Mm IIIBm ,: PfetpHj::::.:;^.::-:;- ''■'■ • 'lamlit^"itv*'i'>■ ■' ■;■'.;'■■"• .111 B+5B v.^ ' ; ;-"» BULLETIN OF THE EDICAL LIBRARY ASSOCIATION NUMBE July 1961 The National Library of Medicine Anniversary Issue 1836-1961 t- '13. ' ^5 7 ^ n i PHONAL LIBRARY OF MtDlUNt v ' &THESUA 14, MO, EDITORIAL POLICIES FOR THE GUIDANCE OF AUTHORS 1. Kinds of articles accepted. Contributions of value to medical bibliography, medical librarianship, to the history of medical books, libraries and librarians, and to the history of medicine are solicited. No paper which has already appeared elsewhere will be accepted, nor will simultaneous publication elsewhere be permitted. 2. The editors reserve the right to return a manuscript to the author for revision if it is not in standard form, or to make minor editorial changes in the manuscript, if this can be done without changing the style of the article. 3. Manuscripts should not exceed twenty-five typewritten pages. 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Hillis Miller Health Center Library, University of Florida, Gainesville, Florida. Checks should be made out to the Medical Library Association. PRINTED BY WAVERLY PRESS, INC., BALTIMORE 2, MD. fflKrawi Em^iima] Make sure your library is of maximum usefulness. Have these popular new Mosby books and new editions available on your reference shelves Ready This Month! New 4th Edition PATHOLOGY One of the most popular and important medical references available, PATHOLOGY can be found in hun- dreds of medical and scientific libraries throughout the world. This new 4th edition has been extensively revised and entirely rewritten in several sections to bring it entirely up to date. With more than 90 new illustrations, this encyclopedic work continues to be the most profusely and effectively illustrated book on its subject. Edited by W. A. D. ANDERSON. M.A., M.D.. F.A.C.P.. F.C.A.P. Written by 35 contributors. Ready this month. Library of Con- gress No. 61-11863. 4th ed., approx. 1410 pp.. 1385 ills., 7 color plates. Price, $18.00. Ready in August! New 7 7th Edition MEDICAL PHYSIOLOGY This popular and clinical reference, soon to be released in its 11th edition, is the coordinated work of outstanding authorities who pooled their efforts to achieve a true classic, emphasizing the application of the latest physiological discoveries in the routine practice of medicine. Edited by PHILIP BARD, Ph.D., Sc.D. Written by 16 contributors. Ready in August. 11th edition, approx. 1185 pages, 508 ills., 4 in color. About $16.50. Ready This Month! THE ANATOMY OF THE VISUAL SYSTEM This magnificent new volume is probably the most authoritative, most up-to-date and most complete com- pendium of knowledge on the historical development and modern research into every phase of ocular anatomy ever to appear in print. By SIR STEWART DUKE-ELDER, G.C.V.O., F.R.S. and KENNETH C. WYBAR, B.Sc, M.D., Ch.M., F.R.CS. Ready later this month. Approx. 900 pp.. 842 ills., 3 colored plates. Price, $30.00. Just Published! HEREDITY IN OPHTHALMOLOGY An eminently practical book for the clinical practitioner, this new book provides valuable descriptions and many case histories of all hereditary diseases and rare syndromes relating directly or indirectly to the eyes. The most modem methods of treatment are described. By JULES FRANCOIS, M.D. Just published. Library of Congress No. 61-5380, 731 pp., 629 ills., 6 in color. Price, $23.00. Just Published! New 2nd Edition RELIEF OF SYMPTOMS This book offers the physician a practical guide to the daily problems of providing quick and effective relief for over 95% of the symptoms which bring patients into the doctor's office. By WALTER MODELL, M.D., F.A.C.P. Just published. 2nd edition, 375 pp. Price, $11.50. Just Published! MEDICAL PHARMACOLOGY—Principles and Concepts Here is a concise, excellently written reference which stresses those principles of pharmacology that the physician must fully understand to keep abreast of the tremendous advances in therapeutics. By ANDRES GOTH, M.D. Just published. Library of Congress No. 61-9980, 551 pp., 49 ills. Price, $11.00. Just Published! THE CARDIAC ARRHYTHMIAS A Guide for the General Practitioner This new book is a straightforward and unsophisticated presentation of electrocardiographic interpreta- tion of the more common cardiac arrhythmias. By BRENDAN PHIBBS, M.D. Just published. 128 pp., illustrated. Price, $7.50. New 2nd Edition Ready In August! PRACTICAL PEDIATRIC DERMATOLOGY This book is a concise distillation of modern dermatologic theory and practice. It is written for the non- dermatologic practitioner of medicine. By MORRIS LEIDER, M.D. Ready in August. 2nd edition, approx, 434 pp. About $13.00. Ready in August! DIFFERENTIATION BETWEEN NORMAL AND ABNORMAL IN ELECTROCARDIOGRAPHY An entirely new and different approach to the evaluation of electrocardiographic data and its clinical interpretation, this book is a thorough examination of normal variability and differentiation between nor- mal and abnormal in electrocardiography. By ERNST SIMONSON, M.D. Ready in August. Approx. 310 pp. About $12.00. Order from your favorite bookstore or direct from The C. V. MOSBY Company 3207 Washington Boulevard, St. Louis 3, Missouri *m Announcing A New Reprint - Available August 1961 Current List of Medical Literature Volumes 1-18, 1941-1950 Cloth bound in 20 volumes $490.00 Paper bound in 20 volumes.................. 450.00 Volumes 1-10, 1941-1946 Cloth bound in 11 volumes.................. 260.00 Paper bound in 11 volumes.................. 240 00 Volume 1, 1941 Paper bound in 2 parts...................... 40.00 Volumes 2-10, 1942-1946 Single volumes, paper bound................ 24.50 Volumes 11-18, 1946-1950 Cloth bound in 9 volumes.................... 240.00 Paper bound in 9 volumes.................... 220.00 Single volumes, paper bound................ 27.50 ;n JOHNSON REPRINT CORPORATION ? ) NEW YORK and LONDON ^r in Fifth Avenue, New York 3 17 Old Queen Street, London, S.W.I WHAT IS CURRENT in medical and scientific foreign-language literature? 1MB Intercontinental Medical Book Corp. 381 Park Avenue South New York 16, N. Y. MU 3-5088 has it The Intercontinental Medical Book Corporation gives the American medical profession access ;to foreign language scientific books published in all parts of the world. I.M.B. maintains an excellent inventory of foreign books so that orders may be filled with the greatest possible speed. I.M.B. also serves as subscription agent for all foreign medical journals. Both books and journal subscriptions are sold at the prevailing rate of exchange; there is no service charge. Ash for our 1961 catalog 6 ANSWERS TO THE QUESTION: What's New in Gynecology and Obstetrics? OBSTETRICAL ENDOCRINOLOGY Jose Botella-Llusia, Univ. of Madrid, Spain. A short, practical introduction to the main problems of the endocrinology of pregnancy, labor, and puerperium. Each chapter includes detailed refer- ences to the latest literature for further study of the problems under discussion. Copiously illus- trated. Pub. date July '61 (Amer. Lee. Gynecology and Obstetrics) PREMATURITY: The Diagnosis, Care and Disorders of the Premature Infant by Beryl Corner, United Bristol Hospitals. The philosophy of the author, who is a clinician and teacher of wide experience in this sphere, is to stress the need for critical evaluation based on an understanding of "the natural tenderness and weakness" of these infants. Hence the important inclusion of a de- tailed section on the anatomy and physiology of prematurity—unique in this type of book. In- cludes an extensive bibliography, many original drawings and photographs. Pub. date Sept. '60, 602 pp., 242 il, $21.00 CARCINOMA IN SITU OF THE UTER- INE CERVIX: A Study of 235 Cases from the Free Hospital for Women by Gilbert H. Friedell, Arthur T. Hertig, and Paul A. Younge, all of Harvard Medical School. A detailed study for those concerned with the diagnosis and management of carcinoma in situ of the uterine cervix. Even in the section devoted to pathology an effort has been made to correlate pathologic with clinical findings. Describes methods for han- dling biopsy, conization, and hysterectomy speci- mens in the laboratory for best evaluation of ex- tent of the disease. Pub. date Aug. '60, 164 pp., 98 il. {6 full color plates), $7.50 TWINS IN HISTORY AND SCIENCE /., Luigi Gedda, Instituto Di Genetica Medica, Rome. Although much has been written on the subject of twins, this is the first complete and comprehen- sive study. Gedda has made use of all available data, including his own personal observations. This book will be of interest to everyone concerned with biological and biopathological problems. It is well-written and excellently illustrated. Pub. date Aug. '61, 292pp. (7)4 x 10), 294 il. FETAL ELECTROCARDIOGRAPHY: The Electrical Activity of the Fetal Heart by S. D. Larks, Univ. Calif. This pioneering mono- graph makes available and understandable the powerful new technique of fetal electrocardiog- raphy. Covers the fetal ECG from the time of its earliest appearance right through the months of gestation to delivery. Potentialities for drug inves- tigations as well as for studies of maternal-fetal relationships are presented. Provides a new dimen- sion in cardiac understanding. Pub. date Dec. '60, 128 (6% x 9%) pp., 70 il. {Amer. Lee. Gynecology and Obstetrics edited by E. C. Hamblen), $6.50 GYNECOLOGICAL UROLOGY (32 < tributors from eight countries). Edited by A. F. Youssef, Cairo Univ. Eminent specialists from eight countries open up, explore, and reveal in forty-two chapters a no-man's land that has, until recently, been but sparsely dealt with. Beautifully illustrated by 367 figures on anatomic principles, pathologic conditions, radiographic appearances, diagnostic procedures, apparatus, and surgical techniques. Pub. date July '60, 916 pp., 367 il., $22.50 Send for our new 1961-62 catalog of over 1450 titles CHARLES C THOMAS • PUBLISHER 301-327 East Lawrence Avenue Springfield • Illinois DAVID EDWARDES' "INTRODUCTION TO ANATOMY" (1532) Edited and with an Introduction by C. D. O^M alley and K. F. Russell This book contains a facsimile reproduction, together with an English trans- lation, of Edwardes' treatise, which shows that a dissection of the human body was performed in England almost a decade earlier than has hitherto been recorded. His treatise is the first book written in England based at least in part on observation of the human cadaver. The editors discuss in their Introduction the position and development of anatomical studies in England during the sixteenth century. August. About $2.75 Order from your bookstore, please Stanford University Press MEDICAL NURSING DENTAL BOOKS OF ALL PUBLISHERS • Full Publishers Discounts allowed to Libraries and Schools of Nursing WRITE NOW FOR A FREE BOOK ORDERING KIT DETROIT TEXTBOOK STORES, INC. "Service on an Individual Basis" 135 E. ELIZABETH DETROIT 1, MICHIGAN PHONE—WO 5-6914 NEW-irom Year Book Medical Publishers Defares & Sneddon's MATHEMATICS OF MEDICINE & BIOLOGY NEW—An especially timely contribution carefully attuned to the needs of the medical re- searcher and biologist, based on the assumption that most of its users will be those who have not recently engaged in a formal study of mathematics. About a third of the book is devoted to actual applications of mathematics to problems in medicine and biology. Basic mathematical tools are developed but always against a biological background. Although the theory of sta- tistics is not treated, considerable care has been taken to include all the mathematics required for the serious study of statistics. By J. G. DEFARES, Dept. of Physiology, University of Leyden, and I. N. SNEDDON, Dept. of Mathematics, University of Glasgow. 633 pages; 177 dia- grams, tables and illustrations. $14.00. Davenport's PHYSIOLOGY OF THE DIGESTIVE TRACT NEW—Prepublication announcement of this new text has excited broad interest among edu- cators, and indeed it should, for here is, we believe, one of the most effective teaching instru- ments for both graduate and undergraduate students of physiology to appear in many years. Excellent illustrative material complements and supplements the text matter. By HORACE W. DAVENPORT, Ph.D., Dept. of Physiology, University of Michigan. 225 pages; illustrated. Ready July 15. Barness' MANUAL OF PEDIATRIC PHYSICAL DIAGNOSIS NEW 2nd EDITION—Includes new procedures, charts of normal growth rate, and other modifications required to keep this highly instructive manual up to date. Emphasis remains on the important points that each examination must be individualized and that most diagnostic errors result from errors in commission rather than lack of knowledge. By LEWIS A. BAR- NESS, M.D., University of Pennsylvania Medical School. 208 pages; illustrated. Ready July. MacFate's INTRODUCTION TO THE CLINICAL LABORATORY NEW—A complete description of essential information on care of laboratory equipment, obtaining, preservation, and handling of specimens, systems of measurement, pertinent calcu- lations, procedures such as titrations, photometry and weighing, care and use of small animals in the laboratory, discarding of specimens and dangerous chemicals, safety precautions and first aid procedures in laboratory accidents, etc. By ROBERT P. MacFATE, Ch.E., M.S., Ph.D., Division of Laboratories, City of Chicago Board of Health. 448 pages; illustrated. $10.00 YEAR BOOK MEDICAL PUBLISHERS, INC. 200 E. Illinois Street Chicago 11, Illinois noteworthy additions to the medical library BIOGRAPHICAL CATALOG of the NEW YORK ACADEMY OF MEDICINE This is the shelf list of the section in the library which contains single biographies of physicians and scientists. 3452 entries, 150 pages, 1 volume..............................$14.00 ILLUSTRATION CATALOG of the NEW YORK ACADEMY OF MEDICINE 20,000 illustrations in the early volumes of the Rare Book and History of Medicine Departments have been indexed, as well as many from histories and journals. 4263 entires, 230 pages. 1 volume.........................................$18.00 PORTRAIT CATALOG of the NEW YORK ACADEMY OF MEDICINE This Catalog includes the indexing of 10,884 separate portraits— paintings, woodcuts, engravings, photographs—in the Academy, as well as 95,844 entries of portraits appearing in books and journals. 4564 pages, 5 volumes....................$196.00 CUMULATED AUTHOR INDEX to the PSYCHOLOGICAL INDEX, 1894-1935 and PSYCHOLOGICAL ABSTRACTS, 1927-1958. This valuable and unique reference tool, which has been prepared and maintained by the Psychology Library at Columbia Uni- versity in New York, is now published for the first time. Cumu- lation is complete and in one alphabet. 32,000 entries. 4,286 p., 5 volumes........................................S295.00 FAMOUS FACES IN DIABETES, compiled by Dr. Cecil Striker. This work, by a former President of the American Diabetes Association, contains a Foreword by Elliott P. Joslin, M.D. and consists of portraits and short biographies of the men who have contributed to the various aspects of this disease. 268 pages, over 200 illustrations, 1 volume...................S25.00 All the above works are available for immediate shipment. There is a 10% additional charge on foreign orders. G. K. Hall & Co., 97 Oliver St., Boston 10, Mass. JULY 1961 Volume 49 Number 3 BULLETIN of the MEDICAL LIBRARY ASSOCIATION Guest Editor—National Library of Medicine Section Frank B. Rogers, M.D. CONTENTS Brodman, Estelle, Ph.D.—Memoir of Robert Fletcher............. 251 Roos, Charles A.—Physicians to the Presidents, and Their Patients: A Biobibliography......................................... 291 Doe, Janet—The Survey and After.............................. 361 Marshall, Mary Louise—Reminiscences......................... 369 Moseley, Elizabeth G.—Medical Dictionaries and Studies of Ter- minology ................................................. 374 Metcalf, Keyes D.—-Housing the Library. Part I. The Old Building.. 396 Kilham, Walter H., Jr.—Housing the Library. Part II. The New Building.................................................. 403 r Schiffmann, Genevieve N.—National Medical Bibliographies....... 411 Kennedy, Maxine—An Internship............................... 423 MacDonald, M. Ruth—Recataloging............................ 426 Falk, Leslie K. and Lazerow, Samuel—Comprehensive Collecting— Then and Now............................................ 434 Schullian, Dorothy M., Ph.D.—Adams Jewett and John Shaw Bill- ings, Partners in Acquisition................................. 443 President's Page (Portrait)...................................... 450 Notes from London............................................ 455 Winnowings: Abstracts and Notes................................ 457 Editorials..................................................... 466 Short Communications to the Editor.............................. 469 Executive Secretary's Page......................................472 Association News.............................................. 474 News Items................................................... 487 Book Reviews and Journal Notes................................. 493 Opinions expressed here are those of the authors and do not necessarily represent those of the Association. Copyright, Medical Library Association, 1961 EDITORIAL BOARD Dr. Alfred N. Brandon Mrs. Mildred Crowe Langner Medical Center Library Jackson Memorial Library University of Kentucky University of Miami School of Medicine ' , 1000 N.W. 17th Street Lexington, Kentucky Miami ^ Fk ^,tor Chairman, Publication Committee Mrs. Jacqueline W. Felter Mr. Frederick D. Bryant Medical Society of the County of Queens, Inc. J. Hillis Miller Health Center Library 112-25 Queens Blvd. University of Florida TT.„ », xt -ir Gainesville, Florida Forest Hills 75, N. Y. Associate Editor Business Manager Mr. Eugene Muench New York University Medical Center 550 First Avenue New York 16, N. Y. Assistant Business Manager EXECUTIVE OFFICERS President...........................Miss Gertrude L. Annan New York Academy of Medicine 2 East 103rd Street Xew York 29, Xew York Vice-President (President-Elect)......Dr. Frank B. Rogers National Library of Medicine Washington 25, D.C. Honorary Vice-President.............Dr. Harold Hillenbrand American Dental Association 222 East Superior Street Chicago 11, Illinois Secretary..........................Miss Ruth J. Mann Mavo Clinic Library 200'First Street, S.W. Rochester, Minnesota Treasurer..........................Mr. John P. Ische Louisiana State University College of Medicine 1542 Tulane Avenue Xew Orleans 12, Louisiana Past President......................Mr. Robert T. Lentz Jefferson Medical College Library 1025 Walnut Street Philadelphia 7, Pennsylvania BOARD OF DIRECTORS The Foregoing Officers and the Following Elected Members: Mr. Gilbert J. Clausman (1 year) Mrs. Bernice M. Hetzner (1 year) Miss Helen Crawford (2 years) Miss M. Irene Jones (2 years) Miss Louise M. 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Price: $3.00 American Library Association, 50 East Huron Street, Chicago 11, Illinois. Price: $10.00 Editor of Vital Notes. Subscription price a year: $2.00 Robert Fletcher, M.D., 1823-1912 During the Civil War and in old age Memoir of Robert Fletcher By Estelle Brodman, Ph.D. Associate for Extramural Planning National Library of Medicine Introduction JL.V.OBERT FLETCHER, physician, hospital administrator, bibliog- rapher, editor, statistician, anthropometrist, and amateur folklorist, was born in Bristol, England, on March 23, 1823. He received his medical edu- cation in Bristol and in London, emigrated to the United States in 1846, and established himself in Cincinnati. He served as regimental surgeon and medical purveyor during the Civil War; in 1871 he came to Washington to work as a medical statistician. In 1876 he reported as assistant to John Shaw Billings at the Surgeon General's Library, and was still serving as Principal Assistant Librarian of that institution at the time of his death on November 6, 1912. To our generation he is a shadowy and almost forgotten figure, yet his contribution to medical bibliography was substantial. This brief biog- raphy sets forth the basic facts of his life and work, and estimates his place in the history of medical librarianship. A more extended version of this memoir has been deposited in the National Library of Medicine. I Fletcher was the fourth child and only son of Robert and Esther Wall Fletcher. His early schooling was in his native city of Bristol. After finish- ing his preliminary education he entered his father's office for the study of the law; two years later, in 1839, deciding that medicine was more to his liking, he began to attend the Bristol Medical School. By the first decade of the nineteenth century Bristol had a private school of anatomy, and by the 1820's there were no less than two schools of med- icine, one an outgrowth of the anatomy school, called the School of Anat- omy and Medicine, and the other called the Bristol Medical and Surgical School. The first was recognized by the Society of Apothecaries and the second by the Royal College of Surgeons. The two schools united in 1833 to form the Bristol Medical School, using as its hospital the Bristol Infir- mary, which at that time had accommodations for over two hundred pa- tients. The Bristol Infirmary was one of the largest of the British provin- cial hospitals. It had all three orders of medical men, physicians, surgeons, and apothecaries, on its staff, and it not only allowed these officers to have 251 252 ESTELLE BRODMAN apprentices and pupils, but it arranged to use these pupils in rotation as emergency house officers in much the same way that modern residents and interns are used by teaching hospitals today. Although the nineteenth century had begun with the three orders of medical men completely separated, the exigencies of urban and industrial society required a medical man whose training embraced all three fields. These stresses produced what was first called the "surgeon-apothecary," and later the "general practitioner." Such a man received training in the practice of medicine, in surgery, and in midwifery; in addition he studied pharmaceutical chemistry and the compounding of drugs. Mr. Hoggins in Mrs. Gaskell's novel Cranford is typical of such practitioners. This system became so much the standard for the education of physicians in England in the first half of the nineteenth century that it was tacitly taken over by the Medical Act of 1858, and became the foundation of the later Conjoint Board. A good outline of the struggle to reach this position, which did not come about without both lay and professional opposition, is given by George Eliot in Middlemarch. Medical students who wished to practice as general medical men usually took the qualification examinations of both the Society of Apothecaries and the Royal College of Surgeons. The former required five years of ap- prenticeship, and to meet this requirement Fletcher was articled to Henry Clark of Bristol in 1839, although his formal studies at the Infirmary did not begin until 1840. In February 1838 the Board of the Infirmary had set up a new code to take care of the many students from the Medical School who wished to get their clinical training at the infirmary. In this code the fees of the "general" students were divided into segments, part going to the Infirmary, part to the physicians, and part to the Surgeons or Apothe- caries. Under this system students were not necessarily attached to one chief, but were the students of all in rotation. In any case Fletcher must have been busy with preclinical studies of anatomy, physiology, chem- istry, materia medica, and compounding during his first year and could have had little time or even the requisite knowledge to serve at the hospital. The reorganization of the Infirmary which resulted in the "general" students also set up a students' medical library. A Library Committee was formed and an "Acting Librarian" appointed who prepared a catalog of the collection and who appears to have had as much difficulty ob- taining the return of overdue works as any other such official. In ad- dition to this educational venture, which occurred while Fletcher was a student, there was a "Bristol Medical Students' Literary Society" where papers of professional and general literary interest were presented. The Bristol Branch of the Provincial Medical and Surgical Society (later the MEMOIR OF ROBERT FLETCHER 253 British Medical Association) was also new and vigorous during Fletcher's student days. The members of the faculty of the School and other phy- sicians and surgeons practicing in Bristol had access to a Medical Read- ing Club; in this club, books and journals were purchased jointly and passed around to the members, usually at a monthly supper party of some conviviality. It is thus obvious that Bristol was well supplied with means for professional education outside the confines of the school, and it is in- teresting to speculate whether Fletcher received the impetus for his later omnivorous reading as a result of these opportunities, or whether he him- self might not have been either one of the founders of the Literary Society or a prime mover in the Library. Fletcher studied as a medical student at the Infirmary for one year (October 1840 to September 1841) and as a surgical pupil for 18 months (October 1841 to April 1843). After he decided to emigrate to America he must have attempted to collect all his diplomas and credentials, be- cause his certificates from the Bristol institution are dated in the Spring of 1846. The medical certificate is signed by G. Wallis, Henry Riley, Gilbert Lyon, and James F. Bernard; the surgical diploma bears the signatures of John Harrison, W. F. Morgan, Henry Clark (his preceptor), and William P. Green. Fletcher would also have known Charles Red- wood Vachell, who served as House Physician and Apothecary to October 1840, and Charles Greig, who held that post after October 1840, since the person who held this office had charge of all the students and thus had more influence on their education than anyone else. Most of the men mentioned both taught at the Medical School and served at the In- firmary, some of them after Fletcher had ceased to be a student in the medical school; this circumstance is due to the interval between his leav- ing Bristol and the issuing of his diplomas. In the certificate on his clinical work in medicine, the physicians of the Bristol Infirmary added in handwriting on the printed form a few phrases characterizing Fletcher's work. "The physicians to the Bristol Infirmary," they noted, "do hereby certify that Mr. Robert Fletcher has attended the medical practice at this Institution for one year, during which time he was kind to the patients and very zealous after knowledge." The surgeons in their turn noted that "Mr. Robert Fletcher has attended our Practice at this Hospital as a Pupil for the space of one year and six months, with much diligence and attention." These characteristics— kindness to patients, zeal after knowledge, and diligence and attention to his work—were to remain with Fletcher throughout his life. The very next year after he qualified for practice by examination before the Apothe- caries and Surgeons he went to school, at the London Hospital, for 18 months of further "medical practice and clinical lectures." Here he was 254 ESTELLE BRODMAN the pupil of James Luke, who was later to be the president of the Royal College of Surgeons. In 1841 Fletcher matriculated at the London University, which was then only a degree-conferring institution without resident students. Mean- while he continued his medical schooling in Bristol. Finishing there in April 1843, he proceeded to London to prepare for the next portion of his life. There he found and furnished a place to live, and there on September 17 he married Hannah Howe, also of Bristol, in St. Martin's- in-the-Fields, Middlesex. He took only a short honeymoon, for by October 10 he had already started as a Dressing Pupil in Surgery at the London Hospital. He remained in that post for a full year, and during this pe- riod he studied for his examination at the Society of Apothecaries, which he passed on May 2, 1844. He evidently had no plans to remain in London, for he took the Extra-Licence, which entitled him "to practice in any part of England and Wales, except the City of London, the Liberties or Suburbs thereof, or within ten miles of the said city." At the expiration of his work as a Dressing Pupil, Fletcher sat for his examinations at the Royal College of Surgeons. On November 1, 1844 he was found "fit and capable to exercise the Art and Science of Surgery." On his diploma (no. 433) his address is given as Bristol, but it does not have the restrictions about practice in London. It would appear, there- fore, that some time between May and November of 1844 Fletcher de- cided to remain in London and set up practice there. What prompted the change in his plans is unknown, as is equally unknown what caused him to decide to emigrate to the United States less than two years later. Since he used the interval for further attendance at the London Hospital, there is a presumption here that, like Arthur Conan-Doyle's, Fletcher's practice in the early years left him much free time. Perhaps the need to earn more money, now that he was married and the father of one child and expecting a second, was the stimulus which led him to think first of remaining in London and then of leaving the country entirely for a wholly new world. At any rate, by the early Spring of 1846 his resolution to try his fortune in a new country had been taken. Beginning in January of that year, Fletcher set about collecting all his diplomas and credentials to take with him to a land where he was not personally known, for use as evidence of his training and experience. In an autobiographical sketch, Fletcher says that he spent six months travelling through the United States before he settled down to practice medicine in Cincinnati. How this must have seemed to his wife is un- known, but travelling through what was then very wild territory with one child less than two years old and with another about to be born must have been an ordeal. The second child, another son, named Stephen MEMOIR OF ROBERT FLETCHER 255 Robert, was born in Chicago in July 1846, and died within two months. It was surely a trying time for the entire family, and one can surmise that Mrs. Fletcher welcomed the decision to remain in Cincinnati. Cincinnati was already a bustling commercial town early in the century; its population grew from 2,500 in 1810 to 80,000 in 1846, and made Ohio the third most populous state in the Union. Cincinnati was also a medical center of some repute. In addition to the luster which three existing medical schools shed, there were several hospitals, both general and specialized. For a period the Western Journal of the Medical and Physical Sciences and the Botanical Medical Recorder were published in Cincinnati, and there was a thriving medical society which took an active interest in the work of the schools and the hospitals. The 35 phy- sicians, 14 druggists, and 5 dentists resident there in 1846 could purchase medical journals through a local bookstore, Robinson and Jones, which advertised that it could supply the London Lancet, Medico-Chirurgical Review, Bell's Medical Journal, the British and Foreign Medical Review, or the American Journal of the Medical Sciences for $5.00 a year each, the Western Lancet for $3.00, and Braithwaite's Retrospect for $1.00. What the 2 homeopathic and 5 botanic physicians read, in addition to the Botanical Medical Recorder, is unknown. With all of Cincinnati's attractions, it is not surprising that Fletcher decided to settle in that city. He must have liked life there, for he was naturalized in Cincinnati in 1852, five years after he first settled in the United States. Fletcher says that he practiced medicine in Cincinnati, but his practice was short-lived. By 1850 he had left medicine to become a wholesale and retail druggist, which he accomplished by purchasing the business of Charles Collins at Sycamore and Pearl Streets, less than two blocks from where he resided at 100 East 3d Street. By that time Cincinnati had 29 apothecaries and druggists serving the 64 physicians and 11 dentists who took care of its 115,000 citizens. Fletcher continued in the drug business for at least seven years, always at the same location, but there is conflicting testimony about his success. On one side is a letter dated August 24, 1866 from Rufus King, journalist, politician, and friend of Fletcher, to the Attorney General in Washington, which was written in an attempt to procure for Fletcher the position of Medical Purveyor in the Army. There King mentions Fletcher's "some years actual dealing in the Drug and Apothecary business in this city," and, without saying so out- right, implies that they were successful. On the other hand, Charles Collins resumed his drug business within a few years, in spite of the fact that most purchases of commercial firms carry a clause in them forbidding the original owner from setting up 256 ESTELLE brodman in competition with his purchaser. If such a contract was made, Collins' resumption of business implies that Fletcher was not able to carry out his side of the contract, thus leaving Collins free to abrogate its terms. It is curious that he did not return to the drug business after making a six month trip to England in 1857, but became instead a "Commission Merchant and Agent for Landreth's Garden Seeds" (as he himself adver- tised in the City Directory) from 1859 until he entered the Army, and that he undertook still another commercial venture after his return from the War. In the short account of his life which Fletcher wrote for the Army Board in 1863, he said: "My health becoming much disordered from frequent attacks of Spinal Neuralgia I gave up professional pursuits and in 1857 I revisited Europe. Upon returning I did not immediately resume practice...." Not only did Fletcher not resume practice im- mediately, it might be said that he never resumed it except for a period of about ten months in the Army in 1861-62. Since he had ceased to practice in 1850, the whole time devoted to the profession for which he had been trained was less than five years: two years in London, during which time he was still "walking the London Hospital," almost two and a half years in Cincinnati before the War, and less than a year in the Army. Fletcher's failure as a physician was the subject of at least one dinner table conversation at William Osier's home. Dr. W. W. Francis, Osier's cousin, who lived with Osier in Baltimore from 1895 to 1902, reports Fletcher's description of his "distaste for and lack of success in practice before the war because few of his patients appreciated his own pet prescription, 'treat it with contempt.' ',:l His ability to pass the examinations of the Army Medical Boards, both the State examination and the Federal, in an outstanding fashion a number of years after he ceased practice is, therefore, to be remarked. Fletcher presents a puzzling picture. He began his education with the legal profession in view. After two years of legal study he shifted to medicine. Following a long course of successful medical study, he then practiced for a short period in his native land. Abandoning medicine at home, he emigrated to a new country where he again practiced for a short period before finally abandoning the private practice of medicine completely. At this point he entered the commercial field as a druggist, and in this he persevered for about seven years before finally withdrawing to still another commercial field. Fletcher's frequent changes of occupation raise interesting questions concerning his personality. What kind of a man was he? On the one hand there are his later successes as Medical Purveyor in the Civil War and at the Library of the Surgeon General's 1 Letter from Francis to E. Brodman, dated March 19, 1959. MEMOIR OF ROBERT FLETCHER 257 Office, while on the other hand the sources reveal his apparent diffi- culties in England and in Cincinnati before the War. Was he one of those charming enigmas who captivate their friends and are the despair of their families? John Keats and Leigh Hunt come to mind immediately, as does Harold Skimpole in Bleak House. If these guesses are correct it is not difficult to understand why his father placed the son's patrimony in a trust fund, only the interest of which could be obtained, instead of presenting him with the entire capital outright. It must be reiterated, however, that these are only conjectures without direct proof. Besides the changes of occupation there is the matter of health. Fletcher was in the Army for approximately six years; during this period he was ill only once, for a short period in March 1862. He appears never to have been sick after the Avar until his almost fatal attack of diphtheria in his eighty-eighth year. With such an enviable record of good health for most of his life (his grandson said of him, "He was never sick a day in his life.") his "spinal neuralgia" in 1857 is surprising. Just what the disease was with which he suffered, how it had been brought about, how long it lasted, and what caused it to disappear are all tantalizing questions for which no certain answers are available.2 Even though Flether was not practicing his profession in these years, he was still keeping up with all that was new in medicine. From his Army examination it is established that sometime during this period he read Virchow's Cellularpathologie, which appeared first in German in 1858 and in English in 1860, and that he perused certain medical journals regularly. He followed with interest the new theories of bacteriology which were beginning to be promulgated about this time. Moreover, he continued his reading in English literature. John H. Brinton, Professor of Surgery of the University of Pennsylvania, and Surgeon in the Army during the war as well as the Curator of the Army Medical Museum, said of his assignment to duty in Nashville in 1865, "I... greatly enjoyed my duty in Nashville ... I had formed . .. some very pleasant acquaint- ances, and, among others, I greatly enjoyed the society of Surgeon Fletcher on duty as Medical Purveyor. He was an Englishman, thoroughly educated, and a deep Shakespearean scholar. Many and many a pleasant talk we had together, and much I learned from him." (This interest in Shakespeare was to continue and become the basis of some of Fletcher's later publications.) II When the Civil War broke out in April 1860 the United States Army consisted of less than 16,000 men, widely scattered in small posts across 2 One contemporary account of this disorder is Porter, Isaac G., On neuralgia of the spinal nerves, Am. J. M. Sc. 23: 81-93, 1838-39. 258 estelle brodman the country. The Surgeon General in Washington had a staff of two Surgeons, two Assistant Surgeons, and three clerks; there were 28 other Surgeons and 81 Assistant Surgeons serving with the troops; resignations and dismissals soon left only 98 officers to carry on the work of the en- tire department. In the course of four years, the Civil War developed into the greatest conflict in history to that time; four million soldiers were engaged on both sides, and 625,000 perished, two out of three dying of disease rather than of wounds. The Army Medical Department went into the War pressed down by outmoded traditions, unprepared, under- manned; there were no large hospitals, no ambulance corps, no nursing services, no plans. Yet four years later an organization had emerged which was efficiently doing the work assigned to it. Each State regiment was expected to furnish its own medical officer, and there was little uniformity in the methods of selection. Ohio was particularly noted for the thoroughness of its tests and the fact that appointments were made in line with the results of these tests. That Fletcher stood at the top of the list of candidates, as the result of an examination which he took at Columbus in the summer of 1861, speaks well for his medical knowledge. The First Ohio Regiment of Volunteers had been organized from a nucleus of older militia companies, had served three months through the First Battle of Bull Run, and had then returned home for mustering out. In October 1861 the Regiment was reorganized for three years of service, and after some time in camp near Dayton, proceeded to Cincin- nati for outfitting and thence to Louisville for action, under the com- mand of Colonel Benjamin F. Smith (a Regular Army officer), and with Robert Fletcher as its Surgeon and A. Wilson its Assistant Surgeon. The First Ohio Volunteers was soon assigned to the Fourth Brigade of General Rousseau, and became part of the Second Division of General Alexander M. McCook. The Regiment spent from November 1861 to April 1862 marching from place to place in Tennessee and Kentucky and engaging in slight skirmishes with the enemy. It was ordered to Shiloh on the morning of April 6, but in spite of forced marches did not arrive until daylight of the following day, by which time most of the fighting had already taken place; nevertheless, the Regiment was credited with relieving the brigade of Colonel Gibson at a crucial point in the battle on the second day and causing the withdrawal of the Rebel troops. Fletcher himself was not present at the battle, however, for by orders of Surgeon Murray in March 1862, he had been assigned to organize Military Hospital No. 1 in Nashville. In July of that year Fletcher was promoted to be Brigade Surgeon on the staff of General I. W. Sill a post in which most of his time was devoted to procuring and distributing MEMOIR OI ROBERT FLETCHER 259 Fig. 1. Militarv Hospital No. 1. Nashville, lenn. in 1864 260 ESTELLE BRODMAN supplies; and in November 1862 he took charge of General Hospital No. 7, also in Nashville, with the additional duties of Assistant Medical Purveyor, for which his previous experience made him eminently quali- fied. Finally, on February 24, 1863, he was named Medical Purveyor in Nashville, a position he held for the rest of the War and one in which he provided the medical supplies and equipment for the entire Army of the Cumberland for the remainder of the conflict. Military Hospital No. 1 grew from its founding until it contained 936 beds in December 1864; while General Hospital No. 7 (called General Hospital No. 19 after August 1863) held 629 beds at the same date. In December 1862, when Fletcher was in charge of it, the latter hospital had a complement of 15 medical officers, and provided accommodations for several hundred soldiers. Specific information is lacking about the building in which General Hospital No. 7 was housed; Hospital No. 1 was in two converted buildings: the Howard High School and a gun factory, which, according to the official report on it, "answered the purpose admirably." In addition to these hospitals, Fletcher for a time was also in charge of the Female Venereal Hospital, a unique institution in the Civil War Army. By the Spring of 1863 the venereal disease rate among soldiers in and around Nashville had risen to alarming proportions, until finally the Commanding General decided the city must be rid of its prostitutes. He therefore ordered the Provost Marshal to round up "all the women of the city publicly known to be of vile character," to place them on a chartered river steamer, and to take them away from the city. On July 8 the steamer started for Louisville, but that city refused to accept the prostitutes, as did Cincinnati also. Alter much legal action the boat was ordered back to Nashville, where it arrived on August 3 and its passengers disembarked "to resume their former modes of life." Admitting failure in his effort at deportation, the Commanding Gen- eral next decided on licensing the prostitutes, with medical examination and necessary treatment a prerequisite. A hospital was established and Fletcher placed in charge. During the first six months 300 women were examined and licensed, of whom 60 required treatment. The women were first assessed 50 cents for their certificates; when the sums procured in this fashion became inadequate, the fee was raised to one dollar, at which some of the prostitutes protested. The system was praised highly by both line officers and the Army Surgeons, and was later imported into Memphis, Tennessee, where, however, it lasted only about six months. In Nashville it was in force for at least one year, for on August 15, 1864, Fletcher submitted a report on it, which said, MEMOIR OF ROBERT FLETCHER 261 It is not to be supposed that a system hastily devised, established for the first time on this continent, and certain to encounter all the obstacles that vicious interests or pious ignorance could put forth, should be other than imperfect. We have here no Parisian "Bureau des Moeurs," with its vigilant police, its careful scrutiny of the mode of conduct of houses of prostitution, and its general care of the public welfare both morally and in its sanitary consideration. This much, however, is to be claimed, that after the attempt to reduce disease by the forceful expulsion of the prostitutes had, as it always has, utterly failed, the more philosophic plan of recognizing and controlling an ineradicable evil has met with undoubted success. Among the difficulties to be overcome was the opposition of the public women. This has so effectually disappeared that I believe they are now earnest advocates of a system which protects their health and delivers them from the extortion of quacks and charlatans. They gladly exhibit to their visitors the "certificate" when it is asked for, a demand, I am informed, not infrequently made. The majority of the patients in the hospital are not sent from the inspection room, but consist of women who, suspecting their malady, have voluntarily come for examination and treatment. Such additional duties wrere interesting and no doubt important, but the greatest contribution which Fletcher made to the War lay in his organization and administration of a large medical supply system; and this, in part at least, was his direct contribution to the victories of Sher- man's March to the Sea and Grant's Mississippi campaign. Before the Civil \VTar the Medical Department of the Army obtained almost all its medical supplies (medicines, hospital stores, instruments, dressings, books and stationery, and bedding) from a single Purveying Depot in New York City. As the country had expanded, several Sub- depots had been set up in Texas, Louisiana, New Mexico, and Utah, but these also obtained most of their stores from New York. The outbreak of the Civil War and the fighting in many places distant from the eastern seaboard soon made evident the deficiencies of such a system. At first most regiments attempted to furnish their own supplies but gradually a system of establishing Medical Purveyors at field army headquarters was evolved, with Congress giving its approval to a newly organized and expanded Medical Purveying Bureau in April 1862, and a new Medical Supply Table in July of that year. While the new Bureau was being established and organized a number of severe battles occurred. Since little help could be obtained from central points, many medical officers in the field improvised methods for ob- taining the supplies they needed. For a time Brigade Surgeons acted as supply officers, and it is extremely likely that the major portion of Fletcher's duties when he was on General Sill's staff had to do with pro- curing medical supplies for the command and furnishing them to the Regimental Surgeons under him. We know from a report of Surgeon Robert Murray on Grant's staff that the Armies in and around Tennessee 262 ESTELLE BRODMAN suffered greatly at first because of the lack of adequate medical supplies and that Murray was strongly in favor of a separate purveying group in the Medical Department. It can be assumed that he was instrumental in having Fletcher appointed by General Rosencrans as Assistant Medical Purveyor in Nashville almost as soon as such a post was authorized, and it can be further assumed that Fletcher's work in a similar position on General Sill's staff had been outstanding enough to warrant what was a promotion. Fletcher was