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.

33

While selecting books Billings had sought works on three subjects of special interest to the Medical Department: cholera, yellow fever, and military surgery. 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.

34

The Medical Department published long reports on cholera and yellow fever, 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. . . .35 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 Flügel, 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 cryptogamic growths" in a government document, Reports of the Diseases of cattle, made to the Commissioner of Agriculture..

Billings continued to dabble with fungi until the early 1870's, publishing

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.

41

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 transferring 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 bibliographer, 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 General's 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

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.

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 congressional committees for funds, was made to develop the collection into the “National 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," that would be "as complete as possible in all publications relating to military organization, medicine, and the allied sciences, "50 and would be "an universal library of references. "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 Washington, 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 appreciation 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 constantly 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 accepted 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 communications that they favored the idea.

Notes