John Shaw Billings

As the first director of the New York Public Library, John Shaw Billings (1838-1913) was the early guiding force behind that institution's reputation as one of the premier information providers in the world. A physician by training, Billings was instrumental in the establishment of the first comprehensive national medical library and provided much of the ideas and innovations that made the medical school of Johns Hopkins University the foremost learning center of its kind. Billings, noted Frank B. Rogers in a memorial essay that appeared in John Shaw Billings Centennial, did "more to advance American medical education than any other individual of his generation."

Trained as Doctor in Cincinnati

Billings was born on December 12, 1838, in southeastern Indiana in Cotton Township. His father's family had emigrated from England in the century before, and settled in Syracuse, New York. His mother, Abby Shaw Billings, was descended from Mayflower settlers. As a child, Billings spent time back East and even attended school in Providence, Rhode Island, for a time. The family eventually returned permanently to Indiana, where his father ran a general store in Switzerland County. Abby Billings was an avid reader, and her son inherited the habit. Billings even taught himself Latin and Greek and as a teen made a pact with his father that he would forego any inheritance if his father agreed to send him to college.

The nearest institution of merit was Miami University in Oxford, Ohio, about 50 miles from Switzerland County. Billings entered it in 1852. He was disappointed to learn that its library was only open to students a mere three hours a week, and he could only check out two books at a time. He borrowed his friends' cards and even revealed later in life that he found a way to enter the building during the summer break and enjoy its resources in solitude. Billings graduated second in his class in 1857. He worked for a traveling sideshow for a time and entered Cincinnati's Medical College of Ohio in 1858.

Career Interrupted by War

Billing's felt that the college's two-year curriculum was inadequate. Instead he read medical texts on his own, spent time in the sole dissection room, and for a time even lived at a Cincinnati hospital cleaning its dissecting room for pay. Funds were still tight, and Billings claimed to have budgeted just 75 cents a week for food one winter. An attempt to write his dissertation, "The Surgical Treatment of Epilepsy," aroused his interest in medical librarianship. He spent six months poring over a thousand journals and books in libraries in Cincinnati, Philadelphia, and New York. He imagined that students and physicians alike might make great progress in their research if there was one single source available with a reliable index to its titles for all medical books.

For a year after he finished medical school, Billings served as a demonstrator of anatomy at the Medical College. With the outbreak of the American Civil War, he took and passed the three-day exam of the Army medical board. He had the highest scores. He was commissioned first lieutenant and given charge of a makeshift military hospital in the Georgetown area of the District of Columbia. The facilities, which were merely filthy barracks, were entirely unsuited to caring for the wounded. They lacked sinks and drainage and no water was available for half a mile. Billings saw that plumbing was installed and ventilation improved. During this period he married Katharine Stevens, the daughter of a Michigan congressman.

Became Assistant to Surgeon General

Billings went on to supervise a Philadelphia military hospital and in April of 1864 was made medical inspector for the Army of the Potomac. From the field, he wrote to his wife that he was sometimes operating for 24 hours at a stretch. Later that year he was called to Washington, marking the end of his field service. He was eventually posted to the office of the U.S. Surgeon General. After the war ended, he oversaw the closing of army hospitals and the discharge of civilian doctors. In 1869 he was given a project involving the United States Marine Hospital Service. He formulated a reorganization plan for the network of facilities that turned it into the United States Public Health Service.

During this time Billings was moving toward the realization of a national medical library. His first order of business was to expand the holdings in the Surgeon General's office. With donations Billings solicited from around the country and even overseas, the number of titles in the library began to grow. A new home for the collection was found in the old Ford Theater building on Tenth Street, the site where President Lincoln was assassinated. The collection expanded from 1,800 to 50,000 volumes by 1873, but Congressional funding to expand, store, and utilize it was not forthcoming. Fortunately, Billings was allowed to use an $80,000 windfall that came from the budgets of closed army hospitals. He also began working on related bibliographic materials. In 1876 he published Specimen Fasciculus of a Catalogue of the National Medical Library, which became the Index Catalogue of the Library of the Surgeon General's Office four years later. Physicians deemed it an invaluable resource, and Billings and his assistant, Dr. Robert Fletcher, issued one volume per year for the next 15 years. Fletcher also helped Billings compile the Index Medicus, which first appeared in 1879 as a monthly guide to current medical literature.