again promoted, this time to be Medical Purveyor in Nashville, only three months after being appointed As- sistant Purveyor. Even more striking, in a time of abundant graft and profiteering on Army contracts, is the testimonial sent him by Surgeon General Barnes on December 1, 1868. "Dr. Fletcher's property and money responsibilities amounted to several millions during his six years of arduous service, and in no instance has he failed to render his accounts with remarkable accuracy and promptitude. The most striking proof of his integrity, energy, and business qualification is the fact that the final settlement of his accounts in August 1867 was accomplished in less than 48 hours without a discrepancy or disallowance." That his position of Medical Purveyor was anything but a sinecure is clear from the fact that the armies commanded by Generals Grant, Thomas, Rosencrans, and Sherman were all provided with medical and hospital materials from Fletcher's office. His ability to get the supplies where needed, when needed, in an orderly fashion and with proper records is attested by Generals Thomas and Rosencrans, as well as by the Surgeon General. During part of this time, Fletcher acted under his State commission, as Surgeon of the First Ohio Volunteers. In June 1863, however, he took the examinations in Cincinnati for appointment as Assistant Surgeon in the Regular Army, and again in September 1863 he returned to Cincinnati to sit for a higher examination to be appointed Surgeon of Volunteers in the Regular Army. In each case he passed at the top of the list. In the June examination he made 1,050 points out of a possible 1,070, falling down 10 points in anatomy and 5 points each in physiology and surgery, but getting perfect marks in all other nine subjects. The Medical Board which examined him was so impressed with his work that it appended a special recommendation to the certificate forwarded to Washington. "It is respectfully recommended," the Board stated, "that Drs. Fletcher and March be promoted as speedily as consistent with the interest of the service. They have both been on regimental duty since the commencement of the rebellion and from personal knowl- edge we can say that their reputation for efficiency and skill is highly de- served." The examination papers which Fletcher wrote for the September 1863 MEMOIR OF ROBERT FLETCHER 263 examining board have been preserved in the National Archives, and from them it is possible to ascertain the state of medical knowledge at the time, as well as how carefully Fletcher had kept up with medical advances. It is amazing to read answers prepared by a man who had left medical school 20 years earlier and had not practiced medicine most of the intervening period but who knew intimately the new theories of Virchow on cellular pathology and the researches of Middleton Goldsmith with bromine in the treatment of hospital gangrene. The detail with which Fletcher described various chemical tests for the purity of common drugs is also surprising, even for one previously in drug work, while his sug- gestions for the treatment of "scorbutic diathesis" mirror the contempo- rary medical scene accurately. As a result of these examinations, Fletcher was appointed Assistant Surgeon, U.S. Volunteers, on November 8, 1863, and Surgeon, U.S. Volunteers, and Purveyor on November 20, 1863. To round out his official Army career, it can be noted here that Fletcher was brevetted Lieu- tenant Colonel and then Colonel of Volunteers from March 13, 1865 "for faithful and meritorious sesrvice" and was mustered out of the Army on August 31, 1867. Sometime during the period when Fletcher was assigned to Nashville he brought his family to that city; and there is a legend that his younger son, Robert Howe Fletcher, then a boy of fourteen, wandered off from home in December 1864, and became involved in the Battle of Nashville. From the volume of correspondence between Fletcher and the Surgeon General on details of his purveying, it is obvious that he was kept busy in his important post; yet he managed to find time to attend a series of medical lectures delivered by John Brinton, Professor at the University of Pennsylvania Medical School, when the latter was assigned to Nashville as Medical Inspector, as well as to cultivate the acquaintance of a number of local inhabitants. The letters and reports which Fletcher transmitted to the Surgeon General's office in Washington show the range of his responsibilities as Medical Purveyor and the detail with which he was faced. For example, on June 19, 1863 he noted that 3,000 pounds of concentrated milk had been omitted from the requisition and he asked that Dr. [name unde- cipherable] be telegraphed to send 1,000 pounds at once. On October 25, 1863, he reported that 20 medical wagons shipped by the Medical Purveyor in June had still not been received. On December 16 he transmitted a special requisition, in compliance with specific orders of General Grant. In 1864 he inquired about issuing bed-sacks and pillow ticks in place of mattresses and pillows. In September of that year he wrote again about 250 iron bedsteads sent to Nashville by mistake. On October 3 he re- 264 ESTELLE BRODMAN quested authority to buy printing paper locally for use of the Surgeon in charge of the hospital. Still in 1864 he reported a great loss of bromine resulting from the current mode of packing it and suggested the use of hermetically sealed tubes in the future. During a battle in July 1864 he urgently telegraphed to Washington for special supplies and followed this up with a letter explaining in more detail. He was concerned with the amount to be paid colored cooks and nurses; wondered if the First Bank of Nashville was recognized as a depository for government funds; reported monthly on the amount of ice distributed; ordered the payment of vouchers for the care of insane soldiers at the Tennessee Lunatic Asylum and explained this to the Surgeon General; requested authority to sell books and instruments to medical officers leaving the service; asked if he could pay laborers the rate paid by other departments of the Arm) (and was refused); wished to pay white female nurses 60 cents a day; and, after the end of the War, recommended the discharge of some of the hospital stewards, the sale of some of the government property locally, and the transfer of other property to civilian hospitals nearby. Interspersed with these official letters are others of a more personal nature. Fletcher requested leave of absence to take the examinations for Assistant Surgeon and Surgeon of Volunteers. On May 5, 1866, he asked for and was granted 30 days leave, during which he came to Washington to see about a permanent position in the Purveyor's Office, and while there found he needed more time and requested an extension of his leave for 15 days. Finally, on October 10, 1866, he tendered his resignation, to be effective December 10, and requested permission to close his accounts as Medical Purveyor in Cincinnati rather than Nashville because of private family business. The actual date for his mustering out was, as noted earlier, not December 1866, but August 31, 1867. Ill When Robert Fletcher was mustered out of the Army he was forty- four years old, married, and the father of three children in their teens or early twenties. There were a number of possibilities for earning a living before him. He had been educated as a physician, and although he had not practiced for any long periods of time, it was quite possible for him to return to that profession. According to family tradition, he seriously considered this course of action, only to be reminded by his wife that this would require his being at the beck and call of anyone at all hours of the day and night. He had also been in the drug business for about seven years, longer than in any other enterprise, and it might have been logical for him to resume this vocation. Yet he had not returned to this when he came back from his European visit in 1857, and perhaps MEMOIR OF ROBERT FLETCHER 265 the same considerations kept him from it in 1867. The seed company and commission merchant venture had lasted only a short time and ap- parently had not been wholly satisfactory. Even before he left the Army, therefore, he set about trying to obtain a permanent position in the Regular Army. The War had naturally caused the expansion of all sections of the Army, not the least of them being the Purveying Bureau. With the advent of peace, the citizen-armies on both sides of the conflict were disbanded, and those corps which, because of their auxiliary positions, had depended upon the size of the total Army to determine their own magnitude also had to contract. Congress set about limiting the size of the agencies drawing funds from the government, and from 1866 to 1879 passed a series of laws establishing the maximum size of the Army and its com- ponents. A major reorganization act for the Army was approved by Congress on July 28, 1866, but a discussion of its provisions had been going on for some time prior to that date. This act provided, among other things, for a Medical Corps which included a Chief Purveyor with the rank of Lieutenant Colonel and four Assistant Medical Purveyors, five medical storekeepers, and a certain number of surgeons (at first less than 75). As early as December 12, 1865, Fletcher was hoping to receive an appointment as Assistant Medical Purveyor, for on that date he wrote to Surgeon General Barnes that he "would be glad to receive an appoint- ment as medical purveyor in the Army if such a corps is established." His appointment was recommended by General G. H. Thomas in a letter to the Adjutant General, General L. Thomas, where it evidently re- mained for a long time before being forwarded to General Barnes for consideration. Fletcher, however, had not been idle in the meantime. On August 25, 1866, he made a formal personal application for the position to the Surgeon General, and during the same week wrote to the Honorable W. Dennison, Congressman from Ohio, asking for help in getting the ap- pointment he desired. Dennison forwarded the request to the Surgeon General's office where it was endorsed by the Assistant Surgeon General, C. H. Crane, who noted, without giving details, that Fletcher was not eligible for this position according to the law, and pointed out that those recommended for the office had, with a few exceptions, held their posts for 20 years. Simultaneously the politician and journalist Rufus King of Cincinnati wrote on Fletcher's behalf to the Attorney General in Washington, the Honorable H. Stanbury, suggesting that pressure be put on the Secre- tary of War or the President to have Fletcher appointed "under the 266 ESTELLE BRODMAN new Army bill." King set forth Fletcher's qualifications for the post, stating that he was "practically experienced by some years actual dealing in the Drug and Apothecary business in this city" and noting that he "had graduated in the London College of Surgeons." (This chatty personal letter also recounts, "P. S. The cholera is rapidly disappearing and politics are growing hot.") In addition, on August 26, 1866, Alphonso Taft of Cincinnati, later to become Secretary of War and Attorney General in Grant's cabinet, and father of President William Howard Taft, wrote to Secretary of War Stanton recommending Fletcher for the post he desired, while several months later a group of prominent Ohio friends signed a joint letter to President Andrew Johnson urging the appointment. Apparently nothing came of all this pressure and finally Fletcher turned to other ways of supporting himself and his family, but he did not really give up his hope for the purveying position for some time. On August 5, 1867, he visited the Surgeon General's office in person to discuss closing out his Nashville accounts and the possibility of a per- manent position. As late as March 4, 1869, he addressed a letter to Major General J. A. Rawlins enclosing a request to the new President, General Grant, that he be appointed Assistant Medical Purveyor of the Army in place of Dr. Satterlee of New York, who had just died. It is obvious from Fletcher's language to General Rawlins that he did not agree with Assistant Surgeon General Crane's statement that he was not qualified for the position under the law. "My Army friends thought I was well entitled to [the position] by my services," he noted bitterly, "out of which I was juggled by the politicians." His enclosure was received at the Executive Mansion on March 18, 1869, with an endorsement by Surgeon General Barnes: "Under the Act of Congress, approved March 3, 1869, no new appointments can be made in the Medical Department of the Army until otherwise directed by law." The entire file was again ex- amined by General Whipple on December 31, 1872, but no appoint- ment was forthcoming as a result of it. By that time Fletcher was working as a civilian in the Surgeon General's Office in Washington under J. H. Baxter, who had in 1867 received the appointment for which Fletcher aspired and then been promoted to Chief Medical Purveyor, and pre- sumably Fletcher was not interested in seeking further appointments. Since a position with the Army was not immediately forthcoming in 1867, Fletcher had to seek other methods for supporting his family in Cincinnati. The city directory for 1868 notes that he was "Treasurer Cincinnati Elastic Sponge Co., s.w.c. 4th and Race; h. 142 Broadway." No indication is given in the alphabetical portion of the directory of what the Elastic Sponge Company was, but in the classified portion it MEMOIR OF ROBERT FLETCHER 267 is listed as a manufacturer of mattresses and bedding. In the 1869 di- rectory the alphabetical list notes that the company is a manufacturer of bedding and gives a new address for it, 176 Main Street. It is not known what kind of bedding "elastic sponge" was, though we can assume it was not today's foam rubber. Presumably Fletcher remained with the company until he left for Washington in 1871. There is a gap in our knowledge of what happened to Fletcher be- tween March 4, 1869, and August 7, 1871, but we do know that on the latter date he reported for duty in the Surgeon General's Office under Lieutenant Colonel J. H. Baxter, Chief Medical Purveyor and formerly Chief Medical Officer of the Provost-Marshal-General's Bureau. His duties were to assist Colonel Baxter in preparing the medical records of the Bureau for publication, and he remained in that position until August 31, 1876 when he was ordered to report to John Shaw Billings at the Surgeon General's Library. The Provost-Marshal-General's Bureau had been created by Congress on March 3, 1863, in an effort to do away with the acceptance of unfit recruits into the Army. It was in charge of all volunteer enlistments and drafts, and when its Medical Branch was organized on January 11, 1864, it began actively to supervise the medical examination of recruits. By the time it was discontinued, in August 1866, four drafts had been made and almost one million men examined, with acceptable records available for about one half of them. In discontinuing the Bureau, Con- gress specified that the Secretary of War should turn over the records to the then Chief Medical Officer of the Bureau, who was directed to com- pile the statistics and publish a report on them. Work began soon after, but it was not until 1875 that the two volume set, Statistics, Medical and Anthropological, of the Provost-Marshall-General's Bureau, finally was printed. In this work over 5,000,000 sets of figures were reduced to more than 5,000 preliminary tables and these further digested into 23 final tables, comprising just over 113,000 ratios. (Rates were given per 1,000.) This work was all done by hand, although "after the tables forming the second volume had been stereotyped, the completion of an improved 'calculating engine' seemed to offer the desirable opportunity of testing the accuracy of the work done." Consequently all the ratios were re- calculated with the new machine, although this delayed the final ap- pearance of the volume. In addition to the purely anthropometric information, which made up the body of the work, there were tables of rates of diseases broken down by place of origin of the soldiers and by race and nationality, with a few ecological maps interspersed. The preface of the first volume con- 268 ESTELLE BRODMAN tained a description of the medical examination systems of the armies of the United States and the principal European countries, a discussion of schemes of classifying physiological and pathological data, and a scholarly twenty-five page "Outline of the History of Anthropometry" including a four page bibliography of background reading. No authors were given for the individual sections of the Statistics, but later publications point to Fletcher as the compiler of the "History" and the bibliography. In the preface Colonel Baxter remarked: "In the preparation of the work, I have been very materially aided by the professional and scientific attainments of the following gentlemen, who have been on duty in the office, viz.: ... Robert Fletcher, M.D., late surgeon and brevet colonel, U.S. Volun- teers ..." The two volumes of the Statistics, Medical and Anthropological... received universal acclaim. The American Journal of the Medical Sciences called it "a magnificent contribution to our exact knowledge of man," and commented on the "tremendous labour. .. encountered in assorting and arranging the collected material in such manner as to exhibit the millions of facts in all their different aspects and in forms available for use." It finally concluded, "The book is a monument of almost in- credible labour of a sort little appreciated by the world." The reviewer for the Boston Medical and Surgical Journal was more restrained, but he referred to the "vast facilities of the government for the accumulation of reliable statistical information," and noted "what services may be rendered to science by a wise utilization of such opportunities. The work before us belongs to this class." Virchow, in his Jahresbericht iiber die Leistungen und Fortschritte der gesammten Medicin, praises the set highly as "eine der vollstandigsten Arbeiten welche iiberhaupt Resultate dieser Art behandeln." Even those attached to the Surgeon General's Office in other capacities were aware of the value of the work. Colonel George A. Otis remarked in a letter to Fletcher of June 1876, "I am glad, dear Doctor, to have the opportunity of expressing to you my congratulations on the completion of your share of the admirable Medical Statistics which display such a great amount of conscientious labor, and of labor wisely directed, and con- stitute such valuable addition to anthropological knowledge." Perhaps the most useful result of the Statistics to Fletcher personally was that it gave him the direction for the remainder of his life. With the publication of the two volumes, Fletcher was again faced with a de- cision about his future. Many years later John Shaw Billings related the circumstances which brought the two men together in the fruitful col- laboration which was to last almost twenty years. Speaking at a banquet in honor of Fletcher in 1906, Billings remarked: MEMOIR OF ROBERT FLETCHER 269 Thirty years ago I had issued from the Government Printing Office a specimen fas- ciculus of an Index Catalogue of the Library of the Surgeon General's Office, showing the plan of the work upon which I had then been engaged for several years. Soon after this publication Dr. Fletcher, having completed his work on the Statistics of the Provost Marshal General's Office, came to me and expressed his general ap- proval of the specimen fasciculus, saying that he would be glad to assist in the work of preparing and printing the proposed catalogue. I knew him to be a most competent and reliable Medical Officer, a statistician and a writer of excellent English, and ac- cepted his offer with great pleasure. From that time until I left the Office in 1895 we worked together in the Index Catalogue, and I soon became satisfied that the obtaining of his aid in this matter was a piece of great good fortune. I came to have a high respect for his scholarship and painstaking accuracy, to admire his energy and perseverance, to appreciate his humor- ous wisdom, and to know him as a thoroughbred gentleman. Moreover I acquired a great affection for him—a warm friendship which has continued unchilled and un- broken down to the present moment, and I am very glad to have this opportunity to say that he deserves every honor and token of appreciation which the Medical Pro- fession of the Country, and indeed of the Civilized World, can bestow upon him. Thus, after 53 years, Fletcher had finally found his metier. On September 1, 1876, in pursuance of orders of the Surgeon General, he reported to John Shaw Billings at the Library of the Surgeon General's Office. IV When Robert Fletcher entered the Library of the Surgeon General's Office, it was in the midst of the expansion which was to make it by the end of the century the largest medical library in the western hemisphere and one of the half dozen largest medical libraries in the world. Begun by Surgeon General Lovell sometime around 1836, by 1840 it had about 200 volumes, and a catalog of 1864 listed over 1,360 volumes, most of which had been gathered for use in preparation of the Medical and Surgical History of the War of the Rebellion. By 1876, when Fletcher arrived, the Library had 52,000 books and pamphlets and was growing at a great rate of speed; by 1895 it would contain more than 110,000 books and almost 200,000 pamphlets. Fletcher spent the last thirty-six years of his life in the Library of the Surgeon General's Office. At an age when most men are considering the possibility of taking their ease in life he began an entirely new career, and a career which was to present him with the opportunity to demon- strate his best qualities. It might almost be said that Fletcher did not really find himself until he was past his fiftieth birthday, but that when he had discovered a position in which his talents could be put to good use, he blossomed forth. Gone were all the doubts, the drifting, the changes in occupation, the numerous financial ventures; now Fletcher knew where he was going and how to get there. In one sense it can be said that the first 270 ESTELLE BRODMAN fifty-three years of his life were the training for his last thirty-six. If his early life were completely blotted out, his position in the history of li- braries and bibliography would always be secure because of these final decades. The Library of the Surgeon General's Office, the Index-Catalogue, and the Index Medicus are his, as well as Billings', memorial and "float through history," as Osier phrased it. On September 1, 1876, then, Robert Fletcher came to the Surgeon General's Library for a salary of $133.33 per month, plus $36.00 for com- mutation of quarters, and $12.00 for fuel, making a total salary of $181.33 a month. Later the commutation of quarters was cut to $12.00 per month, and in 1880 it was proposed to cut off the fuel allowance completely. At this point Fletcher suggested that the government pay him a flat $150 monthly. In forwarding this petition, "approved and recommended," Billings noted: The duties, with which Dr. Fletcher is charged, in connection with the Library of this Office, can only be performed by a thoroughly educated physician, who can read German, French, Italian, Spanish, and English, and who is familiar with bibliographical work, and with both ancient and modern medical nomenclature. This unusual combination of qualifications is possessed by Dr. Fletcher in a high degree and the work which he has done is eminently satisfactory, both in amount and quality. The pay which he was receiving, prior to the recent change in contract, was certainly small for such work, and I think that his request is a very modest and reasonable one, which should be granted if it be possible to do so. J. S. Billings, Surgeon, U. S. Army Library Surg. Genl's Office, Washington, D. C. January 3, 1881. This the Surgeon General agreed to, and a contract was drawn up between his office and Fletcher; in it Fletcher was designated "a private physician serving as Acting Surgeon, with the rank of First Lieutenant." Still later, in 1903, Fletcher's salary was raised to $3,000 a year, a fairly respectable sum for those days, which, with his remittances from England, allowed him to live in comfortable style. No further increase in his salary is noted in the records. At the time he came to the Library, Fletcher was already fifty-three years old while Billings was only thirty-eight, yet neither then or at any other time were their relations any thing but cordial and harmonious. Billings' complimentary words on Fletcher, quoted earlier, were no formal or tradi- tional remarks without substance and backing, nor was this the only time he expressed his appreciation of Fletcher's work. The preface of the first vol- ume of the Index-Catalogue contains Billings' graceful acknowledgment of aid. "I wish," he said, "to specially acknowledge the valuable assistance MEMOIR OF ROBERT FLETCHER 271 which I have received from Dr. Robert Fletcher in carrying this volume through the press, assistance which has gone far beyond mere routine or the limits of office-hours, and without which I should have found it impossible to have done the work and to have performed my other official duties." In a later volume he noted that "the accuracy and typographical excellence of the volumes are largely due to Dr. Fletcher's careful and skillful super- vision." To all who worked in conjunction with the two men, their liking and appreciation for each other was evident. Fielding H. Garrison com- pared their personalities thus in his biography of Billings: "Dr. Fletcher was a true scholar, especially learned in the classics and the older English literature, and, during his long life, he made many valuable contributions to anthropology and the history of medicine. He was a man not unlike Billings in character—forceful, reliable, honourable—but of a different caste of mind. Billings was essentially the man of action who delights in doing things of immediate practical moment. Fletcher's was the spirit that loves to browse and delve in the lore of the past, although, up to his nine- tieth year he took the keenest interest in all advances in medical science. Both were well-trained physicians and surgeons, both were of the same race, both had the same literary and social tastes. Thus the two men were admirably adapted to do effective team work; indeed, as Professor Welch once remarked, 'they worked beautifully together.'3" The proposed publication of the Index-Catalogue was only one reason for hiring Fletcher at this time. A more immediate need was for a medical officer who could be placed in charge of the Library for a period of several months while Billings went to Europe in connection with his work on building of the Johns Hopkins Hospital in Baltimore. Billings sailed on the steamship "Batavia" from Boston on October 7, 1876 in company with Dr. Ezra M. Hunt, a sanitarian also concerned with the Johns Hopkins Hospital, and arrived in Europe on October 16. In Europe he visited Eng- land, Germany, Austria-Hungary, Italy, and France before returning to the United States from Liverpool on December 16. During this three month period Fletcher was in charge of the Library, although he had been attached to the institution for only about a month before Billings left. That this job was not a sinecure is shown by the number of letters dictated by Fletcher to F. W. Stone, Billings' "private clerk," or signed by Fletcher after being written by other members of the staff. Also to be found in the Library's files are memos by Fletcher to individual members of the staff. Apparently the only restriction put on Fletcher at this time was that he was not to order new books or journals until Billings' return. The items in the Library's files for the period October-December 1876 which are signed by Fletcher probably equal if they do not exceed the 8 Attributed to Osier by Sir Humphrey Rolleston. 272 ESTELLE BRODMAN signed communications for all the rest of Fletcher's time with the Library By Army custom and by natural predilection, Fletcher prepared many items for Billings' signature, as is evident by the handwriting of the memos, letters, and reports. It is interesting to speculate whether this "passion for anonymity" might not have been one of the traits which endeared him to Billings; an older man gaining a name for himself under the command of a younger man might have caused some personal difficulties, even with such men as Billings and Fletcher, who were both capable of thinking and acting independently. In a certain sense, Billings needed someone to go behind him and carry out quietly and efficiently the plans which he could so brilliantly devise, and Fletcher filled this need admirably. The obverse of the coin is Fletcher's delight in detail and accuracy, evident in his Army days, his great administrative ability, and his flexibility when alternate plans needed to be devised and carried out. In a certain sense, Billings proposed and Fletcher disposed; and between them they could act as one person. Many large and advancing institutions, including libraries, have evolved a pattern of complementary personnel. There is frequently a chief who sets the policies, has the flashes of inspiration or hammers out new goals and new methods, and does the necessary work to convince governing powers to allocate funds or otherwise support the goals he has devised. Such a man frequently has as his assistant a person whose ability at de- vising fresh approaches and envisaging enlarged purposes are less than the chief's but whose sympathy with the aims of the chief and ability to carry out the details of the schemes devised are particularly great. Because these two can work together harmoniously, their synergistic effort comes to be greater than the mere total of the efforts of each one. In such a case it frequently happens that the one carrying out the plans remains a shad- owy background figure to most of those who use the institution or its prod- ucts. Thus it was for Robert Fletcher. The 36 years that Fletcher spent in the Library represent some seven times the amount he spent in any other professional pursuit during his lifetime, and the work was evidently a labor of love. Having reached this position there was no turning away to another one, no leaving it for another profession, and the importance of his work there was acknowl- edged by many. Fletcher concerned himself with many parts of the Library's work; we know that he checked booksellers' catalogs for additions to be made to the collection, and the thanks he received from 'William Osier and Ru- dolph Matas for uncovering needed information shows that he assisted some of the Library users. He was to be most concerned, however, with cataloging and indexing. MIMOIR OF ROBERT FLETCHER 273 Fic. 2. Fletcher and Fielding H. Garrison Working on the Index-Catalogue Billings hoped to bring to the attention of physicians all over the world the contents of the Library of the Surgeon General's Office. Although in- dexes to medical periodicals had been published for a century or more, and although some indexes contained both books and journal articles, no scheme as ambitious as Billings' Index-Catalogue had ever been proposed. In it was to appear not only the books contained in the Library collection but the articles in the individual issues of the journals, transactions, and other serial publications which made up the bulk (and the most important portion) of the Library. By the third quarter of the nineteenth century the literature of medicine had grown to such proportions that a work which attempted to catalog books and index journals would not only be extremely large but would also be complicated to prepare and use. If it were not to fall of its own weight, careful attention had to be paid to de- tails such as the method of indexing, the headings used, the typography, the press work, the accuracy of the citations, the form of the references, the abbreviations, and the like. After many experiments Billings in 1876 finally put out a specimen of what he had in mind and asked for sugges- tions and comments. With these in hand he proceeded through his ally. Surgeon General Barnes, to persuade Congress to appropriate money for the printing of the entire work—which he estimated would be complete in five quarto volumes, but which actually took 16 volumes to finish. 274 ESTELLE BRODMAN Working with Fletcher, Billings issued the first volume of the Index-Cata- logue of the Library of the Surgeon General's Office in 1SS0. The Index-Catalogue is not only a list of books, pamphlets, theses, and journal titles contained in the Library, arranged under author (or title) and subject, but is an index to the journal articles, arranged by sub- ject. The whole work is in one array, authors and subjects following each other in proper alphabetical sequence. The volumes were issued letter by letter beginning with A-Berlinski in 1880; 16 volumes and 15 years were needed to see the entire first series through the presses, and by that time enough additional material had accumulated to make the publication of a second series desirable. The second series was in its seventeenth volume (the T's) when Fletcher died in 1912 in his eighty-ninth year, having read proofs up until his final illness a few days earlier. Nothing like the Index-Catalogue had ever appeared before. In its scope and richness of information, in its accuracy and thoroughness, in its ease of use and inexpensive price it outdid all other similar works. William Osier called it "one of the most stupendous bibliographical works ever produced." Contemporary reviewers said of it that it was "without excep- tion the most valuable contribution to medical bibliography which has ever been made in any part of the world." Only one person appears to have noted what was later to be its fatal flaw. Dr. W. Gairdner in a private letter to Billings in 1880 remarked, "The only possible drawback is one inseparable from the material, which will necessarily supersede, or at least render incomplete, the earlier volumes before the later ones are pub- lished." Billings and Fletcher were already aware of this disadvantage and had set about to remedy it by the immediate publication of a supplemen- tary work, the Index Medicus. The Index-Catalogue appeared letter by letter; this meant that fifteen to twenty years might elapse before material on a particular subject would be published. The solution of Billings and Fletcher was the publication of a monthly index to the medical literature, complete from A to Z in each issue. There were four main differences between this monthly list, the Index Medicus, and the more monumental cyclical publication, the Index-Catalogue. The first difference has already been mentioned: the Index Medicus appeared monthly and was alphabetically complete. Sec- ond, it included only new literature, being in this way different from the Index-Catalogue, which listed all the Library's new acquisitions, whether the\ had been published recently or were early manuscripts. Third, the contents were, at least during the time Fletcher was in charge of it, ar- ranged in a classified order, based upon a scheme of classification used by the British Registrar General for returns of births and deaths and taken over for the medical and anthropological statistics of the Provost-Marshal's MEMOIR OF ROBERT FLETCHER 275 Office after the Civil War. This was in contrast to the Index-Catalogue, which was arranged alphabetically with author and subject entries inter- filed. The fourth great difference between the two publications was that the Index-Catalogue was a government publication, compiled, printed, and distributed by the government, while the Index Medicus was a private venture of Billings and Fletcher, completed outside working hours, pub- lished by several private firms in succession, and distributed for a sub- scription price. A description of the compilation of the latter is furnished by Garrison in the volume of the Index Medicus edited soon after Billings' death. The cards which had been made for the Index-Catalogue during the day were farmed out to the wives of the Library's male clerical force, who copied them in the evening and returned them to the Library the next morning. Billings and Fletcher assigned the subject headings and made the author and subject indexes on their own time; then at the end of the month, the manuscript was sent to the printer in Philadelphia. Galley proofs were read mostly by Fletcher. It is interesting to speculate upon the reason for the differences between the two publications. No evidence remains to indicate what principles led Billings and Fletcher to vary their products in this way. We can surmise, from the format of the first few numbers, that the early issues of the Index Medicus were conceived of as a bibliographic journal, with short articles and queries and answers in each issue, as well as the list proper. Such a mixed magazine has had a long history in national bibliography; the English Catalogue of Books, the Bibliographie de la France, the Halb- jahrsverzeichnis in Germany, as well as Publishers' Weekly in the United States, have all started with and some have continued in this pattern. It may be that the compilers of the Index Medicus merely followed a pattern with which they were familiar, and that only the lack of outside contrib- utors and the burden of preparing the list itself forced them soon to aban- don it. It is also comparatively easy to form a theory about the use of a classified list instead of an alphabetically arranged one. A monthly publication, meant to be superseded finally by another (the Index-Catalogue), and in- tended to be subscribed to by individuals, would logically be arranged by classified subjects, since presumably the immediate and daily use would be by those who wished to "keep up" with the publications in their fields and those immediately contiguous to them. The particular classification scheme chosen can also be explained; it had been used by Fletcher on the Civil War statistics, and familiarity probably suggested its use for the new work. Less easy to understand is the decision to publish the Index Medicus as 276 ESTELLE BRODMAN a private venture. The cost of bibliographic publications and the returns likely to be received for them have never borne much relationship. It is hard to believe that Billings, at any rate, was not aware of this fact; but had he been ignorant of it, a few years' struggle to build up the subscrip- tion list and to make the publication self-supporting, if not profit-making, would have convinced him of this truth. The private publication of a work so closely allied to his public duties would today place a government official under the suspicion that he was somehow using his public position for private ends. It is true this duality was not taken so seriously then as now, as is shown by Billings' work for Johns Hopkins University and Hos- pital and by the teaching commitments of many of the top Library staff, but it would seem that some question might well have arisen in outsiders' minds about such a situation. No evidence of this has appeared, however. A possible explanation of the decision not to send the Index Medicus through the government presses may be afforded by the history of the struggle to get the Index-Catalogue published and distributed. Although Billings had the cards for the latter ready for publication for some time, he was not able to persuade Congress to appropriate the money for print- ing the volumes, and he finally had to enlist the aid of Abraham Jacobi of New York and other well known physicians, who brought strong pres- sure on Congress to allow the Index-Catalogue to be printed. Even so, the number of copies authorized was so small that Billings often had to refuse requests for sets of the early volumes; indeed, in early years such letters of refusal frequently included a statement suggesting the inquirer write his Congressman urging larger appropriations for printing. After such an experience, it can easily be conjectured that Billings felt a monthly publication would not be possible under governmental ap- propriations; he may even have been weary of the necessary politicking and the constant obligation under which he was placing himself and de- cided to try private means of bringing the information to those who needed it. This may explain also why the first issue of the Index Medicus appeared a year earlier than the Index-Catalogue, though both were from the same cards. Whatever the reason for it, the Index Medicus appeared as a private venture in 1879 and promptly lost money. During its existence, the sub- scription price went from $3.00 to $25.00 per volume without helping the financial situation very much. The original publisher gave it up to another, and finally in 1899, it had to suspend publication because of financial dif- ficulties of its printers. After three annual volumes of a very poor sub- stitute (Bibliographia medica; Index Medicus) had appeared in France it was decided to revive the American Index Medicus as a semipublic ven- ture, with the financial backing of the Carnegie Institution, of which MEMOIR OF ROBERT FLETCHER 277 Billings was President. Fletcher took a firm hand in the planning for the new series. In a letter to Dr. Charles D. Walcott, Secretary of the Carnegie Institution, dated January 3, 1903, Fletcher said, Your letter of December 3, 1902, advising me of the resolutions adopted by the Trustees of the Carnegie Institution in regard to the publication of the Index Medicus was duly received and acknowledged. I have resolved to accept the proposal to be- come Editor in Chief of the journal with the understanding that I am to have the assistance of Dr. Fielding H. Garrison as Associate Editor. I can assure you of his competency for the position, which he has agreed to accept. It is proper to remind you of the opinion which I expressed first in a letter to Dr. Billings, and later to yourself in our interview, of the probable insufficiency of the appropriation made by the Trustees, namely $10,000 for the first year's ex- penses of the undertaking. Since I ended the publication of the Index Medicus, nearly four years ago, the quantity of medical literature in the world has materially in- creased. In a test which I have made during the past month of the number of cards to be copied I find the increase to be fully one third. This means a proportionate increase in the bills for everything up to the Annual Index inclusive. My estimate is as follows: Cost of Vol. XXI (last published) about $ 6,200 Add Vs for card-writing, proof-reading, etc. 2,067 Add for increased cost of printing, paper, etc. 1,500 Editors' salaries: SI200 and §600 1,800 $11,567 So, that in my opinion, the appropriation for the first year should be $12,000. To this view both you and Dr. Billings assented. The subscriptions will be [sic] reduce the amount needed, but I think they should not be relied upon to any extent the first year. In pursuance of our agreement I have had a circular notice printed (which was sub- mitted to you for approval) and 2000 stamped envelopes have been directed and are now ready for mailing. I had a card directory of carefully considered addresses pre- pared, and this I propose to send to you for convenience of reference when the sub- scriptions begin to reach you. About half of these circulars go to foreign universities and schools, the remainder in the United States. I append to this letter a copy of the circular notice. I have made formal application to the Surgeon General of the Army, General O'Reilly, for permission to have the office cards copied for Index Medicus use. It was gladly granted. I may add that Rockwell and Churchill of Boston, who printed the 21 volumes of the Index Medicus did most excellent work which was the admiration of our sub- scribers. They procured expensive fonts of accented type (there are often twenty languages represented in the work) and they have skilled workmen who know how to use such type. I talked with the Chief of one of the principal printing offices in this city, but he fairly admitted his inability to undertake the kind of composition required. There are many miscellaneous expenses which should be paid from a ready money fund. I think it would be well for me to make the requisition for a small amount as needed from time to time. A statement of these disbursements with vouchers can be 278 ESTELLE BRODMAN sent monthly or quarterly as you desire. I enclose such a requisition for $300 out o which to begin with the expenses of the circulars and envelopes may be defrayed. In his eighty-eighth year Fletcher tendered his resignation as Editor of the Index Medicus to the Carnegie Institution to take effect on December 31, 1911. Robert S. Woodward, the President of the Institution, replied, "... the Executive Committee ... accepted [it] with the warmest expres- sions of regret that advancing years should make this step necessary, and with expressions of admiration for the scholarly and painstaking labors you have so long devoted to the preparation and publication of the Index Medicus." Then, at the suggestion of Fletcher, they appointed Fielding H. Garrison the new editor. With all these years of bibliographic endeavor, it is disappointing that so little direct evidence of what Fletcher did in the Library can now be uncovered. There are suggestive data, as when we are told by Osier, in his obituary sketch of Fletcher, that the first time he came to the Surgeon General's Library Billings put him in the charge of Fletcher, from whom he continued to receive much aid over the years, or Kelly's comment on Fletcher's "rare scholarship and that courteous and cheerful spirit of help- fulness which has endeared him to the entire profession of the United States." In spite of this, the Library files show almost no primary docu- ments. A search of the National Archives does not reveal any data beyond Fletcher's Army career and his subsequent attempts to obtain a government position, plus a few scattered fiscal documents on his contracts and pay. His family retains no Library material from this period of his life. If he wrote or received personal letters pertaining to Library matters, these have not been preserved. But in all probability the Library of the Surgeon General's Office could not have risen to the position it did or have accom- plished as much for the good of medicine without the devoted, exacting, and painstaking scholarly work of Robert Fletcher. V ■ During the period that Fletcher was attached to the Library, he taught medical jurisprudence at Columbian (now George Washington) Uni- versity in Washington and at the Johns Hopkins University in Baltimore; was one of the founders and for a number of years President of the An- thropological Society of Washington; was President of the Philosophical Society of Washington, the Literary Society, and the Cosmos Club (a social club of scientists and high government officials); and published a number of papers on literary, philosophical, and anthropological topics. He amassed a large private library which was sold at auction after his death, and the sale catalog attests to the wide range of his interests. In addition to all this, however, Fletcher was an excellent conversationalist and a bon MEMOIR OF ROBERT FLETCHER 279 vivant of the first water. On the latter point, for example, Osier notes that "it was a rare treat to dine with him quietly at his club in Washington. He knew his Brillat-Savarin well, and could order a dinner that would have made the mouth of Coelius Apicius to water," while his grandson complained about the portrait of Fletcher now in the Library: "It made my grandfather look too frail and almost ethereal, for besides being a scholar he was pretty much of a man." After his wife's death in 1889 Fletcher moved to a commodious apartment in Washington's first apart- ment building, the Portland on Thomas Circle, where he lived until his own death in 1912, and where he was known as a tall, well