American Medical Biographies/Billings, John Shaw
Billings, John Shaw (1838–1913)
The family of John Shaw Billings is of Scandinavian origin and came from England to Massachusetts in the first half of the 17th century. About 1835 James Billings, his father, removed from Massachusetts to Switzerland County, Indiana, which was at that time still a sparsely settled pioneer region. Here John Shaw Billings was born April 12, 1838. He spent his early life on the farm and attended the country schools of those rugged pioneer days. He very early showed an uncommonly active and intelligent mind; he had an exceptional memory and was an omnivorous reader. When he grew older he studied Latin, Greek and geometry under a clergyman, Mr. Bonham, who was struck by the extraordinary brightness of the boy and who, much later says of him: "He recited lessons in Latin and Greek, so long that no average pupil could have learned them. He had a marvellous memory. I never met his equal!" Young Billings was soon so proficient that, in 1852, he could pass the entrance examination to Miami University. Here he spent five years of hard study. From the testimony of his teachers we know that he was a student of exceptional ability. One of them, Charles Elliot, Professor of Greek, describes him as "a young man of very superior talents and extensive acquirements," and he adds: "I have observed, moreover, that he possesses great facility in communicating what he knows." Yet Billings' college life was one great struggle with privations for he had to rely entirely on himself for his means of subsistence. But this hard school steeled his naturally strong mind for the arduous course of his later life. Billings graduated from this school with the degree of A. B. in 1857 and in the following year commenced the study of medicine at the Medical College of Ohio at Cincinnati. This school, founded by the celebrated Daniel Drake in 1819, enjoyed a well-merited reputation throughout the West. It laid great stress on practical teaching, and the hospital experience Billings received here served him in good stead in his subsequent career. He says himself: "I practically lived in the dissecting-room and in the clinics, and the very first lecture I ever heard was a clinical lecture." Billings graduated as doctor of medicine in 1860. The subject of his thesis was "The Surgical Treatment of Epilepsy," published in the Cincinnati Lancet and Observer of 1861. Already this early treatise bears the marks of his independent and original mind. His teachers held such a high opinion of him that, after his brilliant graduation, he was at once appointed demonstrator of anatomy in the institution. But soon after the Civil War broke out and young Billings did not hesitate a moment in offering his services to the Union cause. He passed first on the list of candidates before the Medical Examining Board of the Army and was duly commissioned first lieutenant and assistant surgeon. For more than a year he served in the military hospitals of Washington and for some months at the United States General Hospital at West Philadelphia.
On March 31, 1863, Billings was transferred to the field service and assigned to the 5th Corps of the Army of the Potomac. A month later the disastrous battle of Chancellorsville was fought, where he showed his superior qualities as surgeon and executive officer. He then followed the army to the north and was present at the bloody battle of Gettysburg. Billings was a very skilful surgeon and the most difficult operations were turned over to him. He was the first surgeon in America to perform the rare operation of excision of the ankle joint. But the work was so arduous and the strain so great that even an iron nature like Billings' felt its effects. In September, 1863, he was transferred to McDougall General Hospital at Fort Schuyler, New York Harbor, and soon after to the Convalescent Hospital on Bedloe's Island. In March, 1864, he was again assigned to the Army of the Potomac, then under General Grant. He was present at all the sanguinary battles that preceded the siege of Richmond. His note book, published for the most part in Dr. Garrison's biography, gives a vivid picture of those stirring days.
On August 22, 1864, Billings was assigned to the office of the Medical Director of the Army of the Potomac at Washington, where he drew up the field reports which now form a part of the "Medical and Surgical History of the War." In December of the same year he was transferred to the Surgeon General's Office, where he was to remain for more than thirty years. It was in this position that he accomplished the most important work of his life. "Billings," says his biographer, Dr. Garrison. "achieved excellence and gained distinction in no less than six different fields, in military and public hygiene, in hospital construction and sanitary engineering, in vital and medical statistics, in medical bibliography and history, in the advancement of medical education and the condition of medicine in the United States and as a civil administrator of unique ability."
In 1869, Billings was detailed by the Secretary of the Treasury to inspect the Marine Hospital Service which was then in a deplorable condition. It was due to his efforts that this branch of governmental activity which, under the new name of Public Health Service, is now doing such splendid work, was completely reorganized. Of far-reaching importance were the reports which Billings made on the military hospitals of the United States. These reports, known as Circular No. 4 and Circular No. 8, expose with unsparing criticism the deficiencies and the wretched condition of these establishments and are full of new and advanced ideas on hospital construction and management.
During his stay in the Surgeon General's Office Billings was the leading authority on public hygiene in this country. He wrote numerous articles on this subject and his advice was sought and valued everywhere. Billings was among the five men who, in 1876, were invited by the Board of the Johns Hopkins Hospital Foundation to submit plans for the new hospital, and his plan was selected as the best one. It marked a new departure in hospital construction and when the hospital was completed it was the most perfect and best equipped institution of its time. Billings also planned the Barnes Hospital at the Soldiers' Home and the Army Medical Museum in Washington, D. C. (1887), the Laboratory of Hygiene (1892), the William Pepper Laboratory of Clinical Medicine in Philadelphia (1911), and the Peter Bent Brigham Hospital in Boston (1913).
