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Incunabula, the world's oldest printed books, didn't occupy any shelf space in the Library until after the Civil War. Derived from the word "cradle" and generally attributed to all books produced in the infancy of movable type printing, from about 1455 to 1500, a portion of these works were on medical subjects. Often in Latin, they were frequently compilations of the writings of ancient medical scholars such as Hippocrates and Galen.

It may be no coincidence that the Library acquired its first incunable shortly after it was placed under Billings' direction in the late 1860s. So fundamentally different from the Library's routine, of collecting current and specially oriented works, the collecting of such items is indicative of Billings' own ideas of what the Library should be, well before the formal decision to become a national collection.

Title page of book in Latin, with title handwritten in black ink and decorated in ornamentation of blue and tan and a hand-drawn illustration of branches of a flowering plant in green and pink, text as follows: Articella duo paeclaro libro que contineaneur opera, sequens pagina indicat. Impresl. Veneriis anno M.CCCC.RC.III.

Articella, seu, Opus artis medicinae, printed in 1493, was purchased by Billings in 1868. An articella was a bound collection of various medical treatises which served as a medical textbook. This volume contains writings by several authors, including Hippocrates, and Galen. It was accessioned into the collection on August 27, 1868. This was only the third incunable acquired and the first for which there is a known accession date.

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SGO label decoration
Full page woodcut, colored in green, red, and yellow, of a person in a bed, a person on crutches, a person sitting in a chair showing an abdominal scar, a person holding a book, a woman holding a child in her lap, a child and an adult both sitting in the same pose, a man gesturing - all around two tables with drinking glasses and decanters on them.

A page from Ortus Sanitatis (The Garden of Health), printed in Mainz, Germany, by printer Jakob Meydenbach in 1491. This was acquired at some point between 1865 and 1868. It has been in the Library's possession longer than any other incunable.