groomed, cour- teous, typical "gentleman of the old school." As Garrison wrote to Harvey Cushing in 1912, "he was everything we expect the English gentleman of the highest type to be." Anthropology. A sketch of Robert Fletcher done in 1893 by P. Renouard for Harpers' Weekly has as shadowy figures in the background behind Fletcher's head some characters out of English literature, while before him on the desk are a number of skulls. In this way the artist attempted to indi- cate some of the fields with which Fletcher was connected and to which he had made significant contributions. It is difficult to know when Fletcher first became interested in the field of anthropology, although it is prob- ably safe to say that his work on the statistics of the Civil War intensified whatever interest he had had in this field earlier. Fletcher compiled the history and bibliography of anthropometrics in the Baxter volumes; whether this was due to his previous interest in and knowledge of the subject, or whether the historical sketch and bibliography brought forth an interest in the subject is hard to determine. From this time on, however, Fletcher read deeply in the subject, collected in it both privately and for the Surgeon General's Library, published a few articles, and helped to bring into being an organization in Washington where all those inter- ested in the subject could come together for discussions. Anthropology in the 1880's, when the Anthropological Society of Wash- ington was getting under way, had not yet been so extensively subdivided as today. The line between physical and cultural anthropology had not been drawn with present-day rigor, and the study of primitive societies was still being undertaken by amateurs, for the most part—travellers looking for the quaint and surprising, colonial officers whose main interest was in retraining "natives" into European ways, and missionaries searching for the evidences of cultural evolution inevitably leading to what they con- sidered the highest form of the good society, western Christianity. At the same time that the Parisian school of Paul Broca was emphasizing the collecting, description, and classification of anthropological facts (for ex- ample, by the establishment of museums of skulls and other bones and the classification of primitive religious beliefs), the Italians under Lom- 280 ESTELLE BRODMAN broso were attempting a correlation between physical form and social characteristics. Anthropology was thus breaking up into a study closely allied to anatomy on the one hand, and one allied to the social sciences (especially penology) on the other. Fletcher appears to have been interested in both aspects of the subject. He collected catalogs of the holdings of museums of physical anthropology in Europe and the United States with the same assiduity with which he added to the Library works on Siberian shamanism, American Indian burial practices, and crime detection among various peoples. He wrote, for example, both on prehistoric trephining and on the new school of criminal anthropology. Undoubtedly he was partly influenced in this field by the presence of the Army Medical Museum in the same building with the Library, with its collections of anthropological materials and an active staff including such people as William Woodward and Daniel Smith Lamb, and partly by his earlier work with Baxter. But perhaps as in- fluential as any of these was Fletcher's catholic interest in all human affairs. Like Terence, he could say, "Humani nihil a me alienum puto." In anthropology, as in a few other subjects, Fletcher's importance is as a catalyst and as an instigator of interest in others, not as one who does fundamental research on his own or makes useful additions to man's knowledge of the subject. He was basically a middleman-librarian, what Billings in another context called "a hod carrier," helping to build the intellectual edifices of the future. A list of Fletcher's writings in the field of anthropology does not reveal any work comparable to the bibliographic publications he was turning out at the same time. By the very fact that he was instrumental in founding the Anthropological Society and con- tinued as President during its formative years, however, he was useful to the field, providing a forum for the people who were making the real ad- vances in the new science. Nor is this a minor matter. If science is cumu- lative, then each scientist must know the work of the people in his field in order to build on it. Without such communication, each person must discover for himself all that has already been known. Throughout the his- tory of science, the importance of the founding of scientific societies in the forward development of knowledge cannot be stressed too strongly. The Anthropological Society of Washington may not have been another Royal Society or an Accademia dei Lincei, but within its own sphere it was as important as these, and to Fletcher must be attached some of the glory of this fact. Literary work. As a young boy Fletcher had kept a commonplace book, which is still preserved. In it, whether under pressure from some adult or by his own design, he copied bits of prose and poetry which had interested him. This collection shows the wide tastes of the boy, for material in MEMOIR OF ROBERT FLETCHER 281 English, French, and German, and on a variety of subjects is included; the foundation for his future deep interest in the works of Shakespeare is also shown. A few moral precepts are dutifully copied out, but for the most part the passages selected recount some stirring event or describe the beauty of nature. Wide reading in all literature, but especially in Shake- speare, an interest in people, and a delight in nature were to be character- istics of Fletcher all his life. The wide range of Fletcher's reading and the ability to quote pertinent passages at will made his conversation a delight to all those about him. As noted earlier, Brinton had commented on Fletcher's conversational powers, which he enjoyed while both were stationed at Nashville during the Civil War. Osier recalled in later years how a group of the physicians from Johns Hopkins frequently would join Fletcher at Dr. Hurd's after Fletcher's lectures at the medical school and partake of a meal and wonder- ful conversation. Garrison mentioned Fletcher's conversational style with such respect and enjoyment that it is interesting to conjecture if the younger man's famous style might not have been modeled, consciously or unconsciously, on the older man's. ("I think of the Doctor as one of my very best and kindest friends," he wrote Osier in 1912.) Even as late as 1959, Dr. W. W. Francis of McGill University, cousin of Osier, recalled with nostalgic pleasure Fletcher's conversational encounters when both dined at Osier's home in the 1890's. Apparently all who heard Fletcher discourse came away delighted, dazzled, and completely enthralled. As in anthropology, so in belles-lettres Robert Fletcher did very little scholarly research. A few of his writings, such as the article on the robin redbreast in English literature, medical lore in older English dramatists, or word derivations in old English, are useful and enjoyable compilations. In a sense, they are truly library works—a kind of annotated bibliography strung together—but in no sense do they contain new insights or new conclusions derived from the information amassed. A request which he received in February 1890 from Dr. S. P. Langley, Secretary of the Smith- sonian Institution, shows the kind of use to which Fletcher's encyclopedic literary knowledge could best be put. Langley wrote: My dear Doctor Fletcher: ... I would esteem it a very great favor if you could furnish for certain birds among The Birds of Literature in the Children's Case, one or two mottoes, with quotations, and perhaps some brief allusion to any habits of the bird which may have given occasion to the poet's expression..... ... If vou should happen to recall any quaint quotation from an old author about the Barnacle Goose, or other like superstitions connected with birds, I should be very glad to get them..... A knowledge of such tag ends of quotations and literary allusions was Fletcher's greatest strength, and it is not surprising that in preparing an 282 ESTELLE BRODMAN exhibit intended to tie up nature and literature, the Smithsonian would turn to Fletcher for aid. Unlike Bartlett and his Familiar Quotations, however, Fletcher never compiled and indexed his knowledge in this field, and beyond a few articles (the last of which appeared posthumously) Fletcher's stock of such information was lost at his death. It may be that the literary talents of his eldest son, Robert Howe Fletcher, who published a number of short stories and novels of the W'est, were fostered by his father's similar interests. Teaching. From 1884 to 1888, Fletcher taught medical jurisprudence at the Columbian Medical College (now George Washington University), and for a number of years journeyed to Baltimore once a week to lecture to the medical students on the same topic. Although he had originally been intended for the law and had actually started his studies for that pro- fession, this was British law, and of the 1830's and 1840's, to boot. Our lack of knowledge about when he picked up enough information about American medical law to be able to teach it at one of the leading medical schools is as baffling as our ignorance of the date when he first began his lectures. Much more is known about his attempt to resign his position there in 1904; from the interchange of letters about this, it would appear that by then the lectureship was of fairly long standing—-if one can use this phrase about a school which had not even been in existence for twenty years. In February 1904, at the age of eighty, Fletcher sent to Dr. \Y. H. Howell, Dean of the Faculty of Medicine at Johns Hopkins, his resignation as lecturer in forensic medicine. He apparently gave as his reasons his age and the feeling that he was taxing his eyes unduly by the continuous night work he felt to be necessary to keep his lectures up-to-date. Dr. Howell consulted with Dr. Hurd, the Superintendent of the Hospital, and other members of the Faculty, then, on February 25, wrote suggesting that Fletcher withdraw the resignation, "unless the reason is imperative." To this Fletcher replied on March 1, "I thank you for your courteous remarks in relation to my resignation as lecturer. Permit me to say to you, in all frankness, that my sole reason for sending it in was an impression on my part that perhaps it might be desired to confide the work to a younger man, and I desired to leave the Faculty at full freedom to exercise their judge- ment in the matter." Dr. Hurd seconded Howell's entreaties. "We wish to keep you as long as you are willing to remain with us," he noted on March 10. "Your lec- tures are much appreciated by the medical students and I know of no one who would at all fill your place." A week later the Faculty met, and Hurd reported the results to Fletcher immediately: MEMOIR OF ROBERT FLETCHER 283 Dear Dr. Fletcher: Please pardon my writing with the typewriter, but I am anxious to communicate with you as promptly as possible. Your resignation was presented by Dr. Howell at the meeting of the Medical Faculty on Thursday afternoon last. There was, however, such a unanimous feeling of regret and a universal desire that you still continue your connection with the Medical School, I asked that final action be postponed until the next monthly meeting. Meantime I was asked to write to you to express the regret of the Faculty that you had come to this decision, and to ask if it would not be possible for you to still continue to hold the place without taxing your eyes by night work. In other words, the lectures which you are delivering are so satisfactory, the members of the Faculty feel that they do not need constant rewriting. If you feel able to endure the fatigue and exposure of the journey here, I am sure everyone will be fully satisfied with the lectures as they are. Fletcher did not withstand these flattering pressures for long. Hurd's let- ter of March 19 was answered on the twenty-second with one agreeing to continue as lecturer, a position he retained for another five years. Although Fletcher prepared his notes in the evening on his own time, the time of his journeying to and from Baltimore and the actual lectures were all part of a normal working day. This was true of Billings' and later Garrison's lectures, indicating how usual was such extralibrary employ- ment. Other interests. We know that Fletcher was connected with the Philo- sophical Society of Washington and with the Cosmos Club, of which he was President at one time, but little more than this is known of his con- nection with the two groups. It is likely that the number of scientists and philosophers in Washington in the decades between Grant's administra- tion and the turn of the century was so small that almost all of them be- longed to the same professional and social groups, in which the offices were passed around over a period of years among nearly all members. Such a view is bolstered by the fact that Billings held membership in most of the same local organizations as did Fletcher, and that both were elected to the same offices at different times. In such a situation, an organization would tend to rise or fall in importance and usefulness according to the characteristics of the particular individual heading it at a particular time. Even without documentary evidence, it seems reasonable to assume that the kitchens and wine cellars of the Cosmos Club grew and flourished during the years when Fletcher was President. Undoubtedly the spirits of Escoffier, Brillat-Savarin, and the Discoverer of Roast Pig rejoiced at the election of Fletcher to this office. Honors. At least twice in his life Fletcher was honored by the medical profession of Baltimore and Washington by dinners tendered him as a tribute to his work in the Library and medical bibliography in general. 284 ESTELLE BRODMAN In one case Osier arranged the dinner and in the other he came from England to speak at it. In addition, a large group of people, both from the United States and overseas, subscribed to a loving cup and a portrait of Fletcher to be hung in Library Hall. He was the subject of an article in the New York Tribune for August 12, 1900, obviously written by an in- timate. At Osier's instigation, the Royal College of Surgeons in 1910 pre- sented Fletcher with its Honorary Gold Medal, and in 1912 the University DINNER IN HONOR OF Dr. ROBERT FLETCHER JANUARY 11TH, 1906 SitflVt Sitnnr MARTINI COCKTAILS MANHATTAN COCKTAILS SHERRY AND BITTERS + (tape (Slab ©yatera iRariuterea (Clrar (green ulurtlp fbanp (Oliwra (Curlri) (Irlfry (*altri> Almauils llUmkru £>h/au fHaitrr tVffintd {Intatitra ^nllanitaiara (Curumbrra iBrntlpd fHnfihromiiB an anaat &mall Suurtirra a la ffinrllr S>arbet idarquiir au Kummrl Diuiiau S>aiuiaije Btnffeii tutth. (Urfpstuuta ani» g>attaagra &mitbfiel& l[am (glare lyjiiiinrh. nt (Eoqiiillra (Cbauipiiijitr &a»rf Bmiurjiort 1 i i -t 1 $ H 3" n 0 t—i *i B <-H 0 « B H ? 0 W ■3 » 0 5 dddOdddddC X 3 rt 3. •-' 2. i p a SpB- P^Vp * * 3 s £ ^ a ^ 8 S^pSIS v 2 (1 o > jo B w o • 0 c. Dr. Frank Howe Dr. Henry B. Deale Dr. C. F. Stokes Dr. Williams Donnally Dr. C. A. L. Reed Dr. D. K. Shute Dr. Geo. F. Becker Dr. S. B. Muncaster Dr. De Forest Willard Dr. A. Jacobi Dr. Chas. L. Heizmann Dr. W. S. Thayer Dr. Jas. T. Wilson Dr. W. M. Polk Dr. W. H. Welch Dr. A. F. A. King Dr. Henry M. Hurd Dr. Wm. Osier Dr. H. C. Yarrow Dr. Robert Fletcher Dr. R. M. O'Reilly Dr. W. K. Van Reypen Dr. Thomas B. Futcher Prof. R. S. Woodward Admr. J. G. Walker Dr. Howard A. Kelly Dr. Jas. Tyson Dr. Walter Wyman Dr. Henry Barton Jacobs Dr. W. F. R. Phillips Dr. George Tully Vaughan Mr. Richard Rathbun Dr. J. Whittredge Williams NORTH WEST SOUTH EAST 3 • H d d B I 2 < 3 6 < 0) — c"5 2. 3 — o i s S2 t- 3 g d ^1 r; 3 v § a- a - I •< > S. n C 5' s " B. • 3 o • ", = > ? D > l K S ?r n. s £ 3. Dr. Z. T. Sowers Dr. E. M. Gallaudet Dr. Walter A. Wells Dr. T. V. Hammond Dr. James D. Morgan Dr. Walter D. McCaw Dr. S. O. Richey Dr. W. C. Borden Mr. Herbert Putnam Dr. Sterling Ruffin Dr. Lewellyn Barker Gen. Theo. Schwan Dr. G. M. Sternberg Dr. W. S. Halsted Dr. S. S. Adams Dr. J. C. Wise Gen. Joseph K. McCammon Dr. Arnold Hague Dr. F. Fremont Smith Dr. Cyrus Adler Gen. L. A. Matile Dr. Middleton Cuthbert Dr. Albert L. Stavely Dr. C. R. Collins Dr. T. N. McLaughlin Dr. Geo. N. Acker Dr. F. R. Hagner Dr. Wm. Gerry Morgan Dr. Truman Abbe Dr. H. H. Kerr Dr. Philip Marvel Dr. J. O. Skinner 285 286 ESTELLE BRODMAN of Bristol gave him an honorary degree. In America numerous schools and societies declared him an honorary member. When Major McCaw became Librarian of the Surgeon General's Library in 1904, it was intimated to him that he should treat Fletcher well, and Osier noted that McCaw's "kindly interest and care of Dr. Fletcher have been much appreciated by all his old friends." By special Act of Congress in 1891, Fletcher was named Principal Assistant Librarian of the Surgeon General's Library. On his death, a spate of laudatory obituaries in medical journals all over the world bespoke the esteem in which he was universally held. In 1904 at the age of eighty Fletcher, who had once claimed to have suf- fered so severely with spinal neuralgia that he had to give up the practice of medicine, was in such good physical condition that a weekly round trip on the steam cars between Baltimore and Washington did not deter him from continuing his series of lectures at the Medical School. Perhaps he took Osier's famous advice about a heart disease—to take good care of it and so outlive all his contemporaries. Or perhaps Fletcher's own motto about illness, "Treat it with contempt," helped him personally. Whatever the cause, Fletcher continued well and interested in the world about him for almost a decade thereafter. He came to the Library daily; he answered questions for a few chosen people; he classified material for the Index- Catalogue and Index Medicus; and he read proof in the miniscule type used therein—all apparently without difficulty. Major McCaw, Librarian after 1904, gave a cheerful picture of Fletcher's last years. "Time dwelt very gently with him," he noted. "Except for the feebleness of extreme old age, his health was excellent and his mind unimpaired." Thus Fletcher continued until the spring of 1911, when he was the victim of a severe attack of diphtheria. In view of his advanced age (he was eighty-eight years old at that time) it is not surprising that he re- covered very slowly. Even after he returned to the Library in the early fall, which he insisted upon doing against the advice of some of his friends, he was not completely well. He continued to read proofs at the Library desk up to within a few days of his death; finally his weakness precluded even this exertion. He went home to rest, where he died peace- fully on November 6, 1912. A few days later he was buried with military honors in Arlington Cemetery beside the body of his wife and overlooking the Mall which led to his beloved Surgeon General's Library. VI Today we stand almost fifty years from the death of Robert Fletcher. With this perspective, can we determine what Fletcher really did or eval- uate his contributions to society? His contemporaries seemed to have no doubt of his place in the world; yet to our generation he is a shadowy and forgotten figure, worthy only of a footnote or two. We are baffled MEMOIR OF ROBERT FLETCHER 287 by the paucity of documentation about him and confused by the realiza- tion that a man apparently so useful to and so beloved by his peers should have so quickly become a kind of ethereal myth, with fact and story and conjecture all interwoven. What his fellows thought of Robert Fletcher has been revealed in the pages which have gone before. It appears to me that Fletcher's greatest contributions to the world about him were directly related to his love for order and tidiness and good records. This is shown in his three greatest triumphs. The first was in his work as Medical Purveyor during the Civil War, where he took the broken system (or lack of system) of the Medical Department and made it so workable that the troops of Generals Grant, Sherman, and Thomas could be put into the field with assurance of ade- quate medical equipment wherever and whenever they needed it. His second .great success was in the field of medical bibliography. We have noted that Fletcher's Civil War accounts were kept so carefully that it was possible to audit them in a few days after the conflict. The same feeling for good records undoubtedly made Fletcher a careful, exact, painstaking, and accurate medical bibliographer—the ideal editor for the Index-Catalogue and the Index Medicus. It is fascinating to spin con- jectures of what would have happened if Fletcher had not been there to bring to fruition the plans laid by Billings. Would Billings have con- cluded the system itself was unworkable and devised another one, or would he have been able to obtain another assistant who was Robert Fletcher in all but name? "We do not know; all we are sure of is that Fletcher was essential to the success of the bibliographic endeavors of the Surgeon Gen- eral's Library; had he not been there it would have been necessary to locate someone like him. Here also it was Fletcher's love of accurate rec- ords which led him to this, his greatest triumph. The third great contribution which Fletcher made to the world was the help he gave to the users of the Library, and this was due fundamentally to his enormous memory, in which he apparently was able to keep thou- sands and thousands of facts neatly sorted and cataloged, to be produced when requested by inquirers. Although this was undoubtedly one of the traits which brought him the greatest fame, even awe, from his colleagues, to one of this generation it seems to have retarded rather than helped the Library, if one takes the long-term view. Many things can be kept in the memory of most intelligent people, and for these no formal set of catalogs or other mnemonic devices are necessary. Adding to the number of such bits of information, however, finally results in a situation where some ex- ternal system must be set up to act as the memory for all the facts.4 4 This is no new problem, of course. The Preface to the first known concordance to an English Bible—the early fifteenth century Wycliffite Xew Testament—states in part, 288 ESTELLE BRODMAN Billings and Fletcher were able to see that in the field of medical bib- liography the time for an outside system had already come; no one could any longer remember everything that was being published in the field. This was the impetus for founding the indexes they edited and published. But medical literature, although broken up into a large number of units, appeared physically in only a finite number of volumes on the Library's shelves. Apparently to these two men with prodigious memories, the time had not yet come which would demand an elaborate external system for locating the containers in which the literature was stored—the mono- graphs and journals on their shelves. As a result, when these men left the Library, no one could carry on effectively. Had Billings' and Fletcher's in- ternal systems of cataloging and classifying by memory not been so effec- tive, they would probably have realized the need and devised a scheme for numbering, perhaps classifying numerically, the collection and for pre- paring a permanent card catalog of the books in the Library. This is borne out by the fact that Billings started such a system when he went to the New York Public Library. If this had been begun at the Surgeon General's Library when the dynamic spirit of Billings and Fletcher was still a moving force, the work could have been undertaken while the literature was still of manageable proportions, and the uneasy period of the Renaissance of the 1930's and 1940's in the Army Medical Library could probably have been avoided. Thus Fletcher's personal strength led to a grave weakness in the institution he served. In the other fields in which Fletcher was interested, his importance is minor. His work in anthropology, literature, even medical jurisprudence, was such that probably many another person would have been equally useful and successful. Even in these fields, however, his contributions seem of the cataloging, record-keeping, tidying variety. They reveal Fletcher as a well rounded man with many facets to his interests, but with a single focus: accurate records. The traits of accuracy, liking for complete records, order, service to questioners, and even courtesy are those of the ideal librarian. As Sir Humphrey Rolleston has defined him, "the ideal librarian is a saintly character with a keen interest not only in books but in their would-be readers, whose time he saves thereby helping them, rather than himself, into print and prominence." In this sense Robert Fletcher was one of the truly great librarians—those intermediaries between scholars and scholar- ship whose monuments are the writings of those they serve. "Mannes mynde, yat is ofte robbid of ye tresour of Kunnyng bi ye enemye of vat is forgetyng, is greetly releeved bi tablis maad bi lettre aftir ye ordre of ye a MEMOIR OF ROBERT FLETCHER 289 APPENDIX I CHRONOLOGICAL LIST OF WRITINGS OF ROBERT FLETCHER An outline of the history of anthropometry, or the attempts to ascertain the proportions of the human body. (In: Statistics, medical and anthropological, of the Provost- Marshal-General's Bureau. Washington, Government Printing Office, 1875, v. 1, p. lxii-lxxxvii) An owl's revenge. (Transl. by Dr. R. Fletcher from the Bull. Soc. m£d. de la Suisse Rom.) [Severe injuries of eyes.] Am. Naturalist 13: 262-265, 1879. Paul Broca and the French school of anthropology; a lecture delivered in the National Museum, Washington, D.C. Saturday lectures, Washington, p. 113-142, 1882. On prehistoric trephining and cranial amulets. Contrib. N. Am. Ethnol. no. 5, 1882. Abstracted in: Tr. Anthrop. Soc. Wash., 1: 47-51, 1882. Tattooing among civilized people. (Read before the Anthropological Society of Wash- ington, Dec. 19, 1882.) Tr. Anthrop. Soc. Wash. 2: 40-68, 1882-83. A study of some recent experiments in serpent venom. Am. J. M. Sc. n.s. 86: 131-146, 1883. Human proportion in art and anthropometry. A lecture delivered at the National Museum, Washington, D.C. Cambridge, King, 1883. 37 p. Myths of the robin redbreast in early English poetry. Am. Anthrop. 1: 97-118, 1889. The vigor and expressiveness of older English. A paper read before the Anthropological Society of Washington, December 17, 1890. Am. Anthrop. 4: 1-18, 1891. The new school of criminal anthropology. An address delivered before the Anthro- pological Society of Washington, April 21, 1891. Am. Anthrop. 4: 201-236, 1891. The poet—is he born, not made? Am. Anthrop. 6: 117-135, 1893. Brief memoirs of Colonel Garrick Mallery, U.S.A., who died October 24, 1894. Wash- ington, Judd & Detweiler, 1895. 11 p., port. Anatomy and art. The annual address read before the Philosophical Society of Wash- ington, December 12, 1894. Bull. Phil. Soc. Wash. 12: 411-432, 1895. Medical lore in the older English dramatists and poets (exclusive of Shakespeare). Read before the Historical Club of the Johns Hopkins Hospital, May 13, 1895. Bull. Johns Hopkins Hosp. 6: 73-84, 1895. The witches' pharmacopoeia. Read before the Historical Club of the Johns Hopkins Hospital, April 13, 1896. Bull. Johns Hopkins Hosp. 7: 147-156, 1896. Scopelism. An essay read before the Anthropological Society of Washington, April 20, 1897. Am. Anthrop. 10: 201-213, 1897. A tragedy of the great plague of Milan in 1630. Bull. Johns Hopkins Hosp. 8: 175-180, 1898. Also in: Am. Med.-Surg. Bull. 12: 854-860, 1898. William Whitney Godding, 1831-99. Bull. Phil. Soc. Wash. 13: 390-396, 1900. On some diseases bearing names of saints. Bristol M.-Chir. J. 30: 295-315, 1912. Columns of infamy. Am. Anthrop. 14: 636-642, 1912. APPENDIX II REFERENCES I. Printed Works Adams, George Worthington. Doctors in Blue, the Medical History of the Union Army in the Civil War. New York, Schuman [cl952] 290 ESTELLE BRODMAN Baxter, J. D., ed. Statistics, Medical and Anthropological, of the Provost-Marshal- General's Bureau. Washington, Government Printing Office, 1876. 2 v. Bishop, Wt. J. Evolution of the general practitioner in England. Practitioner 168: 171-179. 1952. Brinton, John H. Personal Memoirs of John H. Brinton, Major and Surgeon, USV, 1861-65. New York, Neale Publishing Co., 1914. Cincinnati Almanac for 1840- [1846] ...Cincinnati, Robinson, 1840- [1846] Cunningham, Horace Herndon. Doctors in Gray; the Confederate Medical Service. Baton Rouge, Louisiana State University Press [cl958] Fletcher, Robert Howe, Jr. An Outline Genealogy of the United States Branch of the Chester-Liverpool-Bristol Fletcher Family. Washington, D.C, [n.p.] 1941. Little, Ernest Muirhead, comp. History of the British Medical Association, 1832- 1932. London, British Medical Association [1932] Maxwell, W. Q. Lincoln's Fifth Wheel. New York, Longmans, 1956. Newman, Charles. Evolution of Medical Education in the 19th Century. London, Oxford University Press, 1957. Rivington, Walter. The Medical Profession . .. Dublin, Fannin, 1879. Smith, G. Munro. A History of the Bristol Royal Infirmary. Bristol, Arrowsmith [1917] U. S. Army. Surgeon-General's Office. Medical and Surgical History of the War of the Rebellion (1861-65)... Washington, Government Printing Office, 1870-88. 2 v. in 6. U. S. War Department. War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies ... Washington, Government Printing Office, 1880-1901. 70 v. in 128. Williams' Cincinnati Directory, City Guide, and Business Mirror for 1849/50- [1872] II. Manuscript Collections Correspondence, diplomas, cuttings, writings, notebooks, pictures pertaining to Robert Fletcher presented to National Library of Medicine, Washington, D.C, by Colonel Robert H. Fletcher, Jr. 1959. Files of Surgeon General's Library in National Library of Medicine archives. ... Souvenir. Complimentary Banquet and Presentation of Loving Cup to Dr. Robert Fletcher. By his friends, January 11, 1906. 1 v. War Department files in National Archives. (See especially file on Robert Fletcher, which contains his short autobiography up to 1863). Physicians to the Presidents, and Their Patients: A Biobibliography By Charles A. Roos, Reference Librarian National Library of Medicine Contents Page Page 293 Rutherford B. Hayes......... ..... 327 302 James A. Garfield............ ..... 328 304 Chester A. Arthur......-..... ..... 337 . 305 Grover Cleveland............ ..... 338 . 306 Benjamin Harrison........... ..... 340 308 William McKinley........... ..... 341 308 Theodore Roosevelt.......... ..... 346 311 William Howard Taft........ ..... 350 . 311 Woodrow Wilson............ ..... 350 313 Warren G. Harding.......... ..... 352 313 Calvin Coolidge............. ..... 354 315 Herbert Hoover............. ..... 355 316 Franklin Delano Roosevelt. . . . ..... 355 317 Harry S. Truman............ ..... 357 317 Dwight D. Eisenhower....... ..... 357 318 John F. Kennedy............. ..... 359 326 Name Index of Physicians to the 327 Presidents................ ..... 359 T JL HIS article is an attempt to provide precise literary documentation of the names and, in so far as possible, the role of the physicians who briefly or at length have attended Presidents of the United States. Considera- tion has been limited to physicians who attended the Presidents during their terms of office. The bibliographies prefacing each section are comprehensive and in- clude all signed medical articles relating to the President in question which have been located in the medical literature. Articles from the non- medical literature have occasionally been included, but only when written by a physician to the President or when otherwise particularly relevant. Material on the health of the President while in office has been included mainly to indicate the President's need for the physician and has been held to a mininum. When, however, it is believed this material is here first appearing in a medical publication it has been introduced at more length. Articles which appear in the numbered bibliographies are referred to 291 George Washington..... John Adams........... Thomas Jefferson....... James Madison........ James Monroe......... John Quincy Adams. . . . Andrew Jackson........ Martin Van Buren..... William Henry Harrison John Tyler............ James K. Polk......... Zachary Taylor........ Millard Fillmore....... Franklin Pierce........ James Buchanan....... Abraham Lincoln...... Andrew Johnson....... Ulysses S. Grant....... 292 CHARLES A. ROOS in the text by number. Articles primarily relating to the physician to the President are usually cited under the name of the physician, and text and source material of a general historical nature is cited in the body of the work. General References 1. Bahn, C. A. The eyes of some famous historical characters. Am. J. Ophth. ser. 3, 16: 425-429, 1933. Brief reference to Lincoln, Theodore Roosevelt, Wilson. 2. Dale, P. M. Medical Biographies; the Ailments of Thirty-Three Fa- mous Persons. Norman, University of Oklahoma Press, [cl952]. Washington, 102-111; Jackson, 136-150; Garfield, 211-218; Cleve- land, 219-226; McKinley, 227-234. 3. L'Etang, H. J. C. J. The health of statesmen and the affairs of nations. Practitioner, Lond. 180: 113-118, 1958. Wilson, 113-114; Franklin Roosevelt, 114-115. 4. Ficarra, B. J. Eleven famous autopsies in history. Ann. M. Hist. 4: 504-520, 1942. Lincoln, 513-515; Garfield, 515-516; McKinley, 518-519. 5. Harper, S. B. Gunshot wounds of three presidents of the United States. Proc. Mayo Clin. 19: 11-19, 1944. 6. Robertson, C. W. Some observations on presidential illnesses. Bost. Med. Quart. 8: 33-43, 76-86, 1957. Washington to Eisenhower. The Dr. Hammond referred to in con- nection with Garfield was of course W. A. Hammond, the former Surgeon General. 7. Stafford, J. Top level medical care. Science News Letter 69: 90-91, 1956. Some history of medical care of presidents from Washington to Eisenhower. 8. Tobey, J. A. Two American presidents who had cancer. Hygeia, Chic. 11: 520-522, 1933. Grant and Cleveland. 9. Vincent, E. H. Presidential gunshot wounds; three case reports. Surg. Gyn. Obst. 91: 115-119, 1950. Lincoln, Garfield, McKinley. 10. White House worriers. MD 1: 20-26, 1957. Craik, Physick, Stone, Barker, Mclntire, Snyder. Abstracted and commented on: Med. Ann. D. C. 27: 85-87, 1958. This in turn reprinted: U. S. Armed Forces M J. 9: 595-596, 1958. See also letter to the editor regarding the article: U. S. Armed Forces M. J. 9: 1383, 1958. physicians to the presidents 293 11. Wold, Karl. Mr. President—How Is Your Health? St. Paul, Bruce, 1948. 214 p. The medical histories of the Presidents from Washington to Frank- lin Roosevelt (omitting Hoover). This book is referred to through- out the text as "Wold." 12. Marx, R. The Health of the Presidents. New York, Putnam's, [c 1960] 376 p. The total lack of bibliographic documentation severely compromises the usefulness of this work. GEORGE WASHINGTON (1732-1799) 1st President, 1789-1797 Bibliography GIT' 1. Barker, C. A case report. Yale J. Biol. 9: 185-187, 1936. On the last illness of GW with critique of treatment and re- marks on the probable nature of the disease. GTT' 2. Blanton, W. B. Washington's medical knowledge and its sources. Ann. M. Hist. 5: 52-61, 1933. Physicians to the plantation and other physicians, personal friends of GW, enumerated. GW 3. Blanton, W. B. Washington's physicians, diseases and death. In Medicine in Virginia in the Eighteenth Century. Richmond, Garrett & Massie, 1931. p. 297-312. Dr. Brown's letter of January 2, 1800 to Dr. Craik belatedly conceding the virtues of Dr. Dick's suggestion for treatment of GW (p. 306-307). GW 4. Brickell, J. Observations on the medical treatment of General Washington in his illness; with introductory remarks by Ward Brinton. Tr. Coll. Phys. Phila. ser. 3, 25: 90-94, 1903. GW 5. Brown, M. W. The famous controversy about Washington's last illness. Med. J. and Rec. 135: 39-41, 201-202, 1932. Reprinted: Clin. Excerpts, N. Y. 6(1): 7-13, 1932. GW 6. Brown, M. W. Washington's strange interest in sickness and death. Med. J. and Rec. 135: 201-202, 1932. GW 7. Campbell, D. A. A historic case of cynanche trachealis. U. Mich- igan M. Bull. 24: 121-128, 1958. Includes a brief review of GW's earlier medical history. GTT' 8. Craik, J. and Dick, E. C. [Account of the late illness and death of General Washington] Medical Respository 3: 311-312, 1800. Reprinted from The Times of Alexandria. Craik signed as Attending Physician, Dick as Consulting. Dr. CHARLES A. ROOS Brown had returned to Port Tobacco, so he could not sign. Reprinted: Philadelphia Medical Museum 4: cliv-clvi, 1807-08. GW 9. Dick, E. C. Facts and observations relative to the disease of cynanche trachealis, or croup. [In a letter to the editor, from Dr. Elisha C. Dick, of Alexandria, Virginia.] Philadelphia Med. and Phys. J. 3d supp., p. 242-255, May 1809. The letter is dated Oct. 7, 1808. GW's case, p. 252-253. Dr. Dick castigates Drs. Craik and Brown for having rejected his suggestions for treatment of the dying President. GW 10. [Dick, E. C] The last illness of Washington. [Correspondence] Med. Rec. 92: 1128, 1917. J. A. Nydegger submits a letter of Dr. Dick dated January 10, 1800, addressed to Thomas Semmes, in which he censures Drs. Craik and Brown for not having accepted his suggestions for the treatment of GW and reveals that he drew up at the re- quest of Craik the statement listed as item 8 of this bibliog- raphy. Nydegger is sometimes considered to be the author of this reference. GW 11. Faggart, H. L. A recently discovered second letter from George Washington to John Baker. /. Am. Dent. Ass. 59: 549-551, 1959. GIT7 12. Harwood, B. S. George Washington's health record. /. 5. Caro- lina M. Ass. 38: 39-46, 1942. GW 13. Hay, J. Jr. George Washington's conquest of physical handicaps. Hygeia, Chic. 9: 736-739, 776-777, 1931. GTT' 14. Jackson, James. Memoir on the last sickness of General Wash- ington and its treatment by the attendant physicians. In Library of Practical Medicine, published by order of the Massachusetts Medical Society, 14: 159-179, 1861. GTT7 15. Knox, J. H. M., Jr. The medical history of George Washington, his physicians, friends and advisors. Bull. Inst. Hist. M., Bait. 1: 174-191, 1933. GW 16. [Lear, T., et al.] Last illness and death. In Ford, W. C, ed. The Writings of George Washington. New York, Putnam, 1893. vol. 14, p. 245-267. GW 17. Lewis, F. O. Washington's last illness. Ann. M. Hist. n.s. 4: 245- 248, 1932. GTT7 18. Lloyd, J. U. Who killed George Washington? Eclect. M J 83- [353]-356, [403]-408, 453-456, 1923. GTT' 19. Our most distinguished athlete. [Editorial] New York M J 101 • 581, 1915. In praise of GWs "physical perfection." physicians to the presidents 295 GW 20. Pryor, W. J. The closed bite relation of the jaws of George Washington, with comments on his tooth troubles and general health. /. Am. Dent. Ass. 20: 567-579, 1933. Analysis of GW portraits in terms of his dental problem. Illus. GW 21. Reid, J. Observations on the medical treatment of General Washington's last illness. London Med. and Phys. J. 3: 473-475, 1800. Reid is caustically critical of the treatment given by Craik and his colleagues. The Craik and Reid articles were reprinted: Philadelphia Medical Museum 4: cliv-clvi, 1807-08. GTT' 22. Resnikoff, P. A note on Washington. Internat. J. Psychoanal., Lond. 15: 301-302, 1934. Narcissism and the Oedipus complex inferred. GTT' 23. Stephenson, G. T. George Washington, the physical man. Del- aware M.J. 5: 151-156, 1933. GTT" 24. Thorpe, B. L. John Greenwood; surgeon-dentist to His Excel- lency, George Washington. Dent. Rev. 16: 519-524, 1902. Also in Koch, C. R. E., ed. History of Dental Surgery. Vol. 3. Biog- raphies of Pioneer American Dentists and Their Successors, by B. L. Thorpe. Fort Wayne, Ind., 1910, p. 20-27. For additional remarks on GW's dental problem and his por- traits see the biographical sketch of C. W. Peale in Koch, vol. 3, p. 39-40; also remarks of Rembrandt Peale: Dental News Letter 6: 189, 1853. GW 25. Tobey, J. A. Preventable diseases in the Washington family. Hygeia, Chic. 13: 118-121, 1935. GTT' 26. Turner, V. R. The medical men in George Washington's life. Ohio M. J. 53: 62-64, 190-191, 1957. GW 27. Washington and the medical affairs of the Revolution. [Edi- torial] Ann. M. Hist. n.s. 4: 306-312, 1932. GTT' 28. Washington's death and the doctors. In Solis-Cohen, S. Judaism and Science. Philadelphia, 1940, p. 57-66. GW 29. Weinberger, B. W. An Introduction to the History of Dentistry in America. St. Louis, Mosby, 1948. vol. 2. Especially: George Washington; his need for medical and dental care (p. 291-338); Houdon's life mask of Washington compared with his portraitures (p. 339-361); Letters relating to Washington and his dentist [a checklist] (Appendix B, p. 380-382); Relating to the disposition of the Washington Green- wood Letters and dentures (Appendix C, p. 383-386). Also George Washington and William and John Baker (p. 8 Iff); Gardette and George Washington (p. 150); Washington's in- 296 CHARLES A. ROOS quiry regarding Le Mayeur (p. 169ff). The bibliography on p. 334-338 lists some references on Washington's dental prob- lems not included in this listing. GW 30. Weinberger, B. W. Washington's missing dentures: solving the mystery. /. Am. Dent. Ass. 60: 542-546, 1960. GW 31. Wells, W. A. The case of George Washington, Esq.: a clinical sketch. Hygeia, Chic. 12: 106-109, 176-178, 180, 1934. GTT7 32. Wells, W. A. The final illness of Washington. Hygeia, Chic. 11: 132-135, 139, 1933. GW 33. Wells, W. A. Last illness and death of Washington. Virginia M. Month. 53: 629-642, 1927. Also /. Mich. State M. Soc. 26: 104- 117, 1927. GW 34. Wells, W. A. Washington's predilection for doctors and doctor- ing. Virginia M. Month. 66: 65-68, 1939. GW 35. Willius, F. A. and Keys, T. E. The medical history of George Washington (1732-1799). Proc. Mayo Clin. 17: 92-96, 107-112, 116-121, 180, 1942. Health of President Washington 1789. Operation for carbuncle of the left1 thigh, June 17, at New York. Complications kept Washington under his physicians' care until October 2. 1790. Pneumonia at New York2 commencing May 10, with final re- covery in early June or later. "On Monday last the President was taken with a peripneumony of threatning appearance. Yesterday (which was the 5th day) he was thought by the Physicians to be dying. However about 4 o'clock in the evening a copious sweat came on, his expecteration, which had been thin & icherous, began to assume a well digested form, his articu- lation became distinct, and in the course of two hours it was evident that he had gone through a favorable crisis. He continues mending today, and from total despair we are now in good hopes of him. Indeed he is thought quite safe." Thomas Jefferson to his daughter (Mrs. Randolph) from New York, May 16, 1790; Thomas Jefferson Papers, vol. 54 (9312) 1 "That it was his left thigh is not set forth in any of the numerous references to his 'thigh', but the fact is established by his own remark [Fitzpatrick, J. C. The Writings of George Washington, vol. 30, p. 366] that he had to lie for six weeks entirely on his right side." Freeman, D. S. George Washington. New York, Scribners, 1957. vol. 6, p. 214 (foot- note). Freeman suggests as an etiological factor the "rubbing of his (Washington's) scab- bard," vol. 6, p. 215 (footnote). Cf. Langstaff, J. B. Doctor Bard of Hyde Park (New York 1942), p. 170, 174. *GW 3 (p. 308), GW 35 (p. Ill), Wold (p. 10), and others have incorrectly placed this illness in Philadelphia. physicians to the presidents 297 [Library of Congress]. "The President is well enough to resume business." Letter of May 28, 1790; ibid., (9325).3 1791. "The President is indisposed with the same blind tumour, & in the same place, which he had the year before last in New York. As yet it does not suppurate or be discussed. He is obliged to lye constantly on his side, 8c has at times a little fever." Letter to Madison from Philadelphia, July 24, 1791, Ford, P. L., ed. The Writings of Thomas Jefferson. New York, Putnam, 1895, vol. 5, p. 356-357. "The President is much better. An incision has been made, & a kind suppuration is brought on." Letter to Madison from Philadelphia, July 27, 1791, ibid., p. 359.4 1793. "The President is not well. Little lingering fevers have been hanging about him for a week or ten days and have affected his looks most remarkably." Jefferson to Madison, June 9, 1793, ibid., vol. 6, p. 292- 293.5-6 1794. Treatment for cancer of the cheek, summer 1794. 1794. Injury to his back in attempting to control his stumbling horse at the Lower Falls of the Potomac, June 22, 1794. Physicians to President Washington Samuel Bard (1742-1821); M.D., University of Edinburgh, 1765. Langstaff, J. B. Doctor Bard of Hyde Park: the Famous Physician of Revolutionary Times: the Man Who Saved Washington's Life. New York, Dutton, 1942. GW's carbuncle, p. 166-175. 3 "From that time on Washington never fully regained his health"; Wold (p. 10). For some evidence to the contrary see the statement from Sparks' Life of Washington, quoted in GW 12 (p. 42). Also see GW's reference to his unimpaired health during his southern tour (Fitzpatrick, Writings, vol. 31, p. 18). Also Freeman, vol. 7, p. 235, 430-431, 460. * No medical writer seems to have been aware of this event. Decatur notes "a re- currence of the tumors from which he had suffered two years before" and says this illness forced GW to abandon an intended trip to Mount Vernon in August (Decatur, Stephen, Jr. Private Affairs of George Washington; from the Records and Accounts of Tobias Lear, Esquire, His Secretary. Boston, Riverside Press, 1933. p. 245). Freeman knows the sources, but does not reproduce them in his text (Freeman, vol. 6, p. 324). The opera- tor, however, remains unknown. 5 Wold (p. 10) incorrectly refers this letter to the year 1790, as GW 35 (p. Ill) seems also to do. 6GW 35 (p. Ill) and Wold (p. 10) have erroneously attributed to the President a fever August 19-24, 1793. The quotation from Washington's Diaries in support of this is actually the last entry for August 1798, the fever having occurred August 19-24 of that year (Fitzpatrick, J. C, ed. The Diaries of George Washington, 1748-1799. Boston, 1925. vol. 4, p. 382). For additional details see Fitzpatrick, Writings, vol. 35, p. 419, 420, 423, where, incidentally, the fever is said to have begun on the 18th with remission on the 24th or 25th. The loss of 20 pounds referred to in GW 35 (p. Ill) and Wold (p. 10) is also to be attributed to the year 1798, not 1793 (Sears, L. M. George Washington. New York, Crowell, 1932. p. 495). GW 12 (p. 41-42) has 1797. 298 CHARLES A. ROOS M'Vickar, J. A. A Domestic Narrative of the Life of Samuel Bard. New York, 1822. Remarks on GW as a patient, p. 136-137. John Bard (1716-1799). John Bard. In Thacher, James. American Medical Biography. Boston, 1828. vol. 1, p. 96-103. Samuel Bard operated on Washington June 17, 1789 (six weeks after his first inauguration) for a carbuncle of the thigh, and Washington was under Dr. Bard's care until October 2.7 Dr. John Bard, father of Samuel Bard, was called in consultation at the request of Washington (M'Vickar, p. 137), and later assisted in the operation.8 M'Vickar remarks: "The result of his illness was an intimacy with his patient, which Dr. Bard [Samuel] justly felt proud of. It continued unbroken until the removal of the seat of government to Philadelphia. ... From that period, I believe, they never met: General Washington's sudden death preventing a visit which Dr. Bard, upon his retirement from prac- tice, was preparing to make him."9 (Op. cit., p. 137.) Physicians present at pneumonia episode, New York, May-June, 1790 Mrs. Jay to John Jay, New York, May 15, 1790: "The President is ill and has been so some days; the family think his illness serious. Dr. Jones has been sent for from Philadelphia and is here now to attend with.Bard,10 Charlton and Macknight."11 (Johnston, H. P., ed. The Correspondence and Public Papers of John Jay ... New York, Putnam, 1891, vol. 3, p. 399.) 