About Us: The Story of NLM Collections

When Dr. Joseph Lovell took up his position as the first Surgeon General of the Army in 1818, he filled a few of his office shelves with books, journals, and pamphlets to serve as a reference collection for the Army surgeons under his command.

In 1836, the US government for the first time provided funds for “books for the office,” and the growing collection officially became the Library of the Office of the Surgeon General, United States Army.

The collection grew measurably after the Civil War, when the Surgeon General’s Library received an infusion of medical books and journals from the Army’s temporary hospitals.

The handwritten ownership information, probably in Lovell’s hand, places this book The National Calendar, by Peter Force in Surgeon General’s office in 1830.

Report of the Surgeon-General of the Army to the Secretary of War for the Fiscal Year Ended June 30, 1895.

To take charge of the burgeoning collection, the Army summoned 27-year-old career Army medical officer and book lover John Shaw Billings. MD (1838–1913), who set out to create a comprehensive collection of medical materials.

The relentless Billings wrote letters to physicians, editors, health and government officials, librarians, and society officers requesting donations, exchanges, and outright purchases. He accosted State Department officials traveling overseas, entreating them to bring back foreign medical books and journals.

Billings was so dedicated to his quest to build a world-class library that Oliver Wendell Holmes noted, “Dr. Billings is a bibliophile of such eminence that I regard him as a positive danger to the owner of a library, if he is ever let loose in it.”

Billings’ voracious reading in the Library of the Office of the Surgeon General made him one of the most learned men of Gilded Age America. He was a top authority in such fields as public health administration, hospital design, vital statistics, scientific medicine, hygiene and ventilation technology, census organization, epidemiology, and science administration. Under his tenure, the Library grew exponentially.

Early during his tenure, Billings purchased 6,000 medical portraits from the art collector Cornelius Wilhelm Hendrik van Kaathoven. These portraits formed the basis of a collection that would, by the end of the twentieth century, encompass more than 150,000 prints and photographs, more than 70,000 of which, in digital form, are now immediately accessible to the world via NLM Digital Collections.

Billings also accelerated the Library’s acquisition of manuscript collections relating to American medicine and public health. His successors in the mid-twentieth century grew these collections to include a significant number of Western and Islamic medical manuscripts, and in 1962 they created a distinct modern manuscripts collection. Within a few years, the Library hired its first Curator of Modern Manuscripts and began actively soliciting donations of personal papers and society records. By 1976, the NLM held 236 processed collections, a number which grew to over a thousand by 1999. Today, it’s modern manuscript collections comprise 16,000 linear feet—equivalent to 53 football fields!

The portrait and manuscript collections acquired by Billings and his contemporaries joined the Library’s initial 2,300 medical volumes, which by 1985 had expanded to a collection of some 124,000 bound volumes. By this date, when Billings retired to head the New York Public Library, the Library of the Office of the Surgeon General was the largest medical library in the Americas and possibly in the world.

In this letter to a potential donor, written on May 13, 1872, John Shaw Billings explains his ambition for the library: “I am trying to form a great national Medical Library here—a work of great labor—which I am satisfied can only be done under government auspices…I want to make it as complete as it can be made…”

Initially, Billings and his contemporaries intended the Library of the Office of the Surgeon General as a resource for military physicians. However, they gradually opened the collection to physicians and health professionals everywhere, making it a true national medical library. At the same time, the monthly Index Medicus and the Index-Catalogue, two landmark guides to the collection created by Billings, made the Library internationally famous.

The monumental Index-Catalogue of the Library of the Surgeon General’s Office is a multi-volume subject index to the collection. The Index-Catalogue was published in five (5) series in sixty-one (61) volumes from 1880–1961. Today it remains an invaluable resource for primary source material in the NLM’s historical collections. It can be searched online through the Library’s IndexCat^TMdatabase, and all 61 original volumes of the printed Index-Catalogue are freely available in the NLM’s Digital Collections. Today, as part of its commitment to supporting the burgeoning era of big data, the NLM offers the Extensible Markup Language (XML) data from the entire IndexCat^TM database.

Index Medicus was the first comprehensive index of journal articles in the Library’s collection. Started by John Shaw Billings in 1879 and published for 125 consecutive years, the NLM ceased publication of Index Medicus with the December 2004 edition (Volume 45). Today, MEDLINE/PubMed provides online access to lists references from 1966 to the present.

