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About Us: The Story of NLM Collections

A collage showing the diversity of historical materials.

The Story of NLM Collections

The National Library of Medicine (NLM) is home to a constantly-growing collection of 28 million items and a variety of interrelated digital resources that deliver these collections and related data every day to millions of people around the world. Spanning ten centuries—from the 11th to the 21st—and originating from nearly every part of the world, this collection traces its roots to the early-nineteenth century. From this beginning, it grew through the energy and expertise of a series of dedicated and visionary custodians, moving through several buildings, and developing through a variety of governmental and legislative directives.

Explore the Collections

Origin and Early Years The Leadership of John Shaw Billing Growing the Collection Opening the Collection to the Nation World War and Its Impact on the Library War Again, Relocation, and Further Growth of the Collection A New Home for a Treasured Collection The Collection Today

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Origin and Early Years

The Library of the Office of the Surgeon General

Painted portrait of Joseph Lovell, NLM101422016

Joseph Lovell, ca. 1836

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.

Surgeon General’s Office 1830 inscription, JK 5 N277 1830 - insc detail

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.

The Leadership of John Shaw Billings

A passionate bibliophile and consummate librarian

Photograph, left profile, wearing uniform of Major in the Civil War.

In recognition of John Shaw Billings’s public service, 260 physicians of the United States and Great Britain presented this portrait of him by Cecilia Beaux to the Library at a testimonial banquet in Philadelphia on November 30, 1895. Born in Philadelphia, Beaux won many honors throughout her long career. She studied in Philadelphia under William Sartain and Thomas Eakins and in Paris in the Julien and Lazar schools. She painted, among other notables of the day, Henry James, the American-born British writer; Georges Benjamin Clemenceau, the French politician, physician, and journalist; and Désiré-Félicien-François-Joseph Mercier, a Belgian cardinal of the Roman Catholic Church and a noted scholar.

Surgeon General’s 1895 report excerpt, annual report 1895 - detail

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.

Growing the Collection

Under Billings’ tenure the collections of the Library grew exponentially.

Photograph of man sitting on a chair in a living room.

John Shaw Billings works at his home, located at 84 Gay Street in the Georgetown section of Washington, DC, around the 1870s. From 1874 onward, the drive to index the collection was secondary only to the accumulation of publications. Billings directed his staff in the indexing project and usually, after a full day at the library, brought home an armload of books and journals and continued indexing late into the evening.

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.

Letter written on lined paper.

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…”

Opening the Collection to the Nation

Beyond collecting books, Billings’ expertise in librarianship supported his cataloging of the Library’s collection.

A photograph of men in uniform reading in a library.

Thomas Washington Wise, manager of library operations, stands to the left of the desk as John Shaw Billings sits at a reference table in the new Library Hall in 1887. Billings involved himself with the smallest details of the Library’s planning, including the architectural designs for book shelving and retrieval. A dumbwaiter, or book lift, located at the right end of the stacks enabled staff to move books from one floor to another.

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 IndexCatTMdatabase, 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 IndexCatTM 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.

World War and Its Impact on the Library

Documenting the medical history of the Great War

Portrait of woman in uniform.

Dr. Loy McAfee, pictured in 1917, worked at the Library as a temporary employee during World War I. She became a compiler for the Index-Catalogue and developed special-topic bibliographies. The US Army granted permission to the Library to hire women in large numbers to maintain operations during the war; many stayed on until their retirement.

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.

Front cover titled The Medical Department of the United States Army in the World War

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.

War Again, Relocation, and Further Growth of the Collection

Protecting and preserving a national treasure

Photograph of a group of people sitting and standing.

Staff of the Army Medical Library gather in the mid-1940s. Pictured are William J. Wilson, PhD (first row, second from left), chief of the History of Medicine Division of the Library, and Dorothy Schullian (first row, third from left), who would become one of the most significant scholars and bibliographers in the history of the Library.

Army Medical Library Cleveland Branch

Library staff added bookplates like this to volumes moved to Cleveland during the war years. The bookplates did not change when the collection returned to the East Coast, so many volumes on the shelves of the current National Library of Medicine still bear Cleveland bookplates.

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.

A New Home for a Treasured Collection

Relocation on the campus of the National Institutes of Health

Photograph of the construction of a library.

The front entrance of the new Library building takes shape in this April 7, 1961, photograph.

Photograph of an aerial view of the a library.

Aerial view of the Library from around 1968.

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.

Photograph of a library entrance with people standing around different areas.

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.

The Collection Today

Collage of people and collection materials.

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.

Learn more about the history of the National Library of Medicine

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Last Reviewed: June 13, 2024