, 42, 488 Army Medical News, 334 Army Medical School, 174, 175, 186, 188, 189, 201, 206, 219, 232, 241, 249, 259, 311, 314 commandant of, 241 instructor in, 191 Army-Navy Hospital at Hot Springs, Ark., 241 design of, 168 Army Surgeon General's Reference Library, 331 494 INDEX Army War College, 244, 301 Arnold, Richard G., 50, 69 Arrangement of books, 196 Arrowsmith, 321 Articles, bibliography of, 111 Arthur, President Chester A., 144, 162, 164 179 Asch, M. J., 73 Ash, James E., Museum Curator, 283, 284, 292 Ashburn, Percy Moreau, 253, 259, 260 biographical, 245 Librarian, 254(2) quotation, 253-4 Ashford, Bailey K., 460 Ashhurst, John, Jr., 69, 121 Ashwell, Samuel, 7, 19 Assistant to the director, special, 447 Assistants, Billings', 93 Associates, 463 Association of American Medical Colleges, 400, 439(2), 460 Association of American Physicians, 174 Association of the Honorary Consultants, 299, 302, 303, 304, 312, 332 Association of Professors of Gynecology and Ob- stetrics, 446 Astor and Lenox libraries, 178 Asylums, reports of, 73 Atkins, Representative, 128, 129 Atlanta Medical and Surgical Journal, 117 Atlases, grants for, 402, 407 Atomic Energy Commission, 415 ATS-1, 427 ATS-6, 429 Audiovisual Branch, Medical, 420, 433 renamed, 434 carrel, 445 Center, National Medical, 421, 431, 433, 4 444-5, 446 Catalog, 436 guidelines for, 437 programs, 438 Educational Development, Office of, 438 materials, 406 organization, medical, 394 Audiovisuals application to education, 436 computer-based, 456 distribution of, 439 evaluation of, 439 on-line, 439 Auditorium, 356 John Shaw Billings, 465 Audubon, John J., 4 Auerbach Corp., 388 Augenstein, Bruno W., 389, 475 Austin, Robert Burdette, 348 biographical, 362 quotations, 216, 237, 256, 305 Australia, 387, 448 Austria, 106, 260, 387 Author, 271 cards, 94, 221, 234 catalog, 111 indexes, 111(2) Autobiographies of life scientists, 461 Autograph letters, 205 Autographs of famous physicians, 239 Autographs, inquiries on, 203 Automated book catalogs, 381 Automated systems, 406 Automation, Task Force on, 463 AVLINE, acronym, 439 AVLINE, scope of, 386 AVPROC, acronym, 439 B Bache, Dallas, 113 Bachrach, Clifford, 383 BACK files, 385 BACK, scope of, 386 Bragg, Thomas, 459 Bahlman, Leonard J., 489 Bailey, Daniel, 395 Baker, Henry, 120 Baker Journal, 48 Baker, William O., 475 Balch, GalushaB., 120 Baldwin, Dr. A. S., 50 Ballard, James, 249 Baltimore, 187, 253, 256 Medical College, Board of Visitors, 135 Sydenham Hospital of, 460 Barker, Fordyce, 145 Barker, S. W, 51 Barnes Hospital, Soldiers' Home, 105 Barnes, Surgeon General Joseph K., 18, 19, 21, 25, 29, 36, 106, 118, 123, 144(2), 161, 168 Barnett, Jerome, 441, 472 Battelle Columbus Laboratory, 417 Bats, 347 Battey, Robert, 69 Baxter, Jedediah, 161, 162, 175 Bayard, Senator Thomas, 154(2), 164 Baylor University, 219, 352 College of Medicine, 476 Bayne, Helen, 340 Bayne-Jones, Stanhope, 444, 460, 461 Beall, George T., letter to Billings, 47 Bean, William B., 460, 475 Beardsley, John J., 225 died, 235 Beaumont, William, 3 Beaux, Cecilia, 136 Beck, John B., 6, 18 Bedford, Midwifery, 18 Beer, William, 206 495 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Belgium, 387 Bell, Agrippa, 69 Bell, John, 1, 7(2) Bell's Medical Library, 7 Bell's Surgery, 46 Bell Telephone Laboratories, 475 Bellevue Hospital Medical College, 52, 145,187 Belmont Medical Journal, 56, 57 Belmont, Representative Perry, 145 Bennet, John H., 7, 16, 18 Bentley, Edwin, letter, 45 Bequest, William F. Edgar, 276 Bequest, Gillmore, 465 Berkowitz, Albert M., 456, 472 Berlin, American Memorial Library in, 331 Berlin Medical Society, exchanges with, 81 Berlin, University of, 76, 239 Berliner Klinische Wochenschrift, 117 Bernard, Claude, 16, 95 Berne, University of, 182, 216 Bernstein, Lionel, 432 Bethesda, 351 building, construction of the, 356 move to, 359 NIH grounds in, 353 Biand Foryu, 224 Bibber, R. D., 48 Bibby, Basel G., 339, 468, 475 Bibliographer, 254 Billings' reputation as, 136 Bibliographic data files, other on-line, 417 information, 384 networks, 386 retrieval system, on-line, 423 service, library-based, 388 Services Division, 375, 383 Bibliographical data, selective retrieval, 365 Bibliographies, 271, 290, 329, 360, 413, 415 annual, 365 computerized, 365 demand for MEDLARS, 376 first, 32 grants for, 402, 407 inquiries on select, 203 new, 274 periodical, 375 recurring, 375(2), 449 for researchers, 203 Bibliography, 415 advice on, 81 annual, 368 of articles, 111 cerebrovascular, 375 first major, 117 inquiries on, 203 of journals, 61 medical, 120 of Medical Reviews, 329, 367 Bibliography (continued) monthly, 367 periodic, 413 production system for periodic, 375 production system for recurring, 375 Toxicity, 413 Bibliomaniac, 37, 41 Bibliophile, 71, 264 Biblioteca Regional de Medecina, 448 Bibliotheque Nationale, 155 Bickel, Beatrice Adelaide, 247 biographical, 256 retired, 290 Bill, Joseph H, 30 Billings, John Shaw, 185-488 passim address to Medical and Chirurgical Faculty of Maryland, 155 appetite for books, 67 auditorium and study, 465, 466 becomes librarian, 29 book swap, 49 career, outline of, 182 catalogs and bibliographies, 32 centennial, 466 correspondence of, 460 death, 179 development of, 105 director of hospital, 175 dissertations, 76 in Europe, 123 indexing at home, 113 faculty member, 188 family, 105 gift to, 135 honors to, 135 incurring obligations, 73 instructions to Washington Matthews, 163 last days in the library, 175 lectures at University of Pennsylvania, 175 letters by, 37, 42, 43, 52(2), 53(2), 56, 58, 60, 62, 75, 79, 80(2), 81, 96, 101, 116, 121, 127, 128, 129, 155, 161 letters to, 43, 45, 46(2), 47(3), 48, 49, 50(2), 53, 58, 59, 60, 62, 68(2), 114(4), 115 lobbying, 212 loaned incunabula, 231 manuscripts and letters, 459 memorabilia, 466 Microscope Collection, 162 military hygiene, taught, 174 as a mycologist, hospital examiner, editor, 33 office, 91-2 placed in charge of books and journals, 25 planned statue of, 284 portrait of, 136 promotion efforts, 36 quotations, 124, 148, 155, 210, 468 recommendation of, 178 reports on medical facilities, 36 496 INDEX Billings, John Shaw (continued) reputation as bibliographer, 136 research, 136 resignation from National Board of Health, reasons for, 150 retirement from Army, 176 reward, 135 in search of exchanges, 80 selection of journals, 380 special topics, 33 surgeon general candidate, 161, 175 system of procurement, 31 tenure, 34 a typical regular, 57 Bindery, Cleveland, 299 Binding, 319 GPO monopoly on, 320 pamphlet-, 320 of pamphlets, journals, and reports, 92 Records Section, 320 Section, 320 style of, 92 unit, 291 Bindings, leather, 298 Bingham, Representative Henry H., 212 Bio-Bibliography of XVI Century Medical Au- thors, 275 Biographical Sketches, United States Army, 244 Biobgical Abstracts, 415(2) Biomedical communications, 355, 402 Center for, 419 Conference of Directors of, 440 to education, application of, 422 grants for works dealing with, 402 Lister Hill National Center for, 384, 419, 430 network, 420 network, budget, 422, 432 network, components of, 422 network, planning the, 421 research center in, 420 by satellites, 427 data, rapid communication of, 406 information clearinghouse and referral service, appro- priation for, 420 networks for communicating, 419 storage and retrieval of, 406 monographs, support for, 407 publications, grants for, 402 Biosciences Information Service, 415 Bird, Robert, 432 BIREME, acronym, 448 Birthdate of the Library, 272 Birthdate of the Museum, 272 Bischoff, Andrew, 31, 93 Bistoury, 59 Blackie, George, 48 Blackwell, Harriette B., 216 Blake, John B., 398, 459, 461(2), 471, 472 Bliss, Surgeon General Raymond, 324, 352 Bloc funding, 451 Blodgett, Dr., 68 Bloomquist, Harold, 396, 399 Blount, Representative William, 128 Board of Regents, 353, 355(2), 365, 388 395 398, 401, 400, 419, 426, 430, 437, 438 444' 453, 464, 489 members, 475 Subcommittee for Extramural Programs, 400 Subcommittee on Research, 389 Boards of health, reports of, 73 Bohannon, Lt. Gen. Richard L., 475 Bohemian translations, 205 Bologna Medical Society, exchanges with, 81 Bookbinding, 317, 319 Book agents, Continental, 67 agents, foreign, 31 catalog data, 381 catalogs, automated, 381 catalogs, periodic, 381 Exchange, U.S., 344, 448 numbers, 170 Publishers, National Association of, 468 restoration, 299 scouts, 50, 58, 75 medical officers as, 42 Bookplates, 182 Morris Fishbein's medical, 319 Books arrangement of, 92, 170, 196 author cards for, 221 Black Letter, 31 borrowing, 96 budget, 3 classification of, 196 deterioration of, 458 donors of, 68-71 duplicate, 205 dusted, 360 gathering, 67 gifts and exchanges of, 176 grants for, 407 Japanese, 318 and Medicine Symposium, 358 microfilm copies of early, 318 microfilming for preservation, 458 out-of-scope, 321 purchase of, 4, 18 rebinding, 203 reference, 1 scouting for, 68 second hand, 31 sources of, 30 on special topics, grants for, 402 standard medical, 18 497 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Books (continued) statistics of library, 177 wartime hiatus of new, 222 withdrawal of, 321 writing, 243 Booksellers antiquarian, 230 advice on, 81 ties with, 317 Boorstin, Daniel J., 475 Borrowers, largest, 290 Bossange, Gustave, 31, 60(2), 75, 76 letter to, 80 Boston Athenaeum Library, 80 Journal of Chemistry, 45(2) Marine Hospital, 393 Medical Intelligencer, 45(2) Medical Library, 6, 80, 81, 131, 134, 145, 249, 404 Association, 99 picked duplicates, 215 Medical and Surgical Journal, 7, 8, 17(2), 48, 54, 97, 151, 222 quotation, 36 editorial in, 120 Public Library, 45, 80, 121 Botanic journals, 58 Botanic physicians, 57 Botanic journals, 59(2) Botanico-Medical Recorder, 48 Botany Bay, 208, 210, 216, 225 Bourke-White, Margaret, 437 Bowditch, Henry I., 45, 69, 120, 179 Bower, Lt. Maurice L., 232 Bowling, W. K., 48 Braken, Marilyn Casey, 490 Branch libraries of the Army Medical Library, 331 Brand, Jeanne, 451(3) Bridge, Norman, 81 Bridges, Robert, letter to, 99 Bridgman, Charles, 441 Briggs, William T., letter to, 128 Brigham, Edwin, 134 Bright & Humphrey, 165, 167 Brill, Norman Q., 466, 475 Brinkhous, Kenneth M., 361 Brinkley, Cosby, 301 Brinton, John H., 16, 18 British American Journal, 55 American Journal of Medical and Physical Science, 55 American Journal of Medicine, 55 Army Medical Service, 224 and Foreign Medico-Chirurgical Review, 7, 8, 17 MEDLARS, 379 Museum, 155 Brockhaus, 60 Brodie, William, 69 Brodman, Estelle, 321(2), 322, 331(2), 395, 450 biographical, 340 Brooks Surgery, 46 Brown Francis H, 54, 69, 120 Harvey E., 49(2), 50 -Saequard, Charles, 69 University library, 80 Vice Adm. Robert B., 475 Brunton, Sir Thomas Lauder, 206 Buck, Gurdon, 69 Buckman, Edward D., 58, 59 Bucknell, 393 Buczwinski, Leon, 168 Budget books, 3 for books and journals, 205 Office of Management and, 430 Publications, 2, 3 Buffalo Medical Journal and Monthly Review, 46 Buffalo Medical and Surgical Journal, 46 Building Library-Museum on the Mall, 161 appropriation for, 127, 165 campaign for, 148, 150 construction of, 165 ceremonial closing, 362 death of, 360 description of, 165 deterioration, 207-8, 344-5, 347 Library in, 170 lobbying for, 163 planning for, 141 renovation of, 207, 345 site selection for, 165 wartime compression in, 226 new, 271, 274, 283 campaign for, 311, 349 legislation for, 282 plans for, 232, 263 progress toward, 262 proposed, 232, 291 site selection for, 284 Temporary F, 228 Bull, A. T., 59 Bulletin of the Institute of the History of Med- icine, 196 Bulletin of the Medical Library Association, 334 Bullock, Dr. W. G., 50 Bumstead, Venereal Diseases, 18 Bureau of Agriculture, 33 of the Budget, 352, 356, 398, 400 of Health Manpower, NIH's, 401 of Health Resources Administration, 438 of Military Information, 216 Burnett, Charles, 69 498 INDEX Burnett, Swan, 69 Burney, Surgeon General Leroy, 357, 395, Burrell, Thomas J., loans to, 214 Burwell, George N, 46 Butterworth, Benjamin, 148 Butler College, 307 Butler, Samuel Worcester, 54 56 Byrd, William, 6 Byrne, Bernard M, 7 C Cadwallader, John, 178 Cafeteria, 356 Cahn, Julius N., 411 CAI, acronym, 425 Calcimine, 208 California Medical Gazette, 45 California State Medical Journal, 45 Callender, George, 360 Campbell, CI. T., 54 Campbell, Henry, 152 Campbell, James, 124 Canada, 387 Canada Health Journal, 54, 55, 56, 59 Canada Journal of Dental Science, 59 Canada Lancet, 46, 54(2), 55, 59 Canada Medical Journal, 54, 55(2), 59 Cancer, 254 Chemotherapy National Service Center, 4] President's Commission on, 399 CANCERLIT, 417 scope of, 386 CANCERPROJ, 417 scope of, 386 Cannon, Congressman Joseph, 212 Canteen, 347 Capitol cultural center around, 291 Hill, 263, 284, 356 site on, 351 Library of Congress in, 154 Card catalogs, 111, 171, 178, 226, 293, 296, 334 for public use, 221, 239 input program, 376 services, drug literature by, 412 Cards author, 94, 221, 234 catalog, 94 index, 111, 221, 289 MED series, 323 punched, 325, 365, 466 subject, 94 Carlson, Harve J., 475 Carmichael, Leonard, 354 Carnegie Foundation, 292 Carnegie Institution of Washington, 179, 212 217, 250(3) Carpenter, William B, 7 Carroll, Grisdale, and Van Alen, 430 Carroll, James, 360 Carson, Rachel, 413 Casey, Lt. Col. Thomas Lincoln, 165 Catalog AMA Committee on the, 127 author, 111 card, 171, 178, 226, 293, 296, 323 author, 94 subject, 94 first printed, 19 formats, machine-readable, 463 incomplete, 293 of the Library, 5 lobbying for the, 127, 128 National Medica] Audiovisual Center, 436 portable, 318 printed author, 94 for public use, card, 221, 239 second printed, 20 