Planned Johns Hopkins Hospital

In 1873, Baltimore banker Johns Hopkins died and left a large endowment for the foundation of a hospital and medical school. Billings was asked by the trustees to submit plans for a state-of-the-art hospital facility, and his were approved and then adapted by architects. Construction began in 1877. Billings was also granted permission by the Surgeon General's office to serve as medical adviser to the institution and as such was the author of several reports on hospital construction and organization, nursing education, and a proper medical-school curriculum. "A sick man enters the Hospital to have his pain relieved—his disease cured," Billings wrote in one paper. "To this end the mental influences brought to bear upon him are always important, sometimes more so than the physical. He needs sympathy and encouragement as much as medicine. He is not to have his feelings hurt by being, against his will, brought before a large class of unsympathetic, noisy students, to be lectured over as if he were a curious sort of beetle. … In this Hospital I propose that he shall have nothing of the sort to fear."

At the time, medical students usually attended classes in an amphitheater, where the patient served as passive demonstrator. Billings urged bedside instruction in smaller groups and better diagnostic training. His ideas were implemented into the curriculum, and Billings recruited top names in the field to lead the hospital and medical school. He was a strong advocate of the necessity of medical students earning a bachelor's degree first, a maverick idea at the time that was not enforced until much later, and provided guidelines that made the Johns Hopkins Medical School the first to have a resident system for specialist training. He taught some of the school's first courses in medical history himself.

Idea Led to Punched-Hole Card

Billings's innovations helped change the public perception of hospitals as unsanitary, even gruesome places. His ideas helped shape the American Public Health Association, which he served as founding member in the 1870s, and the National Board of Health. Billings' talents brought him to the attention of the U.S. Census Bureau, and he was named head of its division of Vital Statistics for the 1880 and 1890 federal censuses. Between those two counts alone, there was a massive increase in the U.S. population, a change of 12 million, and the Census Bureau struggled to keep pace with its task. Billings' daughter was romantically linked with a statistical engineer named Herman Hollerith at the time, and over dinner one evening Billings suggested that Hollerith consider some sort of system of tabulation involving punched cards, similar to those used for the Jacquard loom. The result was Hollerith's invention of the punched card, which remained in existence as a method of tabulating data by computer well into the 1970s.

A New and Vast Project

Billings oversaw the opening of the new Surgeon General's Library in 1887; in 1890 he accepted a post as director of the University of Pennsylvania Hospital and professor of hygiene. He officially retired from the Army and the Surgeon General's office in 1894, and many prominent names in medicine journeyed to the Philadelphia banquet held in his honor. Not long after that, however, Billings was invited to take a post of great prestige, but also herculean effort: he was selected as the first director of the newly established New York Public Library. The Library, however, existed in name only, for the city boasted three separate facilities at the time, each created by private endowment. There was the research library named in honor of its benefactor, John Jacob Astor, the wealthiest man in the United States at time of his death in 1848. There was also the James Lenox rare book collection at another site. The former governor of New York, Samuel J. Tilden, also left a bequest in his will for the establishment of a library. The trustees of each of the three libraries agreed to consolidate their holdings into a central library for New York City and recruited Billings to organize it.

