The National Library of Medicine has evolved from a small collection of books and journals in the Office of the Surgeon General in the Medical Department of the Army to the world's largest biomedical library. The Library was begun by Joseph Lovell, Surgeon General from 1818 to 1836, and grew slowly at first. The first request for funds -- $150 to buy books -- appeared in the 1836 estimate of expenses for the Medical Department. In 1840, the first Catalogue of Books in the Library of the Surgeon General's Office was prepared. This handwritten list records only 134 titles representing about 200 volumes, considerably smaller than the personal libraries of many mid-nineteenth century physicians, and far exceeded by those of established medical schools, medical societies and institutions.¹

Although the medical advances and concerns of the Civil War stimulated use of the Library, its collection had grown to only 1,800 volumes by 1864. In that year, Surgeon General Joseph K. Barnes published the first printed catalog. It listed books alphabetically by author under nine subject headings: anatomy; physiology; materia medica; pharmacy and therapeutics; general pathology and practice of medicine; surgery; midwifery and diseases of women and children; medical jurisprudence and medical policy; natural philosophy; chemistry, etc. It also listed miscellaneous journals, reviews, reports, encyclopedias, etc.

After Lee's surrender at Appomattox, the Army closed all temporary military hospitals, dismantled their libraries and sent the most valuable of their works to the Army Medical Library in Washington, D.C. In October 1865, John Shaw Billings, then an assistant to the Surgeon General, was given responsibility for building and managing the growing collection of medical books and journals. Under Billings' leadership, acquisitions expanded dramatically. By 1870, the Library was among the largest medical libraries in the United States, exceeded only by those of the Pennsylvania Hospital and the College of Physicians in Philadelphia.

Sometime during 1871, discussions between Billings and Surgeon General Barnes led to a decision to broaden the objectives of the Library to include the development of a collection to serve the entire American medical profession, rather than the military exclusively. Their vision was to develop a "National Medical Library" with a collection of medical literature that would contain "every medical book published in this country and every work relating to public health and state medicine.”²

Billings was indefatigable in his pursuit of this aim. Although he collected all types of medical publications, Billings concentrated on acquiring and maintaining complete files of American medical journals. During his tenure the Library also made its first significant efforts to acquire rare books, manuscripts, visual records of the history of medicine, and to develop literature exchange programs with domestic and foreign institutions.

In the twentieth century, the collection continued to expand. However, by World War II, the collection's growth rate, which had been the fastest in the nation under Billings, had declined because of low appropriations, low staffing levels and insufficient space, becoming the slowest among America's large research libraries. Wartime demand for medical information gave rise to a survey of the Library's operations and management. The subsequent report recommended an aggressive acquisition program, including a larger book budget and an active gift and exchange program.³

After the war, the Library set out to remedy the deficiencies in its collection. The Library initiated programs to acquire U.S. works published during the depression, to secure literature published in enemy countries during the war, and to reestablish relations with book dealers in all areas of the world. As wartime Army hospitals were closed, their books and journals were shipped to the Library in Washington.

In 1949, Library Director Frank Bradway Rogers established the first internal committee on scope and coverage. The aim of the committee was: "to define the subjects to be collected and the degree of collecting within each subject.”⁴

Its report was in essence a basic guide for materials selection, which has since been refined numerous times to reflect contemporary collecting policy and the growth and specialization of biomedicine.

Billings' dream of a true national library was realized in 1956 when Senators Lister Hill and John F. Kennedy submitted to Congress a bill "to promote the progress of medicine and to advance the national health and welfare by creating a National Library of Medicine.”⁵

On August 3, 1956, the National Library of Medicine Act was signed into law. The Library is an official part of the National Institutes of Health within the U.S. Department of Health and Human Services.

Since that time, the collections of the library have grown considerably. Collection development and expansion in the area of manuscripts, historical and contemporary audiovisuals and posters has been especially notable.

In 1976, NLM was officially designated a U.S. Government Partial Depository for biomedical information. In 1986, the Library established a Preservation Section to develop and implement a national plan for the preservation of the biomedical literature.

At the end of the twentieth century, NLM embarked on an initiative to improve access to health information for the general public. The decision was made to develop a Web-based resource, MedlinePlus, as the primary vehicle for providing access to consumer health information. The Library also began collecting and indexing selected consumer health periodicals for PubMed. NLM continued its existing policy of adding to the collection only representative examples of other consumer health publications.

The Library continues to add to its outstanding collection of early printed works and manuscripts and to develop its modern manuscript collection emphasizing U.S. medicine, public health and health care advocacy. The papers of Nobel laureates are featured on the Library's Web site Profiles in Science™. This site celebrates leaders in biomedical research and public health. It makes the archival collections of prominent scientists, physicians, and others who have advanced the scientific enterprise available to the public through modern digital technology.

In addition to collecting and preserving the print biomedical literature, NLM fulfills its archival and service mission for electronic resources. The Library's general approach to addressing these challenges is to use its own electronic services and to work with its sister National Libraries and other organizations to develop and test strategies for ensuring permanent access to electronic information. PubMed Central, a digital archive of full-text life sciences literature, is the Library's primary service for ensuring permanent access to electronic journals.

Footnotes

¹

Miles, Wyndham D. A history of the National Library of Medicine, the nation's treasury of medical knowledge. Washington, D.C.: Government Printing Office, 1982, p.5.

²

Ibid, p. 36. Letter, Surgeon General Barnes to Rep. J.A. Garfield, Jan. 6, 1872; also letter, Barnes to Sen. L.M. Morrill, February 9, 1872: NA.

³

The National Medical Library: Report of a survey of the Army Medical Library. Chicago : American Library Association, 1944.

⁴

Report of [the] Committee on Scope and Coverage: Army Medical Library. Presented to [the] Association of Honorary Consultants to [the] Army Medical Library, 20 October 1950. Appendix 1. Authorization for the Committee

⁵

34th Congress. 2nd Sess. Bill S.3430. 1955.