subject, 111 third, 32 Cataloging, 311, 322, 373 computer-aided, 381 of historical letters, 460 Catalogs, 79 automated book, 381 card, 111 grants for, 402 periodic book, 381 Catalogue, model for, 111 Specimen Fasciculus of a, 119 Supplement to, 61, 325 Catholic University, 341, 464 CATLINE, 381 scope of, 386 Celebrezze, Anthony J., 466 Centenary Celebration, 11, 268, 272-4, 276 Centennial Celebration, 1876, 121 Center for Disease Control, 433 Central heat, 279 Central Intelligence Agency, 369 Central Vermont Hospital, 427 Centre District Medical Society, 148 Centro National de Informacion y Documen- tacion en Salud, 448 Cerebrovascular Bibliography, 375 Chadwick, James R., 69, 126, 131, 134, 145 Chaille, Stanford E., 54, 70, 122 Chalmers, Thomas C, 475 Chambers, Jacqueline L., 341 Charaka Club, 179 Charen, Thelma G., 471 Charleston Journal, 51 Charleston Medical Journal, 145 Chase, Elizabeth, 399 Chase Hall, 343 Chase, John D., 476 499 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Chelius, Maximilian Joseph von, 7 Chemical Abstracts, 413(2), 415 Chemical Abstracts Service, 374, 412, 417 Chemical-Biological Activities, 416 Chemical News, 97 Chemical substances, registry of toxic effects of, 417 Chemist, Medical Department's, 207 Chemistry laboratory, 28 Chemists, 226 CHEMLINE, 387, 417 scope of, 386 Cheney, T. Apoleon, quotation to, 80 Chereau, Achille, 81 Chester County Medical Society, 148 Chiefs of the Medical Department, 244 Chicago, 250 John Crerar Library in, 178 Medical Center Commission, 354 Chicago Medical Journal, 17 Chicago Medical Press Association, 81 Chicago Medical Times, 54, 59 Chicago offer, 356 Chicago Public Library, 155 Chicago, University of, 306, 308 Graduate Library School, 337 China, American Bureau for Medical Aid to, 300 Chisholm, Julian, 70 Cholera, 33 bibliography on, 117 Epidemic of 1873 in the United States, 118 Christenson, Ralph P., 447 Cincinnati Lancet Clinic, 146 review in, 130 Citation file, current, 389 Citations in Current List, arrangement of, 366 Citations in MEDLARS, numbers of, 382 Citations, specialized lists of, 375 Citations to staff, 471 Citations, storing, 369 City University of New York, 475, 477 Civil defense supplies, 358 Civil function of the Department of Defense, 351 Civil function, Library as a, 350 Civil Functions Appropriation Act, 350 Civil War, 15, 246 assignments, 25 pension records, 153 Clapp, Verner W., 339, 462 Claremont General Hospital, 426, 427 Claremont Vocational Technical College, 427 Clark, Anson L., 54 Clark, C. P., work for hire, 103 Clark, Daniel, 55 Clark, Eloise E., 476 Clark, Franklin B., 276 Clarke, William P., 164 Classification, 91, 92, 178 advice on, 81 anatomical, 116 Army Medical Library, 323 of books, 196 changed to alphabetical, 248 of diseases, 116 James Ballard's, 235 LC, 321, 322 for monographs, 170 new, 226 of obituaries, 116 of poisons, 116 subject, 248(2) system, 116, 122, 293, 311 of Index Medicus, 134 Classifying, 322 Claude, Dr., 49 Cleland, John, 30 Clerical Department, 285 Clerks, 93, 95, 221 borrowed, 210, 224 criteria in hiring, 132 first generation of, 234 final haven for elderly, 208 women, 225 Cleveland Branch, 279, 299 building, 291 documents, incunabula, and statistical pub- lications in, 297 rare book division, 292 Cleveland Medical College, 256 Cleveland Medical Library Association, 343 picked duplicates, 215 Cleverdon, Cyril, 377 Clientele of the Library, 91 Clinical Experience Abstracts, 450 Cluss, Adolph, 142 Clymer, Meredith, 70 CMTS, acronym, 437 Cochran, Jerome, 120, 145, 151, 163 Coffyn, Eleanor, 315 Cohen, Secretary Wilbur I., 421(2), 466 Coit, Henry L., 460 Collection, growth of, 473, 474 Collection, manuscript, 461 Collection, Modern Manuscripts, 461 Colloquium, 466 Collins, Clarkson T., 54 quotation, 62 Cologne Medical Society, exchanges with, 81 Colombat, Marc, 7, 19 Colorado, University of, 378 Medical Center, 316 School of Nursing, 479 Columbia University, 292, 306(2), 341, 382 Medical School, 190, 219, 242 School of Library Science, 306, 316, 408 500 INDEX Columbus Review of Medicine and Surgery, 48 Comings, Isaac M., 58, 59 Commandant, 312, 314 Commission of Fine Arts, 232(2), 284 Commission on Medical and Hospital Services of the Armed Forces, 350 Committee on Aid to Libraries in War Areas, ALA, 317 Consultants on the Study of Indexes, 324, 328, 329 to Coordinate Toxicology and Related Pro- grams, 417 on Medical Research of the National Research Council, 333 on Selection of Journals for Index Medicus, 380 on Science and Technical Information, 462 on Scope and Coverage, 321 Communicable Disease Center, 393, 433, 435 Audiovisual Branch, 434 Communication activities, health, 420 biomedical, 402, 406 cost of, 384 entering science, 397 patterns among researchers, 401 satellite, 422, 427 Services, Office of Computer and, 445 systems of, 396 Communications biomedical application to education, 422 Conference of Directors of, 440 grants for works dealing with, 402 Lister Hill National Center for, 384, 419, 430 Network, 420-2, 432 research center in, 420 Council, Interuniversity, 422 system, satellite, 427 Technology Satellite, 429 Community hospital libraries, 406 Community medical television system, 437 COMPFILE, acronym, 385 Computer -aided cataloging, 381 -assisted instruction, 425 charges, 425 network, 422, 424 programs, 406 -based information systems and audiovisuals, 456 -based national serial record data bank, 463 and Communications Services, Office of, 445 courses, Ohio State College of Medicine, 424 digital, 368 operations, 368 Computer (continued) programs, University of Illinois, 424 Sciences Corp., 388 Computers, 387 Computerized search system, whole text, 415 Comsat Corp., 428 Confederate States Army, medical regulations and orders of, 45 Confederate States Medical and Surgical Jour- nal, 189 Conference network, four-way voice, 428 Conference of Directors of Biomedical Com- munications, 440 Congress AMA committee to petition, 121 of American Physicians and Surgeons, 174 memorials to, 148 petition to, 121, 151 of Physicians and Surgeons, inaugural meet- ing, 174 Congresses, list of, 275 Congressional Joint Committee on Printing, 321 Conn, Granville, 70, 145 Connor, Robert D. W., 278, 296 Consuls, United States, 60, 61, 75 Continental book agents, 67 Continuing education, 394, 445, 447 of health workers, 445 lack of interest in, 134 Medical, Network for, 445 officer, 445 Contract surgeon system abolished, 194 Contractors, indexing by, 382 Contractors, Toxicology Information Program, 414 Contracts, grants replaced by, 397 Contracts for services, 407 Cook, Representative Philip, 144 Coolidge, President Calvin, 312 Cooper, Dr., 144 Cooper, J. J, 61 Cooper, Samuel, 1, 7 Cooper, William, 441 Cooperation, international, 447 Copland, James, 6 Copy writings, upholding the rights of scholars to, 452 Copyflo machine, 452 Copyists, 104, 113 Copyright, 330 Honorary Consultants Committee on, 452 infringement, suit for, 452 law, 454 revision of, 456 Cornell University, 307, 340 Library, 363 Medical Center, 478 Corner, George W., 351 501 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Corning, Mary E., 379, 398, 447, 448(2), 450, 451, 466, 472(3) Correspondence, lack of, 488 Cos, Island of, 358 COSATI, acronym, 462 COSATI disbanded, 463 COSMIS, 389 Cost of communication, 384 Cosmos Club, charter meeting, 174 Cotton, Senator Norris, 430 Coues, Elliott, 70 Council on Library Resources, 365 Council on Medical Education, 445 Councilor, Homer J., research for patrons, 214 Countway, Francis A., Library of Medicine, 404 Coverage, four degrees of, 321 Cox, John, 471 Cox, Vice Adm. J. William, 476 Coxe, John Redman, 6 Crakow Medical Society, exchanges with, 81 Crane, Surgeon General Charles H., 18, 19, 122, 144, 150, 161, 168 Crawford, Susan Y., 476 Crile, George W., donor of publications, 215 Crile, George W., loans to, 214 Critical reviews, 451 grants for, 402 support for, 407 Cross references, 373 Crutcher, James, 475 Cruzat, Gwendolyn S., 476 Cryptogamous fevers, 26, 33 CTS, acronym, 429 Cubicles, 202 Cubney, Virgil, 154 Cullen, Thomas S., 269, 287 quotation, 189, 201, 213 recollections of Library, 171 Cullen's Practice, 46 Cullen's Synopsis, 46 Cummer, Clyde, 304, 341 Cumming, Hugh, 279 Cummings, Martin Marc, 372-471 passim biographical, 393 Director-Elect, 375 heart attack, 457 program, 394 Cumulated Index Medicus, 368, 383 Curran, Jean A., 466, 476 Current Catalog, 381, 489 Current citation file, 389 Current List of Medical Literature, 281, 290, 300, 302, 311, 325(2), 326(2), 329, 365, 367(2) arrangement of citations in, 366 distribution of, 302 metamorphosis of, 367 Curtis, Edward, 33 Cushing, Edward, 341, 351 Cushing, Harvey, 252, 268, 274 biographical, 264 Cushing, Harvey (continued) correspondence with President Roosevelt, 264-9 donor of publications, 215 loans to, 214 quotations, 198, 265, 267, 268, 282 Custis, Vice Adm. Donald L., 476 Custody and Loans Division, 285 Cutbush, James, 6 Cutter, Charles A., quotation, 121 Cuvier, Baron George, 6 Cuyler, Dr., 50 D Da Costa, Jacob, 70, 120 Dale, Thomas, 6 Daley, Mayor Richard, 354 Dalton, John, 18, 70 Daniels, Worth B., 355, 476 Darley, Ward, 461 Darnall, Capt. Carl R., 189 Dartmouth Medical School, 426, 427 Darwin, Erasmus, 6 Data bank computer-based national serial record, 463 MEDLARS, 448 laboratory animal, 417 Data base, MEDLARS, 423 Data base, MEDLINE, 424 Data Processing Division, 398 Davidson Transfer and Storage Co., 360 Davie, Eugenie Mary, 476 Davies, Nicholas E., 476 Davis, Burnet, 445(2), 447 Davis Commissioner James F., 456, 457 Daniel, 205 GeorgeS., 134 Representative Robert, 180 Ruth, 420, 422, 426, 432 Vice Adm. George M., 476 Davison, Wilbur, 304, 335, 341(3) Dawson, William, 70, 145, 146 Day, Melvin S., 448, 472 De Bakey, Michael E., 350, 351, 355, 395, 476 Dean, Amos, 16 Decentralization of the MEDLARS system, 422 DeCoursey, Maj. Gen. Elbert, 352, 361 Dedication ceremonies, 357 Deficiencies in libraries, 396, 399 Delameter, Jacob J., 100 Delano, Franklin, 268 Delano, Judah, 2 Dennis, Senator George R., 137 Dental Advertiser, 59 Dental Cosmos, 54(2) Dental Literature, Index to, 376, 385, 443 502 INDEX Dental Newsletter, 54 Dental Obturator, 45 Dental Quarterly, 54 Dental Register, 48 Dental literature, 443 Dental vocabulary for MESH, 443 Denver Federal Center, 378 Denver Medical Society, 215 Department of Agriculture, 279 Graduate School, 368, 464 Library, 295, 321, 443, 462 Department of Commerce Libraries, 331 Department of Defense, 369 civil function of, 351 Management Committee, 350 Department of Health, Education, and Secu- rity, 350 Deposit, money, 203 Desk lamps, 347 Desktop Analysis Tool for the Common Data Base, 413 Deterioration of books, 458 Deterioration of the building, 344 Detroit Public Library, 322 Detroit Review of Medicine and Pharmacy, 46 Developing countries, services to, 449 Dewees, William P., 6 De Witt, Col. Calvin, 189(2) acting librarian, 187, 199 biographical, 199 DHEW, 369, 417 Scientific and Technical Information Publi- cation Data System, 422 Diaz de Leon, Gines Navarro, 448 Dictionary of American Biography, 244 Digital computer, 368 Digests of articles on drug research, 450 Directors Cummings, Martin Marc, 393 Gardner, Leon Lloyd, 311 Jones, Harold Wellington, 296 NcNinch, Joseph Hamilton, 311 Rogers, Frank Bradway, 311 Disbrow, William S., 205, 215 Disbursing Division, 105 Discovery of drugs, grants for studies on, 402 Disks, optical, 459 Disney, Frank, 209 Dispensatory of the United States, 18 Dissertations, 286 medical, 76 student, 75, 76 District of Columbia public library building, 212 Division of Surgical Records, 28 Divisional organization, 444 Divisional structure, 284 Dix, Dorothea, 70 Dixon, Russel A., 443, 476 Documents cataloging and arranging of, 239 classification of, 297 in Cleveland, 297 out-of-scope, removed, 344 stack area for, 226 wartime medical, 224 Documentation, Inc., 373 Doe, Janet, 292, 339(2) Dorsey, John Syng, 2 Doszkocs, Tamas E., 472 Double shelved, 91, 141 Douglas, Senator Paul, 354 Douglass, Carl, 398, 399(2), 445(2) Dow, Capt. William S., 248 Dowell, Greensville, 56 Dowler, Bennet, letter to, 52 Dowling, Harry F., 444 Doyle, Peter, letter to Billings, 67 Drake, Daniel, 9 Droplights, 208 Drug Digests from the Foreign Language Lit- erature, 450 Drug literature by card and microfilm services, 412 Drug Literature Program, 411, 413(3), 414 abolished, 414 Drug research, digests of articles on, 450 Drugs, grants for studies on, 402 Drugs indexing, 412 Drugs, registry numbers of, 412 Dryer, Bernard V., 445 Duke University, 393, 475 Medical Center, 480 Dumbwaiter, 346-7 Duncan, Louis C, 246 Duncan, Thomas C., 56 Dunglison, Richard J., 67, 97 Dunglison, Robley, 7, 9, 16, 18, 19 estate of, 67 Dunham, George, 314 Duplicates of books and journals, 261, 317 crowded, 206 donated, 206 exchanges of, 318 recipients of, 215 storage of, 278 Dutch translations, 205 Duval, Kate H., 104 E Earle, Pliny, 70 East Germany, 387 East Tennessee Record of Medicine and Sur- gery, 56 Eastern Virginia Medical Authority, 478 Eastman Kodak Listomatic camera, 366 503 A HISTORY OF THE NATIONAL LIBRARY OF MEDICI Eberle, John, 7 Ebert, Robert H., 451, 476 Eclectic journals, 58(2), 59(2) Eclectic Medical Journal of Pennsylvania, 59 Eclectic Medical and Surgical Journal, 57 Eclectic physicians, 57 Edgar, William F., bequest, 276 Edinburgh Medical Journal, 117 Edinburgh Medical Society, exchanges with, 81 Editorials, 112, 120, 145, 147 Education application of audiovisuals to, 436 application of biomedical communications to, 422 continuing, 394, 345, 