7 GW paid Samuel Bard for "attendance and medicine from June 15th to Oct 2d." This is the 109 days so frequently referred to. The bill is cited in Decatur, p. 68. Dr. John Bard was also paid a fee. 8 There is reference to additional physicians, but their names have not been located. "On Wednesday he was visited by several physicians ..."; Pennsylvania Packet, June 19, 1789, cited in Langstaff, p. 172. 9 Langstaff (p. 204) writes of an "urgent request" from GW that Bard visit him in his last illness. The only reference cited in this connection is M'Vickar's statement above. But no mention of such a request is made by Lear or others present during the last illness of GW. M'Vickar's statement itself seemingly implies only a social visit; finally, no letter is to be found in the various collections of GW's writings. 10 Dr. Bard's presence during this episode is not noted by any of the medical writers (including Langstaff), or by any historian consulted, except Freeman. 11 There has been some disagreement concerning who was in charge at this illness of the President. Decatur (p. 133), accounting for the reference to Dr. MacKnight in the Maclay reference, writes: "Dr. Charles MacKnight was evidently called in by Dr. Gardner [i.e., John] Jones to assist," thus apparently assuming that Dr. Jones was in charge. This assumption is presumably based on the entry in Lear's accounts indicating payment "...to Dr. Jones for attendance, etc. during the President's illness, 75/18/4," and the apparent lack of a record of payment to anyone else. The "discovery" by Freeman of Mrs. Jay's reference to the presence of Bard and Charlton at the bedside of the Presi- physicians to the presidents 299 Senator Maclay records the following: "Called to see the President. Every eye full of tears. His life despaired of. Dr. MacKnight told me he would trifle neither with his own character nor the public expectation; his danger was imminent, and every reason to expect that the event of his disorder would be unfortunate." (Journal of William Maclay. New York, Appleton, 1890, p. 265.) [Entry for May 15, 1790.] ".. . We have been very near losing the President. He was taken ill with a peripneumony and on the 5th day of it he was pronounced by two of the three physicians present to be in the set of death. A successful effort of nature, however, relieved him and us." Letter of Thomas Jefferson, New York, May 27, 1790. (Thomas Jefferson Papers, vol. 54 (9324).) [Library of Congress.] John Jones (1729-June, 1791); M.D., University of Rheims, 1751; Surgeon, 10th Massachusetts Regiment, 1777-1781. Mease, James. A short account of the life of Doctor John Jones. In his The Surgical Works of the Late John Jones, M.D. 3d ed. Philadelphia, 1795. p. 1-48.12 dent establishes that these physicians were present before Dr. Jones arrived, and pre- sumably after he departed, thus disposing of Dr. Jones's claim to precedence. Freeman assumes that Dr. Bard was in charge: "Major Jackson assumed direction of the office [i.e., the President's] and made all arrangements for medical attendance. Besides Dr. Samuel Bard, he called in Dr. John Charlton and Dr. Charles MacKnight. ..," to which statement Freeman adds the footnote: "Doubtless these physicians were sum- moned at the request of Dr. Bard." (vol. 6, p. 259.) The word "doubtless" presumably indicates a lack of documentary evidence for the point. Maclay's reference to Dr. Mac- Knight causes Freeman to acknowledge Dr. MacKnight as "then in immediate charge." The most convincing piece of evidence indicating Bard's priority is, perhaps, Jackson's letter to Colonel Biddle which does show that Dr. Jones was summoned by or in con- sultation with Dr. Bard. William Jackson to Col. Biddle. New York, Wednesday noon, May 2nd [i.e., 12], 1790. Dear Sir, The enclosed letter, from Doctor Bard to Doctor Jones, is transmitted to you with a view to insure secrecy, certainty, and dispatch in the delivery of it. To relieve you from any extraordinary personal anxiety I am happy to inform you that the symptoms which attend the President's indisposition, are not threatening—but it has been thought the part of prudence to call upon Doctor Jones in anticipation of any unfavorable change that may arise.... (Selections from the Correspondence of Colonel Clement Biddle. Pennsylvania Magazine of History and Biography 43: 149, 1919. Also: Fitzpatrick, Writings, vol. 31, p. 41 (foot- note).) 12 Describing the events immediately preceding Dr. Jones's death, Mease writes: "On the evening of the 17th [of June 1791] he paid a visit to the President of the United States .. ." (Op. cit., p. 34). Hume (Op. cit., p. 29) repeats this and qualifies the visit in question as "professional." But the story must be forgone, for Washington left Phila- delphia on his tour of the southern states March 21, 1791 (Fitzpatrick, Diaries, vol. 4, p. 300 CHARLES A. ROOS Hume, E. E. Surgeon John Jones, U. S. Army; father of American surgery, and author of America's first medical book. Bull. Hist. M. 13: 10-32, 1943. Mease provides information on the role of Dr. Jones: "In the summer of the year 1790; the President of the United States then at New York; after having been for some days indisposed; became so ill, that other as- sistance in addition to that of his attending physician became necessary. An express arrived for Dr. Jones.13 ... Upon his arrival at New York, he found that the disease from being of an inflammatory nature, had ter- minated in an alarming state of debility, and violent spasmodic difficulty of breathing, which threatened the greatest danger. An unacquaintance with the particular circumstances of the case prevents me from asserting positively, to whose fortunate advice the happy recovery is to be attributed; but the fact is, that in a few hours after the first visit a manifest alteration for the better was perceived, and in a few days the President was out of danger. The importance of the service rendered14 was not forgotten. On the removal of the federal government to Philadelphia, the President chose him physician to his family; and he continued in that honorable station until the time of his death."15 (Mease, op. cit. p. 33-34:) Charles MacKnight (1750-1791). Dr. MacKnight was a noted Revolutionary War surgeon, and is fre- quently referred to in Washington's wartime letters in connection with military medical affairs. John Charlton (d. 1806). Dr. Charlton was a friend of the Bards. Elected to the Board of Trustees of the New York Hospital in 1791, and thus served contemporaneously with Samuel Bard. Trustee of Columbia College (1799-1806). Brief biographical sketch in Shrady, J. The College of Physicians and Surgeons, New York. Chicago, Lewis [1904] vol. 1, p. 11. 149) and did not return to Philadelphia until July 6 (Freeman, vol. 6, p. 324). Washing- ton explicitly states in his diary: "From Monday the 13th [of June 1791] until Monday the 27th [of June] I remained at home [at Mount Vernon]"; Fitzpatrick, Diaries, vol. 4, p. 199. 13 Dr. Jones was sent for on May 12 (Freeman, vol. 6, p. 260); he apparently arrived on the 15th, the day of the crisis. 14 Freeman, seemingly the only writer aware of Jefferson's description of the 'crisis', makes light of Dr. Jones's contribution: "Dr. Jones arrived promptly but could suggest nothing effective." (vol. 6, p. 269.) 15 An entry in Lear's account book for May 11, 1791, of payment to Dr. Bass (druggist) of "his account of medicines furnished by Dr. Jones's direction" (Decatur, p. 233) is the only documented reference to possible medical care or advice in Philadelphia PHYSICIANS TO THE PRESIDENTS 301 Other physicians who attended President Washington James Tate; Surgeon, 3rd Pennsylvania Regiment, 1777-1778. "The Gentleman who will have the honor of delivering this letter to you; is Doctr. Tate, who is possessed of the valuable secret of curing can- cerous complaints. A call to England for some purpose of that sort, or with a view to derive benefit from his discovery, affords me an occasion to inform you (at his request) that I have, myself, experienced the fruits of his skill, in this art; being cured by him of an irritable spot on my right cheek which had for years been encreasing in pricking and disagreeable sensations; and in June last assumed the decided character of a cancer; of which I was perfectly relieved by Doctr. Tate in about two months by an easy course,16 under the operation of which I felt no confinement, or other inconvenience at the time, nor any injury to my constitution since."17 (Washington to Thomas Pickney, Philadelphia, Feb. 25, 1795 (Fitzpatrick, Writings, vol. 34, p. 125).) The earliest reference to Dr. Tate in the Washington correspondence reports that Dr. Tate had fled the city during the yellow fever epidemic of 1793 (Fitzpatrick, Writings, vol. 33, p. 173), and still another letter of 1797 implies, perhaps, that Dr. Tate was dead at the time (ibid., vol. 35, p. 513). But additional information was not found.18 Adam Kuhn (1741-1817); M.D., University of Edinburgh, 1767. "Washington Custes had measles and was treated by Dr. Kuhn. The Washington family had had Dr. John Jones in cases of illnesses, until his death in June 1791. Dr. Kuhn was now generally considered the lead- ing physician in the city." (Decatur, p. 255.) Rush writes of Kuhn: "The patronage of the principle officers of the general government [during its residence in Philadelphia] was given to Dr. Jones and afterwards to Dr. Kuhn." (Corner, G. W., ed. The Autobiography of Benjamin Rush. Princeton University Press, 1948, p. 95.) Evidence that Dr. Kuhn treated the President, however, is wanting. 18 This suggests a nonsurgical procedure. Cf. the references to surgical intervention in GW 7, GW 13, GW 15. 17 GW retained his favorable opinion of Dr. Tate's cancer treatment, for on July 31, 1797, he inquired of Dr. Tate's nephew "...whether his applications for cancerous complaints are attended [with the success his uncle's were] ..." (Fitzpatrick, Writings, vol. 35, p. 513.) 18 He is not referred to, for example, in Powell, J. H. Bring Out Your Dead; the Great Plague of Yellow Fever in Philadelphia, 1793. Philadelphia, University of Penn- sylvania Press, 1949. A "James Tate, physician" is listed in the Philadelphia Directory and Register for 1794 (address 138, High St.), but he is not listed in the 1791, 1793, or 1796 editions. 302 CHARLES A. ROOS William Shippen, Jr. (1736-1808); M.D., University of Edinburgh, 1761. Shippen was Director General of Military Hospitals of the Continental Army, 1777-1781. "The doctor attended the General's family while Congress sat in Phila- delphia."19 Butterfield, L. H., ed. Letters of Benjamin Rush. Vol. 2; 1793-1813. Princeton University Press, 1951, p. 1125 [footnote]. (This would have been in 1794 or 1795.) James Craik (1730-1814). Craik studied medicine at the University of Edinburgh; he was Wash- ington's personal physician in Virginia and attending physician at Wash- ington's death. There is no record of Craik having attended Washington during any of his illnesses while President. Craik wrote to the President August 24, 1789, from Alexandria, regarding the carbuncle incident: "... I have constantly felt unhappy at being such a distance as not to have in my power to con- tribute my mite towards the restoration of your health. Although the abscess on your thigh has proved a painful and tedious termination of your complaint, I flatter myself it will leave you in possession of a large stock of future good health. Much I think will depend upon your de- termination at all events to take exercise." (Langstaff, p. 174-175.) The near daily references in Washington's Diaries for 1789 and 1790 to exer- cise on horseback or in the post chaise perhaps reflects Dr. Craik's advice. In view of Washington's frequent trips to Mt. Vernon while President it is likely that Craik had a more direct hand in Washington's health problems, even during this period. The injury at Potomac Falls would, of course, be a special case in point. JOHN ADAMS (1735-1826) 2nd President, 1797-1801 Health of President John Adams President Adams suffered frequently from colds during his term as President. On March 13, 1797, a few days after his inauguration in Phila- delphia, he wrote of "a great cold" (Adams, C. F., ed. Letters of John Adams Addressed to his Wife. Boston, 1841, vol. 2, p. 250) and on November 28 of the same year Mrs. Adams wrote: "The President took a bad cold and was confined ten days after we came here, but good nursing got the 19 This relationship is not referred to in Corner, B. C. William Shippen, Jr. Pioneer in American Medical Education. Philadelphia, American Philosophical Society, 1951. physicians to the presidents 303 better of it." (Mitchell, Stewart, ed. New Letters of Abigail Adams, 1788-1801. Boston, Houghton, 1947, p. 113-114.) President Adams himself describes what appears to have been his most serious illness while President: "I lodged at Hartford [October 9, 1799], not yet purified of the yellow fever, and there I caught something very like it, or at least almost as bad, a most violent cold, attended with a con- stant fever, which rendered me for six weeks more fit for a chamber ;ind bed of sickness than for uncomfortable journeys, or much labor of the head or hand." (Adams, C. F., ed. The Works of John Adams. Boston, 1854, vol. 9, p. 252-253.) Mrs. Adams has left notice of the illness: "I found a letter from the President, who writes, that he was oppresst with one of his old heavy colds...." Letter of October 20, 1799. (New Letters, p. 210.) On October 25 the President wrote to Mrs. Adams: "I am pretty well recovered by my cold, but it has reduced my flesh." (Letters of John Adams, Addressed to his Wife, vol. 2, p. 263.) Mrs. Adams frequently speaks of the strain of office on the President. Conversely, she wrote in a letter dated November 21, 1800, from Washing- ton: "I have the pleasure to say we are all at present well, tho the news- papers very kindly gave the President the ague and fever.20 I am rejoiced that it was only in the paper that he had it." (New Letters, p. 259.) The Adamses moved into the White House in November, 1800. Perhaps the first instance of a physician calling there in professional capacity is referred to in a letter of Abigail Adams dated Washington, Dec. 1, 1800. The oc- casion was a sudden night illness of Susan Adams, and Mrs. Adams writes: "We sent for the nearest physican, who gave her calomil. . . ."21 (New Letters, p. 260.) Physician to President John Adams Benjamin Rush (1745-1813); M.D., University of Edinburgh, 1768. ". . . our ancient friend, our physician . .."— [Mrs. Adams, upon hearing of Rush's death.] Goodman, Nathan. Benjamin Rush. Philadelphia, Uni- versity of Pennsylvania Press, 1934, p. 349. 20 "The illness of my father and the result of the elections I was informed of at the same time by the English and German newspapers... . Mr. Murray ... has informed me very lately that he had seen in a New York paper a paragraph stating my father having recovered from his fever...." Letter to his mother, Berlin, March 10, 1801. (Ford, Wt. C, ed. The Writings of John Quincy Adams. New York, Macmillan, 1913, vol. 2, p. 511.) 21 The nearest physician was possibly Dr. William Thornton who lived at what was, in 1925, 1331 F Street, N W. However, the event is not mentioned in Mrs. Thornton's Diary for 1800. 22 Personal attendance upon the President himself has not, however, been docu- mented. 304 CHARLES A. ROOS THOMAS JEFFERSON (1743-July 4, 1826) 3rd President, 1801-1809 Bibliography TJ 1. Hall, C. R. Jefferson on the medical theory and practice of his day. Bull. Hist. M. 31: 235-245, 1957. TJ 2. Halsey, R. H. How the President, Thomas Jefferson, and Doctor Benjamin Waterhouse Established Vaccination as a Public Health Procedure. New York, The author, 1936. 58 p. (N. Y. Academy of Medicine. The Library. History of Medicine series No. 5). TJ 3. Hart, A. D., Jr. Thomas Jefferson's influence on the foundation of medical instruction at the University of Virginia. Ann. M. Hist. n.s. 10: 47-60, 1938. TJ 4. Martin, H. A. Jefferson as vaccinator. North Carolina M. J.I: 1- 34, 1881. Jefferson's letters to Waterhouse reproduced. Relation to Dr. Coxe, Dr. Gantt (Chaplain to the Senate), and other early ex- perimenters. TJ 5. Radbill, S. X. Dr. Robley Dunglison and Jefferson. Trans. & Studies Coll. Physicians, Philadelphia, ser. 4, 27: 40-44, 1959. TJ 6. Thomas Jefferson. In Blanton, W. B. Medicine in Virginia in the Eighteenth Century. Richmond, 1931, p. 187-200. Includes Jefferson's interest in and contributions to science as well as information regarding the President's health. Physician to President Jefferson Benjamin Rush (1745-1813). In a letter to Benjamin Rush dated December 20, 1801, Jefferson wrote: "My health has always been so uniformly firm, that I have for some years dreaded nothing so much as living too long. I think, however, that a flaw has appeared which ensures me against that...." (Ford, D. L., ed. The Writings of Thomas Jefferson. New York, 1897. vol. 8, p. 128.) The "flaw" turned out to be a recurrent diarrhea, which Jefferson describes in detail in a letter to Rush of February 28, 1803, in which the President asks for "any ideas which you can without trouble throw on paper, for my govern- ment in the event of a return of the complaints to a troublesome de- gree___" (Ibid., p. 219-221.) Rush prescribed a course of treatment in letters dated March 12 and May 5, 1803, respectively. (Butterfield, L. H., ed. Letters of Benjamin Rush. Princeton University Press, 1951. vol. 2, p. 856-860, 863-865.) A note by Butterfield to the March 12 letter reads: "It is noteworthy that thirteen years later, in returning BR's letter at the re- PHYSICIANS TO THE PRESIDENTS 305 quest of Richard Rush, Jefferson retained this letter and that of 5 May 1803 'because a return of the complaint might happen and again render them useful'." (Op. cit., vol. 2, p. 859-860.) "It would be a great treat to receive you [Rush] here. But nothing but sickness could effect that; so I do not wish it." Jefferson to Rush, Monticello, September 23, 1800. (Ford, op. cit., vol. 8, p. 461.) JAMES MADISON (1751-1836) 4th President, 1809-1817 Health of President Madison "The President sick since last Monday" (Mrs. W. B. Thornton's Diary. [Library of Congress] Entry for Wednesday, June 16, 1813.) "The President is indisposed, with a bilious attack, apparently slight." Monroe to Jefferson, Washington, June 16, 1813. (Hamilton, S. M., ed. The Writings of James Madison. New York, Putnam, 1901, vol. 5, p. 271.) "From the date of my last letter to you the President has been ill of a bilious fever; of the kind called remittent. It has perhaps never left him, even for an hour, and occasionally simptoms [sic] have been unfavorable. This is I think the 15th day." Monroe to Jefferson, Washington, June 28, 1813. (Ibid., p. 271.) Mrs. Madison describes her role in this illness in a letter of July 2, 1813: "I have the happiness to assure you, my dear cousin [Mr. Edward Coles] that Mr. Madison recovers; for the last three weeks his fever has been so slight as to permit him to take bark every hour and with good effect. It is three weeks now I have nursed him, night and day,—sometimes with despair! but now I see he will get well I feel as if I might die myself from fatigue. . . ." (Memoirs and Letters of Dolly Madison ... edited by her Grand-Niece [Lucia B. Cutts]. Boston, Mifflin [1886], p. 93.) But the son of the Vice President reports Madison "very ill" on the evening of the 2nd (The Diary of Elbridge Gerry, Jr. New York, Brentano's, 1927, p. 154) and Mrs. Thornton's Diary for the 5th of July records: "No visiting at the President's as he was sick," and for the 6th: "He [Madison] has a return of the fever." In a letter of August 2, 1813, written from Washington, the President describes his illness: "I have just recovered strength eno', after a severe Sc tedious attack of bilious fever, to bear a journey to the Mountains whither I am about setting out. The physicians prescribe it as essential to my thorough recovery & security against a relapse at the present season." (Hunt, Gaillard, ed. The Writings of James Madison. New York, Putnam, 1908. vol. 8, p. 255-256.) An approximate terminal date for this illness is given in a letter of 306 CHARLES A. ROOS August 28, 1813, written from Montpelier: "My own health has greatly improved since my arrival here; but I have not been without several slight returns of fever which are chargeable rather on the remnant of the influenza than the cause from which I suffered in Washington. I am now pretty well recovered from the last return which took place a few days ago." (Ibid., p. 261.) Physicians to President Madison "Elzey of this place, & Shoaff of Annapolis, with Dr. Tucker attend him. They think he will recover. The first mention'd I have just seen, who reports that he had a good night, & is in a state to take the bark, which indeed he has done on his best days for nearly a week." Monroe to Jef- ferson, Washington, June 28, 1813. (Hamilton, S. M., ed. The Writings of James Madison. New York, Putnam, 1901. vol. 5, p. 271.) Arnold Elzey (1756-1818). Garrison Surgeon's Mate, U. S. Army, 1814-1816. Post Surgeon, Wash- ington, D. C, 1816-1818. Called "Physician to President Madison" by Toner in his unpublished American Medical Biography [Library of Congress, Manuscript Division] and in the History of the Medical Society of the District of Columbia, 1817-1909. Washington, 1909, p. 219. The Medical Annals of Maryland, 1799-1899, by E. F. Cordell (Baltimore, 1903), which has a few lines on Elzey, gives 1758 as his birth date. Elzey is frequently mentioned in Mrs. Thornton's Diary. John Thomas Shaaf (176323-1819). Practiced at Annapolis for several years, then moved to the District of Columbia. Thomas Tudor Tucker (1745-1828). Born in Bermuda. Studied medicine at the University of Edinburgh. Moved to South Carolina. Revolutionary War Surgeon. U. S Treasurer 1801-1828. JAMES MONROE (1758-1831) 5th President, 1817-1825 Health of President Monroe "I had an attack in the winter of the influenza, which, by the confine- ment inseparable from the pressure of business, became complicated with bile & by the depleting remedies, reduced me considerably. I am now in 2* According to The History of the Medical Society of the District of Columbia Tvol 1] p. 218; Cordell, E. F. The Medical Annals of Maryland, p. 564, has 1752. PHYSICIANS TO THE PRESIDENTS 307 much better health but thin." Monroe to Madison, Washington, April 28, 1818. (Hamilton, S. M., ed. The Writings of James Monroe. New York, Putnam, 1902. vol. 6, p. 51.) ". . . until the last winter, my health had not been fully restored since the fatigues of the last Avar." Monroe to Gallatin, Washington, May 26, 1820. (Ibid., p. 130.) "The President was suddenly seized this morning with cramps or con- vulsions, of such extreme violence that he was at one time believed to be dying, and he lay upward of two hours in a state of insensibility. I did not hear of it till the fit was over. I called at his house and saw there Dr. Wash- ington and Mr. Hay. The Doctor said the President was disposed to sleep, and it would be best that no person should see him. Mr. Hay said that Dr. Sim had pronounced the danger to be past and did not apprehend a re- newal of the attack. But, Hay added, he thought it would be some time be- fore it would be prudent to lay before him business of any kind. Before returning home for dinner, I sent to enquire how he was, and the answer to the messenger was, much better." (Adams, C. F., ed. Memoirs of John Quincy Adams. Philadelphia, Lippincott, 1875. vol. 6, entry for August 2, 1823.) Entries for August 8 and 9 indicate the President was convalescent. On August 12 the future President notes: "I called at the President's and found him much recovered." (Ibid., p. 172.) Physicians to President Monroe Bailey Washington (1787-1854); M.D., University of Pennsylvania, 1810. Naval Surgeon, 1810-1854. Dr. Washington24 was the son of Lawrence Washington, George Washington's half-brother. Thomas Sim (1770-1832); M.D., University of Pennsylvania, 1823. Washington, D. C, physician from about 1810 until his death. Charles Everett25 (d. 1848). "He was Monroe's intimate friend, physician, and at one time private secretary." Tyler's Quarterly 4: 96, 1922. 24 Writing to Dr. Charles Everett, November 13, 1823, concerning an illness of Mrs. Monroe, the President says "Dr. Huntt... has attended her in the absence of Dr. Wash- ington." (Tyler's Quarterly, 5: 21, quoted in Blanton, W. B. Medicine in Virginia in the Nineteenth Century. Richmond, 1933. p. 134.) This would seem to give precedence to Dr. Washington as family physician when the President was in Washington. 25 S. M. Hamilton writes "Doctor Everett was Monroe's secretary during his Presi- dency and afterwards his family physician." (Op. cit., vol. 5, p. 103 (footnote).) A reading of Monroe's correspondence with Everett, published in Tyler's Quarterly 5: 18, 1923, makes certain that he was called on to treat Mrs. Monroe in 1820 and establishes the presumption that he was Monroe's personal physician at least during Monroe's sojourns in Albemarle County while President. For a reference to possible attendance of Dr. Everett on Madison during his illness of 1813 see Tyler's Quarterly 4: 406, 1923. 308 CHARLES A. ROOS JOHN QUINCY ADAMS (1767-1848) 6th President, 1825-1829 Health of President John Quincy Adams In his Memoirs, President Adams complains of his health and spirits for the last several months and then writes: "With a defective perspiration and an imperfect digestion, there has been continual heat, part of which has come out from time to time on the surface of the skin, as it did last summer, though not quite in so high degree. Dr. Huntt pronounces this to be erysipelas, and has repeatedly and earnestly advised me to go pass the sum- mer at the North... and vegetate myself into a healthier condition." (Vol. 7, p. 311-312; entry for August 31, 1827.) Physician to President John Quincy Adams Henry Huntt (1782-1838); M.D. (Honorary), University of Maryland, 1824. Asst. Surgeon, U. S. Navy, 1811-1813; Surgeon, U. S. Army, 1814-1815. "[Dr. Huntt was] the medical attendant of most of the leading personages of the day [in Washington] including five successive Presidents of the United States."26 (Pilcher, J. E. The Surgeon Generals of the Army of the United States. Carlisle, Pa., Association of Military Surgeons, 1905, p. 34.) Miller, T. A biographical sketch of the professional life and character of the late Henry Huntt, M.D., of Washington City, D. C. Med. Exam- iner 1: 363-365, 1838. The sketch does not refer to Dr. Huntt's services to the Presidents.26 ANDREW JACKSON (1767-1845) 7th President, 1829-1837 Bibliography Gardner, F. T. The gentleman from Tennessee. Surg. Gyn. Obst. 88: 405- 411, 1949. General medical history. Health of President Jackson Operation for hydrocele, fall or winter 1831. Influenza, January 1832 (?). Removal of bullet from arm, January 1832. Chronic pulmonary condition, with hemorrhages: Massachusetts Tune 24-25, 1833; Washington, D. C. November 1836. 28 Monroe's letter to Everett first documents the entry of Dr. Huntt into the W House; see footnote 24. physicians to the presidents 309 Physicians to President Jackson Thomas Sim (1770-1832). In Jackson's Senate days, Mrs. Jackson, according to Mr. Trist, at- tempted to have the President change to another physician on the oc- casion of a serious inflammation of his arm. "The case was in the hands of Dr. Sims [i.e., Sim]," Mr. Trist relates, "an old friend who was always the family doctor when Jackson was at Washington." To Mrs. Jackson's en- treaty the President replied: "Dr. Sims is my friend—an old and valued friend. His professional reputation, his standing as a physician, his feeling as a man, are all at stake in the matter . . . the thing is impossible; it can not be done. He shall cure me, or he shall kill me." (Parton, James. The Life of Andrew Jackson, vol. 3, p. 608.) In all likelihood Dr. Sim remained as Jackson's physician until late into the President's first term. Thomas Harris (1784-1861). Chief, Bureau of Medicine and Surgery, U. S. Navy, 1844-1853. ". . . Dr. Harris had risen to eminence as a surgeon as well as a teacher and had come to be known as one of the leading men in Philadelphia. His reputation as a surgeon is shown by the fact that when President Jackson desired to have a bullet extracted that he had received in a duel with Charles Dickson in 1806, it was Harris, together with Dr. Triplett, who operated on the President. This was in 1832 [January 12], 26 years after the wound had been received." (Roddis, L. H. Thomas Harris, M.D., naval surgeon and founder of the first school of naval medicine in the new world. /. Hist. M. 5: 236-250, 1950.) Triplett (not further identified). Henry Huntt (1782-1838). "Jackson MSS, vol. 117, p. 133 .. .Jackson's family physician in Wash- ington was Dr. H. Hunt [i.e., Huntt] to whom he paid in January 1837, the sum of $175 for medical services during 1836." (Basset, J. S., ed. Correspondence of Andrew Jackson. Carnegie Institute of Washington, 1931. vol. 5, p. 342 (footnote).) In a letter of November 27, 1836, written from Washington, the Presi- dent tells of being confined to bed by a severe hemorrhage from the lungs "which threatened a speedy end to my existence.... The Doctor [Huntt] tells me I lost from the lungs and by the lancet and cupping, upwards of 60 ounces of blood, which stopped the hemorrhage, without the aid of that potent, but pernicious remedy to the stomach, sugar of lead. I am now mending as fast as I could expect." (Basset, vol. 5, p. 439.) "The unexpected demise of Surgeon General Lovell threw the ad- 310 CHARLES A. ROOS ministration quite at sea with regard to his successor. The natural course would have been to promote Surgeon Thomas Lawson who was the senior officer of the medical corps, but President Jackson wished Dr. Henry Huntt who had been a Hospital Surgeon in the War of 1812, to accept the position. Dr. Huntt was a native of Maryland, who, after a brief period of Naval service, accepted a commission as hospital surgeon in the Army, and succeeded Dr. Lovell at the Burlington General Hospital. At the close of the war he resigned his commission and engaged in private practice in Washington. Here his efforts were crowned with phenomenal success and he became the leader of the profession and the medical attendant of most of the leading personages of the day including five successive Presi- dents of the United States. President Jackson after repeated verbal re- quests that Dr. Huntt assume the surgeon-generalcy, finally wrote him a personal letter formally tendering him the office. This letter was for many years one of the most cherished treasures of the family. Dr. Huntt did not feel justified, however, in accepting the offer and declined the honor, urg- ing that his old friend and comrade, Surgeon Lawson, be appointed in his stead, a request with which the President on November 30, 1836, ulti- mately complied." (Pilcher, J. E. The Surgeon Generals of the Army of the United States. Carlisle, Pa., Association of Military Surgeons, 1905, p. 34.) James C. Hall (1805-1880); M.D., University of Pennsylvania, 1827. Toner, J. M. James Crowdhill Hall. Trans. Am. M. Ass. 32: 506-513, 1881. "Dr. Hall attended professionally every president from Adams27 to Lincoln...." p. 509. "In the Jackson MSS is a receipted bill from Dr. J. C. Hall, dated Jan. 1, 1832, and reading as follows: 'To operating for Hydrocele and subse- quent attendance, $30.' " (Basset, op. cit., vol. 5, p. 342 (footnote).) "He [Hall] had been the family physician of every President of the United States, beginning with Jackson and ending with the death of Lincoln's son." (Busey, S. C. Personal Reminiscences and Recollections of Forty-Six Years' Membership in the Medical Society of the District of Columbia. Washington, 1895, p. 148-149.) Philip Syng Physick (1768-1837); M.D., University of Edinburgh, 1792. "At Philadelphia [June 1833], the President was induced, after much persuasion, to consult the celebrated Dr. Physick, with regard to that pain in the side and the bleeding at the lungs to which he was subject. Upon 27 [Crew, H. W., ed.] Centennial History of the City of Washington D C mavrnn Ohio, 1892) p. 602, has "John Quincy Adams." ' " V ' physicians to the presidents 311 meeting the Doctor, the President explained his symptoms, concluding with these words: 'Now Doctor, I can do any thing you think proper to order, and bear as much as most men. There are only two things I can't give up; one is coffee, and the other is tobacco.'... Mr. Trist from whom I received this anecdote, added that Dr. Physick was completely captivated by the General's manner." (Parton, J. Life of Andrew Jackson. Boston, Houghton, 1888. vol. 3, p. 489.) Letter to Andrew Jackson, Jr., Philadelphia, June 10, 1833: "I have seen Doctor Phisic, who encourages me, and says my heart is not effected in any way, and the pain in my side can be removed by cupping." (Basset, op. cit., vol. 5, p. 109.) John C. Warren (1778-1856); M.D., Harvard, 1797. 3rd President, American Medical Association, (1849/50). "He [Jackson] was sick in bed the whole day, under the care of Dr. Warren. This day... he is convalescent." (Memoirs of John Quincy Adams, vol. 9, p. 4, entry for June 25, 1833.) "I believe much of his debility is politic ... he is now alternately giving out his chronic diarrhea and making Warren bleed him for pleurisy, and posting to Cambridge for a Doctorate of Laws...." (Ibid., p. 5; entry for June 27, 1833.) "In June, 1836, he [Warren] went to Washington with a part of his family, and they were for a time the guests of President Jackson. . . . During General Jackson's visit to Boston in 1834 [i.e., 1833] they had several inter- views; and when the former was taken ill, the doctor gave a further proof of his attachment by attending him with care and bleeding him twice." (Arnold, H. P. Memoir of Jonathan Mason Warren, M.D. Boston, 1886, p. 123 (footnote).) MARTIN VAN BUREN (1782-1862) 8th President, 1837-1841 No information on physicians or health located. WILLIAM HENRY HARRISON (1773-1841) 9th President, 1841 (March 4-April 4) Bibliography WHH 1. Death of the President, [Editorial] Boston Thompsonian Man- ual 7: 173, 217-218, 1841. (With a different introductory para- graph and title: Botanic Med. Reformer, Phila., 2: 172-173, 1841.) 312 CHARLES A. ROOS WHH 2. Miller, Thomas. The case of the late William H. Harrison, President of the United States. Medical Examiner, Phila., 4: 309-312, 1841. Reprinted: Boston M. & S. J. 24: 261-267, 1841. WHH 3. Murder of the President of the United States (from the Boston True Thompsonian). Botanico-Medical Recorder, Columbus, 9: 286, 1841. "Mr. Tyler stands to meet with the same fate. Already seriously indisposed... as certainly as he employs the faculty, his days are numbered." WHH 4. President Harrison's last illness. Boston M. & S. J. 25: 25-32, 1841. Criticism of the attending physicians' handling of the case as reported in WHH 2. WHH 5. Report of the treatment of the late President Harrison. Boston M. if S. J. 25: 36, 1841. Notes the rumor "that the prescriptions in the medical report [WHH 2] were constructed cautiously, under the vigilant supervision of a scholar, sometime after the death of the illustrious patient." The rumor was denounced by the editor of the Medical Examiner (4: 619-620, 1841), and the de- nunciation was accepted by the editor of the Boston Medical and Surgical Journal in an editorial, "Anonymous Criticism on Medical Practice," Boston M. ir S. J. 25: 147, 1841. Health of President Harrison President Harrison was the first United States President to die in office. He was inaugurated March 4, 1841, became ill on the 27th of March, and died of pneumonia April 4. Physicians to President Harrison The last paragraph of Dr. Miller's account of the case [WHH 2] reads: "The deep political and personal interest dependent on the life of the President, imposed on his attending physician a fearful responsibility, of which he felt himself painfully mindful. He speedily sought a consultation and was scarcely ever absent from the house more than one hour together. Dr. James Crowdhill Hall remained with him during the last three nights. Dr. Alexander and Dr. Worthington were in attendance with Dr. Hall and the attending physician the night of his death; Dr. May being absent from indisposition." Thomas Miller (1808-1873); M.D., University of Pennsylvania, 1829. Miller, V. Dr. Thomas Miller and his times. Records, Columbia Historical Society, Washington, D. C, vol. 3, p. 303-323. PHYSICIANS TO THE PRESIDENTS 313 "Harrison's successor, Mr. Tyler, had Dr. John Thomas for his physician, but my father was the physician called in when needed by all the other occupants of the White House until Mr. Lincoln became President, when Dr. Robert King Stone was called" (p. 312). Ashton Alexander (1772-1855); M.D., University of Pennsylvania, 1795. Baltimore physician. James C. Hall (1805-1880) Frederick May (1773-1847); M.D., Harvard, 1811. Miller, T. The late Dr. Frederick May, of Washington. Boston M. ir S. J. 36: 249-252, 1847. Dr. May's service to the President is not referred to. Nicholas William Worthington (1789-1849); M.D., University of Penn- sylvania, 1815. Washington physician. JOHN TYLER (1790-1862) 10th President, 1841-1845 Health of President Tyler "Mr. Tyler had suffered severely from dyspepsia ever since the shock he had experienced the preceding winter [1819]. .. . Indeed, the effects of the attack lingered in his frame until his death.28 The cause of it was ascribed by Mr. Tyler to his eating some stale fish, imposed by the keeper of his boarding house upon his unsuspecting guests." Tyler, L. G. The Letters and Times of the Tylers. Richmond, 1884, vol. 1, p. 334-335. The only other reference to an illness of Mr. Tyler while President is cited as a note to WHH 3. Physician to President Tyler John Moylan Thomas (1805-1853); M.D., University of Maryland, 1826. "Mr. Tyler had Dr. John Thomas for his physician...." (Miller, V., op. cit., p. 312.) JAMES POLK (1795-1849) 11th President, 1845-1849 Health of President Polk Polk's Diary reveals that apart from a day now and then of indisposition he was well until late September 1847, when he sustained an attack of 28 Wold (p. 67) suggests the recurrent attacks were amebic dysentery or typhoid fever. 314 CHARLES A. ROOS chills and fever which lasted a month. The President suffered from another attack of chills and fever in June and July 1848. The illness may be pre- sumed to have been malaria.29 Physicians to President Polk James Crowdhill Hall (1805-1880). "My family physician (Dr. Thomas Miller) I learned was absent from the city, and I sent for Dr. Hall, who is one of the most eminent physicians of the city." (Polk, James. Diary, vol. 3, p. 9-10; entry for May 4, 1847.) The occasion was an illness of Mrs. Polk. When the President first called upon a physician for himself, in Sep- tember 1847, he called in Dr. Hall, requesting him to invite Dr. Miller in the evening. During the remainder of this illness and during the illness of 1848 only Dr. Hall is mentioned. Thomas Miller (1808-1873). Jonathan Messersmith Foltz (1810-1877); M.D., Jefferson Medical College, 1830. Assistant Surgeon, U. S. Navy, 1831; Surgeon General, U. S. Navy, 1871- 1872. Foltz, C. S. Surgeon of the Seas; the Adventurous Life of Surgeon Gen- eral Jonathan M. Foltz in the Days of Wooden Ships. Indianapolis, Bobbs-Merrill, 1931. 351 p. Kidder, J. H. Foltz, Jonathan Messersmith. Trans. Am. M. Ass. 33: 555- 558, 1882. "During this period of service [1848] in Washington ... President Polk, whose health was beginning to give way, often summoned him for medical advice30. .. ." (Foltz, p. 132.) Dr. Foltz accompanied President Polk on a vacation trip to Bedford Springs, Pennsylvania, August 18-28, 1848 (Polk Diary, vol. 4, p. 85-103). Although no medical aid is referred to in the Diary, it is likely Dr. Foltz went as medical adviser. The author of Surgeon of the Seas remarks that Dr. Foltz "had made a thorough study of our medical waters and had published an elaborate treatise on them."31-32 (Foltz, p. 133.) 28 A reading of Polk's Diary will hardly support the statement of Wold (p. 72) that "while Polk was President, he was sickly a good share of the time." 30 This is possibly familial exaggeration; in any event it is not supported by the Diary which refers to Dr. Foltz only in reference to the Bedford Springs vacation. 31 The possibibity of medical care of Presidents Polk and Tyler at White Sulphur Springs by the resident physician, John Jenning Moorman, is indicated in Hinsdale, G. John Jenning Moorman, M.D.; a biographical note. Ann. M. Hist. n.s. 6: 356-358, 1934. 82 This treatise has not been identified. physicians to the presidents 315 ZACHARY TAYLOR (1784-1850) 12th President, 1849-1850 Bibliography ZT 1. Death of the President of the United States. New York Medical Gazette 1: 43-44, 1850. Reprinted: Medical Examiner, Phila. 6: 486-487, 1850. ZT 2. The disease of President Taylor and its treatment [from the New York Herald}. Eclectic Med. J. 2: 464-465, 1850. Health of President Taylor President Taylor first became seriously ill in office in August 1849 while on a trip through the East. "At Harrisburg and Carlisle he was attacked by what was first thought to be cholera, but though weak he insisted on continuing his journey. At Erie August 25 he was again attacked by severe diarrhia and raging fever so alarming in their effects that for two days Dr. Wood and his consulting physicians feared for his life.... But he recovered and on September 1 left for Niagara Falls and Buffalo." (Dyer, Brainerd. Zachary Taylor. Baton Rouge, Louisiana State University Press, 1946, p. 202-204.) President Taylor became ill after attending a Fourth of July celebration at the Monument Grounds in Washington and died at the White House July 9, 1850. His death has been ascribed to an intestinal infection (cholera morbus) complicated by heat exhaustion (Wold, p. 78). Physicians to President Taylor During the critical stage of the President's illness at Erie Dr. William M. Wood of the Navy, stationed at Erie Harbor, was called in as consultant by Dr. Robert Wood. The President was then moved to the Naval Surgeon's residence in Erie where he remained until well enough to travel. (Hamil- ton, Holman. Zachary Taylor. New York, Bobbs-Merrill, 1951. vol. 2, p. 226.) Robert Crooke Wood (1800-1869); M.D., Medical Department, Columbia College. Francis, S. W. Biographical Sketch of General R. C. Wood, M.D., Med. Surg. Reporter 20: 275-276, 1869. The article does not refer to Dr. Wood's medical service to President Taylor. Dr. Wood was the son-in-law of President Taylor. He was stationed at Fort McHenry, Baltimore, at the time of the President's last illness. He was Assistant Surgeon General, U. S. Army, 1862-1865. 316 CHARLES A. ROOS William Maxwell Wood (1809-1880); M.D., University of Maryland, 1829. Surgeon-General, U. S. Navy, 1869-1871. Kerr, W. M. WTilliam Maxwell Wood (1809-1880); the first Surgeon- General of the United States Navy. Ann. M. Hist. 6: 387-425, 1924. The Taylor episode is not referred to in Dr. Kerr's biography. Physicians present during President Taylor's last illness The President had as personal physician in his last illness Dr. Alexander S. Wotherspoon.33 Captain Wotherspoon had as consultants Major Robert C. Wood, Captain Richard H. Coolidge, and Dr. James Crowdhill Hall (Hamilton, op. cit., vol. 2, p. 388-390). Alexander Somerville Wotherspoon (1817-1854); M.D., College of Phy- sicians and Surgeons, New York City, 1841. Army Surgeon, 1843-54. Richard Hoffman Coolidge (1820-1866); M.D., College of Physicians and Surgeons, New York City, 1841. Army Surgeon, 1841-1865. James Crowdhill Hall (1805-1880). MILLARD FILLMORE (1800-1874) 13th President, 1850-1853 Health of President Fillmore "President Fillmore, by the advice of his physicians,34 has taken apart- ments for the night in Georgetown, in consequence of the unhealthful condition of the White House. Of its unhealthfulness there can be no doubt. It is believed that almost every inmate of President Tyler and Presi- dent Polk's families, white and black, were sick there; and there died Gen- erals Harrison and Taylor, who entered its walls well; while from there, with the seeds of disease lurking in his frame, went President Polk, to die a short time afterwards. And there too, died the first Mrs. Tyler." "Unhealthy condition of the White House" [from the Baltimore Ameri- can]. Eclectic Med. J. 2: 464, 1850. 33 "... Dr. Weatherspoon, the trusted family physican, invited Drs. Coolidge and Hall, of Washington, for consultation; these three then sent for another eminent practitioner! Dr. Wood of Baltimore, who specialized in this type of disease." (Wold, p. 77.) Weather- spoon should of course read Wotherspoon. Presumably Dr. Wood was sent for because of his previous medical attendance on the President and in view of the fact that he was the President's son-in-law. He was probably not a specialist in the type of disease in question. 34 Names not found. physicians to the presidents 317 FRANKLIN PIERCE (1804-1869) 14th President, 1853-1857 Health of President Pierce ".. . new responsibilities, and the Washington climate were combining to undermine his health. As early as April [1853] press reports began to appear containing news of illness... . On June 21 he was ill enough to cancel all engagements.. . . The hordes of mosquitoes made it impossible for him to escape the malaria, which was to trouble him a good deal, just as it had made miserable many of his predecessors." (Nichols, R. F. Frank- lin Pierce. 2d ed. Philadelphia, University of Pennsylvania Press, 1958. p. 242-243.) "In the midst of the heat, the President was ill again.... But from heat, malaria and Kansas there seemed no relief." (Ibid., p. 478.) "... late in November, the executive was stricken again; neuralgia was his master and its sharp pains necessitated cessation of labor." (Ibid., p. 495.) [The year is 1856.] "During Pierce's Presidency, his health appears to have been good ex- cept for a persistent cough which was caused by a chronic bronchitis." (Wold, p. 83.) Physician to President Pierce Thomas Miller (1808-1873). "During the Pierce administration he [Miller] was physician to the President's family." Gouverneur, M. As I Remember. New York, Apple- ton, 1911. p. 255. "Mr. Pierce was a frequent visitor at our House." (Miller, V. Dr. Thomas Miller and his times. Records, Columbia Historical Society, Washington, D. C, vol. 3, p. 312.) JAMES BUCHANAN (1791-1868) 15th President, 1856-1861 Bibliography JB 1. Ely, A. W. The poisoning at the National Hotel. N. Orleans M. &S.J. 13:796-799, 1857. Mr. Buchanan's case, p. 796. The author favors the theory that an attempt had been made to poison the President-elect. JB 2. Hall, J. C. [On the National Hotel disease] Am. M. Month. N. Y. 7: 355-358, 1857. 318 CHARLES A. ROOS Physicians to President Buchanan Jonathan M. Foltz (1810-1877). "Dr. Foltz was... an intimate personal friend and the medical advisor of President Buchanan, whom he treated for the mysterious 'National Hotel malady'." Trans. Am. M. Ass. 33: 557, 1882. "Dr. Jonathan M. Foltz, the first regular White House physician,35 was a family friend of James Buchanan and had his own room in the White House." McIntire, R. T. White House Physican, New York, Putnam, 1946. p. 58-59. On January 25 or 26, 1856, when Buchanan was President-elect, he be- came ill of the so-called National Hotel disease. Dr. Foltz, a member of the Buchanan party stopping at the National Hotel in Washington, treated Buchanan on the spot, and again a month later when the President-elect had a recurrence of the disease. Dr. Foltz, at Buchanan's "urgent request," had gone with him to Washington as his medical attendant during the inauguration ceremonies. Foltz was given a room at the White House and stayed on for several days, as the President continued to be unwell; he then returned to Philadelphia, where he was stationed. Dr. Foltz con- tinued to occupy his White House room on his visits to Washington through the first half of 1858. Thereafter there was a gradual falling out with the President, and after midsummer, 1858, Dr. Foltz probably ceased to remain in any association with President Buchanan. This, of course, would account for the advent of Dr. Du Hamel in 1859. William James Chamberlain Du Hamel (1827-1883); M.D., University of Maryland, 1849. "Dr. Du Hamel was physician to the President of the U. S. in 1859, and was continued in that capacity, during the terms of three Presidents, to the employees of the Presidential mansion." Atkinson, W. B., ed. A Biographi- cal Dictionary of Contemporary American Physicians and Surgeons. 