Billings's initial task was to thoroughly catalogue all three collections and their holdings. Negotiations with city and state authorities to choose a site large enough for a building and obtain the necessary funding to erect one took years to complete. Once the land was donated, however, Billings sketched the proposed library and interior. His plans called for a large reading room and seven floors of stacks, as well as a rapid delivery system for patrons that was one of the most modern of the time. The architects chosen for the job incorporated each of the ideas into a large Beaux-Arts building at Fifth Avenue and 42nd Street. At the time, it was the largest marble structure ever attempted in the country. Billings also worked to finesse an agreement with another organization, the New York Free Circulating Library, to consolidate its holdings into the Central Library and convinced steel magnate Andrew Carnegie to donate $5 million to build a system of branch libraries. The New York Public Library, which quickly became a landmark of the city and one of its grandest cultural achievements, opened its doors in May of 1911.

Legacy Continued Well After Death

Billings was still keenly interested in medicine. He served as a consultant to Boston's planned Peter Bent Brigham Hospital between 1905 and 1908 and chaired the board of trustees of the Carnegie Institution of Washington, which furthered research in science. Throughout his life he was known as a tireless executive and an imposing, formidable personality. In his final years he suffered from a form of cancer of the face as well as kidney problems. He was said to be grief-stricken after the death of his wife in 1912 and underwent his eighth operation seven months later. He died after contracting pneumonia on March 11, 1913, in New York City. He was buried with military honors at Arlington National Cemetery.

Billings' achievements were enduring ones: the Index Medicus became a computer index of medical abstracts, Medline, and the Johns Hopkins University is considered one of the foremost research and training centers for the science of medicine in the world. He was a man to whom no task seemed too large. As the John Shaw Billings Centennial volume noted, he had once told a colleague: "I'll let you into a secret—there's noting really difficult if you only begin—some people contemplate a task until it looms so big, it seems impossible, but I just begin and it gets done somehow. There would be no coral islands if the first bug sat down and began to wonder how the job was to be done."

Books

John Shaw Billings Centennial: Addresses Presented June 17, 1965, National Library of Medicine, 1965.

Lydenberg, Harry Miller, John Shaw Billings, American Library Association, 1924.

Online

Dictionary of American Biography Base Set, American Council of Learned Societies, 1928-1936. Reproduced in Biography Resource Center,http://galenet.galegroup.com/servlet/BioRC (January 21, 2002). □

BILLINGS, JOHN SHAW

John Shaw Billings (1838–1913) was one of the towering figures of American medicine—indeed, of American civilization. As a young man, Billings was a surgeon, serving as medical inspector of the Army of the Potomac in the Civil War. The latter post was focused on public health rather than management of wounds and surgical care of soldiers. After the war ended, he assumed direction of the Surgeon General's library in Washington, DC. He was a bibliophile, and set about cataloging and enlarging this collection. He devoted some years to the task of developing a comprehensive Index Catalogue. This became the Index Medicus, which had taken on its main features under Billings' leadership by 1879.

Billings held office as the librarian in the Surgeon General's department from 1864 to 1895. During this time he oversaw the establishment of the National Library of Medicine as it grew into the most comprehensive collection of medical books and journals in the world. In 1889 he supervised compiling of the National Medical Dictionary, a scholarly dictionary of medical terminology with much information on provenance of terms, eponyms, and procedures.

Billings also supervised the national censuses of 1880 and 1890. He helped design the Johns Hopkins Hospital in Baltimore, and also select the outstanding physicians (Welch, Halstead, Osler, and others) who established its reputation as one of the best medical schools in the world. Among his most important nonmedical achievements was his key role in starting the New York Public Library, with the aid of a grant from Andrew Carnegie.

John M. Last

Bibliography

Garrison, F. H.; Billings, K. M.; and Hasse, A. R. (1915). John Shaw Billings: A Memoir. New York and London: Putnam.

John Shaw Billings

1838-1913

American surgeon and librarian who is credited with developing the first system for organizing medical literature in the United States. Between 1864 and 1895 Billings developed the Army Medical Library, which eventually became the National Library of Medicine, the world's largest medical reference library. In 1879 he began the Index Medicus, a monthly guide to medical literature, which is still in use in the United States today. Billings spent the last 17 years of his life as the first director of the New York Public Library.