447 of health workers, 445 lack of interest in, 134 Network for, 445 network, health, 425 program, coordinated medical, 429 via satellites, medical, 427 Educational grants program, 446 institutions, network of, 424 methodology, 440 television, 425-7 Edwards, Lewis A., 56-7 Eggers and Higgins, 284 Egypt, research agreements in, 451 Ehrlich, S. Paul, Jr., 476 Eickhoff, Mr., 129 Eisenberg, Arthur, 216 research for patrons, 214 salary, 209 Eisenhower, General Dwight D., 260 Eisenhower, President Dwight D., 355(2) Eldridge, Stuart, 72 Electricity, wired for, 208 Elements of Military Hygiene, 245 Elevator, 346-7 ELHILL, 387 acronym, 424 Eliot, Charles, 179 Elliotson, John, 7, 19 Ellis, Benjamin, 6, 16 Elsey, Mrs., 21 Embry, Lloyd B., 469 Emory University, 352, 479 Medical School, 393, 437 EMP, acronym, 398 Employees debilitated, 225 with idiosyncrasies, 247 impact of war on, 224 professional class, 295 professional library, 293 shortage of trained, 246 temporary, 226 women, 234 Encyclopedia of Pure Materia Medica, 104 Endicott, Kenneth M., 432, 438 Engle, H. Martin, 476 Englemann, George J., 70 Engravings, inquiries on, 203 Environmental Program International Referral Service, UN, 448 EPILEPSYLINE, 417 scope, 386 Erichsen, John E., Surgery, 16(2), 18 Erotica, 286 Escanaba Hall, 344, 347 Eschmann Elia, 319 Jean Charles, 299 biographical, 307 Escola Paulista de Medicina, 448 von Esmarch, Friedrich, 174 Espy, James, 8 Essex Institute, 45 ETV, acronym, 425 Eureka College, 337 Evans, Luther, 313, 317, 337, 462 Eve, Paul F., 48 letter to, 52 Exchange, 205 international, 319 publications for, 79 relationships, Japanese, 318 Exchanges, 79, 176 assisting libraries with, 81 early, 8 European, 80 and gifts, 319 international, 449 no longer demanded, 206 between SGL and NYPL, 179 Exclusion, process of, 231 Exhaust fans, 346 Exhibit, books loaned for, 203 Exhibition cases, glass, 232, 334 Exhibits, 173 comment on, 95 emphasized, 331 Extensions of the Medical Library Act, 404 Extramural activities, 395 Extramural program, 398(2), 405, 406, 444 associate directors of, 409 Publications and Translations Division, 398 Research and Training Division, 398 shift in emphasis, 407 Subcommittee for, 400 F F, temporary building, 228 Fabrica, 299 Facsimile transmission, 456 Fair use, 456(2), 458 504 INDEX Family Journal of Health, 59 Family Medicine Clinic, 429 Farmer, Charles, 441 Federal Council on Science and Technology, 462 libraries, cooperation among, 462 libraries, survey of, 213 Library Committee, 463 Medical Services, Task Force on, 352 Security Agency, 350, 353 Fees for on-line service, 388 Feiner, Albert, 432 Fenwick, George E., 54 Ferguson, F. Emmet, Jr., 476 Fergusson, Sir William, 83 Fess, Senator Simeon, 267 Field, Helen G., 339 Field installation, 289 Field Medical Supply Depot, 232 File Boxes, Woodruffs Patent, 92 Film collection, 434 Filming for preservation, 456 Finance Section, 291 Fine Arts Commission, 284, 291 Finley, Clement Alexander, 15 Fire, fear of, 29 Fire hazard, 226 Fire-retardant, 29 Fisch, Max Harold, 297, 329, 330 biographical, 307 Fishbein, Morris, 249, 251, 253, 256, 262, 304, 339, 341, 354, 383, 452 medical bookplates, 319 Fisher, George J., quotation, 129 Fisheries Building, 291, 343 Annex, 291, 343, 344 Fitz, Reginald, 341 Fitzpatrick, J. E., 54 Flemming, Secretary Arthur S., 357 Fleming, Thomas P., 292 Fletcher, James C, 476 Fletcher, Robert, 92, 122, 123, 130, 170, 174, 179, 186, 188, 189, 191, 192, 256, 380, 466 Acting Librarian, 189 characterization of, 192 illness of, 212 medal, 194 portrait of, 193 principal assistant librarian, 196 publisher of Index Medicus, 211 salary, 209 testimonial dinner to, 194 Flint, Austin, 145 Jr., 145 quotation, 130 letter to, 52 Sr., 151 Flood, Representative Daniel, 430 Floyd, David O., 225 Flugel, Felix, 31, 60(2), 76, 210 letter to, 81 Fogarty, John, death of, 208 Fogarty, Representative John T., 399, 419, 466 Folger Shakespeare Library, 291 Follett, Representative John, 164 Food and Drug Administration, 411, 413, 461 Foote, John, 16 Forbes, Edward, 459 Force, Peter, 2 Ford, President Gerald R., 458, 467 Ford's Theatre alternatives to, 142 collapse of interior, 168 faults in, 141 fire hazard, 141 move from, 168 move into, 27, 29 museum in, 186 remodeled, 28 space squeeze in, 141 unsafe condition of, 142 Foreign exchange policy, MEDLARS, 379 medical books, grants for translation of, 402 medical legislation, inquiries on, 203 Foster, G. W., 82 de Fort, Leon, 85 Four-way voice conference network, 428 Fowler, Clement P., 472 Fowne, George, 16, 18 France, 106, 192, 220, 259, 311, 387 Francis A. Countway Library of Medicine, 404 Francis, Thomas, Jr., 476 Frank, Mortimer, 205 Frankfurt am Main Medical Society, exchanges with, 81 Frantz, John H., 51 French military publications, 224 Freiburg, University of, 76 Friends of the Armed Forces Medical Library, 335 Friends of the Army Medical Library, 279, 301 expiration of, 302(2) Fryer, Blencowe, 113 Fulton, John, 54(2) Fulton, John F., 303, 312, 339, 341, 351, 355 Fulton, Capt. John S., 227 Funding, bloc, 451 Furnishings in the Library, 91 Funiture, 167 Fussier, Herman H., 476 G Gaddesden, John of, 203 Galen, 203, 254 Galileo, 254 Galveston Medical Journal, 45(2), 56(2) 505 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Gamgee, John, 39 Gannal, Jean-Nicholas, 7, 19 Gardner, George, 213 Gardner, Leon Lloyd changes in Current List, 325 Commandant, 312 Director, 311 plea for elevator, 346 Garfield, Eugene E., 339 Garfield, President James A., 205 Garrard, Richard F., 369 Garrison, Fielding Hudson Acting Librarian, 226 alarm, 267 author, 196 Billings biography, 182, 489 biographical, 195 coeditor, 212 comment, 179, 188, 262 editor of Index Medicus, 196, 212 editorial board, 229 evaluations of, 253 (2) history of the war, 229 incunabula, 231, 329 leaves the Library, 247, 251 letters, 258 Librarianship avoided, 244 Lieutenant Colonel, 251 Major, 224 and Morton, 198 name omitted from History credits, 229 oil painting of, 276 principal assistant librarian, 194, 230 Quarterly Cumulative Index Medicus, 251 quotations, 37, 113, 117, 131, 138, 150, 191, 194, 201, 234, 237, 248, 251, 252, 488 replacement for, 259 salary, 209 secretary of History Advisory Board, 228 servicing inquiries, 203 shortcomings of Library, 294 successor to, 231, 235 translations, 205 • Garrison, Florence, 249 term of service, 257 Garrison, H. D., 54 Gazette Medicale de Paris, 118 Gelhorn, Alfred A., 448, 451, 477 General Electric Co., 369 General Services Adminstration, 356, 360, 430 Gentlemen's Agreement, 452, 456, 468 Gee Aitch 43, 224 Geological Survey, 212 Library, 279 George Hyman Construction Co., 431 George Washington University, 192, 194, 279, 305, 362 Medical School, 209, 216, 249, 393 Georgetown, 93, 105, 113, 122, 123 University, 237, 248, 261, 476 School of Medicine, 123, 195, 209(2), 215, 231 Medical Research Institute, 279 Georgia Blister and Critic, 45 Georgia Medical Companion, 45 Georgia Medical and Surgical Encyclopedia, 56, 57 Georgia Medical Society, 205 Georgia State Medical Association, 144 German universities, 76 German wartime periodicals, 317 Germany, 106, 387 Gesner, manuscript by Conrad, 465 Gibson, Senator Randall, 151 Gibson, William, 6 Gifts, early, 8 Gifts, first, 8 Gifts to Library, 176 Gifts of publications, 205 Gill, Dr., 47 Gillmore bequest, 465 Gillmore, Capt. Robert Tracy, 465(2) Gillmore, Emma Wheat, 465 died, 465 Girard, Alfred C, 113, 117 Glasgow, University of, 81 Glenbrook Golf Course, 356 Gluckstein, Fritz P., 444 Gluge, Gottlieb, 7 Godman, John, 2, 6 Goff, Representative Nathan, 151 Good Health, 45 Good, John M., 6 Gorgas, Surgeon General William, 221, 227, 229, 232, 233, 242 Government libraries, merging of, 154 Government Printing Office, 92, 93, 320, 386 monopoly on binding, 320 GRACE, acronym, 372 GRACE, speed of, 373 Graham, Gerald G., 437 Grants for books, 407 communication of medical research, 397 to establish libraries, 406 for history of medicine, 398 programs, 393, 394, 399 beginning of, 395 educational, 446 reservations about, 397 training, 407 replaced by contracts, 397 for research, 446 for resources, 401, 446 improvement of, 406 projects, 406 506 INDEX Grants (continued) for special scientific projects, 402 totals of, 408 training, 402, 446 Graphic image program, 456 Graves, Robert, 7, 19 Gray, Anatomy, 18 John, 70 Green, B.W., 73 Green, Samuel, 70 Green, Sewell, letter to, 80 Gregg, Alan, 292, 355 estate of, 460 Gregory, George, 6 Greifswald, University of, 76 Griffiths, Thomas J., 49 Grim, Ray W., 359 Groesbeck, Joseph A., 318, 321 Groningen, University of, 76 Gross, Samuel D., 7, 16, 54, 67, 70, 121, 130, 151(2) Gross, Samuel W., 164 Grosvenor Library, Buffalo, 80 Groundbreaking, 356 Growoll, Adolf, quotation, 137 Growth, rate of, 205 Guardian of Health, 45 Gurley, R.R., 104 Guthrie, Commentaries, 18 H Handler, Philip, 467 Hanke, Maxine, 464 Hannon, Mrs. Debora, 216, 281 Harding, Norman E., 131 Hardy, Dr., 49 Hardy, Robert W., 225 Harkins, Henry N., 477 Harris, Representative Oren, 399(2), 466 Harrison, President Benjamin, 175 Hartman, James J., 472 Hartshorn, Principles of Medicine, 18 Harvard, 45, 214, 259, 338, 378 College, gift by, 8 Medical School, 3, 271 University, 292(3), 404 library, 80 Hasson, Alexander B., 42, 51 Hastings, Albert Baird, 461 Hawkins, Thomas, 55 Hawley, Maj. Gen. Paul, 350 Hawley, Senator Joseph R., 150, 163 Hawley s bill, 163 Hayes, President Rutherford B., quotation, 142 Hayes, Whalen J., 416 Haykin, David, 339 Haymaker, Webb, 319 Hays, Isaac, 70 Hays, Lt. Gen. Silas B., 477 Headings, medical subject, 328 problems, 372 Health agencies, reports of, 73 Aspects of Pesticides Abstracts Bulletin, 415, 416 communication activities, 420 education network, 425 Effects of Environmental Pollutants, 416 evolution of international, 444 information research, 402 laws, 421 professionals, grants for studies, by, 402 Programs Extension Act, 405 Services Research, Health Statistics, and Medical Libraries Act of 1974, 405 workers, continuing education of, 445 Heaton, Lt. Gen. Leonard D., 465, 477 Heidelberger, Michael, 461 Henderson, Earl, 459 Henderson, Thomas, 8 Henkle, Herman, 339 Hennen, John, 6 Henry, Morris, 70 Henry, Robert S., 490 Herald of Health, 59 Herbert, Representative Hilary, 145 Herter, Christian A., loans to, 214 Hetzner, Bemice M., 477 Hibberd, James F., 145, 164 Hadassah Medical School, Israel, 450 Hadassah School of Dental Medicine, 450 de Haen, Paul, 415 Hagood, Brig. Gen. Johnson, 271 Hahnemann Medical College library, 80 Hale, Senator Eugene, 164 Halegua, Raquel, 443 Half-yearly Abstract of Medical Sciences, 7 Half-yearly Compendium of Medical Sciences, 54 Hall, Harry O., 172, 225 retired, 235 Hall, Henry, 61 Hall, John, 203 Halle, University of, 76 Halsted, William, loans to, 214 Hamburgisches Magazin, oder Gesammelte Schriften aus der Naturforschung, 19 Hamilton, Allan, 70 Hamilton, Frank H, 85, 205 Hamilton, Robert, 19 Hammer, Dr., 47 Hammond, John F., 51 Hammond, Surgeon General William Alex- ander, 16 Handbook for Medical Officers in the Field, 240 507 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Hierarchical structures, 373 Hilbrandt, Christine C, 235 Hill-Kennedy bill, 336, 354, 355 Hill, S. Richardson, Jr., 477 Hill, Senator Lister, 353, 356(2), 357, 397, 399(2), 419, 421, 431, 461, 466 Himwich, Williamina A., 339 Hine, Maynard K., 468, 477 Hirshhorn, Joseph H., 361 Hirshhorn Museum, 361, 362 Hiscock, Representative Frank, 128, 145 Histopathology laboratories, 360 Historic Landmark, Registered National, 360 Historic Sites and Buildings, National Survey of, 360 Historical letters, cataloging of, 460 Historical Section of the Library Division, 229 Histories of medicine, grants for, 402 History of the administration of the SGO, 229 Board Advisory Council, 228 Division of the SGO, 229 inquiries on, 203 of the Medical Department, 245 in the World War, 225, 227-9 of Medicine, 83, 179, 198, 248 American Association for the, 317 grants for, 398 Introduction to, 191 lecturer in, 261 support for, 407 of Medicine Division, 5, 296, 299, 329, 344, 360, 394, 459, 461(2) binding studio of, 319 budget for programs, 398 chief of, 318 rare books for, 465 of military medicine, 229 oral, 461 production of, 461 planner of the, 220 researching, 244 Section abolished, 229 Hoar, Senator George, 164 Hodgen, John, 70 Hoff, EbbeC, 339 Hoffmann, Frederick L., 214, 215 Hogan, Rear Adm. B. W., 477 Hollifield, Horatio N., 57 Holman, Emile, 461 Holman, Representative William, 163 Holmes, Edward, 70 Holmes, Justice, Memorial Garden, 284 Holmes, Oliver Wendell, 71, 120, 151, 175,179 quotation, 130 Holmes, Thomas James, 298 biographical, 307 Homeopathic journals, 58, 59 Homeopathic physicians, 57 Homeopathic Sun, 59 Honorary Consultants, 299, 303, 312 Association of the, 302, 332 Committee on Copyright, 452 committees, 304, 333 Proceedings, 334 Hooper, Robert, 7 Hoover Commission, 350, 353, 355 second, 352 Hoover, President Herbert H., 263 Horton, Samuel M., 51 Hospital Billings director of, 175 Division, 242 director of, 244 examiner, Billings as a, 33 libraries, community, 406 Memphis, Tenn., 179 steward, 123 Hospitals, 435 books from military, 21 European, 106 reports of, 73 Howard Memorial Library, New Orleans, 206 Howard, Mrs. Frances, 430 Howard University, 476, 479 School of Dentistry, 443 Hours of service, 93, 97, 201 House Committee on Appropriations, 145, 164(2), 212, 283 on Interstate and Foreign Commerce, 355 on Military Affairs, 227, 233 on Public Buildings and Grounds, 144 Subcommittee on Appropriations, 398 