2 ed. Philadelphia, 1880. Biographical additions to the second edition, p. 5. "Said to have attended the occupants of the White House for three Presidential terms." History of the Medical Society of the District of Columbia, 1817-1909. Washington, The Society, 1909, p. 247. ABRAHAM LINCOLN (1809-1865) 16th President, 1861-1865 Bibliography AL 1. Crisp, W. H. The eyes of Abraham Lincoln. Am J Ophth ser 3, 15: 754-755, 1932. This statement can hardly be accepted. physicians to the presidents 319 AL 2. Carman, L. D. Dr. Abraham Lincoln. /. M. Soc. N. Jersey 19: 102- 103, 1922. "... it is the purpose [of the present article] to set forth what little medical knowledge the great President had, as revealed by his own writings." AL 3. Case, A. L.----, aged 56 years---In U. S. Surgeon General's Office. The Medical and Surgical History of the War of the Rebellion (1861-1865). Part I. Surgical Volume. Second Issue. Washington, 1875, p. 305-306. Summary of the case including the post-mortem. AL 4. Eisenschiml, O. The Case of A. L.----, aged 56; Some Curious Medical Aspects of Lincoln's Death and Other Studies. Chicago, Abraham Lincoln Book Shop, 1943. 55 p. AL 5. Friedberg, E. Lincoln's chiropodist. /. Nat. Assoc. Chir. 44(4): 36- 38, 1954. AL 6. Gilmore, H. R. Medical aspects of the assassination of Abraham Lincoln. Proc. R. Soc. M., Lond. 47: 103-108, 1954. AL 7. Holt, E. E. Abraham Lincoln. Ophth. Rec, Chic. 23: 389-393, 1914. "Diagnosis of heterophoria not only from a portrait but from the diplopia which occurred ... in 1860." AL 8. Kempf, E. J. Abraham Lincoln's organic and emotional neurosis. A. M. A. Arch. Neur. Psychiat. 67: 419-433, 1952. AL 9. Last hours of President Lincoln. [Editorial] Med. Times & Gaz., Lond. 51:468-469, 1865. AL 10. Leale, C. A. [Last hours of President Lincoln] Manuscript letter dated July 20, 1867, to General B. F. Butler, Member of the United States Congress, Chairman of Assassination Investigating Com- mittee. [14 p.] [Library of Congress] There are some marked differences between this and the ac- count in AL 11. Most importantly, perhaps, the artificial respira- tion procedures of AL 11 are not indicated at all, and in AL 10 Leale states he probed the wound with his finger, while in the box, whereas this is omitted from AL 11. AL 11. Leale, C. A. Lincoln's Last Hours, n.p., 1909. 16 p. AL 12. Longmore, T. Notes on some of the injuries sustained by the late President of the United States. Lancet 1: 649, 1865. AL 13. Markens, E. W. Lincoln and his relations to doctors. /. M. Soc. N. Jersey 19: 44-47, 1922. AL 14. Maxey, E. E. The effect of impaired vision on Lincoln's personal habits. Northwest M. 25: 310-312, 1926. AL 15. Mitchell, S. Diagnosis of heterophoria from a portrait. Ophth. Rec, Chic. 23: 224-226, 1914. CHARLES A. ROOS AL 16. Purtle, H. R. Lincoln memorabilia in the Medical Museum of the Armed Forces Institute of Pathology. Bull. Hist. Med. 32: 68- 74, 1958. AL 17. Segal, C. M. Isachar Zacharie; Lincoln's chiropodist. Publication Amer. Jewish Hist. Soc. 43(2): 71-126, 1953-54. AL 18. Shutes, M. H. Lincoln and the Doctors: a Medical Narrative of the Life of Abraham Lincoln. New York, Pioneer Press, 1933. 152 P- AL 19. Shutes, M. H. Lincoln's Emotional Life. Philadelphia, Dorrance [1957]. 222 p. AL 20. Stewart, T. D. An anthropologist looks at Lincoln. Annual Re- port of the Board of Regents of the Smithsonian Institution ... for the year ended June 30, 1952. Washington, 1953. p. 419-437, 4 plates. AL 21. [Stone, R. K.] The death of President Lincoln [including remarks on the autopsy]. /. A. M. A. 154: 856-857, 1954. Stone remarks that upon his arrival at the Peterson house "the case was surrendered to my care. ..." He refers twice to Taft, calling him "my friend," but mentions no one else. AL 22. Taft, C. S. Abraham Lincoln's last hours; from the note-book of an Army Surgeon present at the assassination, death, and autopsy. Century Mag. 45(n.s. 23): 634-636, 1892-93. Reprinted: Chicago, 1934. This is the most accurate and gracious of Taf t's several accounts of Lincoln's last hours. He acknowledges the prior presence of Leale in the theatre box and this is the only account that refers to the presence of Dr. King. He further writes of Leale: "It was owing to Dr. Leale's quick judgment in instantly placing the almost moribund President in a recumbent position the moment he saw him in the box, that Mr. Lincoln did not expire in the theatre within ten minutes from fatal syncope." Compare Taft's highly egocentric account, in what is stated to be a letter to the author, dated March 1, 1900: Oldroyd, O. H. The Assassination of Abraham Lincoln. Washington, the Author, 1901, p. 29-31. Dr. Taft's half-sister adds more definite lustre to the role of her brother: "He [Taft] was the first surgeon to reach the Presi- dent . .. [and] until the Surgeon General and the President's family physician arrived, my brother was in charge." Bayne, Julia Taft. Tad Lincoln's Father. Boston, Little, 1931, p. 202. AL 23. Taft, C. S. Last hours of Abraham Lincoln. Med. Surg. Reporter 12: 452-454, 1865. Reprinted: Chicago M. J. 22: 227-231, 1865- Chicago M. Examiner 6: 310-314, 1865; Brit. M. J. 1- 569-57o' 1865. physicians to the presidents 321 The article acknowledges the prior presence and activity of Dr. Leale in the box. AL 24. Taft, C. S. [Notes of the circumstances attending the assassination of Abraham Lincoln ... Washington, April 15, 1865] 5 p. type- written. [National Library of Medicine] Time of the firing of the shot given as "about 10:30." Leale is not referred to in this account. AL 25. Teevan, W. F. How were the fractures of the orbital plates of the frontal bone of the late President Lincoln produced? Lancet 2: 105, 1865. AL 26. [Wilson, J.] [Letter evaluating Washington physicians as possible choices for physician to Lincoln] In Mearns, D. C. Lincoln Papers. Garden City, N. Y., Doubleday, 1948, vol. 1, p. 318-319. Reference to Miller, May, Lieberman, Hall, and others. AL 27. Woodward, J. J. [Report of the autopsy on the body of President Abraham Lincoln] 4 p. handwritten [National Archives]. Reproduced (in another hand) in AL 4. Health of President Lincoln Varioloid following Gettysburg speech, November 19, 1863. "Lincoln became ill on the train leaving Gettysburg, so it is known that he was sick from the very day of the ceremony... until about the middle of Decem- ber." (AL 18, p. 85.) The President was shot between a few minutes after 10 and 10:30 p.m., Friday, April 14, 1865, and died between 7:20 and 7:30 a.m.36, April 15. The autopsy was performed in the White House at noon, April 15. Physicians to President Lincoln Robert King Stone (1822-1872); M.D., University of Pennsylvania, 1845. Lincoln's family physician and in charge at the death bed from the time of his arrival at the Peterson House.37-38 36 Leale (AL 11, p. 12) says 7:20 a.m.; Stone gives 7:30 (Poore, B. P., ed. The Conspiracy Trial for the Murder of the President. Boston, J. E. Tilton, 1865. vol. 1, p. 250). For Taft's statements see AL 23 and AL 24. Shutes (AL 18, p. 115-116) repeats the Taft statement of AL 23 and AL 24, without indication of source. 37 Concerning the time of Dr. Stone's arrival, Leale states in his letter that Dr. Stone arrived "about 20 minutes after we had placed him [Lincoln] in bed in the House of Mr. Peterson" (AL 10, p. 2). In his 1909 account he is content to say Dr. Stone arrived "... apparently a very long time after we had cared for the President in Mr. Peterson's house." (AL 11, p. 14.) At the trial of the Lincoln conspirators Stone testified that he arrived at the Peterson House "about 10:15" (Poore, op. cit., vol. 2, p. 250). Even on the earliest estimate of the shooting (a few minutes after 10) Nicolay, J. G., and Hay, J. Abraham Lincoln; a History. New York, Century, 1914. vol. 10, p. 301), the estimate by Stone would appear to be too early. Regarding the order of Stone's arrival Leale writes: "Several 322 CHARLES A. ROOS Washington Chew Van Bibber (1824-1872); M.D., University of Pennsyl- vania, 1845. Baltimore physician, consultant to Dr. Stone during the varioloid in- cident. Dr. Van Bibber's role as consultant is described in Finney, J. M. T. A Surgeon's Life___New York, Putnam, 1940, p. 259. Dr. Van Bibber is not mentioned by Shutes (AL 18). Physicians present in the box at Ford's Theatre Charles Augustus Leale (1842-1932); M.D., Bellevue Hospital Medical College, 1865. The first physician39 to reach the President. In charge until the arrival of Dr. Stone. Appointed Assistant Surgeon, U. S. Volunteers, April 8, 1865. physicians arrived [at the Peterson House] among whom were Dr. Leiberman and Dr. Ford ... in a short time Dr. Stone arrived." (AL 10, p. 11.) In AL 11 Leale lists Dr. Stone as the first physician "taking a professional part in the care of the President to arrive" (p. 13). He then lists Barnes and Crane. Taft has Stone and Barnes arriving simul- taneously: "Surgeon General Barnes and Robert K. Stone, M.D., the family physician, arrived and took charge of the case." (AL 23, p. 453.) Actually Barnes arrived much later than Stone. Leale speaks of his "long delay in arriving" (AL 11, p. 10), and at the trial of the Lincoln conspirators the Surgeon General testified he was in attendance on Secre- tary Seward "a few minutes after 11 o'clock" (Poore, op. cit., vol. 2, p. 21), his arrival at the Peterson House being correspondingly later. 88 There is conflicting evidence as to who was in final charge of the case. Leale ex- plicitly states in his letter: "Dr. Stone arrived. I was introduced to Dr. Stone as having charge of him. I asked Dr. Stone if he would take charge ... he said 'I will.' " (AL 10, p. 11.) The problem is whether Barnes assumed charge upon arrival. Leale never re- moves Dr. Stone from his charge of the case though he reports that upon the arrival of the Surgeon General he reported to the Surgeon General what he had done and officially detailed to him his diagnosis. (AL 11, p. 10.) Taft writes: "Surgeon General Barnes and Robert King Stone, M.D. the family physician arrived and took charge of the case." (AL 23, p. 453.) Leaving aside the telescoping of the time sequence, this implies that Barnes and Stone were jointly in charge. Sandburg writes: "Dr. Robert K. Stone, the Lincoln family physician, arrives, followed soon by Surgeon General Joseph K. Barnes and his assistant Dr. Charles H. Crane, who take charge." (Sandburg, Carl. Abraham Lincoln: the War Years. New York, Harcourt, 1939, vol. 4, p. 288.) Sandburg seemingly believes that Barnes and Crane were finally in charge. J. A. Bishop is explicit: "The doctors held a conference in the bedroom and they agreed that Surgeon General Barnes should take charge of the case." (The Day Lincoln Was Shot. New York, Harper, 1955. p. 238.) This, however, is dubious. 39 The New York Herald for April 18, 1865, has an accurate account of the role of Drs. Leale, Taft, and King. This account, incidentally, reports that Barnes turned over the case of Secretary Seward to a Dr. Norris, presumably Basil Norris, (notwithstanding the fact that Dr. T. S. Verdi has Dr. Norris, C/.SJV. in his letter "Full particulars of the attempted assassination of the Hon. Secretary Seward, his family and attendants. Wash- ington, April 21st 1865." Western Homoeopathic Observer, St. Louis, 2: 81-86 1865} Frank Leslie's Illustrated Newspaper for May 6, 1865, (p. 193) indicates that the President PHYSICIANS TO THE PRESIDENTS 323 Charles Sabin Taft. ".. . [the first physicians] who reported and simultaneously offered their services to me, which were accepted, were Charles S. Taft, M.D., Acting Assistant Surgeon, United States Army, and Albert F. A. King, M.D., Act- ing Assistant Surgeon, United States Army." (AL 11, p. 14.) Shutes (AL 18, p. 112), Sandburg (op. cit., vol. 4, p. 284), and others have Taft (and King) active in the artificial respiration measures of AL 11. The identification of Taft and King with the two assistants referred to in AL 11, p. 6, would seem to go beyond the evidence. Taft himself does not refer to the measures in question in any of his several accounts. It was Taft, of course, who was lifted into the box from the stage, not Leale, as C. W. Robertson and others would have it. Leale entered by the stairway. Albert Freeman Africanus King (1841-1915); M.D., Columbia Medical College, 1861; University of Pennsylvania, 1865. "... observations of the pulse and respiration were noted down by Dr. A. F. A. King at the bedside... the pulse was counted by Acting Asst. Surgeon Ford." (AL 23, p. 453.) Physicians in attendance at the Peterson House (in addition to Leale, Taft, King, and Stone) Joseph K. Barnes (1817-1883); M.D., University of Pennsylvania, 1838. Surgeon General, U. S. Army, 1864-1882. The role of Barnes in the case is described in the two accounts of Leale and in those of Taft. There are, however, discrepancies between Leale's two accounts as well as between the accounts of Taft and Leale. Charles H. Crane (1825-1883); M.D., Harvard, 1847. Surgeon General, U. S. Army, 1882-1883. "Col. Crane had charge of the head during a great part of the time, being relieved in this duty by myself." (AL 23, p. 453.) Charles Mason Ford (1840-1884); M.D., University of Pennsylvania, 1861. "During the greater part of the night, the pulsations were counted by Dr. Ford and noted by Dr. King." (AL 10, p. 13.) was kept in the theatre box for about 20 minutes after he was shot, and Leale writes in AL 10 (p. 9) that the President was placed in the bed at the Peterson House "in less than 20 minutes from the time that he had been assassinated." 324 CHARLES A. ROOS Other physicians present at the Peterson House "During the night several other physicians unknown to me called, and through courtesy I permitted some of them to feel the President's pulse, but none of them touched the wound." (AL 11, p. 14.) "Several physicians now arrived among whom were Dr. Leiberman and Dr. Ford...." (AL 10, p. 11.) "During the night Drs. Hall, May, Lieberman, and nearly all the lead- ing men of the profession in the city tendered their services." (AL 23, p. 454.) "Surrounding the deathbed of the President were ... Drs. E. W. Abbott, R. K. Stone, C. D. Gatch, Neal, Hall, and Lieberman." [Washington] Evening Star, April 15, 1865 (2d ed.).40 Ezra W. Abbott. Dr. Abbott41 made a detailed record, at generally five-minute intervals, of Lincoln's condition and some other events which took place during the last hours. These so-called "minutes" run from 11:00 p.m., April 14, to 7:20 a.m., April 15. They were published in the New York Daily Tribune for April 17, 1865 (p. 2). They are not to be confused with the pulse and respiration table of Ford and King, the latter published in AL 23 (p. 453- 454). Dr. Abbott's "Minutes" are also published in Oldroyd, op cit., p. 32-35. They are briefly excerpted in New York M. J. 74: 505, 1901. Dr. E. W. Abbott is listed as a homeopathic physician in Boyd's Wash- ington and Georgetown Directory for 1866. Butler's and Polk's Directories place him in New Hampshire, 1874 to 1906. C. D. Gatch. Not further identified.42 James Crowdhill Hall (1805-1880).43 The Secretary of the Navy writes of his arrival at the Peterson House: "Several surgeons were present, at least six, I should think more. Among 40 The New York Herald of April 16 (p. 1) has E. N. Abbott and C. D. Hatch; the Xew York Daily Tribune for April 17 (p. 2) has Neal Hall, and Mr. Lieberman. 41 Oldroyd (op. cit., p. 32) supplies the otherwise elusive first name. Lalghlin, Clara E. The Death of Lincoln. (New York, Doubleday, 1909), which has Dr. Abbott as "attend- ing physician" and Taft in charge in the box, was apparently based on Oldroyd. 42 C. W. Robertson (Bost. Med. Quart. 8: 33-43, 76-86, 1957) has Dr. Charles Gatch along with Leale and King attending the President in the theatre box. Dr. Gatch was almost certainly not present since he is mentioned neither by Leale nor by Taft "Shutes has Neal Hall (AL 18, p. 114) but makes certain the identification with J. C. Hall by adding he was the physician "with whom Dr. Stone consulted in the last illness of Willie Lincoln." Shutes repeats the error in AL 17, p. 142, and in his article "Mortalitv of the five Lincoln boys," Lincoln Herald 57: 5, Spring-Summer (nos. 1-2) 1955 PHYSICIANS TO THE PRESIDENTS 325 them I was glad to observe Dr. Hall, who, however, soon left. I inquired of Dr. H., as I entered, the true condition of the President. He replied the President was dead to all intents, although he might live three hours or perhaps longer." Diary of Gideon Welles. Boston, Houghton, 1911, vol. 2, p. 286. "The Surgeon General was sent for and Drs. Hall and Stone also ar- rived." National Intelligencer, April 16, 1865. Charles H. L. Lieberman (1813-1886); M.D., University of Berlin, 1838. Washington physician. John Frederick May (1812-1891); M.D., Columbian Medical College, 1834. Washington physician. Dr. Neal. Possibly William R. Neal, Washington representative of the U. S. Sani- tary Commission, though not a physician. Beecher Todd. "Dr. Beecher Todd of Lexington, a cousin of Mrs. Lincoln, was there through the long night." (AL 18, p. 114.) Physicians present at autopsy** (in addition to Barnes, Crane, Stone, and Taft) Edward Curtis (1838-1912); M.D., College of Physicians and Surgeons, New York, 1864. Army Surgeon, 1863-1870. Dr. Curtis was Woodward's assistant at the Army Medical Museum from 1864 to 1870. He had been a Medical Cadet, U. S. Army, 1861-1863. Co-author with John Shaw Billings of a report on cryptogamic growths in cattle diseases (1869), one of the earliest investiga- tions on the subject of the bacterial causation of disease. Aided Woodward at autopsy. William Morrow Notson (d. 1882); M.D., Jefferson Medical College, 1861. Medical Officer, U. S. Army, 1862-1882. Presumably his combination of names derives from the New York Daily Tribune account of April 17. "According to Woodward (AL 26) the autopsy was performed at 12:00 noon. The New York Daily Tribune for April 15 and Shutes (AL 18, p. 116) have 11:00 a.m. 326 CHARLES A. ROOS Joseph Janvier Woodward (1833-1884); M.D., University of Pennsylvania, 1853. Performed autopsy and submitted a report of the autopsy to Barnes. Pioneer in microphotography at the Army Medical Museum. (34th Presi- dent, American Medical Association, 1882/83.) ANDREW JOHNSON (1808-1875) 17th President, 1865-1869 Health of President Johnson Illness June 26-July 9, 1865. "The President has been ill... he has been threatened, Dennison tells me, with apoplexy.45 So the President informed him." (Diary of Gideon Welles. Boston, Houghton, 1911. vol. 2, p. 327; entry for July 8, 1865.) Entry for July 9; "The President was afflicted with a severe headache---" (Ibid., p. 330.) Welles reports the President better on the 10th and thereafter. "Afflicted with gravel, he found no cessation from pain, and but little relief in standing while at work for hours, in preference to remaining in a sitting posture, or from the variety of an occasional 'fit of the gravel,' with its excruciating torture." Cowan, Frank. Andrew Johnson, President of the United States; Reminiscences of his Private Life and Character; by One of his Secretaries. 2d ed. Greenesburgh, Pa., Oliver, 1894, p. 7. Residual effects of a fracture of the arm some years before. Royall, M. S. Andrew Johnson, Presidential Scapegoat. New York, Exposition, 1958, p. 62. Physician to President Johnson Basil Norris (1828-1895); M.D., University of Maryland, 1849. Surgeon, U. S. Army, 1852—. "... attended officially President Andrew Johnson and President U. S. Grant during their entire terms of office___" (Records of Living Officers of the United States Army, Philadelphia, Hamersly, 1884, p. 43.) Colonel Norris became involved in an acrimonious debate concerning private medical practice of Army and Navy physicians in Washington. The Medical Association of the District of Columbia set up a committee to in- vestigate this and their report reads in part: Upon this point your committee beg to state that they have examined somewhat in detail into the practice which has obtained here in this city for the past ten or twelve 45 "It was generally rumored that Johnson had a stroke during this period [July 18651 but there is no evidence either to support or deny this hypothesis." (Wold, p. 118) physicians to the presidents 327 years, and find that it has been and still is the custom of certain Army Medical Officers on duty here in Washington to engage extensively in private practice, rendering their services, for the most part, gratuitously and in many instances supplying parties not im- mediately connected with the army with medicines and hospital supplies from the Army Dispensary of this city. That so far has this practice been pursued that Presidents of the United States, we are informed, have not hesitated to avail themselves of the services of any Army Medical Officer stationed here for themselves and families, and permitted him to supply them with medicines, etc., from the public dispensary belonging to the United States. This practice on the part of the Chief Magistrate of the States, we are informed, was initiated by President Johnson and followed by his successor, President Grant, during both of his terms as President of the United States. In the latter case it appears he not only recognized and availed himself of the benefits of this custom, but permitted his in- fluence to be used to retain at this post the particular Medical Officer who had held such relations to his family, and who, under the rules of the Department, should have been transferred to some other post or duty. So far, indeed, was this prerogative exercised by President Grant that this same Medical Officer was required more than once to leave his legitimate duties here in Washington and visit distant points for the purpose of attend- ing the family of the President. It is due to President Grant to add, in this connection, that previous to his term there was a contract surgeon detailed to attend the domestics employed at the Executive Mansion, which was abolished by him. (Busey, Samuel C. Personal Reminiscences .. .Washington, D. C, 1895. p. 305. ULYSSES S. GRANT (1822-1885) 18th President, 1869-1877 Bibliography UG 1. Elliott, G. R. The microscopical examination of specimens re- moved from General Grant's throat. Med. Rec, N. Y. 27: 289-290, 1885. UG 2. Shrady, G. F. General Grant's last days. New York, 1901. 74 p. Dr. Shrady was one of the consulting surgeons during Grant's last illness. The other physicians were Fordyce Barker, Grant's family physician, John H. Douglas, and Henry B. Sands.46 Physician to President Grant Basil Norris (1828-1895). RUTHERFORD B. HAYES (1822-1893) 19th President, 1877-1881 No information located.47 48 Of special interest to medical librarians is Grant's first physician, Dr. John George Rogers of Richmond, Ohio, who was in attendance at the birth of the future President, and was the great, great grandfather of Dr. Frank B. Rogers, Director of the National Library of Medicine. " The President's diary for December 16, 1878, notes the presence at a small White House gathering of "Dr. and Mrs. Woodworth" (Williams, C. R. Diary and Letters of 328 CHARLES A. ROOS JAMES A. GARFIELD (1831-1881) 20th President, 1881 Bibliography JG 1. Baker, F. President Garfield's case; a diagnosis made July 4th. Walsh's Retrospect 2: 617-622, 1881. Dr. Baker correctly diagnosed the course of the bullet on the above date. JG 2. Bliss, D. W. Report of the case of President Garfield accompanied with a detailed account of the autopsy. Med. Rec, N. Y. 20: 393- 402, 1881. Also: Walsh's Retrospect 2: 542-557, 1881. "The complete and technical report which will appear in due time under the editorial direction of J. J. Woodward" men- tioned at the beginning of this article seems never to have ap- peared. The Reyburn report (JG 12) perhaps took its place. JG 3. Bliss, D. W. The story of Garfield's illness; told by the physician in charge. Century Mag. 23: 299-305, 1881. JG 4. The evidence [Editorial]. Walsh's Retrospect 3: 304-308, 1882. In support of Dr. Baxter. JG 5. Fish, S. A. The death of President Garfield. Bull. Hist. Med. 24: 378-392, 1950. JG 6. The Garfield case. In Adams, J. H. History of the Life of D. Hayes Agnew, M.D., L.L.D. Philadelphia, F. A. Davis, 1892. p. 220-249. JG 7. Hammond, W. A., Ashhurst, J. Jr., Sims, J. M., and Hodgen, J. T. The surgical treatment of President Garfield. North. Am. Rev. 133: 578-610, 1881. Former Surgeon General Hammond is alone in believing the wound was not necessarily mortal and that early treatment of the President was deficient. For a discussion of this article see Med. Rec, N. Y. 20: 600, 1881. JG 8. Hunt, Wt. The post mortem examination of Garfield. Med. Rec, N. Y. 20: 642, 1881. Rutherford Birchard Hayes. Columbus, Ohio, State Archaeological and Historical So- ciety, 1924. vol. 3, p. 514). Another guest of the evening recording the presence of the same couple designates them as "Assistant Surgeon General and Mrs. Woodward" (Wil- liams, C. R. The Life of Rutherford Birchard Hayes. New York, Houghton, 1914. vol. 2, p. 310 (footnote)). In the indexes to both the Diary and the Life, Williams converts the name of the doctor in question to Woodward, J. J. (presumably intending Joseph Janvier Woodward). It is apparent, however, that the President has correctly spelled his guest's name; the second guest has given the doctor his approximately correct title and that he was, most probably, John Maynard Woodworth (1837-1879), Supervising Surgeon General, U. S. Marine Hospital Service. physicians to the presidents 329 JG 9. Jennings, R. S. Cooling apparatus used at the White House. Bos- ton M. 6- S. J. 105: 470-471, 1881. JG 10. Miller, J. M. The death of James Abram Garfield. Surg. Gyn. Obst. 107: 113-118, 1958. JG 11. Parker, O. W. The assassination and gunshot wound of President James A. Garfield. Minnesota Med. 34: 227-233, 258, 1951. JG 12. President Garfield's wound and its treatment. Walsh's Retrospect 2: 623-633, 1881. Critical of Bliss's treatment of Garfield as reported in the Medi- cal Record. Letters to Walsh from Smith Townshend, C. B. Pur- vis, N. S. Lincoln, and P. S. Wales, relating their respective roles in the case, p. 624-629. JG 13. Prichard, R. W., and Herring, A. L. Jr. The problem of the President's bullet. Surg. Gyn. Obst. 92: 625-633, 1951. The statement (p. 632) that J. Marion Sims was one of the Presi- dent's physicians is presumably incorrect. On the relationship of Dr. Sims to the Garfield case see JG 7 and Harris, Seale. Woman's Surgeon; the Life Story of J. Marion Sims. New York, Macmillan, 1950. p. 341-342. JG 14. Reyburn, Robert. The case of President James A. Garfield, an abstract of the clinical history. Am. Med. 2: 498-501, 1901. JG 15. Reyburn, Robert. Clinical history of the case of President James Abram Garfield. /. A. M. A. 22: 411-417, 460-464, 498-502, 545- 549, 578-582, 621-624, 664-669, 1894. Also published as a separate under the same title: Chicago, Americal Medical Association, 1894. 108 p. JG 16. Shrady, G. F. Surgical and pathological reflections on President Garfield's wound. Med. Rec, N. Y. 20: 404-406, 1881. JG 17. Smith, A. H. President Garfield at Elberon. Am. Med. 9: 118-120, 1905. JG 18. Temkin, O., and Koudelka, J. Simon Newcomb and the location of President Garfield's bullet. Bull. Hist. Med. 24: 393-397, 1950. JG 19. Turnipseed, E. B. A dissenting voice from the standpoints taken by D. W. Bliss, M.D., in regard to the diagnosis, prognosis, and treatment of the case of President Garfield. Med. Rec, N. Y. 20: 621-624, 1881. JG 20. A violation of medical ethics [editorial]. Walsh's Retrospect 2: 457-459, 1881. In support of Baxter. JG 21. Weisse, F. D. Surgical reflections and anatomical observations bear- ing upon a possible course of the bullet that wounded President Garfiield. Med. Rec, N. Y. 20: 57-61, 1881. 330 CHARLES A. ROOS JG 22. Weisse, F. D. Surgico-anatomical study of the gunshot wound of President Garfield. Med. Rec, N. Y. 20: 402-403, 1881. For some additional articles relating to the Garfield case see Index- Catalogue of the Library of the Surgeon General's Office, U. S. Army, [ser. 1] vol. 5, p. 286. Assassination of President Garfield President Garfield was shot at the Baltimore and Potomac railroad station in Washington, July 2, 1881. He died September 19 of the same year at Elberon, New Jersey, where he had been taken on September 6. Bulletins concerning the President's condition were issued two or three times daily and the case aroused the greatest interest both in the medical profession and in the citizenry at large. Dr. Bliss, physician-in-charge, and his consultants, were subjected to acrimonious criticism by fellow physi- cians and by the press. Public and professional temper was not assuaged when autopsy revealed among other errors of diagnosis that the bullet was in fact some ten inches from where the physicians had supposed it to be. Dr. P. M. Dale sums up the matter: "Whatever the source of the errors, public confidence in the medical profession at large was dealt a heavy blow." (Medical Biographies. University of Oklahoma Press, 1952, p. 218.) Physicians to President Garfield Jedediah Hyde Baxter (1837-1890); M.D., University of Vermont, 1860. Surgeon General, U. S. Army, Aug. 16-Dec. 4, 1890. "I have been President Garfield's family physician for the past five or six years, and since his advent to the White House have continued to treat him professionally." (JG 16, p. 457.) "Meulon, Ohio, Oct. 24th, 1881. This certifies that on or about August 8th, 1881, the late President James A. Garfield made the following state- ment to me in the presence of Mrs. Garfield, viz., that Dr. J. H. Baxter had been his physician for many years and that he still considered him as his physician. He also stated that he had no knowledge of ever having placed himself under the professional care of Dr. D. W. Bliss and he did not be- lieve that Dr. Bliss had ever spoken one word to him upon the subject. Mrs. Garfield stated at the same time that she had never been consulted by Dr. Bliss upon the subject—and had no knowledge of the President having chosen Dr. Bliss as his attending Surgeon, [signed] S. A. Boynton, M.D. Trenton. Oct. 24th, 1881. I have read the statement of Doctor Boynton made this day and will say it is entirely correct, [signed] Lucretia R Gar- field." (JG 3, p. 305-307.) "Baxter was the medical attendant at the White House during the early physicians to the presidents 331 administration of President Garfield, and considerable comment was caused by his failure to be included among the attending surgeons after the President had received his fatal injury. From the standpoint of a score of years later, it would appear to have been simply the outcome of pro- fessional competition and consequent animosity. At the time, however, the feeling on the subject ran high in Washington." (Pilcher, J. E. The Surgeon Generals of the Army of the United States, Carlisle, Pa., Associa- tion of Military Surgeons, 1905. p. 76.) Physicians present from wounding to death and autopsy The first physician (Dr. Smith Townshend) to reach the President after he was shot administered emergency measures and then had the President removed to a private room on the second floor of the station. Here Dr. Townshend was joined by Dr. Purvis, Dr. Bliss, and a number of other physicians who examined the President further, and after consultation decided to remove him to the White House. "The physicians present at this consultation [at the depot] were Drs. D. W. Bliss, Smith Townshend, N S. Lincoln, Basil Norris, P. S. Wales, John B. Hamilton, C. M. Ford, D. C. Patterson, C. B. Purvis, and Robert Reyburn." (JG 15, p. 413.) The President was then taken to the White House in a police ambulance accompanied by Drs. Bliss, Townshend, and Wales. (JG 12, p. 624.) "... we come next to the first formal consultation, in which some of the most prominent medical men in Washington took part.... I append their names as a part of this simple record. Dr. Smith Townshend, Health Officer, D. C, Dr. C. M. Ford, Dr. P. S. Wales, Surgeon-General, U.S.N., Dr. C. B. Purvis, Dr. C. C. Patterson, Dr. Basil Norris, U. S. A., Dr. N. S. Lincoln, Dr. J. B. Hamilton, Surgeon-General, Marine Hospital Service." (JG 3, p. 300.) The time is Saturday afternoon, July 2nd. "At the evening consultation, July 2d (7 p.m.)... the gentlemen invited by me to visit the bedside were Surgeon-General Wales, Surgeon J. J. Woodward, and Dr. Reyburn." (JG 2, p. 394.) "The consultations heretofore referred to were, as a matter of course, held in the adjoining room. Only three or four physicians of the number present were invited to visit the bedside on each occasion to make personal examinations, to verify the reported progress, and enable them to intelli- gently advise the council." (JG 2, p. 394.) "Drs. Bliss and Reyburn remained on duty all the night of July 2 and 3.. .. Miss [e.g., Dr.] Edson ... [was] also at hand to render any needed aid." (JG 15, p. 414.) "All the physicians visited the White House at 8 a.m., July 3d, for the morning consultation___At this consultation Surgeon-General Barnes 332 CHARLES A. ROOS and Surgeon Woodward, U. S. A., Dr. Reyburn and Dr. N. S. Lincoln, visited the bedside of the patient with me, with a view of making the neces- sary examinations, dressing the wound, and of reporting results to the other members of the council." (JG 2, p. 394.) Physicians in attendance through the morning of July 3d Doctor Willard Bliss48 (1825-1889; M.D., Western Reserve, 1845. "Immediately after the shooting of President Garfield, on the morning of July 2d, I was summoned by the Secretary of War [Robert T. Lincoln] to take charge of the case." (JG 2, p. 393.) "Immediately after the consultation [of Sunday morning, July 3d] the subject of medical attendance was considered by the President. The only persons present were, besides the President, Mrs. Garfield and myself. He then formally placed himself under my professional care, and requested me to select my counsel, the result of which is well known. He also desired me to individually thank the large number of physicians who had com- posed the council up to that time, which I accordingly did." (JG 2, p. 395.) "Dr. Bliss as chief surgeon in charge of the case remained on continuous duty every night at the White House, from the time the President was shot until he was taken to Elberon, N. J., and he continued his vigils there until the death of the President... . All the medicine and all the articles of diet were either administered by him or under his immediate direction." (JG 15, p. 414.) Smith Townshend (1836-1896); M.D., Columbian Medical College, 1870. Health Officer of the District of Columbia, 1878-1891. He was dismissed from the case by Dr. Bliss Sunday afternoon. Dr. Townshend left an ac- count of his role: JG 12, p. 624-625. Charles Burleigh Purvis (1842-1929); M.D., Wooster Medical College, 1865. The second physician to arrive after the President had been shot. Writ- ing many years later (1908) Dr. Purvis says, "I was the first physician to attend the President after he was shot." (Letter cited in [Biography] /. Nat. Med. Ass. 45: 81, 1953.) But the Doctor's memory played him false, 48 The life histories of four of the principal doctors involved in this case were curiously interwoven nearly twenty years before. In 1863-64 Bliss and Woodward, both attached to the Army Medical Museum, were to have given a course of lectures on military medi- cine and surgery; this early proposal for an Army Medical School had been initiated by Hammond and was backed by Barnes, but was rejected by Stanton. See Brinton J H Personal Memoirs, New York, Neale, 1914, p. 258-259; and Lamb, D. S. A History of the United States Army Medical Museum, 1862-1917. n.p., n.d., p 23-9"j PHYSICIANS TO THE PRESIDENTS 333 for his 1881 letter to Walsh describing his role in the case (JG 12, p. 625- 626) states that Dr. Townshend was in attendance when he arrived, and this is in accord with all other accounts. "As one of the physicians who attended President James A. Garfield . .. he is the only Negro physician to have served a president of the United States." (/. Nat. Med. Ass. 45: 79, 1953.) Joseph K. Barnes (1817-1883). Chosen by Bliss as one of the consulting surgeons, July 4. Reyburn writes that from this time on "Surgeon General Barnes came twice a day in con- sultation with other surgeons." (JG 15, p. 414.) Seth R. Beckwith (1832-1905); M.D., Homoeopathic Hospital College, Cleveland, Ohio, 1853. Examined the President at the White House July 2 and present at the consultations through Sunday morning, July 3. Dr. Beckwith describes his role in the case: N. Y. Med. Times 9: 221-222, 1881. Charles Mason Ford (1840-1884). John Brown Hamilton (1847-1898); M.D., Rush Medical College, 1869. Dr. Hamilton was Surgeon General, U. S. Marine Hospital Service, 1879— 1891. Dismissed by Bliss Sunday afternoon according to the New York Herald of July 5. Nathan Smith Lincoln (1828-1898); M.D., University of Maryland, 1852. District of Columbia physician. Dr. Lincoln describes his role: JG 12, p. 626-627. Basil Norris (1828-1895). In an interview published in the New York Herald, July 5, Dr. Norris indicated that he had participated in the consultations at the White House and had been taken to the bedside of the President. Dr. Norris, in general, approved of Bliss's handling of the case. DeWitt Clinton Patterson (1826-1893); M.D., Western Reserve, 1851. Dr. Patterson, in an interview published in the New York Herald, re- ports he had heard the President had been shot dead and went to the White House in his official capacity as coroner for the District of Columbia. There Bliss invited him to join the consultations, so he was present Satur- day evening and Sunday morning. He said he was taken to the bedside of the President once, briefly. According to the New York Herald of July 5 334 CHARLES A. ROOS he was dismissed Sunday afternoon by a letter from Bliss. Patterson ex- pressed approval of Bliss's handling of the case in the interview. Robert Reyburn (1833-1909); M.D., Philadelphia College of Medicine and Surgery, 1856. Doctor Reyburn reports he was summoned to the depot by a messenger from Bliss. He was selected as permanent consultant by Bliss, July 4. Ac- cording to his own account, "Dr. Reyburn was assigned the duty of taking notes of the case, which were written each day by him in a book procured for that purpose." (JG 15, p. 414.) Philip Skinner Wales (1837-1906); M.D., University of Maryland, 1856. Surgeon General, U. S. Navy, 1879-1884. He is said to have discovered the fractures of the ribs at the Saturday evening examination, a matter made much of by Bliss's enemies and denied by him and his friends. Dr. Wales was dismissed Sunday afternoon by Bliss. He describes his role: JG 12, p. 627-629. Joseph Janvier Woodward (1834-1884). Present at the depot, according to Purvis. Selected by Bliss as consulting surgeon, July 4. Woodward prepared the daily bulletins "and along with Dr. Robert Reyburn assisted in taking the temperature, pulse and respira- tion, which was done at least three times a day." (JG 15, p. 414.) "Drs. Woodward and Reyburn slept each night alternately in the White House, and were always on hand to furnish such assistance as might be required." (Ibid.) Other physicians said to have been present through the morning of July 3d William James Chamberlin Du Hamel (1827-1883); M.D., University of Maryland, 1849. Present at the depot and again at the White House, July 5. (New York Herald, July 6.) Francis M. Gunnell (1827-1922); M.D., Columbia University, 1847. Surgeon General, U. S. Navy, 1884-1888. Present at the Sunday morning consultation. (New York Herald, Juh 5.) Dismissed from the case by circular of Bliss, according to the same source. PHYSICIANS TO THE PRESIDENTS 335 David Low Huntington (1834-1899); M.D., University of Pennsylvania, 1857. Present at the White House consultations ([Washington] Evening Star, July 4, 1881.) Army Surgeon, 1862-1898. Curator, Army Medical Museum, 1881-1883. Librarian, Army Medical Library, 1896-1897. Joel Pomerene; M.D., Jefferson Medical College, 1861. Surgeon, 42d Infantry, Ohio, to July 1863. (Strait, N. A., comp. Roster of all Regimental Surgeons and Assistant Surgeons in the late War . .. n.p., 1S82. p. 198.) "Dr. Homerine [i.e., Pomerene] of Millersburg, Ohio, formerly Surgeon in Garfield's old regiment, the 24th [i.e., 42d] Ohio Volunteers, and an authority on gunshot wounds .. . had been summoned by the President's personal request shortly after the shooting." (New York Herald, July 4.) "Dr. Bliss spends nearly all of his time in the White House, and so does Dr. Homerine." (New York Herald, July 5.) Dr. Pomerene arrived in Wash- ington July 3d and left on the 7th. (New York Herald, July 24.) Physicians in attendance July 4-Sept. 6 (in addition to Bliss, Barnes, Rey- burn, and Woodward) "It was perfectly apparent that there were more physicians in attendance upon the President than were needed, and Dr. Bliss determined to ascertain the President's wishes in the matter. On the morning of July 3 after the morning consultation ... Dr. Bliss went to the President and said: 'Mr. President, there are a number of the physicians of the city who have kindly volunteered their services and have been associated with me in conducting your case successfully through the day and night since your injur), and have contributed largely to the prospects of your recovery. Now that Mrs. Garfield has arrived and you are so comfortable, we wish to retire from the case and ask you to select your permanent surgeon and his counsel.' The President replied: 'I wish you to retain charge of my case, and select such counsel as you may think best.' .. . Dr. Bliss then said that if it was agreeable to the President and Mrs. Garfield, he would select Surgeon- General Barnes, U. S. A., Surgeon Woodward, U. S. A., and Dr. Robert Reyburn as his counsel...." (JG 15, p. 414.) The President replied: "Doe- tor, your selection is eminently satisfactory." Dr. Bliss then requested per- mission to thank the medical gentlemen in the name of the President and Mrs. Garfield, which was accordingly done. (Ibid.) "At this time [Sunday evening, July 3d] Dr. D. Hayes Agnew, of Phila- delphia, and Dr. Frank H. Hamilton, of New York, were summoned to 336 CHARLES A. ROOS visit the patient in consultation. Dr. Agnew arrived about 4 o'clock the following morning, July 4th, and Dr. Hamilton at 6 a.m. They were pre- sented to the President formally at the consultation, 8:15 July 4th. .. ." (JG 2, p. 395.) David Hayes Agnew (1818-1892); M.D., University of Pennsylvania, 1838. Consultant from July 4 to the President's death. Present at autopsy. Adams, J. H. History of the life of D. Hayes Agnew. Philadelphia, Davis, 1892. 376 p. The Garfield case, p. 220-249. John H. Girdner; M.D., University of the City of New York, Medical De- partment, 1879. "[Dr. Girdner49 was] an assistant to [F. H.] Hamilton [and] was fre- quently present." Caldwell, Robert G. James A. Garfield. New York, Dodd, 1931. p. 353 (footnote). Frank Hastings Hamilton (1813-1886); M.D., University of Pennsylvania, 1835. Consultant from July 4th until the President's death. Present at autopsy. Physicians at Elberon The President was removed to Elberon, New Jersey, on September 6. "The car assigned for the use of the party contained besides the President ... Mrs. Dr. Edson, Professor Agnew, Dr. Bliss, Surgeon-General Barnes, Dr. Woodward, Dr. Reyburn___" (JG 15, p. 621.) "The President desiring to diminish the number of his medical attend- ants, Surgeon-General Barnes, Dr. Woodward and Dr. Robert Reyburn retired from the case on the evening of September 7. Dr. Bliss remains in charge of the case and the services of Professor Agnew and Professor Hamil- ton are retained as consulting surgeons." (JG 15, p. 622.) Physicians at autopsy "Soon after the President expired, it became necessary to make arrange- ments for an autopsy... I deemed it proper to invite Surgeon-General Barnes, and Surgeon J. J. Woodward, U. S. A., and Dr. Robert Reyburn of Washington, D. C---and also invited, at the instance of Dr. Woodward, 49 His article "The death of President Garfield," Munsey's Mag. N. Y., p. 546-549, 1901-02, was not available for examination. He makes no reference to his own role in the Garfield case in his article: On the detecting and locating of metallic masses in the human body by means of the induction balance and the telephonic probe New York M. J. 14: 393-396, 1887. physicians to the presidents 337 Dr. Lamb of the Army Medical Museum . .. The former gentlemen arrived at Elberon, N. J., about 3:45 p.m., when the post-mortem examination was commenced. Dr. A. H. Smith, of New Jersey and New York, and tempo- rarily at Elberon was also invited." (JG 2, p. 398.) F. H. Hamilton and Agnew were also present. Daniel Smith Lamb (1843-1929); M.D., Georgetown Medical School, 1867. Dr. Lamb performed the dissection. Andrew H. Smith (1837-1910); M.D., College of Physicians and Surgeons, New York, 1858. Physicians acting as nurses to the President Silas A. Boynton (b. 1835): M.D., Homoeopathic Hospital College of Cleve- land. "The President's cousin, Dr. Boynton, attends the family [of the Presi- dent] when they are home in Mentor. He returned to this city this morning, and will especially look after the health of Mrs. Garfield." Interview with Dr. Edson, New York Herald, July 8. Dr. Boynton remained until the President's death, during which time he acted as the President's nurse. He was also present at the autopsy. Dr. Boynton is extremely critical of Bliss in a newspaper interview, reprinted in American Homoeopathic Observer 18: 492-494, 1881. Susan Ann Edson (b. 1823); M.D., Cleveland Homeopathic Medical Col- lege, 1854. The President's nurse until immediately after the removal of the Presi- dent to Elberon, when she returned to Washington. (New York Herald, Sept. 9, 1881)49a Dr. Edson had been Mrs. Garfield's physician. CHESTER A. ARTHUR (1830-1886) 21st President, 1881-1885 Bibliography Not so very sick—Arthur's illness explained. Baltimore American, April 24, 1883. 48a Dr. Edson left Elberon on September 8, apparently having shared in the reduction in force noted in JG 15, p. 622. The Herald for the 16th notes that Dr. Edson returned for a visit on the 15th, but her presence at the end is doubtful. She is not included among those said to have been present in accounts in newspapers and medical journals, nor does she claim this in her own sketch "The sickness and nursing of President Garfield ." in Balch, W. R. Life of President Garfield. Philadelphia, Hubbard, [c 1881] p. 612-620. 338 CHARLES A. ROOS The article supplies some general information regarding the Presi- dent's health. Health of President Arthur Nervous indigestion, especially during his last two years in the White House. (Howe, George F. Chester A. Arthur. New York, Ungar, 1935. p. 256.) Florida illness, from April 19, 1883.50 Physicians to President Arthur Nathan Smith Lincoln (1828-1898). The President's family physician according to the Baltimore American, April 23, 1883. Clarence E. Black (d. 1884). President Arthur was staying aboard the Presidential yacht Tallapoosa when he became ill in Florida. He is said to have been treated by the Ship's Surgeon on this occasion.51 This would have been Dr. Black, Surgeon, U.S.N. The Tallapoosa sank in 1884, Dr. Black perishing with the ship. GROVER CLEVELAND (1837-1908) 22nd, 24th President, 1885-1889, 1893-1897 Bibliography GC 1. Keen, W. W. The Surgical Operations on President Cleveland in 1893. Philadelphia, Jacobs [1917]. 52 p. Reprinted with additional papers [not related to Cleveland], Philadelphia, Lippincott, [1928] 251 p. GC 2. Seelig, M. G. Cancer and politics; the operation on Grover Cleve- land. Surg. Gyn. Obst. 85: 373-376, 1947. Health of President Cleveland Operations for cancer of the mouth July 1 and July 17, 1893. 