In 1914, war erupted in Europe and spread across the world. Staff of the Library felt the effects of the Great War. Many European medical publications that they had been acquiring soon stopped arriving due to the German U-boat campaign against merchant ships in Atlantic shipping lanes. The United States entered the war in 1917, and when the US Department of War called men into service, this affected the Library personnel, many of whom were Army clerks. Recognizing that the Library could not function without much of its staff, the Army allowed Library leadership to hire temporary employees, many of whom were women. This marked the first time that the Library employed women in significant numbers, including Audrey Morgan, MD, and Loy McAfee, MD, both contract physicians with the US Army.

In 1917, leadership of the Library saw the need for a medical history of the Great War, as it had done for the American Civil War with the Medical and Surgical History of the War of the Rebellion. The surgeon general created the History Division within the Library to undertake the task of writing The Medical Department of the United States Army in the World War. Published over eight years from 1921 to 1929, this comprehensive 15-volume series covered subjects ranging from general surgery to hygiene, orthopedics to combat disorders, and hospitals to gas warfare.

Issued in 15 volumes, The Medical Department of the United States Army in the World War provided a comprehensive account of the Army Medical Department’s experience during World War I. It covered subjects ranging from general surgery to hygiene, orthopedics to combat disorders, and hospitals to gas warfare.

During the early decades of the twentieth century, despite the short-term impact of Great War, the Library’s collection continued to grow through strategic purchases and thoughtful donations. In August 1942, to ensure the safety of the collection during World War II, Library staff sent to Cleveland, Ohio, 952 boxes of the intuition’s rare and valuable books, manuscripts, and prints and photographs. Weighing 75 tons, the shipment arrived at the Dudley P. Allen Memorial Library Building, owned by the Cleveland Medical Library Association.

The move to Cleveland revealed the poor condition of many of the Library’s older books. Consistent with best practices of the era extensive book repair and re-binding was planned. By September 1943, the Library had a bindery in Cleveland, soon considered to be one of the best in the country.

After more than a hundred years of growth and development, the Library’s collection was immense and contained many rare materials. During this period, Library leadership created an official historical section to care for books published before 1801. Later in the 1960s, the historical designation was expanded to include collection material published through 1913, as well as more recent pamphlets and dissertations.

In the 1950s, the portrait and print collection grew from 15,000 items to almost 60,000, and staff of the Library began to collect and preserve motion pictures, after then director Frank B. Rogers, MD, surveyed the field and discovered that no repository was systematically collecting medical films. By 1962, the Library had acquired almost 700 titles. Today, this collection encompasses more than 12,000 titles of multiple formats, from audio recordings to video recordings to film.

During the sunny and warm afternoon of June 12, 1959, dignitaries gathered on the campus of the National Institutes of Health in Bethesda, Maryland, to break ground for the National Library of Medicine (NLM). It was only a few years earlier that legislation proposed the transfer of the Library, then known as the Armed Forces Medical Library, to the U.S. Public Health Service and the renaming of it the “National Library of Medicine.” President Dwight D. Eisenhower signed the bill into law on August 3, 1956, paving the way for the ground breaking in 1959 and the dedication of the new NLM building two years later, on December 14, 1961.

The entranceway of the History of Medicine Division of the Library around 1963.

In May 1962, accompanied by armed Pinkerton guards, the Library’s treasured historical collections were moved from Cleveland to the Library’s newly-constructed location in Bethesda, Maryland, on the campus of the National Institutes of Health.

Architects designed the building, situated on a knoll facing Wisconsin Avenue, to be a very modern and efficient new home for the Library. While book and journal storage occupied several floors, technical and photographic services had a large amount of space as well. These spaces would also soon house computer technology that would become essential to the Library’s mission.

As the Library operationalizes its Strategic Plan: 2017-2027: A Platform for Biomedical Discovery and Data-Powered Health, its historical collection is ever-more accessible to the world in digital form, and we continue to welcome through our physical doors many researchers, educators, and students who wish or need to consult collection items first-hand. We also welcome many VIPs who value the collection, our stewardship of it, and the programs we undertake to share it with the world.

And we continue to grow and preserve the collection for current research and for future generations of researchers. Our recent acquisitions include all the familiar forms the collection has taken for generations—printed books and other items, hand-written manuscripts, audio-visual materials, and much more—and they also include new “born-digital” materials which are at high risk for loss as Internet-based resources change and disappear well before the long-term value of the content is known. Learn more about this this work, and how we are advancing history and embracing the future more broadly, by digitizing our collections, engaging new audiences, preserving unique medical heritage, and pursuing new research.