Subcommittee on Reorganization, 420 Mr. Vevan's, 3 Mrs. Elsey's, 21 Hubbard, William N., Jr., 445, 447-8, 451, 477 Hudson County Medical Society, 148 Huette, Charles, 16 Hume, Edgar Erskine, 126, 253, 254, 264, 268, 273, 302 Librarian, 259 military career, 259-60 quotation, 199 successor to, 271 Hummel, Donald J., 415 Humphrey, Senator Hubert H., 411, 430(2), 467 Hundley, James, 393 Hunt, Ezra, letter to, 161 Huntington, David Lowe, 141, 148, 162, 182 biographical, 185 Curator, 150 Librarian, 206, 211 Hurley, Patrick, 262 Hussey, Hugh H., Jr., 383, 477 Hutchins, Alexander, 163 508 INDEX Hutchinson, James, 70 Huth, Edward J., 477 I Illinois, 425 University of, 341 College of Engineering, 480 Library School, 337 Medical School, 243 Incunabula, 19 bibliography of, 231 bookcases for, 286 catalog of, 297, 329, 330 in Cleveland, 297 deteriorating, 268 dust, 237 expert on, 237 in glass exhibition cases, 232 inquiries, 203(2) inventory of, 299 loan policy for, 203, 219 medical, 100, 268 microfilm of, 330 photographed, 231, 296 protection of, 91 Index to American medical journals, 113 Index, author, 111 Index-Catalogue, 127, 176, 189, 191, 193, 221, 232, 265, 285 abolition suggested, 229 acceleration of, 251 addendum to, 196 backbone of, 261 basis for Current List, 281 burden of publishing, 202, 365 compliments on, 129 continued, 210 cost of printing, 127, 137 delay of citations for, 222 distribution of, 230 dwindling supply of, 229 editing, 195, 209 editor, 186, 192(2), 216, 219, 247, 254, 295 editorial assistance, 249, 259 end of, 324 entries clipped from, 226 exchange for, 205 foreign literature in, 245 fourth series, 262 goal to complete, 175 inconsistencies in, 294 index cards for, 289 indexers of, 301 influence on Library, 132 lobbying for, 128 manuscripts listed in, 459 microfilm of index cards for, 330 Index-Catalogue (continued) modifications, 262 prominence through, 449 proposed changes, 254 publication of, 129 recipients of volumes of, 489 resumed, 311 for searching books, 293 series 2, 210 series 3, 230 series 4, 251 size of volume 1, 129 slow distribution, 239 slowed by war, 224 staff writings listed in, 489 started, 61 stopped, 325 stored volumes of, 141 studies on continuing, 251 supplements, 275 suspended, 262 survey on continuing, 230 typography of, 131 utility of, 130 Index-Catalogue and Research Division, 284-5 Index cards, 111, 221, 289 Index to Dental Literature, 385, 443 Index to library journals, subject, 130 Index Medicus, 127, 144, 176, 367, 454, 466 Abridged, 383, 384 to AID nations, 449 Austrian substitute for, 217 by-product, 210 circulation of, 138 citations from, 386 classification system, 134 coeditor, 192, 229, 248, 249, 386 correspondence on, 217 Cumulated, 383 sole publisher, 383 deficit of, 138 delay of citations for, 222 editor, 196, 254 first number, 368 founding of, 132 French substitute for, 217 indexer, 443 lack of interest in, 134 lapse of, 212 with MESH, 372 metamorphosis into, 367 more complete, 211 new, 368 origin of name, 137-8 overtime work on, 216 photocomposing equipment to print, 370 preparing copy for, 369 produced by GRACE, 373 prominence from, 449 509 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Index Medicus (continued) Quarterly Cumulative, 248, 250, 251, 262, 281, 367 revival of, 196, 212 rise and fall of, 211 sales of, 134 staff writings listed in, 489 support of, 212 Index of Rheumatology, 375 Indexes author, 111 mechanized production of, 316 numbers of, 382 to periodicals, 179 subject, 111 preference for, 111 title, 111 Indexing assistance in indexing by brother officers, 113 assistant, 366 beginning of, 111 by contractors,382 drudgery of, 249 drugs, 412 journals, 111 periodicals, 111 unit, 291 Indiana Scalpel, 56 Indiana University, School of Dentistry, 477 Industrial Toxicology, 451 Inflation, 205 Informatics, Inc., 415 Information bibliographic, 384 center, active, 419 clearinghouse, biomedical, 420 network, science, 388 networks for communicating biomedical, 419 program, toxicology, 394, 413, 414(2), 431, 444 charges for, 415 contractors, 414 development of, 414 funds of, 414 objectives, 415 publications, 415 referral service, biomedical, 420 requests for, 103, 331 research, health, 402 retrieval, language analysis for, 401 scientific and technological, 396 services, specialized, 411, 414(2), 418, 444 system, national, 400(2) systems, computer-based, 456 Infringement, risks of, 454 Infringement, suit for copyright, 452 Inouye, Senator Daniel K., 362 Input typist, 366 Inquiries, 331 servicing, 203 Insect infestation, 359 Institute for the Advancement of Medical Com- munication, 400 Institutional prices, 457 Instruction, computer-assisted, 425 Instruction programs, computer assisted, 406 Instructional network, computer-assisted, 422, 424 Instructional network, evaluation of, 425 Interact, 426 Interactive retrieval, 389 Interactive searching, 389 Interactive television network, 422 Inter-Departmental Committee for the Acqui- sition of Foreign Publications, 317 Interlibrary loans, 99, 101, 202, 402, 453, 488 operation, survey of, 454 service, 459 Intern program, 463 International Business Machines Corp., 325, 466 school, 365 cooperation, 447 Council of Scientific Unions, 448 exchanges, 319, 449 health, evolution of, 444 Index of Medical Film Data, 436 Medical Congress, 121, 135 resolutions of, 122 Medical Convention, 186 Neurological Conference, 4th, 319 Nursing Index, 385 organizations, 448 programs, 447 service, interruption, 449 International Nursing Index, 376 Interorganizational aspects of urban community health, 402 Interuniversity Communications Council, 422 Interurban Clinical Club, 460 Intramural Program, 398, 444 Introduction to the History of Medicine, 191 Iowa Board of Health, 151 Iowa, University of, 239, 475 Iran, 387, 448 Ireland, Surgeon General Merritte, 229(2), 233, 239, 245, 251, 444 Iron stacks, 91 Irregulars, 57, 59 Irwin, Bernard J. D., 73, 113, 117 letter, 116 Israel, 396, 450(2) Israel Journal of Medical Sciences, 382, 451 Israeli, Beruch biographical, 215 research for patrons, 214 510 INDEX Israeli, Beruch (continued) salary, 209 servicing inquiries, 203 translations, 205 work for hire, 103 Italy, 387 J Jablonski, Stanley, 471 Jackson, John, 70 Jackson, Mary Alice, 341 Jackson, President Andrew, 3(2) Jackson, William, 292 Jacksonville Hospitals Educational Programs, Inc., 478 Jacobi, Abraham, 70, 120, 148, 205 letters to, 127, 129 Jacobi, Mary, 120 James, L. A., 48, 57, 59, 103 James, Representative Darwin, 151 Japan, 387 Japanese exchange relationships, 318 Japanese journals and books, 318 Jarcho, Saul, 477 Jefferson Medical School, 199, 245, 275 Jeljaszewics, Janusz, 451 Jenkins, J. Foster, 126 Jenner, pamphlets by, 219 Jennings, Lt. Gen. Hal B., Jr., 477 Jewett, Adams, 103 report to Billings, 68 John of Arderne, 191 John Crerar Library, 178, 275 John of Gaddesden, 203 John Shaw Billings Centennial, 466 Johns Hopkins University, 195, 209 Hospital, 105, 189, 251(2) construction of, 168 design of, 136 library, 80, 99 Medical Institutions, 460 medical school, 149, 171, 187, 189, 192, 249, 259(2) School of Public Health and Hygiene, 313 Welch Medical Library, 248, 253, 261 Johnson, Christopher, 145, 154 Johnson, Dr. George, 47 Johnson, Hosmer, 151 Johnson, President Lyndon B., 413, 421, 447 Johnson, President Lyndon and Mrs., 361 Johnson, Samuel, 6 Johnson, Secretary of Defense Louis, 351 Joint Congressional Committee on the Library, 350 Joint Congressional Committee on Printing and Binding, 453 Joint Council Subcommittee on Cerebrovascu- lar Diseases, 375 Joint resolution for Lister Hill Center, 421 Joint Working Group on Medical Cooperation, 451 Jones, Diseases of the Eye, 18 Jones, C. A., 55 Jones, John, 203 Jones, Harold Wellington, 277, 281, 289, 291, 302(2), 311, 332, 333, 341, 452, 462 biographical, 271 Director, 296, 312 letter, 308 Librarian, 262, 282, 283, 465 organizes staff, 284 portrait, 304 quotation, 278 Jones, M. Irene, 339 Jones, Tom, 341 Josiah Macy, Jr., Foundation, 467, 472 Journal of the American Chemical Society, 294 Journal of the American Medical Association, 196, 222, 249 Journal of Education, 59 Journal of the Franklin Institute, 7, 8 Journal of Health and Monthly Miscellany, 45 Journal of Medical Education, 374 Journal of Medical Reform, 59 Journal de Medicine de Quebec, 53 Journal of Materia Medica, 54 Journal of Physiological and Medical Reform, 59 Journal of Rational Medicine, 59 Journal and Transactions of the Maryland Col- lege of Pharmacy, 51 Journals, 17 back issues, 317 bibliography of, 61 binding, 8, 92 borrowing, 96 defunct, 60 European, 60 file, 389 foreign, 59 grants for support of, 402 hunt, 41 index to American medical, 113 for Index Medicus, Committee on Selection of, 380 indexing of, 111 Japanese, 318 Latin-American, 318 List of American medical, 61 list of wanted, 43, 45, 49, 53, 59, 60, 68, 79, 113, 281, 319 microfilmed, 289 microfilming for preservation, 458 old, 42 511 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Journals (continued) quest for, 41 received, 289 selection of, 380 shelved according to size, 92 stack area for, 226 statistics of library, 117 subscription reduced, 261 Justice Holmes Memorial Garden, 284 K L Laboratory animal data bank, 417 LADB, acronym, 417 Laird, Representative Melvin R., 357 Lamb, Daniel S., 21, 141, 490 Lancaster, F. Wilfrid, 377 Lancet, 8, 55, 97 Lancet, New York edition, 8 Langley, Leroy L., 409, 451 Language analysis for information retrieval, 401 Lapham, Senator Elbridge, 154 Larkey, Sanford, 324, 339(2), 341 Latin-American journals, 318 Latman, Alan, 456 Lawson, Surgeon General Thomas, 3, 7, 8, 9, 273 Lay ton, Jack M., 477 Lea, Henry C, 54, 120, 163, 164, 175 editorial, 146 Leake, Chauncey D., 303, 329, 331, 339, 351, 355, 459 Leake, James P., 444 Learning resource centers, 406 Learning Resources Program, 438 projects, 438 Lee, William, 83, 104 quotation, 130 Legal medicine, bibliography of, 275 Leidy, Joseph, 7 Leipzig, University of, 256 Leiter, Joseph, 389, 398, 472 Lending to civilian physicians, 97 Lending, no uniform policy on, 219 Lending rules, 172 Lenox and Astor libraries, 178 Lesinski, Representative John, 398 Letters, historical, 83 cataloging of historical, 460 Levy, Kate, 210 Leypoldt, Frederick, 132, 134(2) Liatis, Greek Ambassador Alexis S., 358 Librarian becomes Director, 296 Billings becomes, 29 first civilian, 312 Principal, 247 principal assistant, 192, 194 of the Surgeon General's Office, first, 23 Librarians Ashburn, Percy Moreau, 244 Billings, John Shaw, 29 Hume, Edgar Erskine, 259 Huntington, David Lowe, 185 Jones, Harold Wellington, 271 McCaw, Walter Drew, 189 McCulloch, Champe Carter, 219 Merrill, James Cushing, 186 Noble, Robert Ernest, 242 Otis, George A., 23 Phalen, James Matthew, 243 professional, 290, 292 Reed, Walter, 187 Straub, Paul Frederick, 239 Taylor, Kanardy, 316 training programs for, 463 Winter, Francis Anderson, 241 Wright, Wyllis, 296 Libraries advice, 81 van Kaathoven, Cornelius Wilhelm Hendrik, 82 Kahn, Representative Julius, 233 Kansas, University of, 261, 479 Karel, Leonard, 375, 380, 383, 448 Kean, Jefferson R., quotation, 190 Keen, William W., 97, 126, 194, 205 testimonial, 131 Kefauver, David, 399, 409 Keifer, J. Warren, 148 Keio University, 341, 381 Kelly, Howard Atwood, 171, 215 loans to, 214 Kelsey, F. Ellis, 411 Kelsey, Frances O., 411 Kenney, Rear Adm. E. C, 477 Kennedy, Senator Edward, 405, 430, 467 Kennedy, Senator John, 353 Keyes, Thomas, 341 Key-puncher, 366 Keys, Thomas Edward, 290, 297, 299, 477 biographical, 306 Kilham, Walter H., 356 King, Benjamin, 3 Kirk, Surgeon General Norman, 292, 296, 302, 311, 313, 349 Kirkbride, Thomas, 70 Kissman, Henry M., 415, 417, 472 Klebs, Arnold, 215, 231, 252 Knickerbocker, Bolivar, 42, 51 Knowledge Base Research Program, 447 Kober, George M., 122 Korea, medical schools in, 448 Korean medical libraries, 331 Krumbhaar, E. G., 341 Kuch, Mildred, 326, 340 Kurth, William H., 359, 454 512 INDEX Libraries (continued) Air Force Surgeon General's, 331 American Antiquarian Society, 80 American Medical Association, 97, 104 Army Medical, 279, 488 Army Surgeon General's Reference, 331 assistance to medical, 396 Boston Athanaeum, 80, Boston Medical, 80, 99 Boston Public, 80, 121 Brown University, 80 College of Physicians of Philadelphia, 80 community hospital, 406 construction of, 400 cooperation among federal, 462 Cornell University, 363 deficiencies in, 396 Department of Agriculture, 321 Department of Commerce, 331 design of, 136 funding of regional, 407 Geological Survey, 279 government, 4 grant for regional medical, 402 grants to establish, 406 grants for works dealing with, 402 Grosvenor, 80 Hahnemann Medical College, 80 Harvard University, 80 Johns Hopkins University, 80, 99 Korean medical, 331 Massachusetts Historical Society, 80 Massachusetts Medical Society, 80 Medical and Chirurgical Faculty of Maryland, 80 Medical College of Ohio, 80 merging of government, 154 Michigan State, 80 National Bureau of Standards, 279 New Hampshire State, 80 New York Historical Society, 80 New York Hospital, 80, 99 New York State, 80 other government, 321 private support for, 402 sizes of other, 176 South Carolina State, 80 Starling Medical College, 80 survey of Federal, 213 University of Pennsylvania, 363 Veterans Administration, 317, 323 in War Areas, Committee on Aid to, 317 Welch Medical, 248, 253, 261 Wisconsin State, 80 Library annual cost of, 350 Assistance Act, Medical, 378, 398, 399, 400, 404, 408 associates program, 464 Association, Medical, 174, 220, 304, 381 Library (continued) birthdate of, 11, 272 -based bibliographic service, 388 building, Chicago's efforts to get, 354 D.C. public, 212 journal's support for, 147 medical societies' support for, 148 of Congress, 92, 142, 143, 164, 205, 262, 268, 282, 284, 291, 292, 343, 350, 351, 434, 452, 456, 462(2), 475 acquisition program, 317 annex, 267 author cards from, 221 cooperative agreement with, 323 hours of service, 227 influence of, 220 fear of merger with, 268 practices of, 221 proposal to merge with, 154, 213, 227, 267 size of staff, 255 Centenary of the, 272 civilian control, 316 as a civil function, 350 card, 203 clientele of, 91 combined with Museum, 162 contributions to the, 134 design of, 142 divisional structure, 284 divisions, functions of, 285 decline of, 234 expansion of, 177, 206 full, 277 furnishings of the, 91 Hall, 277 stack capacity of, 166, 167 holdings, statistics of, 177 hours, 97 housekeeping in, 173 illumination in, 166 lobbying for the, 144, 150, 303 modernizing the, 311, 322 move to Bethesda, 359 -Museum Building, 141, 278 intruder in, 174 on the Mall, 161 need for a new, 264 National Medical, 25 network, national, 400 newspaper attack on, 156 New York Public, 178, 179, 292 in the 1920's, 239 objectives for the, 34 100th anniversary of, 268 in operation, 1895-1913, 201 operation and services of the, 91 operations, 444 plan of the new, 358 proposals to combine with other agencies, 270 513 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Library (continued) proposals to remove from Medical Depart- ment, 212 recollections of, 171 regional medical, 448 renovation of the, 347 research and development in the, 419 Resources, Council on, 365 rate of growth of, 293 run-down, 278 School, 246, 314, 315 scope of, 40 services, demand for, 239, 289 services, extensions of, 443 size of, 3, 5, 20, 29, 34, 36 Staff Association, 312 study of the, 291 of the Surgeon General's Office, 1 name changed, 243 survey of the, 292 system, Regional Medical, 403 visitors to, 171 weaknesses of, 293 during World War I, 219 Library's appropriation, 148 License for single-copy reproductions, 457 Liddell, Henry, 104 Lieberman, James, 434, 441 Lille Medical Society, exchanges with, 81 Lincoln, President Abraham, 28 Lincoln, Secretary of War Robert T., 144, 163 Lindsay Laboratories, 256 LINES, other, 384 Linguistic assistance in proofreading, 131 Linguists, 186, 216, 240, 249, 260, 329 List of American Journals, 93 Lister Hill National Center for Biomedical Communications, 384—447 passim Building, viii, 430 construction of, 430 directors of, 431-2 functions, 421 Lister Hill papers, 460 Literature aids, secondary, support for, 407 appropriations for, 95 Arabic, 72 dental, 443 gathering, 67 important, 131 Indian, 72 Japanese, 73 Program, Drug, 414 Russian, 450 searches, distribution of, 377 South American, 73 Turkish, 72 veterinary, 443 world's, 254 Lloyd, Representative James, 235 Loan deposits, 100 Loan operation, survey of interlibrary, 454 Loan policy, 99, 203, 290, 453 Loan system, 96 Loans, 331 Loans to famous physicians, 214 Loans, interlibrary, 202, 453, 488 Loans, personal, 202 Loans, requests for, 100 Lobbying, 148, 163 by Billings, 96, 212 for the catalog, 127, 128 for new building, 163 Lochboehler, George J., research for patrons, 214 Lockwood, Wilton, 193 Lodge, Edwin A., 59(2) Logan, Senator John, 154(2) London Medical Society, exchanges with, 81 London Medical Times and Gazette, 48 London Practitioner, 48 Long, Esmond, 460 Longmore, Gunshot Wounds, 18 Lorini, R., 104 Louisville Medical News, 151 offered editorship of, 135 Louisville Review, 54 Lovel, Surgeon General Robert A., 1, 2, 273, 351 Lowndes, William T., 19 Lull, George, 341 L'Union Medicale de la Louisiana, 45 Lusk, Graham, loans to, 214 Lyell, Charles, 17 Lyman, Representative Theodore, 163, 164 Lynn, Kenneth C, 443 Lyons, Champ, 477 M MacDonald, Arthur, 270 MacDonald, M. Ruth, 295, 312, 322, 326, 331, 339 Machine-readable catalog formats, 463 Maclise, Joseph, 7, 19 Maddin, Thomas L., 48 Magazines, Army hospital, 224 Magee, Surgeon General James C, 272, 284 Magnuson, Senator Warren, 430, 467 Mahone, Senator William, 163(2) Maillot, Francois C, 7 Maine Medical and Surgical Reporter, 47 Mall, 233, 356 death of the building on the, 360 location for the Library, 161, 232 Management Committee, 351 Defense Department's, 350 514 INDEX Management practices, up-to-date, 295 Manchu rule, 191, 244, 246 exception to, 314 Manuscripts, 83 Arabic medical, 276-7 Catalogue of, 330 collection, 460, 461 Modern, 459, 461 Early Western and Oriental, 459 librarian, 460 of life scientists, modern, 459 March, Henry, 82 Morgan, John, 459 Marine Hospital Service, 34, 118, 149 Markfield, I. Nathaniel, 305 Marseilles Medical Society, exchanges with, 81 Marshall, J. Stanley, 477 Marshall, Mary Louise, 292, 295, 302, 322, 339, 340, 477 Martinet, Louis, 7 Mary Hitchcock Memorial Hospital, 426 Maryland Medical School, University of, 145 Marysville Medical and Surgical Journal, 45 Massachusetts General Hospital, 424, 425 Massachusetts Historical Society library, 80 Massachusetts Institute of Technology, 178, 259, 271 Massachusetts Medical Society library, 80 Massachusetts Medico-Legal Society, 81 Massachusetts National Guard, 260 Mastin, Claudius H., 145, 151 Mather, Cotton, 298 Mather, Increase, 298 Matthews, Washington, 163, 170 Maxwell, Allison, 145 May, Angelo M., 477 May, Representative Andrew J., 283 Mayer, Claudius Francis, 247, 262, 275, 281, 285, 295, 329 biographical, 256 Mayer, Nathan, 57 Mayer, William D., 478 Mayo Clinic, 290, 477 McAfee, Loy, 225, 275 McCarn, Davis, 384, 389, 432 McCarthy, Senator Joseph, 353 bill, 354 McCaw, James B., 9 McCaw, Maj. Walter Drew, 186 characterization of, 190 Librarian, 189, 205-10 passim, 252, 294 quotation, 196 servicing inquiries, 204 McClellan, Ely, 49, 118 McCrea, Dr., 50 McCulloch, Lt. Col. Champe Carter, 219-31 passim, 250, 253, 294, 324, 329, 462 Librarian, 219 McDermott, Walsh, 478 McGovern, John P., 478 McGuire, Hunter, 120, 163 McGuire, Ignatius, 325, 340 editor, 326 Mcintosh, James, 55 McKenzie, R. Tait, loans to, 214 McKinley, President William, 321 McLane, Representative Robert, 145, 154 McLeish, Archibald, 291, 296 McLeod, Surgical Notes, 18 McNabb, Maj. P. E., acting Librarian, 269 McNarney, Surgeon General Joseph, 350 McNeil, Comptroller William J., 350 McNinch, Col. Joseph Hamilton, 311 Director, 313-4, 323-52 passim, 452(2), 462 Major General, 478 portrait, 465 McPheeters, William M., 47, 70 Meacham, Frank, 117 Mead Data Central Corp., 415 Mechanized system, 365 stages of, 366 Medals, physicians on, 83 Medical Advisory Committee to the Secretary of De- fense, 350, 351 assistance via satellites, 427 Audiovisual Branch, PHS, 420, 433 Audiovisual Center, National, 394, 421, 431, 433, 434, 444-5, 446 Catalog, 436 programs, 438 books, duplicate, 262 books, grants for translation of foreign, 402 Bulletin, Philadelphia, 145 and Chirurigical Faculty of Maryland, 135, 145 Billings' address to, 155 Library, 6, 80 Chronicle, 55(3) Chronology, 198 Center, Walter Reed, 246, 263, 292, 352, 360, 488 College of Alabama, 145, 477 College of Ohio, 25, 145 library, 80 at Toledo, 317 College of Pennsylvania, 479 College of South Carolina, 145 Colleges, Association of American, 400, 439(2), 460 Communication, Institute for the Advance- ment of, 400 Counsellor, 48 Cooperation, Joint Working Group on, 451 Cosmos, 54 Department, 1(2), 189 515 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Medical (continued) Department (continued) Histories of the, 10, 220, 229, 245 of the U.S. Army in the World War, 227- 9 Departments, Air Force and Navy, 319 Education, Council on, 445 Education, Network for Continuing, 445 education program, coordinated, 429 Examiner, 9 Field Service School, 245, 260, 311 Film Data, International Index of, 436 Gazette, 59 History of the Conquest of America, 246 History of World War II, 313, 314 and Hospital Services of the Armed Forces, Commission on, 350 Independent, 59 inquiries, general, 203 Institutions, Johns Hopkins, 168, 460 Investigator, 56, 59 journals, index to American, 113 Journals, List of American, 61 jurisprudence, teacher of, 192 legislation, inquiries on foreign, 203 Libraries assistance to, 396 deficiencies and needs of, 399 grant for regional, 402 Korean, 331 Library Assistance Act of 1965, 378, 398 appreciation of, 408 extensions of, 404 implementation of, 400 legislative support for, 399 Libraries Act of 1974, 405 Library Association, 174, 220, 304, 381 Bulletin of the, 334 Exchange, 318 president of, 316 library, largest in America, 86 library, regional, 448 Library system, Regional, 403 literature, inquiries on, 203 Magazine, 45 Motion Picture Archives, National, 433, 434 motion pictures, 433 News, 48, 146, 151 News and Library, 54 numismatics, inquiries on, 203 publications, classic, 196 publications, editors of, 402 publications, purchase of, 41 Record, 127 editorial, 120 records, 28 Register, 148 of New York and its Vicinity, 82 Medical (continued) research, grants for communication of, 397 Research Institute, 279 research, questions on, 203 research reports, U.S. military, 317 Reviews, Bibliography of, 329, 367 school, postgraduate, 360 Services, Task Force on Federal, 352 Society Alpha Omega Alpha Honor, 460 of the County of Kings, 148, 151 of the County of New York, 127, 135 of Denver, picked duplicates, 215 of Indiana, 145 of London, 135 of Pennsylvania, 164 of the State of New York, 135, 163 societies, exchanges with, 81 subject headings, 328 and Surgical History of the War of the Re- bellion, 16, 18, 26, 29, 30, 73, 79, 80, 81, 93, 105, 156, 186 and Surgical Reporter (Philadelphia), 16, 17, 54, 117 Times and Gazette, London, 48 television system, community, 437 World, 45 Medicine advancement of, 196 decentralized, 429 grants for histories of, 402 history of, 83, 179, 248, 407 Introduction to the History of, 191 LC schedule for, 322 legal, 275 papers of contemporary leaders in, 460 preventive, 444 Medicinische Annalen, 114 Mediocofilm Service, 281, 300 Medico-Legal Society of the City of New York, 81 Medinger, Elizabeth E., 286 MEDLEARN, acronym, 387 MEDLEARN, scope of, 386 MEDLARS, 368 acronym, 368 bibliographies, 375, 489 British, 379 centers abroad, 379 citations for, 382 cost of development of, 374 data base, 423, 448 decentralization of, 370, 378 demand searches, 376 free, 388 design of, 369 development of, 369 evaluation of, 377 516 INDEX MEDLARS (continued) expansion of coverage, 412 foreign exchange policy, 379 improving, 394 indexer for, 450 indexing procedure, 370 internal use of, 370 international expansion, 447-8 international programs, 379 international use of, 387 on-line test, 423 in operation, 383 photocomposer, 372 problems with, 371 programing, time required for, 370 publication system, 393 search procedure, 371 selection of literature for, 380 Swedish, 379 system, decentralization of the, 422 MEDLARS II, 388 development of, 422 from evaluation of MEDLARS, 377 projects of, 422 seven-level vocabulary, 389 MEDLARS III, planned, 390 MEDLINE, 384 access to, 385 acronym, 384 from AIM-TWX, 381 data base, 424 file, 389 international expansion, 447 replaces demand search service, 379 role in TIP, 415 scope of, 386 training needed, 387 MEDNAM, acronym, 386 scope of, 386 Mehl, John W., 478 Meigs, Charles D., 7(2) Merge with Library of Congress, proposal to, 213 Merrill, James Cushing, 252 Librarian, 186 Merritt, Doris H, 478 MESH acronym, 369 for chemical terminology, 413 for dental terminology, 443 development of, 371 for drug terminology, 412 in MEDLARS II, 389 old, 372 refinement of, 373, 443 staff group, 373 training in, 464 use of, 376, 387 MESH (continued) vocabulary, scope of, 386 Mess Kit, 224 Metabolic and Excretion Kinetics, 451 Metcalf, Keyes, D. commentary, 363 classification study, 339 consultant, 313, 352, 356 in study group, 291, 292 Methodology, educational, 440 Miami University, 124 Michael, Max, Jr., 451, 478 Michel, Representative Robert, 430 Michigan State Health Department, 393 Michigan, State Library of, 80 Michigan, University of, 378, 476(2), 479 medical school, 214 picked duplicates, 215 Microfilm, 279, 300(2), 330, 452 alternatives to, 301 copies, 290 of early books, 318 demand for, 301 service, 278 drug literature by, 412 text on, 370 Microfilming for preservation, 458 Middle States Medical Reformer and Journal of Health, 56 Middleton, J. V. D., 51 Middleton, William S., 339, 460, 461, 478 Mider, G. Burroughs, 451 Deputy Director, 462 Military Affairs, House Committee on, 227, 233 Affairs, Senate Committee on, 227, 233 Appropriations Act, 350 hospitals, books from, 21 hygiene, 174 Elements of, 245 professor of, 191, 219, 245, 249 Information, Bureau of, 216 medicine, 325 history of, 229 monographs on, 79, 325 professor of, 219 Surgeon, 226, 229 surgery, 33 Miner, Julius F., 46 Miner, Thomas, 2 Miner and Tulley, 6 Minor, Thomas, 146 Minneapolis-Honeywell 800, 369 Mississippi Valley Medical Monthly, 163 Missouri Dental Journal, 54 Missouri, University of, 341 Mitchell, George, 441 Mitchell, John Kearsley, 8 517 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Mitchell, Senator John, 154 Mitchell, S. Weir advocate, 82 autographed photographs, 191 comment, 39 contributor, 70 loans to, 214 lobbying, 151, 154, 164 novelist and neurologist, 8 quotation, 175 recommends Billings, 178, 180 Modena Medical Society, exchanges with, 81 Modern Manuscripts Collection, 461 Modules, self-teaching, 406 Mohrhardt, Foster, 443, 462, 463 Moll, Aristides A., 279 Molnar, Charles E., 478 Monocular viewer, 301 Monographs, classification for, 170 Monographs, foreign, 317 Monographs, grants for, 402 Monographs, inventory of, 322 Monographs, support for biomedical, 407 Monroe, President James, 3 Montagnana, Bartolomeo, 202 Monthly bibliography, 367 Monthly Journal of Medicine, 56, 57 Montreal Monthly Journal of Medicine and Sur- gery, 55 Moore, Surgeon General John, 175 Moore, William G., 49 Morgan, Audrey G., 225 research for patrons, 214 Morgan, John, 85 Senator John, 145, 151 Morrill, Miss, 104 Morse, Representative Leopold, 145 Morton, Leslie, T., 198 Moseley, Benjamin, 6 Motion Picture Archives, National Medical, 433, 434 Muller, Frederick, 31, 60 Mumford, L. Quincy, 292, 463, 478 Munich, University of, 76, 216, 259 Murchison, Charles, 17 Murphy, Lois, 460 Murray, Surgeon General Robert, 144, 161, 162(2), 163, 168 Museum, 26, 28, 141 Army Medical, 16, 488 birthdate, 272 Building for the Library and, 141 curator of, 161, 186, 269 Hall, 165 of Health, National Library and, 353 and Library Division, 162, 189, 236 Musser, Marc J., 478 Mussey, William H., 49, 70, 120 Myers, C. J., 103 Myers, Lt. Gen. Paul W., 478 Myoplastic Amputation. 