50 Wold (p. 141) calls the illness malaria, but his documentation is obscure. Wold's account would appear to be exaggerated, at least with respect to the immediate conse- quences, in light of the April 24 Baltimore American article and other considerations. Howe (op. cit., p. 246), however, says the President never completely recovered from this illness, and that it forced him to adopt a reduced diet and a lightened schedule during the remainder of his term as President. 51 The ship's log (on file at the U. S. National Archives) notes when the President boarded and left the vessel but does not refer to his illness. PHYSICIANS TO THE PRESIDENTS 339 Physicians to President Cleveland Robert Maitland O'Reilly (1845-1909); M.D., University of Pennsylvania, 1886. Surgeon General, U. S. Army, 1902-1909. "Upon his return from sick leave (1882) he was assigned to duty as at- tending surgeon in Washington. . . . This duty he performed during the two administrations of President Cleveland, with whom his relations were most intimate and agreeable." (Pilcher, J. E. The Surgeon Generals of the Army of the United States of America. Carlisle, Pa., Association of Military Surgeons, 1905. p. 90.) "R. M. O'Reilly was family physician and intimate friend of President Grover Cleveland." [Obit.] Mil. Surg. 31: 741, 1912. George Miller Sternberg (1838-1915); M.D., College of Physicians and Surgeons, New York, 1860. 15th President, American Medical Association, 1898/99. Surgeon Gen- eral, U. S. Army, 1893-1902. "In 1893, President Cleveland not being in good health, his close per- sonal friend and physician, Dr. Joseph D. Bryant, came at intervals from New York to see him and prescribe for him. Dr. Bryant asked General Sternberg if he would consent to see the President and prescribe for him should Mr. Cleveland require special medical care during Dr. Bryant's absence. General Sternberg agreed to respond to any call and to render every possible service. The President had great responsibility at that time and the constant anxiety caused by numerous important and vexatious legislative matters was a tremendous tax on his vitality. Dr. Sternberg be- came, therefore, a welcome advisor, and as the President's physician, he was greatly loved and trusted. He soon became very much attached to Mr. Cleveland, for they had many interests in common. Both were sons of ministers and both had a feeling of loyalty and love for New York state. In due time they became very good friends." Sternberg, Martha L. George Miller Sternberg; a Biography. Chicago, American Medical Association, 1920. p. 136. Leonard Wood (1860-1927); M.D., Harvard University Medical School, 1884. ". . . two Presidents of the United States adopted him as their familv doctor—Cleveland and McKinley." (Bradford, C. H. Leonard Wood. New England J. Med. 247: 526, 1952.) "When Grover Cleveland was President of the United States, he asked 340 CHARLES A. ROOS Daniel Lamart, his Secretary, to secure for attendance at the ^ hite House the services of a suitable surgeon of the Army. An officer now a Major General of the United States Army, was appealed to, and suggested Dr. Leonard Wood. After Mr. Cleveland left the White House, Dr. Wood con- tinued as the attending physician to President McKinley." Lowry, E. G. Washington Close-Ups. Boston, Houghton, 1921. p. 98. "Wood saw nothing at first of the President or his family, for a superior officer attended them . .. [But] at last the President himself became aware of him and took him on an occasional fishing trip." (Hagedorn, Hermann. Leonard Wood: A Biography. New York, Harper, 1931, vol. 1, p. 135-136.) Physicians in attendance at the cancer operations Joseph Decatur Bryant (1845-1914); M.D., Bellevue Hospital Medical College, 1868. 59th President, American Medical Association, 1907/08. Dr. Bryant performed the operations. John Frederick Erdman (1864-1954); M.D., Bellevue Hospital Medical College, 1887. Bryant's assistant in private practice. Edward Gamaliel Janeway (1841-1911); M.D., College of Physicians and Surgeons, New York, 1864. Assistant to Bryant during operation. William Williams Keen (1837-1932); M.D., Jefferson Medical College, 1862. Dr. Keen was assistant to Bryant during the operation. He published the first "official" account of the operation (GC 1). Keen was joint author with S. Weir Mitchell and George R. Morehouse of the celebrated Gunshot Wounds and Other Injuries of Nerves. Philadelphia, Lippincott, 1864. BENJAMIN HARRISON (1833-1901) 23rd President, 1889-1893 Physician to President Harrison52 Jedediah Hyde Baxter (1837-1890). Surgeon General, U. S. Army, Aug. 16-Dec. 4, 1890. "At the time of General Moore's retirement [as Surgeon General of the Army] it so happened that these facts [Baxter's 'peculiar administrative 52 Mrs. Harrison died in the White House October 24, 1892, of pulmonary tuberculo- sis. For a remark on the possible involvement of the President see: Tuberculosis in the physicians to the presidents 341 ability,' etc.] coincided with... the incumbancy of the Executive by a comrade and long-time patient, President Benjamin Harrison. Colonel Baxter was then promptly on August 16, 1890, appointed Surgeon Gen eral." (Pilcher, J. E. The Surgeon Generals of the Army of the United States. Carlisle, Pa., Association of Military Surgeons, 1905. p. 77.) WILLIAM McKINLEY (1843-1901) 25th President, 1897-1901 Bibliography WM 1. Death of President McKinley. /. A. M. A. 37: 779-787, 1901. In- cludes: The wounds of Presidents Garfield and McKinley [a com- parison]; Management of the case of President McKinley; The shooting of the President [including comments on the post- mortem]; Official bulletins [Sept. 6-14]. WM 2. The official report on the case of President McKinley. /. A. M. A. 37: 1029-1036, 1901. Remarks on the operation by M. D. Mann, p. 1030; Report on the autopsy by H. R. Gaylord, p. 1033-1036; Report on the bacteriologic examination by H. G. Matzinger, p. 1036. Also as Report of the medical staff attending the late President William McKinley. New York Med. J. 74: 732-743, 1901. This last in- cludes portraits of Rixey, M. D. Mann, Mynter, Park, Wasdin, McBurney, and Stockton. WM 3. Parmenter, J. The surgery in President McKinley's case. An ac- count of the operation narrated by one of the surgeons who as- sisted. Buffalo M. J. n.s. 41: 205-206, 1901. WM 4. Rixey, P. M. Guarding the health of our Presidents. Better Health, San Francisco 6: 215-221, 1925. Portraits of Rixey, Grayson, Coupal, Sawyer, Delaney. Per- sonal experiences as physician to McKinley and Roosevelt. Brief remarks on subsequent physicians to Presidents from Taft to Coolidge. Reprinted in WM 5, p. 454-461. WM 5. Rixey, P. M. The Life Story of Presley Marion Rixey, Surgeon General, U. S. Navy, 1902-1910. Biography and autobiography. Biography by . . . William C. Braisted . . . and William Hemphill Bell, 1910. Strasburg, Va., Shenandoah Publishing House, 1930. 518 p. WM 6. Rixey, P. M. Medical and surgical report of the case of the late White House. [Editorial]. Med. Rec, N. Y. 42: 512, 1892. Mrs. Harrison's physician was Dr. Franklin A. Gardner, a homeopath. The Medical Mirror (3: 471^72, 514, 1892) is critical of the President for allowing homeopathic attendance. 342 CHARLES A. ROOS President of the United States. Annual Report of the Surgeon General, U. S. Navy, year ended June 30, 1901. p. 297-318. Daily case record and autopsy. Also: WM 5, p. 51-82. WM 7. Wilson, N. W. Details of President McKinley's case. Narrated by the recorder at the operation. Buffalo M. J. n.s. 41: 207-225, 1901. (Portraits of Park, M. D. Mann, Mynter, Parmenter, W'asdin, Rixey.) Health of President McKinley Grippe, January 1900. President McKinley was shot at about 4:07 p.m., September 6, 1901, while in the Academy of Music, Pan-American Exposition, Buffalo, New York. An operation was performed in the emergency hospital at the Expo- sition grounds. The President was then taken to a private home in Buffalo where he died at 2:15 a.m., September 14. Physicians to President McKinley Newton L. Bates (1837-1897). Surgeon General, U. S. Navy, Oct. 1-18, 1897. Physician to the President, March-August 1897. "President McKinley had a family physician and friend in Medical Director Bates and determined that he should be our next Surgeon-Gen- eral, and he was appointed. He died a short time after." (WM 5, p. 295.) Leonard Wood (1860-1927). Physician to the President, 1897-April 1, 1898, at which time he left to organize the 1st Volunteer Cavalry (Rough Riders), with Theodore Roose- velt second in command. George Miller Sternberg (1838-1915). The President had appointed Rixey White House physician ". . . know- ing that the frequent trips from Washington obligatory upon Dr. Sternberg in the capacity of White House physician were interfering with his duties as chief of the Medical Department of the Army. . . [However] at Dr. Rixey's suggestion Dr. Sternberg was asked to continue his visits to the White House as consulting Surgeon53 .. . and accordingly the two doctors met at the White House every Sunday morning, a practice which was 53 Mrs. Sternberg implies that Dr. Sternberg's employment was restricted to Mrs. Mc- Kinley (op. cit., p. 142, 228). And so too Gibson, J. M. Soldier in White; the Life of General George Miller Sternberg. Durham, N. C, Duke University Press, 1958. p. 179- 180. PHYSICIANS to the presidents 343 continued until Dr. Sternberg went to the Philippines on a tour of in- spection [June-September, 1901]. It was during General Sternberg's ab- sence that Mr. McKinley died." (WM 5, p. 32-33.) Presley Marion Rixey (1852-1928); M.D., University of Virginia, 1873. Surgeon General, U. S. Navy, 1902-1910. "Returning to Washington [after assignment to the Presidential party in a tour of the South, Dec. 13-20, 1898] I resumed my duties at the Naval Dispensary and looked upon the very pleasant experience as a thing of the past, as I thought that Surgeon General Sternberg, who had succeeded General Leonard Wood as White House physician, would con- tinue. To my surprise, a few days later, the President sent for me and directed that in the future I was to be White House physician and that I should make two calls, 10 a.m. and 10 p.m. at the Executive Mansion and to hold myself in readiness to accompany him and Mrs. McKinley when- ever they left Washington." (WM 5, p. 456.) "... Dr. Rixey achieved national—and, indeed, international—fame through his devoted service at the bedside of President McKinley during his mortal illness, as well as on previous occasions, when the President was sick, and the family and more intimate friends of Mr. McKinley knew and often expressed their conviction that the complete recovery from a most virulent attack of grippe from which he suffered in January, 1900, was due to the excellent advice given and care exercised by . .. Dr. Rixey." (WM 5, p. 83.) "President McKinley was most appreciative of my professional services as White House physician and informed me a few months before his death that he intended to appoint me Surgeon General of the Navy when the vacancy should occur, which would be in about a year. .. . After his death, Mr. Roosevelt carried out Mr. McKinley's promise. .. ." (WM 5, p. 459.) Physicians present or in attendance at the emergency operation "The President was immediately [after the shooting] conveyed to the Emergency Hospital on the Exposition grounds by the motor ambulance, where he arrived at 4:18. Dr. G. McK. Hall and Mr. Edward D. Mann, medical student of the house staff, were in charge of the ambulance, medi- cal student T. F. Ellis being the driver.... On arrival at the hospital, President McKinley was ... placed upon the table in the operating room and undressed ... Dr. Hall placed a temporary antiseptic dressing over the wound, and Mr. Mann ordered a nurse to administer .. . morphine and ... strychnin .. . Dr. Herman Mynter ... was the first surgeon to arrive, at 4:45 o'clock. At that time Drs. P. W. Van Peyma, and Joseph Fowler, of Buffalo, and Dr. Edward Wallace Lee, of St. Louis, were present. Dr. 344 CHARLES A. ROOS Mynter brought with him Dr. Eugene Wasdin, of the United States Marine- Hospital Service . . . Dr. Mynter inspected the President's wounds, and im- mediately saw their serious nature. He told the President that it would be necessary to operate, and at once set about making preparations, aided by . . . Dr. Nelson W. Wilson .. . Dr. Matthew D. Mann arrived at the hospital at 5:10 p.m.... He was followed, five minutes later, by Dr. John Par- menter. An examination was at once made, followed by a short consulta- tion between Drs. Mann, Mynter and Wasdin, which resulted in the de- cision to operate at once . . . Dr. Mann was selected to do the operation, with Dr. Mynter as his associate . . . Dr. Mann selected Drs. Lee and Parmenter as assistants. . . Dr. P. M. Rixey . . . did not arrive until 5:30, when he gave very efficient service by guiding the rays of the sun to the seat of the operation by aid of a hand-mirror, and later by arranging an electric light. Dr. Roswell Park arrived just as the operation on the stomach was completed, and gave his aid as consultant. Mr. E. C. Mann had charge of the needles, sutures and ligatures. Mr. Simpson,54 a medical student, was at the instrument tray .. . Besides those immediately engaged in the operation, there were present Drs. P. W. Van Peyma, Joseph Fowler, D. W. Harrington and Charles G. Stockton, of Buffalo, and Dr. W. D. Storer, of Chicago. . . . (WM 2, p. 1029.) George McKenzie Hall; M.D., University of Buffalo, 1901. The first physician to reach the wounded President. Assisted with lights during laparotomy (WM 6, p. 297). House physician at Emergency Hos- pital. Joseph Fowler (d. 1908); M.D., University of Buffalo, 1873. Devillo W. Harrington; M.D., University of Buffalo, 1871. Edward Wallace Lee. Sponged during laparotomy. "Dr. Lee, of St. Louis . . . appeared earlv and voluntarily assumed charge of the medical department [of the Emer- gency Hospital]. He was relieved almost immediately by the resident staff " (WM 7, p. 208.) Edward Cox Mann; M.D., University of Buffalo, 1902. Matthew Derbyshire Mann (1845-1921); M.D., College of Physicians and Surgeons, New York, 1871. 54 Burton Thorne Simpson, M.D. University of Buffalo, 1903. PHYSICIANS TO THE PRESIDENTS 345 Herman Mynter (1846-1903); M.D., University of Copenhagen, 1871. Roswell Park (1852-1914); M.D., Chicago Medical College, 1876. Medical director of the Pan-American Exposition, Buffalo, New York. John Parmenter (b. 1862); University of Buffalo, 1883. Sponged at laparotomy. (WM 6, p. 297.) Charles G. Stockton (b. 1853); M.D., University of Buffalo, 1878. "Dr. Stockton helped us in the last 3 days with the highest skill and best judgement." (WM 2, p. 1031.) Willis D. Storer; M.D., Northwestern University, 1888. Peter W. Van Peyma; M. D., University of Buffalo, 1872. Eugene Wasdin (1859-1911); M.D., Medical College of the State of South Carolina, 1882. Surgeon, U. S. Marine Hospital Service. The first physician to reach the wounded President, according to Kelly and Burrage, Dictionary of American Medical Biography (1928), p. 1266. Administered anesthetic during laparotomy. Nelson Waltow Wilson (1865-1915); M.D., University of Buffalo, 1898. Sanitary officer of the Pan-American Exposition. In charge of the hos- pital until the medical director's arrival. "Dr. Wilson was assigned to take records of the operation and time." (WM 7, p. 210.) Physicians in attendance at the Milburn House, Sept. 6-14 "I requested Dr. Roswell Park... to take personal charge of the re- moval of the President [from the operating room to the Milburn House].53 On his arrival I assumed charge of the case, having as consultants Dr. M. D. Mann, of Buffalo . . . Dr. Roswell Park, of Buffalo .. Dr. Herman Mvnter, of Buffalo .. . Dr. Eugene Wasdin .. . Dr. Charles McBurney, of New York, joined the consultations at 3 p.m. September 8, and left for home after the 9:30 a.m. bulletin of September 12. Dr. Charles G. Stock- ton, of Buffalo. .. joined the consultations at 5 p.m. September 12. Dr. Edward G. Janeway, of New York, and Dr. W. W. Johnson, of Washing- 53 "At 7:32 the patient was removed from the hospital in the ambulance. Dr. Rixey asked Drs. Park and Wasdin to go in the ambulance .. . Drs. Mann and Mynter followed in the carriages." (WM 2, p. 1030.) 346 CHARLES A. ROOS ton, D. C, arrived and Dr. McBurney returned after all hope had de- parted. All were present at the autopsy." (WM 6, p. 318.) Edward Gamaliel Janeway (1841-1911). William Waring Johnston (1843-1902); M.D., University of Pennsylvania, 1865. Charles McBurney (1845-1913); M.D., College of Physicians and Surgeons, New York, 1870. Additional physicians present at the autopsy (WM 6, p. 312) Hermanus Ludwig Baer (b. 1874); M.D., Jefferson Medical College, Phila- delphia, 1900. Charles Cary (b. 1852); M.D., University of Buffalo, 1875. Harvey Russell Gaylord (b. 1872); M.D., University of Pennsylvania, 1893. Made histological examination of tissues. Performed autopsy. William Pratt Kendall (b. 1858); M.D., College of Physicians and Sur- geons, New York, 1882. Surgeon, U. S. Army, 1885— . Herman G. Matzinger (b. 1860); M.D., University of Buffalo, 1884. In charge of chemical and bacteriological work. Performed autopsy. Edward Lyman Munson (1868-1947); M.D., Yale University, 1892. Asst. Surg, (later Brig. Gen.), U. S. Army. THEODORE ROOSEVELT (1858-1919) 26th President, 1901-1909 Bibliography TR 1. Clinical aspects of Mr. Theodore Roosevelt. Physician's Bull. 23: 91-94, 1958. TR 2. The condition of the President [Editorial]. Med. News, N. Y. 81: 655, 1902. Some details of both leg operations. For additional information see: The President's injury [News of the Week]. Med. Rec, N. Y. 62: 543, 1902; and Buffalo M. J. 42: 232, 1902. TR 3. The little pus sac that killed Roosevelt. In Ryan, T. J. and Bowers, E. F. Teeth and Health. New York, Putnam, 1921. p. 163-164. PHYSICIANS TO THE PRESIDENTS 347 TR 4. [Richards, J. H.] Roosevelt's talks with his physician. Edited by Hermann Hagedorn. Sat Eve. Post 195: 40, 42, 44, 46 (Dec. 9) 1922. Dr. John H. Richards was one of the physicians in attendance during Theodore Roosevelt's last illness, October 1918-January 6, 1919. The other physicians were Drs. Faller and John A. Hart- well (Wold, p. 168). TR 5. President Roosevelt's injury; consultation with Indianapolis phy- sicians; operation at St. Vincent's Hospital. Indiana M. J. 21: 169- 172, 1902-03. Portraits of Drs. Cook, Oliver, Jameson. Health of President Theodore Roosevelt Two operations for an abscess on the leg resulting from a bruise sus- tained in a trolley accident in Pittsfield, Massachusetts, September 3, 1902. The first operation was performed at St. Vincent's Hospital in Indianapolis, September 23, 1902. The second operation was performed in Washington, D. C, September 25, 1902. Fall from a horse October 22, 1904, with injury to face. Incident not re- ferred to by Rixey, WM 5.56 Injury to left eye (December 1904) while boxing. The President be- came almost blind in this eye as a result of retinal detachment. The in- cident is not referred to by Rixey, Life Story. Physicians to President Theodore Roosevelt Presley Marion Rixey (1852-1928). The official White House physician during the President's two terms. Dr. Rixey was abroad from May 3 through August 28, 1906. Rixey left Drs. Braisted and Pryor in charge of the President and family during his absence. President Roosevelt wrote to Dr. Rixey from the White House 56 Wold's account of this (p. 164) is apparently much exaggerated, to judge from the President's own story: "A week ago my horse put his foot through a rotten plank on a bridge and turned a somersault. I landed on my head and skinned my forehead. Most fortunately the papers have not seemed to get hold of it—which, as the mark was about the size of a small saucer and the skin came completely off, was remarkable." Selections from the Correspondence of Theodore Roosevelt and Henry Cabot Lodge, 1884-1918. New York, Scribners, 1925. vol. 2, p. 106. Roosevelt to Lodge October 31, 1904. Actually the New York World for November 3, 1904, did report the fall, but said that the President was back in his office the day following the accident and thereafter. News- paper reporters noted nothing amiss, as the President left Washington for Oyster Bay, November 6. Edward Wagenknecht's The Seven Worlds of Theodore Roosevelt (New York, Longmans, 1958), which has a section on the President's health (p. 23-30), states, in connection with this incident, that the President "narrowly escaped meningitis." (p. 27). 348 CHARLES A. ROOS on June 11, 1906: "Dr. Braisted and Dr. Pryor are taking splendid care of us. I like them both, particularly Dr. Pryor, who is such a nice little fellow." (WM 5, p. 338.) William Clarence Braisted (1864-1941); M.D., Medical Department, Co- lumbia University, 1886. Surgeon General, U. S. Navy, 1914-1920. 73rd President, American Medical Association, 1920/21. James Chambers Pryor (b. 1871); M.D., Vanderbilt University Medical Department, 1895. Cary T. Grayson (1878-1938); M.D., University of South Medical De- partment, 1903. "Surgeon Grayson came into the Navy during my [Rixey's] administra- tion of the Bureau of Medicine and Surgery and was with me occasionally at the White House and notably on the one-hundred mile ride made by President Roosevelt, Major Archibald Butt, and myself, to Warrenton, Va., and return the same day." (WM 5, p. 460.) "He was personal physician to President Roosevelt, Taft and Wilson, and although retired he remained the personal physician to President Wilson up to the time of his death." [Obit.] Mil. Surg. 82: 376, 1938. "Surgeon to Presidents Roosevelt and Taft on board the Presidential Yacht 'Mayflower' "... Who's Who i?i American Medicine, 1925, p. 594. Physicians in attendance at the first operation on the President's leg "At 3:15 p.m. [Sept. 23, 1902] the President went. . . to St. Vincent's Hospital... the operation required was performed by Dr. John H. Oliver, of Indianapolis in consultation with the President's physician, Dr. George A. Lung, and Dr. George A. [i.e., J.] Cook, Dr. Henry Jameson and Dr. J. J. Richardson." (WM 5, p. 258); (TR 5, p. 171.) John H. Oliver (1859-1927); M.D., Medical College of Indiana, 1881. George J. Cook (1844-1916); M.D., Kentucky School of Medicine, 1866. Indianapolis physician. Henry C. Jameson. Indianapolis physician. James Julius Richardson; M.D., University of Maryland, 1889. Washington physician. PHYSICIANS to the presidents 349 George A. Lung (1862-1921); M.D., University of Pennsylvania, 1886. Naval Surgeon. Apparently Dr. Lung had been detailed by Rixey to accompany the President on his trip. Lung treated the President im- mediately after the accident in Pittsfield and was present at both opera- tions. Physicians present at the second operation in Washington "The [second] operation was performed by Surgeon General Rixey, assisted by Dr. Lung and in consultation with Surgeon General O'Reilly and Drs. Shaffer, Urie and Stitt." Bulletin from the Secretary to the President as published in the New York Herald, September 29, 1902, p. 3. Reprinted: TR 2. R. M. O'Reilly (1845-1909). Newton Melman Shaffer (1846-1928); M.D., New York University Medi- cal College, 1867. Called in at the request of the President as consultant to Dr. Rixey. (WM 5, p. 258.) Edward R. Stitt (1867-1948); M.D., University of Pennsylvania, 1899. Surgeon General, U. S. Navy, 1920-1928. J. F. Urie; M.D., Harvard, 1888. Consulting physician William Holland Wilmer (1863-1936); M.D., University of Virginia, 1885. "A . .. serious handicap was defective eyesight. This was bad from birth, and it constantly grew worse. On December 12, 1904, Dr. William H. Wilmer, then an eye specialist in Washington and later head of the De- partment of Ophthalmology at Johns Hopkins Hospital, was called to the White House. President Roosevelt told him that he had for some time noticed a dimness of vision in his left eye after violent exercise. A few days previously he had been struck in this eye while boxing with a young army officer.57-58 Since then, black spots had floated in front of him. . .. Examina- 57 For information on a previous injury to the President's left eye see the cartoon in Hacedorn, H. Leonard Wood. New York, Harper, 1931. vol. 1, p. 402, and the statement on the following page: "He [Wood] cracked Roosevelt over the left eye with a single-stick and the bruise started wild rumors of duels with rapiers and broad-swords." The event is placed in "the last days of 1902." 5* In his autobiography the President has "a young captain of artillery." (Theodore Roosevelt; an Autobiography. New York, Scribners, 1929 [c 1913] p. 41.) Wold (p. 164) has "a young naval officer," and so too TR 1, p. 92. 350 CHARLES A. ROOS tion disclosed a minor hemorrhage in the retina; Dr. Wilmer ordered that Roosevelt refrain from his more energetic exercises. Otherwise he would lose the eye at once . .. another blow might cause a cataract to form. . . . For a time he was careful, but during 1908 the growth developed and from then on Roosevelt was blind in his left eye. Not more than a half- dozen people in the country knew it, however." Pringle, H. F. Theodore Roosevelt; a Biography. London, Cape [1932?] p. 18-19; Dr. William H. Wilmer to the author, Oct. 31, 1930.59 According to the Dictionary of American Biography (Suppl. I, p. 722) Dr. Wilmer treated a succession of Presidents. C. H. Bagley writes: "Five of the Chief Executives of the United States. .. [were] Dr. Wilmer's pa- tients." William H. Wilmer. [Obit.] Surg. Gyn. Obst. 62: 901, 1936. WILLIAM HOWARD TAFT (1857-1930) 27th President, 1909-1913 Physicians to President Taft "William H. Taft changed to the Army [for his physician], appointing Colonel A. M. [i.e., M. A.] Delaney, but also made much use of Cary Gray- son, then a young officer in the Navy Medical Service who had been Dr. Rixey's aid during the Roosevelt administration." (FDR 6, p. 59.) Matthew A. Delaney (1874-1936); M.D., University of Pennsylvania, 1898. Cary T. Grayson (1878-1938). Thomas Leidy Rhoads (1870-1940); M.D., Jefferson Medical College, 1893. "During this period (1909-13) he served as physician to President Taft, and for one year (1912-13) as his personal aid." [Obit.] Mil. Surg. 87: 388, 1940. WOODROW WILSON (1856-1924) 28th President, 1913-1921 Bibliography WW 1. Grayson, Cary T. Woodrow Wilson; an Intimate Memoir. New York, Holt, 1960. 143 p. Published in part as "Memories of Woodrow Wilson," At- lantic Monthly 204: 65-74 (Nov.), 1959. 59 For an additional description of the event see Morison, E. E., ed. The Letters of Theodore Roosevelt. Cambridge, Harvard University Press, 1951. vol. 4, p. 1065. physicians to the presidents 351 WW 2. The illness of President Wilson. In Hugh Young: a Surgeon's Autobiography. New York, Harcourt, 1940. p. 398-403.60 WW 3. Lamaladie du President Wilson. Chron. med. 28: 52-55, 1921. See also p. 123. Health of President Wilson "As professor and President of Princeton .. . there was a retinal hemor- rhage in his left eye which partially destroyed the sight of that organ."61 (WW 1, p. 81.) Chronic neuritis (WW 1, p. 3, 81). Headache and digestive disturbance. March? 1913 (WW 1, p. 2-3). Influenza while attending the peace conference in Paris, 1919. "A few weeks ago the President was taken violently sick with the influenza. He was very sick for a few days. I am happy to say that he is now fully re- covered." Grayson to Rixey, April 23, 1919, from Paris. (WM 5, p. 393.) Asthmatic attacks at the peace conference, Spring 1919 (WW 1, p. 85). "Asthmatic attacks and severe headaches" on Western Tour, Sept. 3-28, 1919. (WW 1, p. 97.) "Slight paralytic stroke" Sept. 25 or 26, 1919. (WW 2, p. 399.) Severe stroke with paralysis of the left arm and leg and left side of the face, at the White House, October 2, 1919. "He fell striken with a throm- bosis. ... A clot had formed in an artery in the brain, though there was no rupture." (WW 1, p. 100.) Physicians to President Wilson Cary T. Grayson (1878-1938). The President's personal physician from 1912 until the President's death. "President Wilson appointed P. A. Surgeon Cary T. Grayson of the Navy as his official White House physician .. . His service was so much appreciated by Mr. Wilson, that he was promoted over the heads of two grades of older medical men from the rank of Surgeon, Lieutenant Com- mander to Medical Director, Rear Admiral. . . ." (WM 5, p. 460.) 60 For a substantial disagreement with Dr. Young's account see Wilson, Edith B. My Memoir. Indianapolis, Bobbs-Merrill, 1939. p. 291-292. Mrs. Wilson's account also disagrees with some details of Wold's account, this last, in turn, apparently based on Hoover, Irwin H. Forty-Two Years in the White House. Boston, Houghton, 1934. p. 102. ^Bahn, C. A. The eyes of some famous historical characters. Am. J. Ophth. set. 3, 16: 427, 1933. "President Woodrow Wilson ... was blind in his right eye from retinal hemor- rhage." 352 CHARLES A. ROOS Consultants during stroke During the stroke,62 Dr. Grayson reports, "I summoned in consultation Dr. Sterling Ruffin, Rear Admiral E. R. Stitt, and Dr. F. X. Dercum. Later I called in Dr. H. A. Fowler, Dr. Hugh Young, Dr. George De Schweinitz and Dr. Charles Mayo. At intervals the President's friend and classmate, Dr. E. P. Davis, would confer with me about the case." (WW 1, p. 100.) Edward Parker Davis (1856-1937); M.D., Rush Medical College, Chicago, 1882; Jefferson Medical College, 1888. Philadelphia physician. Francis Xavier Dercum (1856-1931); M.D., University of Pennsylvania, 1877. Harry Atwood Fowler (b. 1872); M.D., Johns Hopkins, 1901. Dr. Fowler's role is described in WW 2, p. 400. Charles Horace Mayo (1865-1939); M.D., Northwestern University Medi- cal School, 1888. Sterling Ruffin (1866-1938); M.D., George Washington University, 1890. George Edmund de Schweinitz (1858-1938); M.D., University of Penn- sylvania, 1881. 75th President, American Medical Association, 1922/23. Edward R. Stitt (1867-1948). Hugh Hampton Young (1870-1949); M.D., University of Virginia, 1894. WARREN G. HARDING (1865-1923) 29th President, 1921-1923 Bibliography WGH 1. Ackerman, C. W. How the President keeps well; an interview with Brigadier General Charles Elmer Sawyer. Sat. Eve. Post 195: 46, 48 (May 5) 1923. WGH 2. Clauch, B. S. W7as President Harding's death due to medical ignorance? Naturopath., N. Y. 28: 444-449, 1923. 62 According to Wold (p. 177), Dr. Grayson was in Philadelphia when the stroke oc- curred. But I. H. Hoover (op. cit., p. 102) explicitly says he was at his home in Washing- ton (and so Mrs. Wilson implies, My Memoir, p. 287). PHYSICIANS TO THE PRESIDENTS 353 WGH 3. President Harding's last illness: official bulletins of attending physicians [July 30-August 3]. /. A. M. A. 81: 603, 1923. Attending physicians: C. E. Sawyer, R. L. Wilbur, C. M. Cooper, J. T. Boone, H. Work. The entry for August 2 gives a brief review of the President's previous health record. WGH 4. Wilbur, R. L. The last illness of a calm man. Sat. Eve. Post 196: 64 (Oct. 13) 1923. Health of President Harding Influenza, Spring 1923. Final illness beginning with "an acute gastrointestinal attack associated with abdominal pain and fever" (WrGH 3) around July 26 and ending in death, at San Francisco, August 2, 1923. Physicians to President Harding Charles E. Sawyer (1860-1924); M.D., Cleveland University of Medicine and Surgery, 1881. "President Harding elected to have Dr. Sawyer as his official physician, and gave him the rank of Brigadier General in the Army [Mar. 1921], and he had Past Assistant Surgeon Boone of the Navy as his Assistant." (WM 5, p. 460.) "Dr. Charles B. [i.e., E.] Sawyer, a homeopath, was brought to Washing- ton by President Harding. He was not only a close friend but had been Mrs. Harding's personal physician for many years." (FDR 6, p. 59.) Joel Thompson Boone (1889- ); M.D., Hahnemann Medical College, 1913. Physician to the President from the fall of 1922 until the President's death. Physicians during the last illness (in addition to the above) Charles Miner Cooper (1873- ); M.D., University of Edinburgh, 1897. Ray Lyman Wilbur (1875-1949); M.D., Cooper Medical College, San Francisco, 1899. 76th President, American Medical Association, 1923/24. Secretary of the Department of the Interior, 1929-1933. Hubert Work (1860-1942); M.D., University of Pennsylvania, 1885. 74th President, American Medical Association, 1921/22. Postmaster General, 1922/23. Secretary of the Department of the Interior, 1923-1928. 354 CHARLES A. ROOS CALVIN COOLIDGE (1872-1933) 30th President, 1923-1929 Bibliography CC 1. Boone, J. T. The wrong "Aye, Aye." Good Housekeeping 100: 39- 40 (April) 1935. The article consists of non-medical anecdotes. Dr. Boone is de- scribed as Commander, U. S. N., formerly physician, "U. S. S. Mayflower." CC 2. Brown, Edward W. Beneath a hospital window (with comments by Mrs. Coolidge). Good Housekeeping 100: 248 (May) 1935. "Apart from being called in to treat a light cold I found very little to do for Mr. Coolidge . .. Once on a fishing trip he slipped, fell, and broke his left wrist. .. He was subject to asthma . .. Also, he sometimes had minor digestive disturbances." Dr. Brown does not supply dates for the ailments he lists. He was family physician in Plymouth, Massachusetts, until the President's death. CC 3. Coupal, J. F. Football "medicine" (with comments by Mrs. Cool- idge). Good Housekeeping 100: 219-220 (March) 1935. Dr. Coupal reports: "It was a part of my work to report to the President daily at 6:30 P.M." Health of President Coolidge Asthma. (CC 1) Minor digestive disturbances. (CC 1) Physicians to President Coolidge Charles E. Sawyer (1860-1924). From Oct. 11, 1923 to July 1924. James Francis Coupal (1884-1935). "Wrhen planning to move from Boston to Washington, Mr. Coolidge thought it expedient to make some provision for a medical advisor. He asked Colonel Blanchard, who had attended him in Boston, to recom- mend some one he knew. He suggested Major James F. Coupal, who was then on duty at the Museum of Medicine connected with the Smithsonian Institute.63 He attended the Vice-President when his services were re- quired and was made physician to the President upon the resignation of General Sawyer, who had been President Harding's medical attendant." Comment by Mrs. Coolidge (CC 2, p. 220). Major Coupal was phvsician to the President from July 1924 until March 1929. Actually the Army Medical Museum, of which he was the Curator, 1922-1924 PHYSICIANS TO THE PRESIDENTS 355 Joel T. Boone (1889- ). From 1923 until 1929. HERBERT CLARK HOOVER (1874- ) 31st President, 1929-1933 Physician to President Hoover Joel T. Boone (1889- ). Rear Admiral, U. S. Navy. Admiral Boone was one of the physicians at the White House from the early fall of 1922 through the Harding and Coolidge terms, until Mr. Hoover took office, when he became the sole physician. Dr. Boone stayed on at the White House from the 4th to the 30th of March, 1932, during which time he examined Mr. Roosevelt, Dr. Mclntire's arrival having been delayed. [Personal communication] FRANKLIN DELANO ROOSEVELT (1882-1945) 32nd President, 1933-1945 Bibliography FR 1. Bateman, H. E. Observations on President Roosevelt's health during World Wrar II. Mississippi Valley Hist. Rev. 53: 82-102, 1956. FR 2. Eliasberg, Wt. G. How long was Roosevelt ill before his death? Dis. Nerv. Syst. 14: 323-328, 1953. FR 3. Fabricant, N. D. Franklin D. Roosevelt's tonsillectomy and polio- myelitis. Eye, Ear, Nose, Throat 36: 348-349, 1957. Tonsillectomy, December 1919; poliomyelitis, August 1921. FR 4. Fabricant, N. D. Franklin D. Roosevelt's nose and throat ail- ments. Eye, Ear, Nose, Throat 36: 103-106, 1957. Covers the period 1887-1945. FR 5. Fabricant, N. D. Franklin D. Roosevelt, the common cold and American history. Eye, Ear, Nose, Throat 37: 179-185, 1958. FR 6. "A history of the case" in Franklin D. Roosevelt's own words. /. S. Carolina M. Ass. 42: 1-2, 1946. Roosevelt's letter of October 11, 1924, to Dr. William Egleston describing his polio attack and subsequent treatment. FR 7. McIntire, R. T. Unconquerable spirit. Collier's 117: 21 (Feb. 2) 1946. FR 8. McIntire, R. T. White House Physician. New York, Putnam, 1946. 244 p. 356 CHARLES A. ROOS FR 9. Walker, T. Roosevelt and the Warm Springs Story. New York, Wyn, 1953.311 p. FR 10. Wold, Karl. The truth about F. D. R's health. Look 13(4): 23-29 (Feb. 15) 1949. The article is a reprint of the chapter on FDR in Mr. President —How is Your Health?, with, however, the statements con- cerning the alleged three strokes journalistically emphasized. Wold's article was denounced by Elliott Roosevelt in his "They're lying about F. D. R.'s health," Liberty 40: 18, 73- 76, (May) 1949, and some of its implications were repudiated by Mrs. Eleanor Roosevelt, This I Remember. New York, Harper, 1949. p. 328-329. Health of President Roosevelt Chronic sinus condition (FR 8, p. 57). Influenza 1941 (FR 8, p. 139). ". . . influenza [Christmas 1943] and . . . several attacks of acute respiratory infections in the weeks that followed." (FR 8, p. 21.) Bronchitis, winter-spring 1944 (FR 8, p. 183-187). Death from "massive intracerebral hemorrhage" (FR 8, p. 243) at Warm Springs, Georgia, April 12, 1945. The President was stricken at 1:20 p.m. and died at 3:35 p.m. Physicians to President Roosevelt Ross T. McIntire (1887-1959); M.D., Willamette University Medical De- partment, Salem, Oregon, 1912. Surgeon General, U. S. Navy, 1938-1946. Personal physician to the President, 1933-1945. Dr. McIntire was in Washington when the President died. Naval assistants or consultants Howard Gerald Bruenn (1905- ); M.D., Johns Hopkins, 1929. "The problem now [early 1944] was to protect the President's reserve strength, with constant watch on the heart, and this became the particular business of Commander Howard Bruenn." (FR 8, p. 183.) Dr. Bruenn was the only physician present at the time of the President's fatal attack; he administered emergency treatment until the end. Charles F. Behrens (1896- ); M.D., University of Pennsylvania, 1920. Captain, U. S. Navy. physicians to the presidents 357 Robert Edwin Duncan (1894- ); M.D., Jefferson Medical College, 1919. Captain, U. S. Navy. John Harper (1890- ); M.D., Medico-Chirurgical College of Philadel phia, 1913. Captain, U. S. Navy. Civilian consultants Paul F. Dickens (1895- ); M.D., University of Nashville Medical De- partment, 1905. Consultant in 1944. Frank Howard Lahey (1880- ); M.D., Harvard University, 1904. Called in consultation, May 1944. 95th President, American Medical Association, 1941/42. James E. Paullin (1881- ); M.D., Johns Hopkins 1905. 97th President, American Medical Association, 1943/44. Dr. Paullin reached the President's bedside a few moments before his death. HARRY S. TRUMAN (1884- ) 33rd President, 1945-1953 Physician to President Truman Wallace H. Graham (1910- ); M.D., Creighton University School of Medicine, 1936. Brig. Gen. U. S. Air Force. DWIGHT D. EISENHOWER (1890- ) 34th President, 1953-1961 Bibliography DE 1. Lear, J. President Eisenhower's illness. New Scientist 3 (55): 26, 1957. The cerebral accident. DE 2. Military physicians' role in the medical care of the Presidents has long tradition. Army, Navy, Air Force Journal 93: 123, 1955. Article centers around military physicians attending President Eisenhower in Denver in 1955. DE 3. [President Eisenhower's medical history from boyhood to 1954] Med. Ann. D. C. 23: 281-282, 1954. 358 CHARLES A. ROOS Excerpts from an interview with Dr. Snyder originally published in the Washington Daily News, Feb. 26, 1954. Health of President Eisenhower Heart attack, Denver, September 1955. Ileitis operation, June 1956. Cerebral accident, November 1957. Physicians to President Eisenhower Howard McCrum Snyder (1881- ); M.D., Jefferson Medical College, 1905. Major General, U. S. Army. Leonard D. Heaton (1902- ); M.D., University of Louisville School of Medicine, 1926. Surgeon General, U. S. Army, 1959- . Performed ileitis operation while Commanding General, Walter Reed Army Medical Center. Thomas William Mattingly (1907- ); M.D., Georgetown Medical School, 1930. Brigadier General, U. S. Army. Consultant during heart attack. Byron Edward Pollock (1910- ); M.D., Tulane University, 1936. Chief Cardiology Service, Fitzsimons Army Hospital, Denver. Consultant during heart episode. Colonel, U. S. Army. George M. Powell (1906- ); M.D., Washington University, 1932. In attendance at Fitzsimons Army Hospital, Denver. Colonel, U. S. Army. Isador Ravdin (1894- ); M.D., University of Pennsylvania, 1918. Consultant during ileitis incident. John A. Sheedy (1920- ); M.D., St. Louis University, 1945. In attendance at Fitzsimons Army Hospital, Denver. Lt. Col., U. S. Army. Paul Dudley White (1886- ); M.D., Harvard University, 1911. Consultant on heart problems. PHYSICIANS to the presidents 359 JOHN F. KENNEDY (1917- ) 35th President, 1961- Physicians to President Kennedy Janet Graeme Travell (1901- ); M.D., Cornell University Medical Col- lege, 1926. Appointed Personal Physician to the President of the United States, January 1961. The first woman to be appointed to the position. George Gregory Burkley (1902- ); M.D., University of Pittsburgh School of Medicine, 1928. Captain, U. S. Navy. Assistant Physician to the President. Name Index of Physicians* Abbott, E. W., 324 Agnew, David Hayes, 336 Alexander, Ashton, 313 Baer, Hermanus L., 346 Bard, John, 298 Bard, Samuel, 297 Barnes, Joseph K., 323, 333 Bates, Newton L., 342 Baxter, J. H, 330 Beckwith, Seth R., 333 Behrens, Charles F., 356 Black, Clarence E., 338 Bliss, Doctor Willard, 332 Boone, Joel T., 353, 355 Boynton, Silas A., 337 Braisted, William Clarence, 348 Bruenn, Howard G., 356 Bryant, Joseph D., 340 Burkley, G. C, 359 Cary, Charles, 346 Charlton, John, 300 Cook, George J., 348 Coolidge, Richard H., 316 Cooper, Charles M., 353 Coupal, James F., 354 Craik, James, 302 Crane, Charles H., 323 Curtis, Edward, 325 Davis, E. P., 352 Delaney, Matthew A., 350 Dercum, Francis X., 352 Dickens, Paul F., 357 Du Hamel, W. J. C, 318, 334 Duncan, Robert E., 357 Edson, Susan Ann, 337 Elzey, Arnold, 306 Erdman, John F., 340 Everett, Charles, 307 Foltz, Jonathan M., 314, 318 Ford, Charles M., 323, 333 Fowler, H. A., 352 Fowler, Joseph, 344 Gatch, C. D., 324 Gaylord, Harvey R., 346 Girdner, J. H., 336 Graham, Wallace H., 357 Grayson, Cary T., 348, 350, 351 Gunnell, Francis M., 334 Hall, G. McK., 344 Hall, James C, 310, 313, 314, 316, 324 Hamilton, Frank H., 336 Hamilton, John B., 333 Harper, John, 357 Harrington, D. W., 344 Harris, Thomas, 309 Heaton, Leonard D., 358 Huntt, Henry, 308, 309 Huntington, D. L., 335 Jameson, Henry C, 348 Janeway, Edward G., 340, 346 * Names shown in boldface type. 360 CHARLES A. ROOS Johnston, W. W., 346 Jones, John, 299 Keen, William W., 340 Kendall, W. P., 346 King, Albert F. A., 323 Kuhn, Adam, 301 Lahey, Frank H., 357 Lamb, Daniel S., 337 Leale, Charles A., 322 Lee, Edward Wallace, 344 Lieberman, Charles H. L., 325 Lincoln, Nathan S., 333, 338 Lung, George A., 349 McBurney, Charles, 346 McIntire, Ross T., 356 MacKnight, Charles, 300 Mann, E. C, 344 Mann, Matthew D., 344 Mattingly, Thomas W., 358 Matzinger, Herman G., 346 May, Frederick, 313 May, John Frederick, 325 Mayo, Charles H., 352 Miller, Thomas, 312, 314, 317 Munson, Edward L., 346 Mynter, Herman, 345 Neal, 325 Norris, Basil, 326, 327, 333 Notson, William M., 325 Oliver, John H., 348 O'Reilly, R. M., 339, 349 Park, Roswell, 345 Parmenter, John, 345 Patterson, De Witt C, 333 Paullin, James E., 357 Physick, Philip S., 310 Pollock, Byron E., 358 Pomerene, J., 335 Powell, George M., 358 Pryor, James C, 348 Purvis, Charles B., 332 Ravdin, Isador, 358 Reyburn, Robert, 334 Rhoads, Thomas L., 350 Richardson, James J., 348 Rixey, Presley M., 343, 347 Ruffin, Sterling, 352 Rush, Benjamin, 303, 304 Sawyer, Charles E., 353, 354 Schweinitz, George E. de, 352 Shaaf, John Thomas, 306 Shaffer, Newton M., 349 Sheedy, John A., 358 Shippen, William, Jr., 302 Sim, Thomas, 307, 309 Simpson, B. T., 344 Smith, Andrew H., 337 Snyder, H. McC, 358 Sternberg, George M., 339, 342 Stitt, E. R., 349, 352 Stockton, Charles G., 345 Stone, Robert K., 321 Storer, W. D., 345 Taft, Charles S., 323 Tate, James, 301 Thomas, John Moylan, 313 Todd, Beecher, 325 Townshend, Smith, 332 Travell, J. G., 359 Triplett, 309 Tucker, Thomas T., 306 Urie, J. F., 349 Van Bibber, Washington C, 322 Van Peyma, P. W., 345 Wales, Philip S., 334 Warren, John C, 311 Wasdin, Eugene, 345 Washington, Bailey, 307 White, Paul D., 358 Wilbur, Ray L., 353 Wilmer, William H., 349 Wilson, Nelson W., 345 Wood, Leonard, 339, 342 Wood, Robert C, 315 Wood, William M., 316 Woodward, Joseph J., 326, 334 Work, Hubert, 353 Worthington, Nicholas W., 313 Wotherspoon, A. S., 316 Young, Hugh H., 352 The Survey and After By Janet Doe Library Consultant New York Academy of Medicine -L-/ URING the years the old Army Medical Library had passed through alternate cycles of nurture and starvation and, as its centennial year ap- proached, the Library was once again in the latter phase, accentuated by the depression economy. During 1933-35 scarcely half the budget asked for was received; current periodicals dropped from 2,041 to 1,600 and only 16 books were bought. The institution was understaffed and still function- ing under the primitive organization which tradition had bequeathed it. Yet even then, at the celebration of its one-hundredth anniversary in 1936, it was being acclaimed as "the greatest collection of medical literature in existence." Unease was stirring, however. The newly appointed Librarian, Colonel Harold Wellington Jones, realized that the Library's affairs were out of joint; he began reorganization, secured some increases in funds, and added a few professional librarians to the staff. He realized, too, that a permanent cure for the Library's ailments could come only from thorough diagnosis followed by sustained and intelligent treatment. At the suggestion of the newly appointed Chief of the Circulation and Reference Division, Helen Norris (now Mrs. Balduin Lucke), who was abetted by Dr. Archibald Malloch, Librarian of the New York Academy of Medicine, in sounding out support from the Rockefeller Foundation, Colonel Jones initiated the survey of the Library carried out in 1943, the report of which was pub- lished in 1944. From this prescription he and his successors have pursued a careful and successful course of therapy. The Survey, sponsored by the American Library Association and fi- nanced by the Rockefeller Foundation, was carried out by a committee of three general librarians, Keyes D. Metcalf, in charge, L. Quincy Mumford, and Andrew D. Osborn, together with three medical librarians, Mary Louise Marshall, Janet Doe, and Thomas P. Fleming. Each was made re- sponsible for the investigation of one or more aspects of the Library's situation, in order that the whole might be covered with the necessary detail. The Committee began with an introductory visit to all departments to get acquainted with the staff, the building, and the general routine. Thereafter, each was on his own, spending as much time as was needed for his particular assignment. 