Of inestimable value is Billings' work as a statistician. He may be called the father of medical and vital statistics in this country. It was on his advice that medical statistics were included in the United States Census of 1880. He himself took an active part in drawing up the vital statistics for the tenth, eleventh and twelfth Census.
Billings' most important work, one which will perpetuate his name in the history of medicine, is the creation of the Surgeon General's Library and the publication of the great Medical Index Catalogue. Being a man who delved deep in medical literature, he very early felt the want of a great reference work which would guide writers on medical subjects in the literature of the past. His position in the Surgeon General's Office enabled him to carry out this favorite wish of his student days. But in order to publish a medical catalogue he had first to establish a library. The small stock of books which was on hand in the Surgeon General's office at the close of the Civil War was gradually enlarged. Billings worked with such earnestness that already in 1876 he had collected 40,000 volumes and a like number of pamphlets. In 1880 he obtained the necessary appropriation from Congress and commenced the publication of the first series of the catalogue. It was completed in 16 volumes in 1895, the year of his retirement from the army. The work was continued under Dr. Robert Fletcher (q.v.) and later under Dr. F. H. Garrison. The second series, in 21 volumes, was completed in 1916.
With this work Billings takes easily the first place in medical bibliography; he is "the prince of medical bibliographers," as Sir Thomas Barlow called him at the International Congress of London. The catalogue was Billings' life work, his love and his pride. Its successful accomplishment was due to him alone. He laid out the general plan and supervised every detail, and after he left the Surgeon General's Office his interest in this great work never ceased, and during all his later life he remained in constant touch with it. Simultaneously with the catalogue Billings published the Index Medicus, a monthly bibliography of medical literature. This publication was taken over, in 1902, by the Carnegie Institution and has appeared under the able editorship of Dr. Garrison.
During his arduous work in the Library at Washington Billings found time to write numerous articles and treatises, and whatever he wrote bears the marks of his originality and shows the brilliancy of his strong and versatile mind. With fondness he delved in the past of American medicine, and his writings on the history of medicine in the United States belong to the best that have appeared in this field. No man knew better than he the shortcomings of medical education in this country. In lectures and writings he unceasingly advocated higher standards in medical education, and the great advances in this field are in no small part due to his caustic criticisms. Billings made a number of trips to Europe in the interest of the Library. He met most of the noted medical men of England, France and Germany and gained their lasting friendship. In 1881 he made a notable address before the International Medical Congress at London on "Our Medical Literature." The witty humor and the caustic criticism with which he surveyed the medical literary activity of the time attracted general attention.
When Billings was retired from the army at his own request in 1895, he, for a short time, filled the chair of hygiene at the University of Pennsylvania. But a greater field of activity was soon to open for him. In 1896 he was appointed Director of the New York Public Library. In this position, which he held until his death, he performed the difficult task of consolidating the three great libraries of the Astor, Lenox and Tilden Foundations. Billings, with his unsurpassed executive ability, brought order out of chaos, and today the New York Public Library, with its more than two million volumes and fifty branch libraries, is without its equal anywhere. Billings also laid out the plan for the new building of the great library, which is now one of the ornaments of the American metropolis.
The cares of this work and the ceaseless toil gradually began to wear down his iron constitution. After a brief illness he died in New York March 11, 1913. His body was buried at Arlington, near Washington, in the presence of innumerable friends and admirers.
Besides a great number of articles and treatises published in the various medical journals, Billings wrote the following books: "The Principles of Ventilation and Heating and Their Practical Application" (1884); "Report on the Mortality and Vital Statistics of the United States as Returned by the Tenth Census" (1885; "Description of the Johns Hopkins Hospital" (1890); "The National Medical Dictionary" (1890); "Ventilation and Heating" (1893); "The History of Surgery" (1895); "Report on the Local Statistics of the Eleventh Census" (1895), and "Vital Statistics of Boston and Philadelphia" (1895).
Billings was married to Miss Kate M. Stevens in 1862, who was to him a loving and faithful helpmate in his laborious life. He left one son, Dr. John S. Billings, and four daughters.
In personal appearance Dr. Billings was tall and commanding. His handsome features bore the marks of a strong mind with unlimited will power. He was kind and sympathetic in personal, always disposed to bantering jokes. His was a frank and open nature, a true and honest Westerner who hated shams and empty pretensions. During his long and toilsome career numerous honors were showered upon him. He received honorary degrees from the universities of Edinburgh, Oxford, Dublin, Munich, Budapest, Harvard, Yale and Johns Hopkins, and was a member of numerous medical and scientific societies.
A full account of the life and work of Dr. Billings is given in a memorial volume by Dr. F. H. Garrison, who was his friend and assistant in the Surgeon General's Library for many years. Dr. Garrison's book, the fruit of laborious research, is an able and well-merited tribute to the great man. The present sketch is largely based on this work.