451 N Name Authority, scope of, 386 Nancrede, Joseph, 6 Nashville Journal, 48 Nashville Journal of Medicine and Surgery, 48, 52 Nashville Monthly Record of Medicine and Physical Science, 48 Nashville, University of, 52 The Nation, 148, 151 National Academy of Sciences, 135 Aeronautics and Space Administration, 417, 427, 429 Agricultural Library, 443, 456, 462 Archives, 278, 291, 353 Association of Book Publishers, 468 Board of Health, 136, 144, 149, 154, 168 Bureau of Standards Librarv, 279, 369, 384, 454, 459 Cancer Institute, 417 Capital Park and Planning Commission, 268, 283, 384, 430 Center for Air Pollution Control, 435 Center of Biomedical Communications, Lister Hill, 384 Center for Urban and Industrial Health, 435 Drug Information Clearinghouse, 411 Environmental Protection Act, 431 Heart Institute, 368, 375 information system, 400 Institute of Arthritis and Metabolic Diseases, 375 of Health, 279 See Also National Institutes of Health of Mental Health, 426 of Neurological and Communicative Dis- orders and Stroke, 417 of Neurological Diseases and Blindness, 375, 435 for Occupational Safety and Health, 417 Institutes of Health, 319, 351, 353, 356, 394, 395, 397, 411 See Also National Institute of Health Bureau of Health Manpower, 401 Bureau of Health Resources Administra- tion, 438 construction grant programs, 401 Intelligence Authority, 317 Library Bindery Co., 299, 319 Library of Medicine, viii, 1, 343 See Also National Medical Library Acquisition Policy of the, 322 Bulletin, 490 518 INDEX National (continued) Library of Medicine (continued) cooperation with other federal libraries, 462 Current Catalog, 381, 449 divisional organization, 444 History of Medicine Division, 5 honors to staff, 471 independent agency, 353 major reorganization, 444 News, 463, 490 selected statistics, 472-3 structure revisions, 444 transferred to NIH, 401, 445 transformed into, 336, 352, 355 visitors to, 449 Library and Museum of Health, 353 Library network, 400 Medical Audiovisual Center, 421, 431, 433- 41 passim, 445-6, 457, 475 budget and personnel, 441 carrels, 440 Catalog, 436 demonstration area, 440 program, 438 reorientation of, 437 Medical Audiovisual Facility, 434 Medical Library, 25, 67 See Also National Library of Medicine catalog of, 124 decision to become, 34 early name, 48 fulfillment of name, 351 Medical Motion Picture Archives, 433, 434 Museum, 186, 212 and Smithsonian Institution, 150 Research Council Committee on the Army Medical Library, 351 Division of Medical Sciences, 351 Science Foundation, 412, 450, 463, 476, 478, 480 Survey of Historic Sites and Buildings, 360 Technical Information Service, 413, 417 Union Catalog, 323 Nations, service to AID, 449 Nationwide retrieval service, 415 Naval Medical Center, 351, 352, 353, 356 Naval Observatory, 356, 361 Naval medical department, 319 Nebinger, Andrew, 164 Nebraska Medical Center, University of, 404, 477 Nelson's Northern Lancet, 51 Nemec, Jaroslav, 471 Network biomedical communications, 419, 420 Network (continued) budget, 422, 432 components of, 422 computer-assisted instructional, 422, 424 for Continuing Medical Education, 445 of educational institutions, 424 four-station duplex, 427 four-way voice conference, 428 health education, 425 interactive television, 422 national library, 400 New Hampshire-Vermont Medical Interac- tive Television, 425 satellite, 428 science information, 388 Tymshare, 425 Networks, bibliographic, 386 Neumann, Felix, 231, 329 biographical, 237 research for patrons, 214 retired, 247 servicing inquiries, 203 translations, 205 New building, 283 authorization for, 394 campaign for, 311, 349 legislation for, 282, 283 locations considered for, 356 move to, 316 proposed, 291 New England Journal of Medicine and Surgery and the Col- lateral Branches of Science, 45 Medical Center, 476 Medical Gazette, 54, 59 Medical Review and Journal, 45 Quarterly Journal of Medicine and Surgery, 45 New Hampshire, 148, 260 Central Medical Society, 151 Medical Journal, 56 Medical Society, 145 State Library, 80 picked duplicates, 215 -Vermont Medical Interactive Television Network, 425 New Jersey, 148 Medical Society, resolutions, 163 New Orleans Medical News and Hospital Gazette, 45 Medical Record, 45, 52 Medical and Surgical Journal, 8, 45(2), 52 54 Monthly Medical Register, 45 New York Academy of Medicine, 154, 275, 292, 319, 477 library, 176 City University of, 475, 477 College of Pharmacy, 99 519 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE New York (continued) Eclectic Medical Journal, 56 Historical Society library, 80 Hospital Library, 6, 80, 99 Journal Association, 79 Journal of Medicine and the Collateral Sci- ences, 7, 8, 46 Medical Record, 117 Medical Society of the County of, 127 Medical Society of the State of, 163 Medical and Surgical Reporter, 54, 61 Post Graduate Medical School, 244, 249 Public Library, 178, 292 Billings' plan for, 178 exchanges with SGL, 179 State library of, 80 picked duplicates, 215 University School of Medicine, 438 Newberry Library, 176, 363 Newburn, Loren R., 448 Newton, Robert S., 58, 59, 70, 120 Nichol, William L., 48 Niess, Maj. Gen. Oliver K., 478 Nightingale, Florence, 173 Nixon, President Richard, 404 NMAC, See National Medical Audiovisual Cen- ter Noble, Robert Ernest, 242, 252(2) Nomenclature, standard, 401 Norris, Helen, 339 North Africa, 260 North American Journal of Homeopathy, 59 North American Medico-Chirurgical Review, 54 North Carolina Medical Journal, 145 North Carolina, University of, 361, 478 School of Medicine, 479 Northern Lancet and Gazette of Legal Medi- cine, 55 Northwestern University, 243, 337, 338, 479 Dental School, 443, 479 Medical School, 151, 210, 275 Noyes, Henry D., quotation, 129 Numerals, Arabic, 262 Numismatics, medical, 203 Nursing, schools of, 435 O Oak Ridge National Laboratory, 415 O'Brien, Representative Leo W., 354, 466 bill, 355 O'Connor, Robert B., 356 and Kilham, 420 Office of Alien Property Custodian, 289 of Audiovisual Education Development, 438 Office (continued) Billings', 91-2 inventory of, 92 of Computer and Communications Services, 445 of Education, 399 of Malaria Control in War Areas, 433 of Management and Budget, 430 of Science and Technology, 379, 398-9, 400, 462 of the Surgeon General of PHS, 445 Officers, assistance in indexing by, 113 Officers Reserve Corps, 224 Offices for authors, 444 Ogle, Maj. Gen. D. C, 478 Ohio Medical and Surgical Journal, 48, 53 Ohio Medical and Surgical Reporter, 59 Ohio State University, 314, 378, 425 College of Medicine, 315 computer courses, 424 Oklahoma Medical Research Foundation, 480 Oklahoma, University of, 394, 479 Olch, Peter D., 373, 460(3), 461(2), 472 O'Leary, Charles, 151 Oley, Commander John A., 352 plans for Bethesda building, 356 Olszewski, George J., 490 On-line audiovisuals, 439 bilbiographic data files, other, 417 bibliographic retrieval system, 423 computer serials control system, 401 retrieval system, 422, 424 service, fees for, 388 systems, 384 frequency of use, 386 training for use, 387 Oral history program, 461 Oral Research Abstracts, 450 ORBIT, 423, 424 O'Reilly, Surgeon General Robert O., 187, 189 Orfila, 6 Organization for Economic Cooperation and Development, 379 Environmental Information Panel, 448 Osborn, Andrew D., 292, 339 Osier, William, 70, 191, 194, 205, 212 loans to, 214 quotations, 103, 123, 130, 136, 191, 192 Osteopathy, schools of, 435 Ostertag, A., 100 Otis Archives, 488 Otis, George A., 18, 19, 26, 28, 161 curator, 21 Owen, William O., 232 Plans for Library Building, 232 Owen's Dream, 232 Oxman, Michael, 417 520 INDEX P Pacific Medical Center School of Medical Sci- ence, 438 Pakistan, translating and printing activities in, 451 Pamphlets, 92 binding of, 92, 320 cataloging and arranging of, 239 donation of, 182 gifts and exchanges of, 176 medical, 45 statistics of Library, 177 Pan American Federation of Associations of Medical Schools, 448 Pan American Health Organization Advisory Committee on Medical Research, 448 Pan American Sanitary Bureau, 279, 282, 302 Papers of contemporary leaders in medicine 460 Paris, John A., 6 Paris, Medical Faculty of, 76, 228 Parkes, Hygiene, 18 Hygiene Museum, 81 Parkinson Information Center, 382 Parrish, Joseph, 18, 70 Partridge, James, letter to, 60 Parvin, Theophilus, 100, 145, 151 letter to, 137 Passano, William N., 456 Patent Office Library, 229 Pathology, 226 Armed Forces Institute of, 319, 343, 347, 360 361 forensic, 438 Patterson, Surgeon General Robert A., 263, 264, 265, 267, 268, 302, 478 Pearne, Thomas, letter to, 60 Pearson, Karl, loans, 214 Peckham, A. W., 182 Peele, Representative Stanton, 145 Peete, Dr. G. W, 50 Pennsylvania, 148 Hospital Library, 6 Medical Society, 151, 164 Railroad, 171 University of, 178, 215, 311, 414, 478 Library, 363 Medical School, 85, 185, 186 provost, 175 Pension Building, 164 Pension and Record Division, 28, 153, 165 Pension records, 28, 226(2) Civil War, 153 Peoples Medical Gazette, 56 Pepper, William, 97, 144, 145, 179 laboratory for research in clinical medicine, 176 Pepper, William (continued) provost, 175 Pereira, Jonathan, 7 Periodic bibliography, 413 production system for, 375 Periodic book catalogs, 381 Periodicals bound, 113, 226 German wartime, 317 indexes, 111, 179 medical, 2 need for a complete collection of, 118 standard, 7 Thomsonian, botanic, eclectic, and homeo- pathic, 59 Perkins, Fred B., 118 Perrin, Glover, 51 Pershing, General John, 249, 271 Personal loans, 202 Peter Bent Brigham Hospital, 179, 264 Peters, John C, 70, 118 Pfender, Charles A., 214 Phalen, James Matthew, 181, 253, 284 Librarian, 243 Pharmaceutical Manufacturers' Association, 412 Pharmacology, literature on, 206 Pharmacy, 243 schools of, 435 Philadelphia, 145 Almshouse Library, 6 Billings' move to, 176 College of Pharmacy and Sciences, 81 College of Physicians, 82, 86, 176, 275, 319 Conference on Librarians in, 121 County Medical Society, 148, 151 Medical Museum, 203 Medical Times, 114, 117(2), 144, 148 Surgical and Medical Reporter, 97 University Journal of Medicine and Surgery, 58, 59 Philippine Islands, 190, 192, 198, 205, 219, 224, 240, 241, 242, 244, 245, 248, 249, 251, 253, 259, 271, 311, 316 Phillips, Harlan, 461(2) Philosophical Society of Washington, 174, 192 Philosophical Transactions of the Royal Society, 203 Phinney, F. D., 72 Phoenix Iron Works, 180 Photocomposer, 369 Photocomposition, 389 Photocopy suit, 456 Photocopying, 457 Photoduplication Service, 300(2), 330, 453 Photographs, 205-6 autographed, 191, of incunabula, 231, 296 of physicians, 219, 239 521 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Photographs (continued) and medical subjects, 319 Photon Co., 372 Photon Zip 901, 373 Photoprints, 301, 330 Photostats, 301 Physician General, 1 Physicians American College of, 445 Annual, 42 botanic, Thomsonian, eclectic, and homeo- pathic, 57 famous, 214 lending to civilian, 97 photographs, 191, 219, 239, 319 portraits, 191 sketches of American, 244 visiting, 263 Physio-Medical Recorder, 59 Pierce, Representative Henry, 124 Pilcher, James E., 181 Piotroski, Jerzy K., 451 Pirrie, William, 7 Pittsburgh, University of, 414 Pituitary Insufficiency due to Postpartum Ne- crosis, Anterior, 377 Pixley, Lt. Gen. Charles C, 478 Plan for a Post Hospital of Twenty-four Beds, 79 Plane tree on the Island of Cos, 358 Planning Commission, National Capital, 430 Plattsburgh Reflex, 224 Pletcher, Lt. Gen. Kenneth E., 478 Plumb, Senator Preston, 154 Podiatry, schools of, 435 Poland, 387, 396, 450, 451 Polish medicine, inquiries on, 203 Polish Ministry of Health, 450 Polish translations, 205 Polish-U.S. Joint Committee for Cooperation in the Field of Health, 452 Pollitzer, Robert, 444 Poole, William, letter, 155 Pooley, J. H, 82 Poradnik Weterynaryjny, 168 Porcher, F. Peyre, 67, 70 Porcher, Peter, 50, 51 Portrait collection, 82, 275, 319 reorganized, 296 Portraits, 319 of former directors, 465 inquiries on, 203 repairs to, 276 Union List of Medica], 275 Portugese translations, 205 Postmasters, letters to, 56 Potter, Representative Orlando, 164 Power, Surgical Anatomy, 8 Power, D'Arcy, 191 Practitioner, London, 48 Preservation, future of textual, 459 Preservation, microfilming books and journals for, 456, 458 President's Commission on Heart Disease, Can- cer, and Stroke, 399, 411 President's Science Advisory Committee, 413 Preventive medicine, 444 first school of, 174 oldest school of, 188 Price, David E, 339 Prices, institutional, 457 Priest, Representative Percy, 355(2) Principal Assistant Librarian, 