361 362 JANET DOE The primary requisite, of course, was to delineate the Library's condi- tion in order to ascertain what was wrong. To do this, the main facets had to be carefully examined; these were the physical plant, the organization, the collections, cataloging, the Index-Catalogue, readers' services, the his- torical section in Cleveland, and relations with other libraries. Each in- vestigator made protracted visits, sometimes of several weeks, to the de- partments with which he was concerned. He sat with the chief and his assistants while they performed their daily routines, following each proc- ess from beginning to end. Comparisons were made with the accomplish- ments of similar libraries; holdings were measured by the yardstick of others' collections or of the total possible and desirable; advantages or shortcomings of tools and procedures were noted; qualifications of staff members passed under review; questionable holdings, methods, and serv- ices were criticized. No aspect of importance was overlooked. Following several weeks of such individual study, the Committee met a number of times to hear and discuss the members' reports. Out of these conferences came the final report with its recommendations. A considered view of the overall picture was both encouraging and dis- tressing. Here was found probably the world's greatest assemblage of medi- cal literature published before 1920, and here, working with it, was a corps of predominantly clerical staff members devoted to their particular divi- sions and giving sustained effort beyond the call of duty. Yet the Library was falling farther and farther behind in meeting its responsibilities. It was the Committee's task to find out why. A basic difficulty concerned personnel. The directing head, a medical officer without library training or experience, was superseded about every four years, just when he might have gained some insight into the Library's problems. The internal organization of the Library had been extremely loose, the work being done by a few devoted and indefatigable staff mem- bers (five of them served thirty to forty years each between 1865 and 1932) who, with the clerical help of Army enlisted men, worked at their separate tasks without relation to others and without noticeable central supervi- sion. Departmentalization only began to be put into operation tentatively in 1942. After that, friction between some departments seriously impaired the work. Of the four divisions in the Library at Washington at the time of the Survey, only one was directed by a trained librarian. Lack of funds had resulted in holdings that were far below expectations. W Adams Jewett to JSB, May 28, June 3 and 9, 1872. "Adams Jewett to JSB, May 31, June 7, 12, and 28, and July 10, 1872; JSB to Adams Jewett, July 15, 1872. 446 DOROTHY M. SCHULLIAN sixty reports and issues of journals. To German-born Dr. Baltz, who had practised for some time in Dayton but was on the point of returning to Berlin, he paid on behalf of Billings $22.00 for some sixty volumes, "al- most all of them standard works,—by eminent authors—all but two (I think) bound substantially & good looking"; the box in which they were shipped to Washington raised the cost to $22.25, a receipt for which fol- lowed promptly.7 When Dr. A. G. Walden contributed some volumes from an old preceptor and asked nothing in exchange, Jewett at first suggested to Billings on October 14, 1872 that labels reading as follows be pasted in the books: "From the library of the late Dr. Cortland Williams of Milford, Ohio, through his pupil Dr. A. G. Walden of Dayton, O." On second thought, however, he applied the labels himself so that Billings, in ac- knowledging the gift to Dr. Walden, might report the thing as "done did." Just back on November 4, 1872 from attending the funeral of his niece's husband in Troy, Ohio, he reported immediately on his book hunting among physicians there. These are samples of his activities. As late as June 22, 1874, he was re- porting on hunts in Rock Island, Illinois, and Davenport, Iowa. He was patient, energetic, and persistent. The genuine sparkle in all these trans- actions—the frosting on the cake—is, however, the counsel which he freely proferred in almost every letter to a Billings who, acquiring steadily to the very limit of the funds voted by Congress, was at the same time steadily harassed by their utter insufficiency to forward his projects as he would have liked. In Jewett he found a kindred spirit, a man who saw the same vision of a universal medical library and realized the difficulties ahead, and to him he expressed as early as May 31, 1872 "personal thanks for the valuable aid you have rendered, and for the manner in which you have given it. It is rarely that I find any one who so thoroughly appreciates the nature of the task I have undertaken." From Billings, never given to in- flated and affected utterances, this was high praise. Jewett provided him above all with a sympathy which was not always available in official circles in Washington. "If Congress has failed," he wrote on July 20, 1872, to put at your disposal the necessary funds for buying up as occasion offers books no longer found regularly on the shelves of bookdealers when these books can be had—not at fancy prices but at reasonable, even moderate prices, I think it is a very unfortunate failure.8 On August 2 he expressed his vexation at the actual sum allotted for the ensuing fiscal year: 7 Adams Jewett to JSB, September 21 and 28, October 1 and 9, 1872. 8 In this and succeeding quotations from the letters of Adams Jewett most of the abbreviations have been silently expanded for ease of reading. A. JEWETT AND J. S. BILLINGS, PARTNERS IN ACQUISITION 447 So Congress has appropriated only 4000 for your library for the year. I think it a meager pittance considering the great & noble object in view. Evidently there must be but few physicians in the councils of the nation and they too perhaps like the common herd of politicians looking out for party success—places for themselves, relatives or friends.... Let us hope that Congress will show itself more enlightened and give you 20000 next year, as it ought to do. On August 16 he enveloped his sympathy in suitable metaphor: What a pity, what a drawback to be obliged to go out with a scanty supply of am- munition—to see very desirable game all the time escaping because you could not spare the small amount of ammunition necessary to save it—and with the knowledge that another time you might have to hunt a long time perhaps for the very same game that is now in full view & possibly not find it after the hunt. Now is always the accepted time. Billings was, however, putting to effective use even so scanty a supply of ammunition, and Jewett from the wisdom of his own years of collecting sent repeated recommendations. Binding was to wait; the matter of mo- ment was acquisition, for with just a short delay much could be lost for- ever.9 Voracious paper mills stood waiting, and even the most devoted widows and daughters eventually grew weary of dusting twice a year at housecleaning time row after row of heavy medical tomes and pile upon pile of unbound, slithering journals.10 The latter could be purchased often at paper mill prices of 3 cents or 4 cents a pound.11 Files of journals were by all means to be completed,12 and it would be well for Billings to prepare for distribution to the profession lists of the issues desired and to solicit contributions.13 In building up a library for universal reference it was desirable to obtain not only the latest and best edition of some standard work, but also the first and worst, to serve not current medicine but its history.14 And in any purchase Billings would need to act like the botanist assembling his herbarium—laying hold gladly of every new specimen, even if a poor one, in the hope of finding later a better one to take its place.15 It was canny and shrewd advice, reminiscent of the Edinburgh where Jewett had trained, and Billings adopted of it what he could. It was laced with surprising and vigorous touches, like the comments of August 16, 1872 on the Webster-Parkman murder case: Jewett was offering Elements of Chemistry, for the use of schools and academies ..., by Andrew Fyfe, with 9 Adams Jewett to JSB, August 2, 1872. 10 Adams Jewett to JSB, June 3 and 7, July 20, and August 31, 1872. "Adams Jewett to JSB, June 7, 1872. 12 Adams Jewett to JSB, August 2, 1872. "Adams Jewett to JSB, July 10, 1872. "Adams Jewett to JSB, June 12, 1872. 13 Adams Jewett to JSB, June 10, 1872. Jewett's herbarium was given to the Uni- versity of Michigan by his son. 448 DOROTHY M. SCHULLIAN additions and alterations by John W. Webster, and he expressed the opin- ion that Webster had been most deservedly hanged for the murder of Dr. Parkman in Boston before you were born perhaps—certainly before you can remember, for my son was astonished to find you a young man, quite a young man, he said—a most remarkable murder, a most remarkable detection & a most remarkable hanging which could hardly have taken place anywhere but in the Old Bay State against the powerful efforts made to save Prof. Webster's neck from the halter. This son, he for whom the father was replacing the old books of his library with new, was Henry S. Jewett (1846-1929), A.B. University of Michigan 1868, M.D. 1870, A.M. 1875. In the summer of 1872 he was preparing to continue his professional studies for a year or more in Berlin and Vienna, and on July 10 the father suggested that Billings might be willing to furnish a letter in his behalf to some friend abroad. This was, however, before the first of Billings' many trips to Europe, and he could only answer, on July 15, that he had never had the opportunity of visiting Europe and therefore could not assist with letters as he would be very glad to do were it in his power. It would appear that Dr. Henry S. Jewett called on him in Washington before sailing and promptly reported on his youth (he was 34) to Dr. Adams Jewett. But in all these relations with the Jewett family it is well to remember that Billings had even closer ties in Dayton. His father (d. 1892) and mother (d. 1898) were living there, and very probably Adams Jewett knew them; certainly Henry S. Jewett did, for he reported on April 22, 1876, that James and Abby Shaw Billings had been well when he last saw them, a little more than a week earlier. There was also, at Dayton's National Asylum for Disabled Volunteer Soldiers, a Miami classmate, Dr. A. S. Dunlap, who corresponded with Billings on various matters and co-oper- ated with Adams Jewett in hunting journals for the library.16 These as- sociations would have confirmed Billings' regard for Jewett, and we are glad to have evidence from Billings himself that two such kindred spirits actually met more than once.17 Word of the death of Adams Jewett on March 11, 1875 reached Billings promptly, and on March 27 he sent his condolences to the son, expressing his regret and also his surprise at an event which was entirely unexpected, "as the last time I saw him he seemed to be in excellent health Sc spirits." Billings and Henry S. Jewett continued in some degree the mutually profitable relations which Adams Jewett had begun, but since the vision was each year coming ever closer to realization, the pressure in acquisition 10 A. S. Dunlap to JSB, September 21, 1872. 17 JSB to Henry S. Jewett, March 27, 1875. A. JEWETT AND J. S. BILLINGS, PARTNERS IN ACQUISITION 449 had lessened. The younger Jewett died on January 7, 1929, by which time the prophecy sent by his father to Billings on February 12, 1874, had long been fulfilled: The day will be—not in my lifetime of course, but in yours I hope—when the Nat'l. Med. Library will furnish all the information to be found anywhere in regard to ... every ... medical subject. Our representative is a justly and liberally disposed man. He will hear from the brethren. President's Page GERTRUDE L. ANNAN President, Medical Library Association, 1961-62 Not so many years ago, one entered medical librarianship more by chance than by planning, either through working in general libraries or through some clerical occupation in medicine. Gertrude Annan came to it through neither, nor did she plan for it. Having majored in English at Brown University, hoping to teach literature or direct dramatics, she be- came, instead, assistant to Lawrence C. Wroth, Librarian of the John Carter Brown Library. There, work with rare books produced in her that love of old literature and the broad knowledge of its tools which were to form the core of her existence. Called in 1929 to the New York Academy of Medicine, she organized its Rare Book and History Room and spent twenty-five years developing it (there can be today but few historians of medicine in this country who have not received assistance from the Acad- emy's scholarly rare book curator), until in 1953 she became the Academy's Associate Librarian and, in 1956, Librarian. Not only has Gertrude Annan concerned herself with aid to medical historians: she has tried to show librarians the value, fascination, and methods of dealing with rare books. Her chapter in the Handbook on "Rare Books and the History of Medicine" forms a basic text and refer- ence source for them. Articles and talks have reiterated her tenets that old books are not "rare" because they are scarce or old, but because of what they contribute to knowledge, that they should be used and not locked out of reach, that even ephemeral pieces can make history, that the archives of an institution should be part of its historical collection, and that such a collection can be built up at reasonable cost. She has twice given the Medical Library Association's refresher course on rare books, and has often been a guest-lecturer on historical works in the medical library courses at Columbia and Catholic Universities. To break down the barriers which awe and ignorance have raised between rare books and the rest of litera- ture, she has shown her colleagues what such books can mean to a library and has given simple instructions for dealing with them. Many a medical library will in the future be servicing a useful rare book collection because of Gertrude Annan's devotion to this idea and her efforts to spread it. When, after a quarter of a century's work with her beloved rare books, Gertrude Annan assumed administrative duties, she showed the same in- sight into the Library's general problems and energy in dealing with them. 450 Gertrude L. Annan President. Medical Library Association, 1961-(->2 president's page 453 Not only has the Academy benefited; New York metropolitan library con- ditions have had her attention, too. In 1958, acutely aware of space diffi- culties in medical libraries, the Academy, at Gertrude Annan's instigation, called a conference of New York librarians and physicians to discuss a depository collection and center for interlibrary co-operation. She was unanimously asked to become chairman of a committee to implement the decision for co-operation, and gave unstinted time and effort to it. This culminated in the incorporation of the Medical Library Center of New York and the appointment of a director who started work May 1, 1961. Activities such as this have meant many meetings and much speaking. She responds generously to requests for talks, and she speaks with charm, con- viction, and simplicity. Her ideas and energy have found expression in her activities for the Medical Library Association while she worked on many of its committees, especially those on publications and as chairman for the New York meet- ing in 1957. Her good sense and practicality were invaluable when she was Finance Committee chairman, on the Board of Directors, chairman of the Committee on Committees, and Vice-President. Her experience and ini- tiative augur well for the presidential year ahead. This devotion to her tasks has its firm base in Gertrude Annan's New England background, with a touch of German thoroughness thrown in. A social conscience drives her to unremitting endeavor for the principles she believes in: she will not compromise. Definitely not a "yes-man" herself, she respects the right of others to be nonconformist. For a cause she con- siders worthy, no effort and no sacrifice are too great. All the more sweep- ing, in consequence, is her condemnation of misdirected or slipshod work. If some have felt such a sting—perhaps through misunderstanding not al- ways deserved—many have been encouraged to improve their gifts, learn new skills, or overcome a disability. Her readiness to help goes out espe- cially to those from abroad who face difficulties of language or inexpe- rience. This may sound as though work and no play filled Gertrude Annan's days. Not a bit of it; no companion could be more fun. Ex-dramatics student, she loves the theater. Reading is one of her great resources, and she shares it with others, reading aloud to family or traveling companion biography, history, archaeology, English detective stories. Crossword puz- zles and double-crostics bring out her mental agility. She likes jaunting, especially by the sea, and touring old houses anywhere. Most of all, she was thrilled by her trip to England as the Academy's representative at the First International Congress on Medical Librarianship in 1953. History came alive for her. She visited the Scottish village of Annan whence her forebears came. Wherever she may be, she enjoys good food, above all, 454 JANET DOE lobster in its unadulterated perfection—as befits one with Maine ancestry. Moreover, she is an excellent cook and loves to entertain, producing seem- ingly without effort a conservative turkey dinner or a daring experiment with shrimp, eggs, cocoanut, and curry. Whatever Gertrude Annan does— cooking, historical research, teaching, administration—she does with her whole mind and heart. This should produce a successful technique for the presidency. Janet Doe Notes from London The need to prepare these notes some three months before they appear in print sometimes produces awkward situations. In the April Bulletin I reported a discussion in London on the new Index Medicus. The supple- ment to the January Bulletin, received in London several weeks later, provided a complete answer to the criticisms made and explained the necessity for adopting some of the measures to which exception had been taken. The Supplement has been read here with admiration. It has made us all realize the painstaking research that went into the planning of the IM and the care that is exercised in its production. Hospital Abstracts, the new monthly survey of world literature on hos- pital administration, is proving a valuable addition to the literature on the subject. It is compiled by the Librarian of the Ministry of Health, Mr. A. E. Fountain, and his staff. It is a well-produced publication, providing abstracts of papers covering the whole field of hospitals and their adminis- tration except strictly medical and related professional matters. It is pub- lished by Her Majesty's Stationery Office at an annual subscription of $11.52. Applications for subscription may be addressed to British Informa- tion Services, 45 Rockfeller Plaza, New York 20, N. Y. Specimen copies are obtainable from H. M. Stationery Office, Publications Division (P6C), Atlantic House, Holborn Viaduct, London, E.C. 1. * # # # Mr. G. J. Hipkins has retired from the secretaryship of the Medical Section of the Library Association after serving in that office for ten years. During that period he has contributed more than anyone else to the de- velopment of the Section and leaves it in a flourishing condition. To mark their appreciation of his work members of the Section recently made a presentation to him. He is replaced as honorary secretary by Mr. E. H. Cornelius (Royal College of Surgeons). The occasion of the presentation was the annual business meeting of the Section, held in the library of the Royal College of Physicians. After the meeting we browsed among the books, looked at the Gold-headed Cane, and saw other College treasures, perhaps for the last time in their present surroundings, for the familiar building in Trafalgar Square is soon to be vacated by the College for a new home in Regent's Park. * Contributed by Mr. L. T. Morton, Librarian, National Institute for Medical Re- search, London. 455 456 NOTES FROM LONDON # # # # A small committe has been formed in London to co-ordinate the ar- rangements of British librarians expecting to attend the Second Inter- national Congress on Medical Librarianship. It is hoped that Britain will be well represented in Washington in 1963 and that delegates from this country will make a worthwhile contribution to the proceedings of the Congress. Some of us had the pleasure of meeting Dr. F. B. Rogers in London in February and hearing from him the details of the Congress programme. Winnowings By AVilliam K. Beatty-J- Annan, Gertrude L. Medical Classics: Editions Old and New. Stechert- Hafner Book News. 15: 53-55, Jan., 1961. Classics of medicine receive this appellation because of the author, sub- ject, place, or time. The many facsimiles and translations of these works make them available to most medical libraries at relatively small cost. Miss Annan suggests some of the pleasure and excitement of dealing with the classics in the historical development of medical theory and practice. Cogan, David G. (Editorial). Publication Explosion. Arch. Ophthal. 65: 319-320, Mar., 1961. "Certainly not all that goes under the name of research warrants publi- cation. .. ." This heresy is the major reason for the author's dim view of the rapidly increasing number of journals in his field. The Archives has shown for some time a considerable interest in bibliographic matters, and has used abstracts as a suitable method of reporting papers presented at meetings. These thoughtful comments by the Editor are, therefore, of particular value. Davidson, Henry A. How to Save Time on Your Medical Reading. RISS 4: 41-45, Mar., 1961. Recognizing a bad article early can save the physician a great amount of time. In a refreshing turn-around Dr. Davidson gives the reader some pointers for spotting a worthless article before he is trapped. Effective Medical Writing. New Physician. 10: 65-80, Mar., 1961. This special section contains six papers which were originally presented at the 1960 Conference of the American Medical Writer's Association. Fishbein and Alvarez contribute some anecdotes; Garland has written a most interesting essay on the duties and activities of a medical editor; DeBakey underlines the pressure forcing physicians to write, and offers some possible solutions; Snively has some forceful remarks and guides on the subject of prolixity; and Hewitt apologizes (unnecessarily) for drawing attention to the underlying cause for poor medical writing. * Longer reviews of some of the items mentioned here may appear either simultane- ously or later in the section, "Book Reviews and Journal Notes." f Medical Librarian, University of Missouri, Columbia, Missouri. 457 458 WINNOWINGS Francke, Gloria. Guide to Information Sources for the Hospital Pharma- cist: 1960 Revision. Amer. J. Hosp. Pharm. 18: 15-23, Jan., 1961. Librarians will find much helpful material in this list. Many of the items are annotated. The sections on reference tools and journals are particu- larly good. The textbook section is spotty both in coverage and currency. Freund, Gerhard. The Profile of a Publication; An Aid in the Critical Evaluation of Medical Articles. Med. Docum. 5: 2-6, Jan., 1961. The author has worked out a "publication profile", analogous to the "liver profile", as a method for evaluating articles and, indirectly, for im- proving one's own writing. The six tables used are shown at the end of the text. This is a stimulating article, and it deserves careful reading and thought. Gall, Edward A. The Three Faces of Medicine. J. Med. Educ. 36: 275-281, Mar., 1961. Dr. Gall, with the aid of some "poorly labeled liquids", a moon-lit statue, and a facile pen has produced a delightful essay on the activities and needs of the medical student, the teacher, and the practitioner. Gano, S. N. Deficiencies in the English Medical Vocabulary. The Leech. (Cardiff). Autumn, 1960. The Leech's noted New York correspondent has distilled a mass of linguistic knowledge into this little gem. One may quibble over the doubt- ful position of the woman who "dysps", but there can only be sympathy for the poor patient who is "Wolff-Parkinson-White-ing". Gibson, W. C. (Outline of Speech to 2nd B. C. Medical Library Service Conference). Brit. Columbia Med. J. 2: 779-781, Dec, 1960. The importance is stressed of financial support by physicians for regional medical library service. Relatively small payments will enable the prac- ticing physician to keep up with the current literature and to avoid over- looking important work from the past. Enthusiasm for a worthwhile cause has unfortunately led to some errors of fact. Gooddy, William. Syndromes. The Lancet 1: 1-3, Jan. 7, 1961. This thoughtful paper contains, in addition to flashes of delightful humor, some excellent observations on medical education and history, and on human psychology. Hecht, Hans H. The Blight of Medical Science. Amer. Heart J 61- 282- 283, Feb., 1961. winnowings 459 Our present system of written communication in medical science is inadequate, and will become useless within a few years. "Quantitative mediocrity" is one of the principal causes of this situation. As a remedy the emphasis should be placed on the publication and dissemination of abstracts and upon the central storage, classification, and distribution (upon request) of the complete articles. Herrmann, Josephine. Medical Library Services. Part 1—References. Hosp. Prog. 42: 164, 166, 168-170, Mar., 1961. This practical paper gives suggestions for helping the different types of readers who use the medical library, and presents, with annotations, the essential books, both medical and general, needed for basic reference work. Hudson, Robert P. The Lunar Society of Kansas University. J. Med. Educ. 36: 182-187, Feb., 1961. The Society, a student organization which was founded at Kansas in 1955, is a spiritual descendant from the Birmingham group of the eight- eenth century. Its primary purposes are encouragement of discussion of the "medical humanities" and the improvement of the student's abilities to think and converse. The report is written in a delightful manner, and it suggests possibilities for the formation of groups to study medical history and other subjects. Ingle, Dwight J. Percy T. Diorets, Endocrinologist—A Fable. Pharos of Alpha Omega Alpha. 24: 32-37, Jan., 1961. The Editor of Perspectives in Biology and Medicine has written a gently satiric account of the temptations of modern scientific life. His skill at con- structing apt phrases is a match for his ability to see the ridiculous aspects of a sacred calf. This paper originally appeared in the July, 1960, issue of Endocrinology. MacDermot, H. E. The Fiftieth Anniversary of the Association Journal. Canad. Med. Ass. J. 84: 1-5, Jan 7, 1961. A former editor of the Journal has summarized its history and made some perceptive comments on the organization and growth of a national medical journal. T. C. Routley adds further information (pp. 24-26). MacMillan, Judith T., and Welt, Isaac D. A Study of Indexing Pro- cedures in a Limited Area of the Medical Sciences. Amer. Docum. 12: 27-31, Jan., 1961. The authors draw a logical distinction between "document" and "in- 460 WINNOWINGS formation" retrieval. They discuss some of the methods and problems of the Cardiovascular Literature Project. An interesting example is given of one of the major problems: the variation in index terms when more than one person indexes a particular article. The paper ends with some provoca- tive comments on the use of author abstracts. Marriott, Henry J. L. (Editorial). Balm for Writer's Itch. Amer. J. Cardiol. 7: 161-166, Feb., 1961. Unfortunately articles on medical writing have become so popular that they are now being written by authors who are unaware of the major prin- ciples involved or who are incapable of putting them into practice. Dr. Marriott does not fall into either of these categories. His comments are lively, realistic, and practical. Writers at all levels of experience will enjoy this helpful paper. Marshall, John David. On Books and Their Dedications. Stechert-Hafner Book News. 15: 65-67, Feb., 1961. At the end of this brief essay the author warns the reader who skips the dedication page of a book, "If you do, the chances are good that you'll miss a choice bit of reading". The reader who skips this essay will miss a choice bit of reading—and writing. Marshall's selections, especially the one from Steele, will make a wonderful antidote to "librarian's doldrums". Masters, Anthony. Mental Hospital Libraries. Libr. Rev. 137: 29-31, Spring, 1961. A librarian describes, with a gentle and practical touch, some of his ac- tivities. One feels that the patients in this hospital are fortunate in at least one respect. May, Charles D. Selling Drugs by "Educating" Physicians. J. Med. Educ. 36: 1-23, Jan., 1961. Many authors have written many articles in many journals on, around, and about this problem. To say that the subject suffers more from emo- tionalism than from logic is to belabor the obvious. There is a need for a rational and productive view of the whole matter. Dr. May, with the critical assistance of an independent group of authorities, has provided such an article. Librarians might well peruse this and leave copies where their readers will stumble over them. Medical Communication. J. Einstein Med. Cent. 8: 238-287, Oct., 1960. Of the dozen articles contained in this issue the following are of special interest: Pogge—an enjoyable piece of writing; Hill—useful information about graphs and illustrations; Clagett—basic, but essential, material on WINNOWINGS 461 preparation of papers; Orr and deKoven—excellent comments on the im- portance of the summary or abstract written by the author; Beck—needed comments on accuracy of references; Morse—some interesting figures on circulation of journals. Medical Writing. J. Mich. Med. Soc. 60: 191-230, 234-235, Feb., 1961. It is seldom that a collection of papers on this subject provides so ef- fectively examples of both "how to do it" and "how not to do it." On the plus side are the articles by Bartley (some good practical points); Brewer (brief and useful); Good (excellent practical advice); those by Reveno and Miller offer some points for the editor of a hospital or society bulletin; Woodson and Slee (on statistics); Houtz (on graphic methods); and Bailey (on the duties and responsibilities of an editor). Menkes, John H. Normalcy and the Gamma Efferent System. Lancet 2: 1394-1395, Dec. 24, 1960. Using Pirandello's "Cosi e, se vi pare" as his final thrust Dr. Menkes describes a new method for defining normalcy, and emphasizes the im- portance of the gamma efferent system. This carefully constructed report, based on the remarkable work done by Coward, Held, and Lilly, will pro- vide valuable information for the thinking medical scientist. Monaghan, Margaret A. The Library Committee in a School of Nursing. Hosp. Progr. 42: 104, 106, Feb., pt. 1, 1961. The faculty and student library committees at the Sisters of Charity Hos- pital in Buffalo are concisely described. The relationships between these committees and the library show a productive history that has several im- portant lessons. Moore, Francis D. Leonardo and Vesalius; The Two Roads: Surgery and Science. Rhode Island Med. J. 44: 35-38, Jan., 1961. This is a clever, effective, plea for more emphasis on the "full-time" sys- tem of teaching at medical schools. It is also a charming historical essay. Mosher, Fredric J. A Sermon for Beginning Reference Librarians. The Rub-Off. Vol. 12, No. 1, Jan./Feb., 1961. Many of the suggestions apply to the experienced reference librarian as well. All librarians should be sceptical because "our little island of knowledge is floating in a sea of ignorance". Neelameghan, A. Current Indexing and Abstracting Services in the Medi- cal and Related Sciences. Ann. Libr. Sci. 7: 101-116, Dec, 1960. Medical libraries, especially the small and medium-sized, often have 462 WINNOWINGS difficulty in selecting the most suitable indexing and abstracting journals. Broad coverage is sought within a straitened financial framework. The annotated list of current indexing and abstracting periodicals recently put out by the WHO (their Library News, vol. 12, supp. 2, 1959) has been examined and re-cast to provide two shorter lists that will give broad coverage by subject and by region. Although there is room for further re- finements these lists should be quite helpful. Page Charges in APS Journals. Physiologist 4: 25-26, Feb., 1961. The availability of medical information is directly affected by the costs of production and acquisition. The American Physiological Society will adopt a relatively new approach in July, and the thinking behind this change is clearly stated in this brief report. Science (Mar. 31, 1961, p. 1003) contains some related comments and background material. Patterson, Marian A. The Life and Times of the Hon. John Rolph, M.D. (1793-1870). Med. Hist. 5: 15-33, Jan., 1961. Miss Patterson has written a lively account of a major contributor to the medical, political, and legal history of Upper Canada. She has drawn on manuscripts preserved in the medical library of the region, and has pro- vided, in addition to a pleasant essay, a good example of the scholarly side of medical librarianship. Piez, Gladys T. Laminator for Libraries. ALA Bull. 55: 269-275, Mar., 1961. The Library Technology Project sponsored part of this test and carried out the second phase in their laboratory. This report describes the testing and evaluation of one type of laminator which uses the heat method. The Project staff has amassed a great amount of useful information on this and other subjects. The staff will be glad to answer any specific questions. Rosenblum, Marcus. (Editorial). The Vocabulary of Health. Amer. J. Public Health. 51: 279-281, Feb., 1961. "Like radiation, words can be dangerous, or useful, or both." Several horrible examples of frequently mis-used words are exhibited to illustrate this thesis. Rothstein, Samuel. Reference Service: The New Dimension in Librarian- ship. Coll. & Res. Libr. 22: 11-18, Jan., 1961. Reference services should move from the atmosphere of "education and fear" to that of "faith and efficiency". Librarians should cease working WINNOWINGS 463 merely "with" books, and should spend more of their efforts "in" books. Some target-hitting pot shots are taken at the weak points in minimum or restricted reference service. S.A. The Martians Have Landed. Med. Bull. (M Sc B). 9: 13-16, Jan., 1961. Librarians who rely solely on Aerospace Medicine for keeping up with advances in space medicine will miss this important contribution from the South West London Resident Staff Scientific Group. Sheppard, C. W. (Editorial). Brains, Data and Machines. Circulat. Res. 8: 489-494, May, 1960. Machine methods are rapidly making themselves felt in libraries. Many librarians take a dim view of these complicated approaches that require new learning on the librarian's part or the assistance of trained persons from outside the library field. Whenever a clear and practical statement describing these methods becomes available it behooves librarians to pay attention to it. This editorial is an excellent example of a logical account of the possibilities and impossibilities of machine methods, and it should clarify many obscure points for the librarian who feels lost or inferior when a machine glowers at him. Soxxedecker, Glenn. The Pharmacist as a Book Collector. Amer. J. Hosp. Pharm. 18: 24-30, Jan., 1961. Practical suggestions are given primarily for the inexperienced collector, and several general comments on the pleasures of book collecting show that the author is probably a "victim" himself. Thornton, John L. The Distribution of Medical Literature in Great Britain, and the Need for a National Library of Medicine. Libr. Ass. Rec. 63: 79-82, Mar., 1961. A short history is given of the need for a national library of medicine, and some pointed comments are made about the proper staffing for such a library. The various medical libraries are described briefly by size and loca- tion, and, in some cases, by type of user. The medical collection of the British Museum is suggested as the most likely basis for a national library. Wood, S. Mr. Tipple's Chest Wound. Ann. Roy. Coll. Surg. Eng. 28: 122- 130, Feb., 1961. The author, a member of the library staff, described the incident fully in the July 1960, issue of Medical History. This article deals with a rare pamphlet that was recently obtained by the College. 464 WINNOWINGS Youmans, John B. The Humanities in Medicine. Amer. J. Cardiol. 7: 145- 151, Jan., 1961. "Science must augment not displace education." There is a vast dif- ference between the educated physician and the trained technician. Ex- posure to the humanities in pre-medical education does not guarantee an "educated" graduate any more than does a lack of such exposure guarantee a "trained" graduate. Dr. Youmans has presented a thoughtful and literate discussion of some of the major problems confronting medical education and the medical profession. The "Crisis" in medicine today may hinge more directly on the problems discussed here than it does on those put forward by the screechings of blatant journalists. Zeitlin, Jacob. What Kind of a Business is This? Reminiscences of the Book Trade and Book Collectors. Amer. Book Collector. 11: 5-15, Jan., 1961. The cover of this issue, if not actually chosen by the author, would certainly appeal to him. Jake Zeitlin speaks and writes in an enjoyable fashion. His reminiscences are delightfully presented, ranging from sly humor to touching understanding. Brief Notes: Hasan has some interesting things to say about medical librarianship in the Karachi Medicus (20: 174-177, 1960). Philippine medi- cal libraries receive the same treatment from Stransky (/. Philipp. Med. Ass. 36: 372-375, 1960). The kind of library in which one would like to spend a rainy afternoon or so, the Cole Library of Zoology and Early Medicine, University of Reading, is described in Nature (Dec. 31, 1960). Evelyn Puhl tells about "Planning the Psychiatric Library" (Hosp. Progr., Jan., 1961). Hospital library services in Paris were the subject of an article by Basset in the Jan.-Feb., 1960, issue of L'Hopital et I'Aide Sociale a Paris (LSA 10695). Tettey provides information on medical library services in English-speaking West Africa in the May, 1960, issue of the WALA News. The Proceedings of the 1960 Conference of the Catholic Library As- sociation contain many useful papers. Among them are those by: L. B. Miller, Proposed Cumulative Index for the Literature of Nursing (p. 151— 154); E. Cairns, Adequate Budget for the School of Nursing Library (p. 149-150); and W. C. Bier, Responsibility of the Hospital Librarian in the Selection, Acquisition, and Circulation of Books in Psychology (p. 155- 163). The page-cost of journals is in the correspondence columns of Na- ture again (Dec. 17, 1960, p. 1052). A brief statement of the general needs for a clinic library will be found in the Mar., 1961, issue of Group Prac- tice. Since group practice seems to be increasing, these comments will be quite helpful. Josephine Dolan has some ideas for brightening up the WINNOWINGS 465 teaching of nursing history by using postage stamps (Nurs. Outlook, Mar., 1961). The Report of the Joint Committee on Pharmacy College Libraries appears in the Winter, 1961, issue of Amer. J. Pharm. Educ. Dennis Brunning, Librarian at the Chester Beatty Research Institute, makes some sensible comments on the subject of reprints (Lancet 1: 452, Feb. 25, 1961). Washburn and \\ lllis take a good look at dental journals (Conference on Dental Journalism, June, 1960). Klinicheskaia Meditsina celebrated its fortieth anniversary with a brief history in the Aug., 1960, issue. J. M. de Rocha tells about twenty-five years of the Jornal de Pediatria in the June, 1960, issue. Miles Conrad tools up Biological Abstracts for the future in the Oct., 1960, issue of AIBS Bull. Jacqueline Felter's stimulating paper at the 1960 MLA convention receives fine support from Kathryn Shaffer (Phys. Ther. Rev., Feb., 1961). Horno Liria dilates on the medical publish- ing industry in the Feb., 1960, issue of Clin. Lab. (Zaragoza), and speaks at some length on medical journalism in the July, 1960, issue of Sem. Med. (Buenos Aires). The Editor of the "new" Journal of Pharmaceutical Sci- ences has some cogent remarks on the need for more journals (Mar., 1961). He writes, among other things, "Present limitations are in the quantity of suitable manuscripts rather than in the journal space in which to publish them". Gamma-irradiation is offered as a method for disinfecting books in an article by Beliakova (Mikrobiologiia, Sept.-Oct., 1960). "What to Look for in a Reading Machine" (who hasn't asked this question) is treated compre- hensively by Ballou in the Jan., 1961, ALA Bull. Brief biographical notes have appeared on Miss Blake Beem (/. Kentucky Med. Ass., Feb., 1961, p. 168) and on T. J. Shields (Brit. Med. J. 1: 304, Jan. 28, 1961). The recent spate of medical encyclopedias left one of the most important phe- nomena untouched, but Brian Maegraith provides the needed information on the Gekochteundgebrocheneeierschale Phenomenon in the Dec. 24, 1960, issue of Lancet (p. 1395-1396). The attitude, prevalent in some quarters today, that the maintenance of health is not the province solely of the physician, receives a neat twist from a note entitled "Status" in the Feb., 1961, issue of /. Irish Med. Ass. (p. 52). If there are still devotees of medical ornithology they will find an important contribution in the Mar., 1961, issue of the same journal (p. 84). Editorials GUEST EDITORIAL When, that day in 1836, Dr. Lovell approved the budget item of $150 for medical books for the Office of the Surgeon General, he could not have had the faintest dream of the remarkable development he set in motion. One hundred and twenty-five years, thousands of books, millions of bib- liographical citations, and several buildings later, the National Library of Medicine is a sight to behold. The lineaments of the institution are still changing, and will continue to change; hardy the soul who cares to predict what even the next decade may bring! When the Editorial Board of the Bulletin suggested this special anni- versary issue, the Staff of the National Library of Medicine was glad and ready to respond. It is our hope that the contents of this number will con- vey some of the flavor of the Library's activities, illumine some of its his- tory, and contribute some substance to the rich store of medical bibliog- raphy. As we begin the second century-and-a-quarter, we have faith in our stars, hope for the future, and charitable feelings toward that unknown librarian of 1683 who said that "if men would take care that ill Books be not written, and that good Books be not ill written; but that in their com- posing a due regard be always had of Prudence, Solidity, Perspicuity, and Brevity, there would be no cause left for us to complain of the too great number of Books." Frank B. Rogers THE NATIONAL LIBRARY OF MEDICINE ANNIVERSARY ISSUE Several years or so ago your editor had a wonderful idea (sometimes even editors do) that it would be a fine thing for the Association if some of the largest medical libraries would agree to be responsible for individual is- sues of the Bulletin. Consequently, the director of the National Library of Medicine was asked if he would start off this important project whereby our readers could be informed of the history, development, and special fields of activity of the leading medical libraries. On February 24, 1958, he agreed, provided that the National Library of Medicine issue could be published in 1961 to commemorate its one hundred and twenty-fifth an- niversary. It is with great pride that the Editorial Board of the Bulletin presents this issue, edited by Dr. Frank B. Rogers and written by him and 466 editorials 467 many members of the staff of the National Library of Medicine. We feel that it is a contribution to medical literature and an issue greatly to be prized by Bulletin readers. As an editor bowing out in the aura of this fine issue, I hope that the idea inaugurated here will flourish. L'ENVOI It is time to say goodbye. I will not pretend that I hate to do so— because frankly, I am looking forward with great glee to reading succeed- ing issues of the Bulletin after they arrive from the printer rather than partaking of the agony of getting them there. I won't worry about dead- lines, having enough material, having good material or having any ma- terial! I won't pester my friends to write, write, write. I won't try to stop other friends who can't write but do. I won't be horrified if authors fail to send the required number of copies or if they completely murder the Manual of Style or positively ignore the correct abbreviations of the Index Medicus. I won't have to harry committee chairmen, program chairmen, section editors or anyone else to "get them to the church on time." I will now know at last what the date of the year is, rather than living months in the future, and I won't be planning for July in January. I won't be balancing school with society and hospital with dental or phar- macy with nursing libraries. I won't care if there is a preponderance of reference material and nothing on cataloging. I won't mind if librarians decide to devote their energies entirely to medical history or if they decide instead to concentrate on documentation. I won't worry if one issue has 200 pages and the next one just 50. It won't be my problem if the cost of printing goes up four times a year. I won't have to determine what the incoming budget should be and I won't fume if an author wants to add 64 lines to his article at the page proof stage. I can just laugh when an author hits the ceiling because a reviewer didn't like his book and I can just relax when some sensitive soul notes that his article was omitted from a bibliography. I won't have to wait for those promised articles that never arrive. But oh, how I shall miss the many heart-warming letters of praise and understanding. How lonesome it will be without the pleasant and reward- ing contacts with friends both old and new. How lonely it will be without daily missals from a wonderful editorial board. How sad a prospect not to know every news item instantaneously, and every new development the minute it happens. How tragic not to be planning, planning, planning. How staid life will be without the risks, the uncertainties, and the excite- ment of being an editor. How dull it will be—but oh, how peaceful! Good bye, good luck and God bless you to the brave and intrepid in- coming editor, Alfred Brandon; the capable and most understanding 468 EDITORIALS Associate Editor, Jacqueline Felter; the exceptionally co-operative editorial board who devoted untold hours to providing this journal, G. S. T. Cava- nagh, David Kronick, and Frederick Bryant; the fine and friendly Waverly Press; and the Bulletin readers, of which group I soon will be the hap- piest one. Mildred Crowe Langner Editor Short Communications to the Editor Dear Editor: The study, "The Bibliographic Control of Supplements to Medical Periodicals," by H. Bloomquist, T. P. Fleming and J. B. Balkema1 is a fine example of the use of systematic research to answer questions of policy and to evaluate practices which may have become outmoded. While the conclusions are well supported by evidence, however, there are some prob- lems which may be usefully raised. It is assumed that supplements contain important information and that a subject approach to them, whether through the catalog or other biblio- graphic tools, should be available to the librarian as well as to the reader. With this in mind, I would like to examine certain aspects of the study. 1. Adequacy of the tools of control. The study shows (Table 1, p. 302) that 99.3 per cent of the supplements in the sample could be found in a search of six separate indexing tools. This fact in itself could hardly evoke great enthusiasm if it would be necessary to search all six tools in order to obtain a significant percentage of the supplements published. Such a procedure might take as much time in searching as it would take to catalog a supplement. Happily, Table 2 indicates that a single tool, the Current List of Medical Literature, had indexed 92.3 per cent of the sample which would seem sufficient coverage for most searches. This alone does not solve the time problem, because if we had to search through all volumes of the Current List we again would be expending a great deal of time. Cumulations which cover at least five years are therefore essential. These exist in the form of the cumulation of the National Library of Medicine Author and Subject Catalogs. The study shows that the National Library of Medicine Author and Subject Catalog also indexes a high percentage of the supplements of the sample. There is some question whether this has always been the case. To test this, a list of all supplements to Acta psychiatrica et neurologica Scandinavica published between 1950 and 1957 was checked against the Au- thor Catalogs of the National Library of Medicine 1950-1954 and 1955- 1959. Of the 60 supplements 51 or 85 per cent were found (Table 1). This is a good percentage but not particularly impressive. The real effectiveness of the tool is revealed when these overall figures are broken down chrono- 1 Bulletin, 48: 299-307, July, 1960. 