192, 248 Principal Librarian, 247 Pringle, John, 1 Print collection, portrait and, 319 Printed catalogs, 111 Print activities, 451 Printing, cost of, 137 Printing, error-free, 131 Prisons, reports on, 73 Private support for libraries, 402 Program, card input, 376 Programs, international, 447 Programs, support, 396 Proofreading, 131 linguistic assistance in, 131 Proudman, Sheila, 489 Providence Hospital, 200 Public Building Commission, 232 Building Service, 356 Buildings Administration, 346 Buildings Commission, 262 Buildings and Grounds, House Committee on, 144 card catalog, 239 documents, 202 health, first school of, 174 Health Service, 191, 353, 355, 429, 433((2), 434 Communicable Disease Center, 420, 434 health communication activities, 420 Medical Audiovisual Branch, 420 Office of the Surgeon General, 445 Law 480 library building, D.C., 212 Printer, 119, 127 Service suspended, 349 works, 265, 266 Administration, 283 appropriations, 267 program, 264 Publications budget, 2, 3 classical medical, 196 damage to, 203 editors of medical, 402 522 INDEX Publications (continued) European, 221 French military, 224 grants for biomedical, 402 Medica] Department, 79 purchase of, 41, 191 system of payment for, 222 and Translations Division, 398 water damage to, 347, 348-9 Publishers Weekly, 137 Puerto Rico, 242 University of, 460, 475 Punched cards, 365 tabulation equipment, 325, 466 Purchase of medical publications, 41 Purchasing, responsibility for, 29 Purdue University, 478 Purdy, Alfred E. M., 82 letter, 79 quotation, 130 Purkyne, book by, 219 Purple, Samuel Smith, 43, 70 Putnam, Herbert, 205, 264, 265, 267, 268, 282 Pyrwes, Moshe, 451 Q Quain, Jones, 7 Quarantine, 117 stations, reports of, 73 Quarterly Cumulative Index Medicus, 248, 249, 250(2), 251 262, 281, 367(2) Queries, answering, 191 Query-response, TIP, 415 R Ramsay, Secretary of War Alexander, 142 Rand Corp., 389(2), 425, 475 Randall, Burton, 49 Randall, Representative Samuel, 121, 163, 164(2) Randolph, John F., 42, 45, 52, 73 Random access, 369 Rapid communication of biomedical data, 406 Rare books, 91, 296 classification of, 297 curator of, 297 division, 292 for History of Medicine Division, 465 loaned, 219 plan for rebinding, 298 restoration and binding of, 317 shelf-list of, 297 Rare works, purchase of, 222 Rauch, John, 71 Ravdin, Isador, S., 478 Ravenel, Mazyck P., loans to, 214 Ravenell, H. W, 39 R&D grants, 401 Readers, number of, 171 Readers, rules for, 172 Readers, service to, 191 Reading room, 170, 226, 334 Rebinding, 297 RECON satellite system, NASA's, 417 Recataloging, 322, 323 Record and Pension Division, 28, 168, 206 Records of Army Medical Library, 488-9 Records, pension and medical, 28 Recurring bibliographies, 375, 449 production system, 375 Red Cross, 319 Reed, Major Walter, 252, 360 curator of the museum, 174, 186 Librarian, 187 Reeves, James, 71, 151 Reference service, 103 international, 203 References, cross, 373 References, unpublished, 324, 325 Referral service, biomedical, 420 Referral Service, UN Environmental Program International, 448 Regents, Board of, 353, 355(2), 356, 388, 395, 398, 401, 419, 426, 430, 437, 438, 444, 453, 464, 489 members, 475 Subcommittee for Extramural Programs, 400 Subcommittee on Research, 389 Regional libraries, funding of, 407 medical libraries, grant for, 402 medical library, 448 system, 403 Register, 38, 91, 171 Registered National Historic Landmark, 360 Registration number, 91 Registry numbers of drugs, 412 Registry of toxic effects of chemical substances, 417 Reid, John, 39 Remote access systems, 423 Remote Information Systems Center, 423 Removal of the library, rumors of, 217 Renovation of the library building, 347 Reorganization, major, 444 Repairs, routine, 208 Report on Amputations at the Hip-joint in Mil- itary Surgery, 79 Report on Barracks and Hospitals, with De- scriptions of Military Posts, 34, 79, 142 Report on Epidemic Cholera in the Army of the United States During the Year 1866, 79 Report on the Hygiene of the U.S. Army, 105 Report of Surgical Cases Treated in the Army of the United States from 1865 to 1871, 79 Reports annual, 490 523 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Reports (continued) binding of, 92 U.S. military medical research, 317 Reproductions, license for single-copy, 457 Requests, form letter for, 80 Requisition procedure, 171 Research agreements in Egypt, 451 Center in biomedical communications, 420 and Development, 394, 419, 444 grants for, 446 lack of interest in, 134 for patrons, 214 and Training Division, 398 Researcher, hired, 204 Researchers, 104 Researchers, communication patterns among, 401 Resolutions by state medical societies, 151 Resolutions in support of the building, 151 Resource centers, learning, 406 Resource grants, 401 Resource improvement grant, 406 Resource projects grant, 406 Resources, grants for, 446 Retrieval of biomedical information, storage of, 406 Retrieval, interactive, 389 Retrieval program, 424 Retrieval, selective, 365 Retrieval service, nationwide, 415 Retrieval service, on-line, 379 Retrieval systems, 367 analysis and, 373 on-line, 386, 422, 424 on-line bibliographic, 423 scope of, 386 time-shared, 422, 423 upgrading of, 387 Retrospect of Medicine, 7-8 Reviews, critical, 451 grants for, 402 support for, 407 Reynolds, R. M, 51 Reynolds, Surgeon General Charles, 274, 282(2), 283, 302 Rhees, William James, 19 Ribicoff, Secretary Abraham, 357 de Ricci, Seymour, 318 Rice, Charles N., 131, 414 quotation, 130 Richardson, Tobias, 151, 152 Richmond, Julius B., 478 Ridout, Dr., 49 Riggs and Co., 16, 91 move from, 29 Riley, C. N., 39 Riley, John, 71 Ripley, S. Dillon, 361 Robertson, D., 55 Robertson, Dr. Frank, 50 Robertson, William, 151 Robinson, Mrs. Breed, 341 Robinson, Victor, 459-60 Roby, Joseph, 83 Rochester, Thomas F., 46, 71 Rochester, University of, 475 Rockefeller Foundation, 282, 291, 292, 304, 322, 355 Yellow Fever Commission, 242 Rockefeller, Nelson, 302 Rockingham Memorial Hospital, 427 Rodenbaugh, T. F., 489 Roehrig, F. L. O., 29 Rogers, Frank Bradway, 311 awards to, 316 Billings papers, 489 Director, 314-72 passim, 395, 397(2), 411, 433, 444, 452, 454, 458, 459, 462, 463, 464, 466 portrait of, 465 Rogers, Representative Paul, 420, 430 Rogers, William B., 179 Rokitansky, Carl, 7 Rolleston, Sir Humphry Davy, 269, 274(2) Roosa, D. B. St. John, 120 Roosevelt James, 264 President Franklin, 264, 265, 274, 283, 284 letters to, 264, 265, 268 quotations, 266, 267, 268(2) President Theodore, 186, 228 Sara Delano, 264 Rose, Lewis H., death of, 216 Rosecrans, Representative William, 163 Bill, 163, 164 Rostock, University of, 76 Roth, George B., 279 Rous, F. Peyton, loans to, 214 Royal College of Physicians, London, 92, 134, 274 Royal College of Surgeons of England, 194, 466 Royalty, photocopy, 456 RTECS, acronym, 417 RTECS, scope of, 386 Rules for lending, 172 Rules for readers, 172 Rush, Benjamin, 1, 7 Russell, Frederick, 360 Russian, 186 literature, 450 medicine, inquiries on, 203 Scientific Translation Program, 396 translations, 205 S Sage, Cary R., 203, 214 Saigon, University of, 448 524 INDEX St. John, Francis R., 295, 296, 339 biographical, 306 Saint Joseph Medical Journal, 47 St. Louis Courier of Medicine, 151 Medical College, 194, 241 Medical Reporter, 47 Medical Society, 148, 163 Medical and Surgical Journal, 47 University Medical School, 194, 271 Salaries, comparative, 221 Salaries, low, 225 Salaries of staff, 209 Sanford, J. F., 56 San Francisco Medical Journal, 45 San Francisco Medical Press, 45 Sanitariums, reports of, 73 Sanitary associations, reports of voluntary, 73 Sanitary Bureau of the Pan American Union, 282 Sanitary Commission, 21 Sargent, Minor Surgery, 18 Satellite communication, 422 system, 427 Satellite, Communications Technology, 429 Satellite network, 428 Satellites Application Technology, 427 biomedical communication by, 427 education via, 427 medical assistance via, 427 in WAMI, use of, 429 Saunders, H. J., 55 Savage, Howard M., 224 Sayler, Representative Morton, 124, 127 Sayre, Lewis, 71 Scheele, Surgeon General Leonard, 354 Schmidt, L. W., 67, 76 Scholars-in-Residence Program, 444 School of Library Science, Columbia Univer- sity, 408 School of Medicine, New York University, 438 Schoolman, Harold M., 439, 447 Schroder, J., 68 Schullian, Dorothy May, 299, 329, 335 biographical, 308 Schuman, Henry, 330 Schuppert, Moritz, 50, 71 Sciaky, Ino, 450 Science Citation Index, 415 communication, entering, 397 Information Exchange, 418, 444 Scientific and technological information, 396 Scope and Coverage, Committee on, 321 Scope, books out-of-, 321 Scope, documents out-of-, 344 Scope of Library, 40 Scope of retrieval systems, 386 Scott, Eugene W., 339 Scott, General Winfield, 27 Scouts, book, 42, 50, 58, 75 Scranton, Representative Joseph, 145 Scudder, John, 71 SDLINE, acronym, 386 SDLINE, scope, 386 Search procedures, 376 Search service, MEDLARS, free demand, 388 Search system, whole text computerized, 415 Searches, demand, 376(2) Searches, distribution of literature, 377 Searches, numbers of, 380 Searching, interactive, 389 Secondary literature aids, support for, 407 Secretary of Health Gines Navarro Diaz de Leon, 448 Seibert, Dean, 426 Seidell, Atherton-, 279(2), 281(2), 302, 330, 341 interpretation of, 308 quotation, 300 Selden, William, 49 Selective retrieval of bibliographic data, 365 Self-instruction materials, 401 Self-teaching modules, 406 Semple, J. E., 73 Senate Committee on Appropriations, 148, 396 Senate Committee on Military Affairs, 227, 233 Senn, Milton, 460 Senn, Nicholas, 71 Serial record data bank, computer-based na- tional, 463 Serials control system, on-line computer, 401 Serials, inventory, 322 Serials, old, 322 Serials, world medical, 324 SERLINE, acronym, 386 SERLINE, scope, 386 Service to AID nations, 449 Service, demand for library, 239 Service, fees for on-line, 388 Service, hours of, 97, 201, 221 Library of Congress, 227 Service, providing, 330 Service, Sunday, 289 Services, contracts for, 407 Services, demand for library, 289 Services to developing countries, 449 Services, essential, 239 Services of the Library, 91 Severance, Robert W., 352 Sewell, Winifred, 371, 411 Shallenberger, Representative William, 144, 150 Shannon, James A., 394, 399, 401, 413 Sharp, Dr., 51 Shattuck, George, 212 Shaw, Edward, 93, 208 Shaw, Ralph Robert, 295, 339, 462 biographical, 306 Shelf list, 226 absence of, 293 525 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Shelf list (continued) of rare books, 297 Shelf listing, 295, 311, 322 unit, emergency, 291 Shelf space, 206 Shelved, double, 91 Shelves, wood, 91 Shelving journals, 92 Sheppard, Senator Morris, 283 Sheps, Cecil G., 478 Shingling, 326, 365 Shoemaker, John V., 145 Shrady, George F., 71, 127 Shufeldt, Maj. Robert W., 233 Shumway, Norman P., 374, 472 Sim, Frank L., 163 Simmons, George H., 249, 488 Simmons, Ralph A., 384, 389, 423, 472 Simons, Manning, 50 Simpson, Joshua, 51, 73 Single-copy reproductions, license for, 457 Singleton, Representative James, 129, 144 Skilton, Julius A-, 61 Sklodowska-Curie, Marie, Joint Fund, 452 Sloan, William J., 42, 49 Slocum, Representative Henry, 151 Slush fund, 39 Smart, Charles, 52, 117 letters to Billings, 43-5, 114 quotation, 141 Smith, Andrew H., 71 Smith, Andrew K., 42, 45, 97 Smith, Austin, 339 Smith bill, 354 Smith, Dr. N., 49 Smith, James R., 18 Smith, Joseph, 113 Smith, Joseph R., 162 Smith, Kathryn M., 479 Smith, Nathan R., 71 Smith, Robert W., 7 Smith, Senator H. Alexander, 353 Smith, Stephen, 18, 71 Smith, Winford, 251 Smithsonian Institution, 97, 164, 352, 354, 361, 373 National Museum and, 150 Science Information Exchange, 418, 444 Smoot, Reed, 262 Snow, Edwin M., 73 Society of Medical Officers of Health, London, 135 Society for Research in Child Development, 460 Soldiers' Home, 105, 186, 356 Soleure, Switzerland, Gymnasium, 209 Solis-Cohen, Solomon, loans to, 214 Sommer, Francis Erich, 329, 335 biographical, 340 Soper, Fred L., 444, 460 South Carolina, Medical College of, 145 South Carolina, State Library of, 80 Southern Dental Examiner, 45 Southern Botanico-Medical College Journal, 58 Southern Medical Reformer and Review, 59 Southern Medical and Surgical Journal, 45(2), 48, 52 Sparkman, Senator John, 421 Space, expanded, 291 Space, lack of, 292 Space problems, 207, 277, 343-4, 420 Space, rearranged, 291 Space, rented, 420 Space squeeze, 226 Spanish, books in, 205 Spanish translations, 205 Special assistant to the Director, 447 Special foreign currency program, 449, 452 scope, 450 Special scientific projects, grants for, 402 Specimen Fasciculus of a Catalogue, 119, 122 Spector, Benjamin, 336, 341, 479 Spencer, William C, 19, 25, 113 Spittoons, 173 Spivac, C. D., 182 Spofford, Ainsworth, 154, 155, 156, 212, 462 Spooner, Representative Henry, 151 Squibb, Edward R., 71 Stack area for documents, 226 Stack area for journals, 226 Stacks, buckling, 347 Stacks, capacity of, 166, 167 Stacks, iron, 91, 206 Stacks, open, 94 Stacks permission, 172 Stacks, roofs on, 345 Stadel, William W., 479 Staff, ages of, 208 Staff, authorized, 474 Staff, divisions and sections, 295 Staff in the 1920's, 246 Staff, Library, 269 Staff members, biographies of, 487 Staff, organization of, 284 Staff, responsibilities of, 170 Staff salaries, 209, 269 Staff, size of, 299 Staff unrest, 312 Standard nomenclature, 401 Stanton, Edwin, 18 Star Shell, 224 Starling Medical College library, 80 State Department, 379 Agency for International Development, 449 State Serum Institute of Denmark, 393 State University of New York at Syracuse, 385, 423 Statistical publications, classification of, 297 Statistical works in Cleveland, 297 526 INDEX Statistics, 473 of Library holdings, 177 variety of, 473 Stecher, Robert M., 336, 341(3), 479 Stechert, G. E, 82 Steel shelves, 343 Steele, James, 443 Steigers, Alonzo Frank, 194 Steiner, Lewis, 71, 126, 137 Steinfeld, Jesse L., 479 Steinmetz, William R., 114 Stephan, Faith, 443 Sternberg, Surgeon General George M., 174, 186(2), 187, 188, 211 Stevens, B. F., 75 Stevens, Edward, 71 Stewart, William H, 479 Stille, Therapeutics, 18 Stokes, William, 182 Stockman, Frank John, 229, 235, 248 biographical, 256 servicing inquiries, 203 translations, 205 Stockslager, Representative Strother, 114, 163, 164(2) Stockton-Hough, John, 231 letter to, 100 Stokes, William, 7(2) Stoll, Rolf, 304 Stone, Frederick W., 31, 93, 103, 225 died, 235 Storage and retrieval of biomedical information, 406 Storage, wartime, 296 Straub, Col. Paul Frederick, 229, 252 biographical, 239 Streeter, Edward C, 252 Stribling, Francis, 71 Study, John Shaw Billings', 465 Subheads, reinstated, 373 Subject catalog, 111 Subject classification, 248(2) Subject headings, 94 Subject indexes, 111 preference for, 111 Sullivan, Michael X., 279 Sullivant, Mr., 53 SUNY, 423, 424 Superintendent of Documents, 230 Supreme Court decision, 457 Support of journals, grants for, 402 Support programs, 396 Surgeon General title, 1 Billings' candidacy for, 161, 175 Office of first librarian, 23 history of the administration of the, 229 Library of, 1 Surgeons, American College of, 445 Surgeons General Barnes, Joseph K., 18, 118, 144(2), 161, 168 Bliss, Raymond, 324, 352 Burney, Leroy, 357, 395 Crane, Charles, 144, 150, 161, 168 Finley, Clement Alexander, 15 Gorgas, William, 221, 227, 229, 232, 233, 242 Hammond, William Alexander, 16(2) Ireland, Merritte W., 233, 239, 244, 245, 251 Kirk, Norman T., 292, 296, 302, 311 Lawson, Thomas, 3, 7, 273 Lovell, Joseph, 1, 273 Magee, James C, 272, 284 McNarney, Joseph, 350 Moore, John, 175 Murray, Robert, 144, 162, 163, 168 O'Reilly, Robert, 187, 189 Patterson, Robert, 263, 265, 267, 268, 302 Reynolds, Charles, 274, 282(2), 283, 302 Scheele, Leonard, 354 Sternberg, George M., 174, 186(2), 188, 211 Sutherland, Charles, 175, 187 Terry, Luther, 393, 397, 419, 466, 479 Torney, George, 191, 198 Surgical Records, Division of, 28 Survey of interlibrary loan operation, 454 Survey of the Army Medical Library, report of 294 Surveyors, report of the, 314 Sutherland, Charles, 51, 92, 162 Surgeon General, 175, 187 Sweden, 387 Swedish MEDLARS, 379 Swedish translations, 205 Swiss, 231(2) Switzerland, 387 Sydenham Hospital of Baltimore, 460 Sydenham, Thomas, 1 Symposium, "Books and Medicine," 358 Synonym matching, 413 Syracuse Medical and Surgical Journal, 56, 59 Syracuse, State University of New York at, 385, 423 System, analysis and retrieval, 373 System Development Corp., 384, 389(2), 423, 424 System, mechanized, stages of, 366 System, retrieval, 367 Systems, automated, 406 Systems of communication, 396 Systems, on-line, 384 frequency of use, 386 retrieval, 386 training for use of, 387 Systems, retrieval, upgrading of, 387 Systems, scope of retrieval, 386 Szent-Gyorgy, Albert, 461 527 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE T Tager, Morris, 451, 479 Taine, Seymour Irving, 326, 328, 329, 336, 340, 365, 368, 369, 372, 375, 456 biographical, 340 Talbot, I. Tisdale, 54 Tampa Hall, 326, 343, 344, 347 Task Force on Automation and Other Cooper- ative Services, 463 Task Force on Federal Medical Services, 352 Tasker, Maj. Arthur Newman, 248 biographical, 249 Taube, Mortimer, 339 Taylor, Alfred S., 16 Taylor, Kanardy Leslie, 331, 351 biographical, 337 Librarian, 316 Taylor, Lt. Gen. Richard R., 479 Taylor, Morse K., 51 Technical Services Division, 381 Technological information, scientific and, 396 Telephone, pay, 208 Telephones, interoffice, 291 Teletypewriter Exchange Network, 384 Teletypewriter Exchange System, 423 Television, educational, 426 Television network, interactive, 422 Television system, community medical, 437 Tempo F, 228 Temporary buildings, 343, 344 Temporary wing, proposed, 278 Terry, Surgeon General Luther, 393, 397, 419, 466, 479 Tessier, P. O, 53 Tessier, Xavier, 53 Teuscher, George W., 443, 479 Texas A & M, 219 Texas Christian University, picked duplicates, 215 Texas Medical Center, 378 Texas Medical Journal, 51 Texas, University of, Graduate School of Bio- medical Sciences, 478 Thayer, William S., 182 Theses, 474 French, 317 numbers of, 79 statistics of library, 177 Thoma, George, 459 Thomas, Amos R., 58, 59 Thomas, W. G, 50 Thomas, James C, 144 Thomas, Robert, 1 Thomson, Anthony T., 6 Thomson, William, 75 Thomsonian journal, 58(2), 59(2) Thomsonian physicians, 57 Thomsonian Recorder, 59 Thornton, Robert J., 6 Thorpe, Francis N., 181 Tibbetts, Edgar A., linguist, 216 Tilden, H. A, 54 Tilton, James, 81 Time-shared retrieval system, 422, 42.3 TIPCOM, acronym, 414 Tissue Culture Association, 438 Title indexes, 111 Toepper, Charles G., 201, 224 biographical, 305 research for patrons, 214 retired, 290 Toner, Joseph, 42, 47, 71, 113, 126(2) Torney, Surgeon General George H., 191, 198 Town, Francis L., 48 letters of Billings, 46, 47 Towner, Lt. Gen. Alonzo A., 479 Townsend, Frank M., 361 Townsend, John L., 479 TOXBACK, acronym, 386 TOXBACK, scope, 386 Toxic effects of chemical substances, registrv of, 417 Toxicity Bibliography, 413, 415 Toxicology data bank, 417 Toxicology Information Program, 394, 413, 414, 415, 431, 444 Toxicology Research Projects Directory, 418 Toxicology testing-in-progress, 417 TOXICON, acronym, 415 TOXLINE, 387, 417(2) acronym, 416 scope, 386 Tox-Tips, acronym, 417 Toynbee, Diseases of the Ears, 18 Training Division, Research and, 398 Training, in house, 464 Training grants, 402, 446 program, 407 Training programs for librarians, 463 Training programs, graduates of, 464 Transactions of the Belmont Medical Society, 57 Transactions of the Maine Medical Society, 46 Transactions of the New York State Medical So- ciety, 46 Transactions of the Pathological Society of Phil- adelphia, 114 Transactions of the Society of Biology, 116 Transactions, statistics of library, 177 Translating, 290 unit, 291 Translation activities, 451 Translation program, 450 Translations, 205, 396 Division, Publications and, 398 of foreign medical books, grants for, 402 Russian, 450 Yugoslav, 450 528 INDEX Translators, 104 Tree structures, 373 Trouble Buster, 224 Trowbridge. Tillman C, 72 Trucksess, Frederick C, 469 Triibner, 31, 60 letter to Billings, 60 Tucker, Harold W., 331 Tufts University, 479 Tulane University, 292, 436 School of Medicine, 477 Tulley, William, 2 Tunisia, translation and printing activities in, 451 Turnbull, Helen, 320 Tweedie, Alexander, 17 TWX, 423 Tymshare, 384, 424, 425 network, 415 Typhoid, 188 vaccine, 360 Typography, difficult, 131 Typography, electronic, 375 Tyson, J., loans to, 214 U UN Environmental Program International Re- ferral Service, 448 UNESCO/UNISIST, 448 Union Journal of Medicine, 57 Union List of Medical Portraits, 275 Union List of Serials, 294, 296 Union Medical Journal, 56 Unlisted Drugs, 411 United Kingdom, 387 United States Book Exchange, 344, 448 —Israel Binational Science Foundation, 451 —Polish Joint Committee for Cooperation in the Field of Health, 452 —Yugoslavia Joint Board on Scientific and Technical Cooperation, 451 Univers Medicale, 117 Universities Associated for Research and Edu- cation in Pathology, 447 Upjohn Co., 477 Upper Canada Journal of Medical, Surgical and Physical Science, 55 Upper Canada Medical Journal, 55 Urban community health, interorganizational aspects of, 402 Utah, University of, 476 V V-mail equipment, 300, 322, 330(2), 452 Vacuum cleaner, 286 Valk, William L., 479 Valley, Sharon, 415, 471 Van Dellen, Theodore, 479 Van Deusen, Edward H, 73 Van Duzen, A. C, 51 Van Slyke, Donald D., 461 Van de Warker, Edward Ely, 57(2) letter to, 128 Vanderbilt University, 311 Vandervoort, John L., 118 Vasta, Bruno M., 417 Vattier, John, 71 Vaughan, Victor C., 228 quotations, 213, 214 Venneri, Arthur, 356, 363 Vermont Medical School, University of, 427 Vermont-New Hampshire Medical Interactive Television Network, 425 Vesalius, works of, 299 Veterans, 208 Administration, 476(2), 478(2) libraries, 317, 323 Veterinary Advisor, 168 Veterinary literature, 443 Veterinary medicine, 444 schools of, 435 Vevan, Mr., 3 Videotapes, 433, 439 Viets, Henry, 304, 341(4), 350 Viewer, monocular, 301 Violation of copyright laws, 452 Virchow, Rudolph, 17, 18 Virginia Medical Journal, 9 Virginia, Medical School of, 190 Virginia, University of, 187 Visitors to National Library of Medicine, 449 Vocabulary file, seven-level, 389 Vocabulary for MESH, dental, 443 Volker, Joseph F., 421, 479 Voluntary sanitary associations, reports of, 73 Volwiler, Ernest H., 479 Voorhees, Senator Daniel, 151 W Wagman, Federick H., 479 Wagstaff, William R, 62 Walker, Francis A., quotation, 178 Walter Reed Hospital, 220, 233, 244, 254, 267, 268(2), 316 Walter Reed Medical Center, 246, 263, 292, 352, 360, 488 WAMI, acronym, 429 WAMI program, expansion of, 430 WAMI, use of satellites in, 429 Wangensteen, Owen, 461 Want lists, 43, 45, 49, 53, 59, 60, 68, 79, 113, 281, 319 Ward Healer, 224 Waring, George E., Jr., 179 Warren, Edward, 71 529 A HISTORY OF THE NATIONAL LIBRARY OF MEDICINE Warren, Shields, 461 Wartime publications, 318, 326 Waserman, Manfred J., 460(4), 471, 489 Washington, 192, 195, 250, 252 Auditorium, 291 Planograph Co., 281 Society for the Blind, 347 Sunday Herald, 156 University of, 429, 478 School of Medicine, 341, 362, 429, 477 Water damage to publications, 347, 349 Waterbury, Conn., Medical Association, 81 Watson, Beriah A., 163 Watson, Thomas, 7, 16, 18 Watt, James, 368 Wayne State University, 480 Weather data, 8 Webster, English Dictionary, 18 Webster, Warren, 45 letter to, 43 Weed, Lewis H., 339 Weeds, James F., 42 quotation, 48 Weinberg, Ethel, 479 Weins, Muriel, 434 Weisel, Daniel, 117 Weiss, Marian, 451 Welch, S. M., 50 Welch Medical Library, 248, 253, 261 Welch, William Henry, 71, 132, 189, 191, 194, 228, 251, 253, 254, 259, 265 loans to, 214 quotation, 188 Wells, Warner L., 479 Wesley, William, 31 Wesleyan University, 249 West India Quarterly Magazine, 61 West, Kelly M., 479 West Virginia Board of Health, 151 Western Homeopathic Observer, 59 Western Journal of the Medical and Physical Sciences, 48, 49 Western Journals of Medicine and Surgery, 48 Western Lancet, 46, 48, 117 Western Medical Gazette, 54 Western Medico Chirurgical Journal, 56 Western Reserve University, 305, 306, 308, 338 School of Library Science, 362 Western Union Datacom System, 384 White, James P., 46, 71 White, Robert H., 113, 117 White, Samuel S., 54 White, William A., loans to, 214 White, William L., 279 Whitney, James L., quotation of, 121 Whittock, John M., Jr., 339 Whole text computerized search system, 415 Wiggins, Emilie V., 471 Wiley, Harvey, 194 Wilkes, Charles, 30 Williams College, 307 Williams, James F. II, 480 Williams, Martha E., 480 Williams & Wilkins, 456(2), 457(2) Williamson, Alex., 88 Wilson, Col. John, 165 Wilson, JohnT., 480 Wilson, Marjorie P., 397, 399(5), 400, 409 Wilson, Secretary of Defense Charles, 352 Wilson, William J. Erasmus, 6, 7, 16, 18 Wilson, William Jerome, 318 biographical, 338 Wilson, Woodrow, House, 361 Winder Building, 15 Windsor State Prison, 427 Windsor, Thomas, 72, 206 Winsor, Justin, 179 quotation, 121 Winter, Francis Anderson, 229 biographical, 241 Winthrop-Stearns, 256 Wisconsin, State Library of, 80 Wise, Thomas Washington, 93, 95, 103, 150, 170, 172 Wislicki, Leo, 450 Wolcott, Senator Frederic C, 259 Wolf, Stewart G., Jr., 451, 480 Wolff, Heinrich, 82 Woman, first to be hired, 216 Women hired by library, 246 Wood, Casey, 228, 229 Wood floors, 226 Wood, Horatio C, Jr., 71, 73, 97, 121, 126, 127, 144, 212 Wood, John B., 7 Wood, Leonard, 191 Wood shelves, 91 Wood, Thomas, 145 Woodhall, Barnes, 480 Woodhull, A. W., 83 Woodhull, Alfred A., 117 Woodruffs Patent File Boxes, 92 Woods, James, 441 Woodward, Joseph J., 9, 18(2), 19, 26, 28, 53, 57, 156, 161 Woodworth, John, 71 Wooster, Harold, 425, 426 Worcester, Mass., Medical Society, 81 World Catalog of Medical Books, 275 World Health Organization, 448 World medical serials, 324 World War I, the Library during, 289 World War II, changes during, 289 World War II, Library on the eve of, 271 Wormley, Theodore C, note to Billings, 53 Wright, J. H., 181 530 INDEX Wright, Wyllis Eaton, 312, 339 biographical, 307 Librarian, 296 quotation, 314 Wiirzburg, University of, 76 Wycoff, Richard, 151 Yearbook proposal, 250 dropped, 251 Yellow fever, 33, 50, 149, 188, 190, 242(2), 360 Youmans, John B., 460 Young, Representative Casey, 163 Yugoslavia, 450 -U.S. Joint Board on Scientific and Technical Cooperation, 451 Yahuda, Abraham S., 277 Yale, 93, 185, 209, 215, 408 Medical School, 264 Yandell, David W., 71, 145, 152 Yarrow, Henry Crecy, 71, 122, 131, 150 Ziegler, George Jacob, 54 Zipf, Alfred R., 389, 480— Zurich, University of, 76 •U.S. GOVERNMENT PRINTING OFFICE: 1985—480-985/NF 531 ■ '■':''!!ii'jjp; '/'7 •■ "'■■'■■ : '. . .'.;■: '.-. r,;r:?rif■:.".::...: • :.;.::'--:"?-?sf»M^i; ::';.7.VV yv/gi-;;;.;;. -V'g -£/.. 'i-j-iiiuilr1* 7ZI;, ■: '■::•;•:: ". '. ■■ii::'!*'-'il!i"*hit8*uis'iZ>; .':;.-::;.:::.:.';-'.".::v;: :" ' • ...-..- •g*it-s:;i:. .:: : ■:...::: :: J ,:::::.:!::r:-H5!,!iii ■ ■: j~:-:i:ihx:i5;i:iiir!:':r :::} '■':■:.:•:••. ■.:r.:::::i':r':: ■ :::i;:::::xzzIt£Si£t%HL-:':r.;::, ::::-::xii:ixx:tS8SnU:i:): ''mmiH^-l-::-::-:'-:- rs;;;i;f.-f.r.->; '::::z::xgzai&fiii:i!txr::. ;:■::: :.::::;;:;i:sw»w;sss:;-j:;..;.-..-;; as«ffi7s$ .::■;■