469 470 SHORT COMMUNICATIONS TO THE EDITOR TABLE 1 *Number oj Supplements Found in National Library of Medicine Catalog 1950-1954, 1955-1959 Total Number of Supplements Published Total Number* Located in NLM Catalog Percentage Locatedf 60 51 85 * Acta psychiatric a et neurologica Scandinavica Supplements #59-118, 1950-1957. f Supplements Nos. 72 and 97 were actually not listed as supplements. They had been previously published as dissertations and were indexed as dissertations only. Since both had been cataloged they were included here as located items. If a stricter meas- ure were applied, therefore, the number of located items would be reduced to 49 and the percentage located to 81.7 per cent. TABLE 2 Number of Supplements Found in National Library of Medicine Catalog, 1950-1954, 1955-1959, by Date of Publication Year Published Number Number Located Percentage Located 1950-1951 18 9* 50 1952-1953 12 12 100 1954-1955 17 17* 100 1956-1957 13 13 100 * In each of these periods there was one supplement which was actually not listed as a supplement but only as a dissertation. This would reduce the number and per- centages located to 8 and 44.4 per cent and to 16 and 94.1 per cent. logically in Table 2. It is evident that beginning with the year 1952 the coverage was practically complete while in the period from 1950 through 1951 only 50 per cent of the supplements were covered. This points to a change in policy at the National Library of Medicine around 1952. I suspect that such a change of policy also took place in the Current List because the previous preliminary study cited by H. Bloom- quist, and others2 which, admittedly was based on an inadequate sample, recorded only a 60 per cent coverage by the Current List of the supple- ments in that sample. Before analytics are abandoned, we should make sure that tools exist which index at least 90 per cent of the supplements of the journals re- ceived by a library and that adequate cumulations are available. Appar- ently, the Index Medicus will index all supplements to the journals which it covers.3 2 Meveroff, E. and Bloomquist, H. Unpublished data. 3S. Taine, Editor, Index Medicus Personal communication. SHORT COMMUNICATIONS TO THE EDITOR 471 2. Adequacy of the sample. An inspection of the sample reveals only one journal published by Karger. Karger, however, has earned a small reputation not only because of the quantity of the supplements which his journals produce, but also because of their varied designations. (Supplementum ad, Bibliotheca, Fortschritte, for example) But, since the study is a pilot study, this should not detract from its general value, although it does, 1 feel, affect the con- clusions which were drawn. Decisions of policy should be based upon facts whenever possible and I hope that this study can be extended into the paramedical fields. Such studies also deserve adequate financial support from foundations and other institutions. Sincerely yours, Erich Meyerhoff,* Director Medical Library Center of New York * Formerly Librarian, State University of New York, Downstate Medical Center, Brooklyn, New York. Executive Secretary's Page HELEN BROWN SCHMIDT It is the privilege of the Bulletin to introduce to the membership of the Medical Library Association its Executive Secretary, Helen Brown Schmidt. Mrs. Schmidt comes to MLA from the Midwest Inter-Library Center, where she has been a member of the staff since 1951 and Assistant Director since 1956. Helen Schmidt is a graduate of Butler University, Indianapolis, and re- ceived her B.L.S. degree in 1937 at Columbia University School of Library Service. Between 1930 and 1940 Mrs. Schmidt served in various capacities at the Indianapolis Public Library. Then she went to Nashville, Tennessee, as Head of the Gifts and Exchanges Department of the Joint Universities Libraries. Since January 1947 she has been in Chicago, where, first, she was Assistant in the Gifts and Exchanges Department of the University of Chi- cago Library, re-opening foreign exchanges halted by World War II; then, Assistant on The Booklist, ALA, for two years; and, finally, Head of the Acquisitions Department, University of Illinois, Undergraduate Division, 472 473 Chicago, until 1951, when she became Acquisitions Librarian at the Mid- west Inter-Library Center. Mrs. Schmidt's professional energy is matched by her enthusiasm for a variety of diversions. Her taste in music ranges from Dixieland jazz to chamber music, and she enjoys the legitimate theatre. Like our current MLA President she collects cookbooks and enjoys preparing exciting meals. She likes to dance, swim, and hike (to keep the appetite keen, perhaps?). And recently, having been converted from an apartment dweller to a house- holder, has become, also, a gardener, "learning about hedges and ground cover, flowering bulbs and trees." One of Helen Schmidt's co-workers has said of her that she has "an ability to co-ordinate and satisfy simultaneously the frequently disparate needs and ideas of many people and institutions . . . with a grace and charm rarely found." These are attributes desirable indeed for one who is to work with 1,000 librarians in 583 libraries. For the Association we welcome Mrs. Schmidt to MLA and wish her suc- cess and happiness in her new position. Association News SCHEDULED MEETINGS Chicago, Illinois Washington, D. C. San Francisco, California Boston, Massachusetts June 4-8, 1962 June 16-22, 1963 June 1-5, 1964 June 21-25, 1965 Philadelphia, Pennsylvania 1966 (Date to be announced) MEDICAL LIBRARY ASSOCIATION, INC. 1961/62 BOARD OF DIRECTORS President Vice-President (President Elect) Honorary Vice-President Secretary Treasurer Immediate Past President Miss Gertrude L. Annan New York Academy of Medicine Library 2 East 103rd Street New York 29, New York Dr. Frank B. Rogers National Library of Medicine Washington 25, D. C. Dr. Harold Hillenbrand American Dental Association 222 East Superior Street Chicago 11, Illinois Miss Ruth J. Mann Mayo Clinic Library Rochester, Minnesota Mr. John P. Ische Louisiana State University School of Medicine 1542 Tulane Avenue New Orleans 12, Louisiana Mr. Robert T. Lentz Jefferson Medical College Library 1025 Walnut Street Philadelphia 7, Pennsylvania 474 ASSOCIATION NEWS 475 Elected Members Mr. Gilbert J. Clausman (1 year) Miss M. Irene Jones (2 years) New York University Medical Center Mooney Memorial Library Library University of Tennessee 550 First Avenue 62 Dunlap Street New York 16, New York Memphis 3, Tennessee Mrs. Bernice M. Hetzner (1 year) Miss Helen Crawford (2 years) College of Medicine Library University of Wisconsin University of Nebraska Medical School Library 42nd & Dewey Avenue Service Memorial Institute Building Omaha 5, Nebraska 428 N. Charter Street Madison 6, Wisconsin Miss Louise M. Darling (3 years) Biomedical Library University of California Medical Center 405 Hilgard Avenue Los Angeles 24, California Appointed Officers, 1961/62 Editor of The Bulletin Mr. Alfred N. Brandon Medical Center Library, University of Kentucky Lexington, Kentucky Exchange Manager Mr. Gilbert J. Clausman New York University Medical Center Library 550 First Avenue New York 16, New York Organization and Procedure Manual Compiler Miss Helen Crawford University of Wisconsin Medical School Library Service Memorial Institute Building 428 North Charter Street Madison 6, Wisconsin Placement Advisor Mrs. Mary Fenlon Kaylor Bureau of Laboratories New York City Department of Health Foot of East 15th Street New York 9, New York 476 ASSOCIATION NEWS Assistant Placement Advisor Mrs. Lois B. Miller The American Journal of Nursing 10 Columbus Circle New York 19, N. Y. Regional Group Coordinator Miss Otilia D. Goode American Dental Association Library 222 E. Superior Street Chicago 11, Illinois Committees, 1961/62 Awards Committee Miss Mary M. Post (2 years), Chairman Ramsey County Medical Society 1500 Lowry Medical Arts Building 25 West Fourth Street St. Paul 2, Minnesota Mrs. Ella M. Crandall (2 years) Mr. Scott Adams (4 years) Miss Melecia E. Cranny (4 years) Mrs. G. M. Gait (4 years) By-Laws Committee Miss E. Louise Williams, Chairman Mississippi State Board of Health Library P.O. Box 1700 Jackson 5, Mississippi Mrs. Barbara Coe Johnson Mr. William D. Postell Central Office Committee Mrs. Bernice M. Hetzner, Chairman University of Nebraska College of Medicine Library 42nd & Dewey Avenue Omaha 5, Nebraska Miss Bertha B. Hallam Miss Wilma Troxel Committee on Committees (Board) Dr. Frank B. Rogers, President-Elect, Chairman National Library of Medicine Washington 25, D.C. ASSOCIATION NEWS 477 Miss Helen Crawford, Organization & Procedure Manual Compiler Miss Ruth J. Mann, Secretary Mr. Gilbert J. Clausman Miss M. Irene Jones Committee on International Co-operation (set up by By-Laws) Miss Louise M. Darling, Chairman Biomedical Library University of California Medical Center 405 Hilgard Avenue Los Angeles 24, California Mr. John B. Balkema, Co-Chairman New York State Psychiatric Institute 722 West 168th Street New York 32, New York Miss M. Ruth MacDonald Mrs. Sarah G. Mayer Miss Mary Joan Campbell Committee on Postgraduate Institute Dr. Estelle Brodman, Chairman Washington University School of Medicine Library 4580 Scott Avenue St. Louis 10, Missouri Mr. Harold J. Bloomquist Miss Eleanor Johnson Mrs. Raissa Maurin Miss Wilma Troxel, Consultant Committee on Standards for Medical Librarianship Mrs. Helen S. Monahan, Chairman Medical Library of Mecklenburg County 1012 Kings Drive Charlotte 7, North Carolina Miss Elizabeth F. Adkins, Assistant Chairman Miss Elsie Bergland Mrs. Vera S. Flandorf Miss Marie Harvin Miss Pauline Duffield Subcommittee on Certification Mrs. Vera S. Flandorf, Chairman Children's Memorial Hospital 478 ASSOCIATION NEWS 707 Fullerton Avenue Chicago 14, Illinois Miss Miriam Hawkins (2 years) Mrs. Flora H. Wellington (3 years) Miss Margaret E. Hughes (4 years) Subcommittee on Curriculum Miss Elsie Bergland, Chairman College of Veterinary Medicine Colorado State University Fort Collins, Colorado Miss Eleanor G. Steinke (2 years) Dr. Carroll F. Reynolds (3 years) Mr. Robert F. Lewis (4 years) Subcommittee on Internship Miss Marie Harvin, Chairman Medical Center Library University of Arkansas 4301 West Markham Little Rock, Arkansas Miss Louise M. Darling (2 years) Miss Christa M. Sykes (3 years) Miss Maxine Kennedy (4 years) Subcommittee on Recruitment Miss Pauline Duffield, Chairman Texas Medical Association 1801 North Lamar Boulevard Austin 14, Texas Miss Dorothy E. Nieman (2 years) Miss Mary McNamara (3 years) Miss Genevieve Cole (4 years) Convention Committee (set up by By-Laws) Dr. Donald A. Washburn, Chairman American Dental Association 222 East Superior Street Chicago 11, Illinois Mrs. Vera S. Flandorf, Chairman, Banquet and Meals Committee Miss Marguerite Gima, Chairman, Facilities Committee Miss Otilia D. Goode, Chairman, Entertainment, Tours and Trans- portation Committee ASSOCIATION NEWS 479 Mr. Charles Hughes, Chairman, Exhibits Committee Miss Elizabeth A. McLaughlin, Chairman, Hospitality Committee Miss Helen T. Yast and Mr. Earl C. Graham, Co-chairmen, Program Committee Mr. William S. Budington, Chairman, Printing Committee Miss Clara L. Meckel, Chairman, Publicity Committee Miss Minnie A. Orfanos, Chairman, Registration Committee Editorial Board of the Bulletin Mr. Alfred N. Brandon, Editor Medical Center Library University of Kentucky Lexington, Kentucky Mrs. Jacqueline W. Felter, Associate Editor Medical Society of the County of Queens Library 112-25 Queens Boulevard Forest Hills 75, New York Mrs. Mildred C. Langner, Chairman, Publication Committee Jackson Memorial Library University of Miami School of Medicine 1000 NW. Seventeenth Street Miami 36, Florida Mr. Fred D. Bryant, Business Manager J. Hillis Miller Health Center Library University of Florida Gainesville, Florida Mr. Eugene Muench, Assistant Business Manager New York University Medical Center 550 First Avenue New York 16, New York Exchange Committee (set up by By-Laws) Mr. Jerome S. Rauch, Chairman Seton Hall College of Medicine Medical Center Jersey City 4, New Jersey Miss Jean E. Foulke (2 years) Miss Rita Sue King (3 years) Mrs. Sonia L. Gruen (4 years) Mr. Gilbert J. Clausman, Manager 480 ASSOCIATION NEWS Finance Committee (set up by By-Laws) Mrs. Bernice M. Hetzner, Chairman University of Nebraska College of Medicine Library 42nd &: Dewey Avenue Omaha 5, Nebraska Miss M. Irene Jones Mr. John P. Ische, Treasurer Gifts and Grants Committee Mr. Wesley B. Draper, Chairman Medical Society of the County of Kings and Academy of Medicine of Brooklyn 1313 Bedford Avenue Brooklyn 16, New York Mrs. Bernice M. Hetzner, Chairman, Finance Committee Mr. Jess A. Martin, Chairman, Membership Committee Mr. John P. Isch£, Treasurer Dr. Saul Jarcho Miss Louise C. Lage Miss Nettie A. Mehne Ida and George Eliot Prize Essay Committee Mrs. Mildred C. Langner, Chairman Jackson Memorial Library University of Miami School of Medicine 1000 N.W. Seventeenth Street Miami 36, Florida Dr. Alfred N. Brandon Dr. Estelle Brodman Membership Committee (set up by By-Laws) Mr. Jess A. Martin, Chairman Ohio State University Libraries 1858 Neil Avenue Columbus 10, Ohio Mr. Theodore Wolfe (Middle East) Miss Dorothy Long (South East) Miss Wilma E. Winters (Northeast and Canada) Mrs. Carmenina Tomassini (West Coast) Miss Loraine Neal (South Central) Miss Lorraine F. Gardner (North Central) ASSOCIATION NEWS Murry Gottlieb Prize Essay Committee Mrs. Mildred C. Langner, Chairman Jackson Memorial Library University of Miami School of Medicine 1000 N.W. Seventeenth Street Miami 36, Florida Miss Janet Doe Dr. Dorothy M. Schullian Nominating Committee (elected, set up by By-Laws) Miss Mildred E. Blake, Chairman Lovelace Foundation Library 4800 Gibson Boulevard, S.E. Albuquerque, New Mexico Miss Ida J. Draeger (1 year) Mrs. Sarah C. Brown (2 years) Miss Helen L. Woelfel (2 years) Mrs. Jacqueline M. Felter (3 years) Periodicals and Serials Publication Committee Mrs. Elizabeth F. Bready New York Academy of Medicine 2 East 103rd Street New York 29, New York Mr. William K. Beatty Mr. Thomas P. Fleming Mr. Elliott H. Morse Subcommittee on Bibliography Mr. Elliott H. Morse, Chairman College of Physicians of Philadelphia 19 South 22nd Street Philadelphia 3, Pennsylvania Mr. Earl C. Graham Mr. David K. Maxfield Miss Isabel McDonald Miss Gretchen R. Riese Mr. Seymour I. Taine Subcommittee on Union List of Serials Mr. Thomas P. Fleming, Chairman Columbia University Medical Library 630 West 168th Street New York 32, New York 482 ASSOCIATION NEWS Miss Myrl L. Ebert Miss Anna P. Kennedy Mr. Samuel Lazerow Mr. Harold Oatfield Mr. Francis B. O'Leary Subcommittee on Vital Notes Mr. William K. Beatty, Chairman and Editor, Vital Notes University of Missouri Medical Library Columbia, Missouri Mrs. Virginia Beatty Miss Liselotte Bendix Mr. Robert T. Divett Mr. Leslie K. Falk Miss Sylvia H. Haabala Miss Elizabeth D. Runge Mrs. Mildred C. Langner, Chairman, Publication Committee Personnel Survey Committee Mrs. Breed Robinson, Chairman University of Maryland, Library of Health Sciences 111 South Greene Street Baltimore 1, Maryland Mrs. Simone C. Hurst Mrs. Florence R. Kirk Miss Beatrice Marriott Miss Hilda E. Moore Publication Committee (set up by By-Laws) Mrs. Mildred C. Langner, Chairman Jackson Memorial Library University of Miami School of Medicine 1000 N.W. Seventeenth Street Miami 36, Florida Miss Isabelle T. Anderson Mr. Lee M. Ash Mr. Alfred N. Brandon, Editor of the Bulletin Mrs. Jacqueline W. Felter, Associate Editor Seminar Committee Dr. David A. Kronick, Chairman Cleveland Medical Library 11000 Euclid Avenue Cleveland 6, Ohio ASSOCIATION NEWS 483 Miss Ann Hodge Mr. Thomas E. Keys Miss Margaret M. Kinney Mr. Erich Meyerhoff Miss Eleonor E. Pasmik Miss Betty Ann Withrow Representatives, Delegates, Consultants 1961/62 American Library Association, Reference Services Division. Bibliography Committee Mr. Elliott H. Morse American Library Association, Acquisitions Section, Resources and Tech- nical Services Division. Reprinting Committee Miss Sonia S. Wohl American Standards Association Sectional Committee Z39 on Library Work and Documentation Mr. Harold Oatfield American Standards Association Sectional Committee Z85, Standardiza- tion of Library Supplies and Equipment Mr. Ralph T. Esterquest Council of National Library Associations Miss Gertrude L. Annan, President Dr. Sanford V. Larkey Interagency Council on Library Tools for Nursing Mrs. Helen W. Munson Interassociation Hospital Libraries Committee Mrs. Margaret Hopkinson foint Committee on Library Education (CNLA) Miss Cecile E. Kramer oint Committee on Standards for Pharmacy School Libraries (AACP) Miss M. Margaret Kehl (1 year) Mr. Philip Rosenstein (2 years) Joint Committee on the Union List of Serials Mr. Samuel Lazerow Joint Committee on Visiting Foreign Librarians (CNLA) Miss M. Ruth MacDonald Library Work as a Career Miss Mary McNamara United States Book Exchange, Incorporated Mrs. Henrietta T. Perkins United States National Commission for UNESCO Mr. James W. Barry 484 ASSOCIATION news SEVENTH ANNUAL MURRAY GOTTLIEB PRIZE It is with pleasure that the Association announces that the Murray Gottlieb Prize of $100.00 will again be awarded for the best essay written by a medical librarian on some phase of the history of American medi- cine. The award is named for Mr. Gottlieb, an Associate Member of the Medical Library Association whose particular interest was American medi- cal history, who died in 1954. It is given in his memory by his widow and her husband, Mr. and Mrs. Ralph Grimes, owners of the Old Hickory Book Shop, Brinklow, Maryland. Articles should conform to the instructions given on the inside cover of the Bulletin and should be sent to the Chairman of the Publication Committee before April 15, 1962. Announcement of the winning article will be made at the Annual Meeting of the Medical Library Association in Chicago, Illinois, June, 1962. Judges are Miss Janet Doe, Dr. Dorothy M. Schullian, and Mrs. Mildred Crowe Langner. SOUTHERN CALIFORNIA REGIONAL GROUP The MLA Regional Group of Southern California was co-sponsor with the Southern California Chapter of SLA for a one-day Communications Congress: Idea Exchange on March 13, 1961, at the College of Osteopathic Physicians and Surgeons, Los Angeles. At the morning session there were three speakers: Bee Finne, Special Assistant in the Training Department, Pacific Telephone & Telegraph Co., whose subject was " 'One Moment Please': Good Telephone Usage"; Dr. William Himstreet, Associate Pro- fessor and Head, Business Communications, School of Business, University of Southern California, speaking on "Your Slip is Showing"; and Earl J. Sachs, Vice President in charge of Customer Relations, Title Insurance and Trust Company, "How Business Creates Good Relations with Its Customers." In the afternoon there were the Panel of Library Experts Application Report, business meetings of the two sponsoring organiza- tions, a discussion of the feasibility of regional library subject responsibil- ity, and group meetings to discuss various library procedures such as readers' services, technical processes, and book selection. NEW YORK REGIONAL GROUP The New York Regional Group held its spring dinner meeting at the New York Academy of Medicine on April 19, 1961. The guest of honor and speaker was Dr. Frank B. Rogers, Director of the National Library of Medicine. Dr. Rogers spoke on "Nigerian Libraries." Jean E. Foulke, Chairman of the Group for 1960/61, conducted the business meeting which included a report on the establishment of the first New York Regional Group Scholarship for the Medical Bibliography course at ASSOCIATION news 485 Columbia University. Miss Foulke introduced five past, present, or future presidents of the MLA: Janet Doe, Wesley Draper, and Robert T. Lentz, Gertrude Annan, and Dr. Rogers. The Group welcomed, also, Dr. Howard R. Craig, Director of the New York Academy of Medicine, and Mrs. Craig. PLACEMENT SERVICE: CHANGE OF ADDRESS Attention of the readers of the Bulletin is called to the fact that the new Placement Advisor is Mrs. Mary Fenlon Kaylor, Librarian, Bureau of Laboratories, New York City Department of Health, Foot of East 15th Street, New York 9, N. Y. MEMBERSHIP APPLICATIONS All applications for membership in the Medical Library Association should be sent to the Chairman of the Membership Committee, Jess A. Martin, Ohio State University Libraries, 1858 Neil Avenue, Columbus 10, Ohio. Information about membership, however, may be obtained from the regional members of the committee whose names are given in the list of committees for 1961/62 at the beginning of Association News in this issue of the Bulletin. EXCHANGE KEY LIST A limited number of extra copies of the newly revised MLA Key List are available at $2.00 each, for libraries wishing additional copies. The offer is limited to two to a library. Cash should accompany each request, and re- quests should be sent to the Exchange Manager, Gilbert J. Clausman, New York University Medical Center Library, 550 First Avenue, New York 16, NY. MIDWEST REGIONAL GROUP OCTOBER 1961 MEETING SCHEDULED The Fall meeting of the Midwest Regional Group will take place at Rochester, Minnesota, October 27-28, 1961. The headquarters will be Hotel Kahler. Thomas E. Keys, Librarian of the Mayo Clinic, and Mrs. Keys have invited the members of the Group to a pre-meeting Open House on Thurs- day, October 26, from 5 to 8 P.M. The first general session will take place on Friday, October 27, at 2 P.M., when the program will be a Panel on Medical Book Selection where the authors will be represented by Drs. Ed- ward H. Rynearson and Howard P. Rome; the editor, by Dr. George G. Stilwell; the publisher, by Alexander M. Green; and librarians by Barbara Coe Johnson and William K. Beatty. Friday evening there will be a dinner at the Mayo Foundation House and the after dinner speaker will be Dr. Norbert O. Hanson, whose subject is "Greek Philosophy and Greek Medi- cine." 486 association news On Saturday, October 28, there will be a breakfast business meeting for the Minnesota Hospital and Medical Librarians. The morning program will consist of Group Work Shops on Current Problems, with the medical-dental libraries group led by Bernice M. Hetzner and Donald Washburn; the pharmacy libraries group led by Nettie Mehne; and the hospital libraries group, by Ruth M. Tews. Following luncheon, Scott Adams, Deputy Direc- tor of the National Library of Medicine, will speak on "Medical Library Education and the National Library of Medicine." The session will close with the business meeting. The members of the Midwest Regional Group will be glad to welcome medical librarians from all parts of the country. NEW FLORIDA REGIONAL GROUP The "suncoast hospital library group" has been organized into the Re- gional Conference of Florida Medical Librarians. This new group held its first meeting on May 24, 1961. Its purpose will be to co-ordinate and mutually assist in the operation of the medical libraries in Suncoast hos- pitals. The officers for 1961 are: Pauline H. Wooldridge, Sarasota Memorial Hospital, President; Stephania Osborn, St. Anthony's Hospital, Vice- President; Mildred I. Moore, Mound Park Hospital, Secretary; Florence M. Bulmer, VA Center, Pay Pines, Treasurer. Chairmen of committees are: Membership, Eleanor P. Diekema, Manatee Veterans Memorial Hospital; Social Program, Christine J. Metcalf, VA Regional Office, Pass-a-Grille; Publicity, Helen C. Donnelly, VA Center, Bay Pines; and By-laws, Mrs. L. Hughes, Sarasota Memorial Hospital. ADDITIONAL FORTHCOMING REGIONAL GROUP MEETINGS The New England Medical Library Association will meet on October 20-21, 1961, at the New Hampshire State Hospital, Concord, New Hamp- shire. The hostesses are Margaret Mackown, Librarian of the New Hamp- shire State Hospital, and Dorothy Glidden, Librarian, Dartmouth College Medical Library. Rooms may be reserved at the Highway Hotel. The southern Regional Group will meet at Austin, Texas, on October 20-21, 1961. The headquarters will be the Driskill Hotel. Pauline Dufheld, Librarian of the Texas Medical Association, will be hostess. The New York and Philadelphia Regional Groups will hold a joint meeting in Philadelphia. The meeting is expected to take place in No- vember. The Washington, D. C. Area Group will hold its Fall 1961 meeting in Washington in connection with the dedication of the new National Li- brary of Medicine building, November 16, 1961. News Items DIRECTORY OF SPECIAL LIBRARIES AND INFORMATION CENTERS The Gale Research Company, Detroit, Michigan, is planning the pub- lication in 1961 of the first edition of the Directory of Special Libraries and Information Centers. The Directory will be revised triennially. The data will be assembled from questionnaires sent to all special libraries and special collections in the United States and Canada. For each entry the information will include name and address, name of sponsoring in- stitution or organization, name and title of person in charge, names and positions of other professional staff members, size of professional and nonprofessional staff, annual budget, year established, important subjects represented in the collections, size and composition of collections, publi- cations, and services available to outside agencies. The entries will be arranged alphabetically by name within eight major catagories, and a detailed subject index will be provided to facilitate the location of collec- tions, libraries, and information services in specific fields. Dr. Anthony T. Kruzas of the faculty of the Department of Library Science, University of Michigan will serve as editor. The usefulness of this directory will be greatly enhanced by a maximum response to the questionnaires and the publishers look forward to full co-operation on the part of the members of the Medical Library Association. AMERICAN LIBRARY ASSOCIATION MEETING The 80th annual Conference of the American Library Association will be held in Cleveland, O., July 9-15 with more than 5,000 librarians ex- pected to participate in a program designed to alert them to rapid changes taking place within the profession. The theme of the conference, "Libraries for All," will be pointed up at three general sessions. Presiding officer will be Mrs. Frances Lander Spain, co-ordinator of Children's Services, New York Public Library and president of ALA. RUSSIAN SCIENTIFIC TRANSLATION PROGRAM, 1961 The Russian Scientific Translation Program, sponsored by the U. S. Public Health Service, National Institutes of Health, has announced the following changes of contract awards for translation, publication, and distribution of the 1961 run of nine Russian journals produced under its auspices: 487 488 NEWS ITEMS The Royer and Roger, Inc., Publishing Company received the contract for Sechenov Physiological Journal of the USSR; Pavlov Journal of Higher Nervous Activity; Biophysics; and Problems of Oncology. Consultants Bureau Enterprises, Inc., received the contract for Journal of Microbiology, Epidemiology and Immunobiology; Problems of Hema- tology and Blood Transfusion; and Problems of Virology. Consultants Bureau Enterprises, Inc. will also continue the production of Biochemistry and Bulletin of Experimental Biology and Medicine. Pergamon Press Publishing Company, holding the 1960 contract for the production of the first seven of these journals will continue to com- pletion all issues of the 1960 run of these seven titles. The Russian Scientific Translation Program will continue to distribute the nine journals to the collaborating libraries on its free subscription list. COMMISSION ON THE COST OF MEDICAL CARE AMERICAN MEDICAL ASSOCIATION The Commission on the Cost of Medical Care, which was established in February 1960 by the American Medical Association, requests the aid of members of the Medical Library Association in its three-year study of medical care costs. The Commission is attempting to identify and assess the significance of the causal factors involved in determining the prices of and expenditures for medical care. In the study, medical care will be interpreted to include services provided by physicians, dentists, nurses, and ancillary personnel, as well as services provided by hospitals, nursing homes, and diagnostic and treatment centers. It also includes medical re- search, drug preparations, orthopedic appliances, and premiums paid for health insurance and prepayment plans. At present, the Commission is in the process of gathering studies, pub- lications, critiques, and surveys published in the past five years which will be of help in making the study. The Commission would like to receive lists of publications and studies on medical care costs. They should be sent to Commission on the Cost of Medical Care, American Medical As- sociation, 535 North Dearborn Street, Chicago 10, Illinois. COUNCIL ON LIBRARY RESOURCES, INC. The Council on Library Resources, Inc., continues to sponsor investiga- tions which will aid libraries in the control of their literature. An award of S31,755 for a contract of approximately fifteen months duration has been given to Intectron, Inc., Newton Lower Falls, Massachusetts, for investigation of various factors affecting high-reduction microphotography, which is expected to provide a better understanding of high resolution microphotographic processes as applied in information storage and re- NEWS ITEMS 489 trieval systems and to result in the development of working rules of use to documentar) laboratories. The high resolution photographic storage media, some of which have resolution capabilities ten or more times greater than conventional microfilm, hold great promise for the future of storage and retrieval systems, but very little study has been made of the inter- relations of the elements of the photographic process when reduction ratios of 100 or more are employed. Intectron's investigation will en- deavor to bring together data on the scattering of light by photographic materials; the aperture response of optical systems, making use of sine wave (Fourier) analysis; measurement of the effects of development on resolution and acutance utilizing sine wave response techniques; measure- ment of the loss of detail in production of successive generations from an original microimage; and factors affecting the acceptability of enlarge- ments. A grant of S58,886 has been awarded to the University of Pittsburgh to assist the Health Law Center of the Graduate School of Public Health to test and refine techniques developed by the University's Computation and Data Processing Center for information retrieval in the legal field. The grant will enable its Health Law Center to create a tape "library" of statutes of sufficient size that the effectiveness of retrieval techniques can be demonstrated. Searches of the tape library will be compared for speed and accuracy with manual searches by traditional methods. The grant will also provide support for the analysis of such experiments and for the fur- ther development of retrieval techniques so that they function efficiently for a library of operational size. The University's new IBM 7070 Com- puter will be used in the research program. CONFERENCE FOR HOSPITAL LIBRARIANS On March 9-10, 1961, a Conference for Hospital Librarians was held in the Library of the J. Hillis Miller Health Center, University of Florida, Gainesville. Librarians and staff participated in six instruction periods covering acquisitions, serials, cataloging, and reference. A problem period was held at the end of the Conference and was tempered to an open forum on any questions presented. At the close of this last period, the group rec- ommended to Fred D. Bryant, Librarian of the Health Center Library, that the Conference be made an annual one and that it be a three-day conference instead of a two-day one. It was felt that the librarians' en- thusiasm revealed their interest in their jobs and their appreciation of such a conference. The social functions included a banquet and a buffet luncheon. The instructors were Christa Marie Sykes, Eunice Disney, Dorothy Byron, Mayo Drake, and Fred D. Bryant. 490 NEWS ITEMS PUBLICATIONS Western Reserve University has announced publication of a compre- hensive Manual of Information for Biological Libraries compiled by Ardis Engle, of the WRU Biology Library, who was also national chairman, 1960/61, of the Biological Sciences Division of the SLA, assisted by a com- mittee composed of Viola Bryner, Cleveland Garden Center, Helen Enlow, Ohio Agricultural Experimental Station, Louise Graves, Cleveland Public Library, and Gertrude Lorber, Pfizer Laboratory, Brooklyn, New York. The manual, of approximately 50 pages, assembles lists of abstract jour- nals, bibilographies, names of associations and of publishers, titles of manuals and handbooks, statistical publications, public health reports, drug information, names of government officials and agencies, biographical sources and addresses with dates and publishers where indicated. Lists of addresses and information about laboratories and biological stations, titles of doctoral dissertations, drug discoveries, and audiovisual aids are also included. The contents of the manual was compiled from replies to questionnaires sent out to 579 libraries of the SLA Biological Sciences Division. The Catholic Hospital Association of the U. S. and Canada has pub- lished Guides to Hospital Administrative Planning and Control Through Accounting. The manual examines ten types of administrative reports in detail, explains why they are important, how they are to be interpreted, and what uses the administrator can make of the information contained in them. Nonessential reports are reviewed in a final chapter. It uses non- technical terms which can assist the administrator to acquire an under- standing of and ability to use accounting information and statistical data in planning and control of hospital activities. Before publication the Guides were tested in a sample group of hospitals, which reported that they are of practical, not merely theoretical, value. The manual may be purchased from the Publication Department of the Catholic Hospital Association, 1438 South Grand Boulevard, St. Louis, Missouri, for $2.00 per copy. Basic Lists of Books and Journals for Veterans Administration Medical Libraries, August 1960 Revised (G-14, M-2, Part XIII) is now available. W. B. Saunders Company inaugurated with the May 1961 issue a new periodical entitled The Journal of Surgical Research to be published bi- monthly at $10.00 per year. Kybernetik, a new journal published by Springer, beginning in January 1961, bears the subtitle "A Journal Dealing with the Transmission and Processing of Information as Well as with Control Processes in Both Or- ganisms and Automata." The price is DM 12.80. Pergamon Press Publishing Company has announced plans to publish NEWS ITEMS 491 in 1961 cover-to-cover translations of a number of Russian journals. These will be published independently of the the Public Health Service, National Institutes of Health, Russian Scientific Translation Program, which has distributed to collaborating libraries translated Russian scientific journals for five years. Information about the subscription prices of the transla- tions to be published by Pergamon Press in 1961 may be obtained from the company. PERSONAL NOTES Lea M. Bohnert, formerly with RCA and Lecturer at The American University, Washington, D. C, is now Chief, Information Retrieval Sec- tion, Library Branch, Federal Aviation Agency. Dr. Estelle Brodman has accepted the position of Associate Professor of Medical History in the Department of Anatomy and Librarian of the Washington University Medical School to take effect at the beginning of the 1961 '62 academic year. Formerly Dr. Brodman was Assistant Librarian for Reference Services at the National Library of Medicine and recently has been Associate for Extramural Planning there. Thomas E. Keys, Librarian of the Mayo Clinic, has been elected a cor- responding member of the Section of Medical History of the Swedish Medical Association. Ellen Mayeux, formerly Reference Librarian at the National Library of Medicine, is now Librarian, Medical Library, Federal Aviation Agency. The National Library of Medicine has announced the names of the in- terns who have been selected for a one-year period of work and study beginning September 5, 1961. They are Karen S. Hampe, a graduate of the University of Wisconsin Library School, Elizabeth J. Sawyers, Uni- versity of California at Los Angeles, and David A. Smith, University of Illinois. Tordis Vatshaug, formerly on the staff of the Acquisitions Division, National Library of Medicine, is now Reference Librarian, Federal Avia- tion Agency. Winifred Sewell, 1960/61 President of Special Libraries Association and former Librarian, Squibb Institute for Medical Research, will join the staff of the Index Division of the National Library of Medicine as Subject Heading Specialist on May 1, 1961. In this capacity Miss Sewell will be responsible for the conversion of the present subject structure used in the Index Medicus and the NLM Catalog to the future system to be employed in the Library's projected Medical Literature Analysis and Retrieval Sys- tem (MEDLARS). Alberta L. Brown, formerly Head Librarian of Upjohn Company, has been named to the Special Libraries Association Hall of Fame, which was 492 NEWS ITEMS established in 1959 to grant recognition to those who have made outstand- ing contributions to the growth and development of the Special Libraries Association during their professional careers. Fred D. Bryant, Librarian of the J. Hillis Miller Health Center, Uni- versity of Florida, and Business Manager of the Bulletin, is also Execu- tive Secretary of the Florida Library Association. The Mayo Clinic Library, of which Thomas E. Keys is Librarian was host to the Minnesota Chapter of Special Libraries Association on May 20, 1961. Helen R. Bayne, formerly Librarian and recently Humanities Librarian at New York University Medical Center, retired on June 1, 1961. Miss Bayne was honored at a reception. After a vacation Miss Bayne will go to the New York Academy of Medicine to undertake a special cataloging project. Mildred Crowe Langner, Librarian of the Jackson Memorial Library, University of Miami School of Medicine, and retiring Editor of the Bulletin, has accepted the position of Chief of Reference Services at the National Library of Medicine. Mrs. Langner will go to her new position in September. Louise M. Darling, Librarian of the Biomedical Library, University of California at Los Angeles, was the recipient on June 7, 1961, of the Golden Bruin award of the UCLA Medical Center Auxiliary. The award was created to honor a professional woman in a field other than medical science for her contribution to the progress of the Medical Center. Medical Library Association scholarships for courses in medical library administration and bibliography, Summer 1961, were awarded to Carolyn Billitzer and Ruth Levine, Columbia University; Constance Porter, Catho- lic University; Mayo Drake, Emory University; Jack Dayton Key, Univer- sity of Illinois; and Arline Le Porte and Tibor V. Barteky, University of Southern California. On September 5 Jacqueline W. Felter, Librarian of the Medical Society of the County of Queens, and Associate Editor of the Bulletin, will be- come Director of the Union Catalog of Medical Periodicals of Greater New York. The Union Catalog is one facet of the newly developing Medi- cal Library Center of New York. Mr. Irwin Pizer will join the staff of the Washington University School of Medicine Library, St. Louis, on completion of his internship at the National Library of Medicine in Autumn 1961. Book Reviews and Journal Notes Otilia Good, Editor Books received January-March 1961. Suitable titles will be selected for review Abramson, Harold, ed. Resuscitation of the newborn infant; principles and practice. St. Louis, Mosby, 1960. 274 p. illus. $10.00. Bennett, Ivy. Delinquent and neurotic children; a comparative study. New York, Basic Books, 1960. xii, 532 p. $10.00. Blaine, Graham B., Jr. and McArthur, Charles C. Emotional problems of the student. N. V, Appleton, 1961. xxv, 254 p. .VI.95. Burton, Arthur, ed. Psychotherapy of the psychoses. N. Y. Basic Books, 1961. x, 386 p. $7.50. Dubos, Rene. Mirage of health; Utopias, progress, and biological change. Garden City, Doubleday, 1959. 235 p. 95^ (Anchor Books, paper, pocket ed.) Engel, Leonard. Medicine makers of Kalamazoo. N. Y., McGraw-Hill, 1961. viii, 261 p. S4.50. Eysenck, H. J. Handbook of abnormal psychology; an experimental ap- proach. New York, Basic Books, 1961. xvi, 816 p. $18.00. Falcao, Edgard de Cerqueira. Novas achegas ao estudo da determinacao da especificidade do "Schistosomum Mansoni." Sao Paulo, Empresa Grafica da "Revista dos Tribunals" 1957. 211 p. no price. Falcao, Edgard de Cerqueira. Pinrajd da Silva; o incontestdvel desco- bridor do "Schistosoma Mansoni." Sao Paulo, Empresa Grafica da "Revista dos Tribunals," 1959. 314 p. no price. Fitch, Grace E. Arithmetic review and drug therapy for practical nurses. N. Y, Macmillan, 1961. viii, 164 p. $3.50. Forster, Francis M., ed. Evaluation of drug therapy; proceedings of the symposium on evaluation of drug therapy in neurologic and sensory diseases held at the University of Wisconsin, May 1960. Madison, Uni- versity of Wisconsin Press, 1961. xxiv, 167 p. $4. Goldman, Robert P. Lose weight and live. Garden City, Doubleday, 1961. 235 p. $3.95. Goostray, Stella and Schwenck, J. Rae. A textbook of chemistry. 8th ed. N. Y., Macmillan, 1961. xiii, 502 p. $6.95. Gordon, Gavin C. Congenital deformities. Edinburgh, Livingstone, 1961. (Williams 8c Wilkins, Baltimore, exclusive U. S. agents) vii, 128 p. $8.50. 493 494 book reviews and journal notes Herms, William B. and James, Maurice T. Medical entomology. 5th ed. N. Y., Macmillan, 1961. xi, 616 p. $12.50. Jacobius, Arnold J. and others. Aerospace medicine and biology; an an- notated bibliography. Washington, Library of Congress, 1960. v, 542 p. $6. paper, (v. Ill, 1954 literature) Jores, Arthur and Frevberger, Helmuth. Advances in psychosomatic medicine; symposium of the Fourth European Conference on Psycho- somatic Research (1959 Hamburg), [vii] 334 p. $8.50. Kimber, Diana Clifford and others. Anatomy and physiology. 14th ed. by Lutie C. Leavell, and others, (with Teachers's Guide, paper). N. Y., Macmillan, 1961. x, 779 p. $6.95. Kroger, "William S. Childbirth with hypnosis, edited by Jules Sternberg. Garden City, Doubleday, 1961. 216 p. $3.95. Meyer-Schwickerath, Gerd. Light coagulation; translated by Stephen M. Drance. St. Louis, Mosby, 1960. 114 p. $9.50. PirajA da Silva, M. A. Estudos sobre o "Schistosomum Mansoni" (1908- 1916). Sao Paulo, Empresa Grafica da "Revista dos Tribunals," 1958. 123 p. no price. Polson, C. J. and Tattersall, R. N. Clinical toxicology. Phila., Lippin- cott, 1959. xi, 588 p. $10. Ritchie, Douglas. Stroke, a study of recovery. Garden City, Doubleday, 1960. 192 p. $3.50. Sass-KortsAk, Andrew, ed. Kernicterus; report based on a symposium held at the IX International Congress of Paediatrics, Montreal, July 1959. Toronto, University of Toronto Press, 1961. xi, 22 p. $8.50. Spotnitz, Hyman. The couch and the circle; a story of group psychother- apy. N. Y., Knopf, 1961. ix, 274 p. $4.50. Wyblrn, G. M. The nervous system; an outline of the structure and func- tion of the human nervous system and sense organs. N. Y., Academic Press, 1960. vii, 184 p. $5. Clinical obstetrics and gynecology, v. 3, no. 4, December 1960. Quarterly, $18 a year. N. Y., Hoeber. Journal of theoretical biology, v. 1, no. 1, January 1961. London and New York, Academic Press. $17 a year. The completely revised and enlarged edition of the MEDICAL LIBRARY ASSOCIATION HANDBOOK OF Medical library practice with a bibliography of the reference works and histories in medicine and the allied sciences edited by Janet Doe, Librarian, New York Academy of Medicine and Mary Louise Mar- shall, Librarian, Tulane University School of Medicine Completely revised in accordance with the many changes in the medical and library fields, this new Handbook is a guide to the collection, organiza- tion, and care of medical literature and to the chief reference works and histories in medicine and its allied fields. Emphasizing the differences between general and medical libraries it provides basic in- formation for the new medical librarian and new ideas and helps for the veteran. The annotated Bibliography of 1965 entries lists the chief reference works and histories in medicine and its allied fields. It will be of continuing value to all users of medical literature—librarians, physicians, scientists, and students. 630 pages, $10.00 2nd edition, 1956. Order from: American Library Association 50 E. Huron St. Chicago MEDICAL NURSING DENTAL BOOKS OF ALL PUBLISHERS • Full Publishers Discounts allowed to Libraries and Schools of Nursing WRITE NOW FOR A FREE BOOK ORDERING KIT CLEVELAND TEXTBOOK STORES, INC. "Service on an Individual Basis" 10638 EUCLID AVE CLEVELAND 6, OHIO PHONE—SW 5-2510 SWETS & ZEITLINGER Keizersgracht 471 & 487 Amsterdam-C. Holland New and Secondhand Bookdealers Current Subscriptions Periodicals: Complete sets, long or short runs, odd volumes and single issues Books: New and second-hand, out-of- prints Current Subscriptions: Publishers' prices, postpaid Prices: Our catalogue prices and invoices are in dollars Duplicates and Collections: Bought for cash or by exchange American Representative WALTER D. LANTZ 555 Woodside Ave., Berwyn, Pa. Suburban Philadelphia Phone: Niagara 4-4944 SCIENTIFIC AND TECHNICAL TRANSLATIONS BY PHYSICIANS. PHYSIOLOGISTS, CHEMISTS. ETC. THE LANGUAGE SERVICE SPECIALISTS IN ALL FIELDS OF MEDICINE PHARMACOLOGY CHEMISTRY — ALL LANGUAGES — ACCURATE AND CONFIDENTIAL TRANSLATIONS BY THE LANGUAGE SERVICE 141 E. 44TH ST.. N.Y. 17 MURRAY HILL 7-4183 WHAT ARE YOUR MEDICAL BOOK NEEDS? CHICAGO MEDICAL BOOK COMPANY, the pioneer medical book dealer in the country, offers unequaled service to medical libraries. A COMPLETE SE- LECTION OF ALL PUBLISHERS TITLES assures you of prompt delivery of your order. PUBLISHERS DISCOUNTS are given all medical libraries. In addition we pay all postage charges to libraries located in the United States. This is a sub- stantial savings to you. ONE ORDER will bring you all your medical, dental and nursing books in one shipment and on one invoice. This is a time saving item to the busy medical librarian. "WHAT'S NEW IN MEDICAL BOOKS" a complete listing of all new books and new editions in the medical and allied fields is available to you quarterly. Write today for your free copy, future copies will follow quarterly. CHICAGO MEDICAL BOOK COMPANY "Your First Thought in Medical Books" • Medical, Nursing and Dental Books of all Publishers. Since 1865 Jackson & Honore Streets, Chicago 12, Dlinois, SEeley 3-7744 Important new Springer Publications HANDBUCH DER NEUROCHIRURGIE Ed. by Dr. H. Olivecrona (Stockholm) and Dr. W. Toennis (Cologne) Vol. IV Part 1: KLINIK UND BEHANDLUNG DER RAUMBEENGENDEN INTRAKRANIELLEN PROZESSE XVI, 782 pages, 4to, 271 (partly colored) illustrations, 1961 cloth. Subscription price $77.25 List price $96.50 Subscription price is valid only with a standing order for all future volumes SIEBECK, ROBERT (Erlangen) OPTIK DES MENSCHLICHEN AUGES (THEORIE UND PRAXIS DER REFRAKTIONSBESTIMMUNG) $11.70 277 pages, 157 illustrations, cloth 1960 STECHERT-HAFNER, inc. FOUNDED IN NEW YORK 1872 The World's Leading International Booksellers 31 East 10th STREET, NEW YORK 3, N. Y. RITTENHOUSE BOOK STORE Rare Book Department Specializing in: Out of Print Medical Books Medical History Medical Biography // we do not have it, we will search for it 1706 RITTENHOUSE SQUARE PHILADELPHIA 3, PENNSYLVANIA Just off the press: H. Kuhlenbeck (ed.): MIND AND MAI- TER. An Appraisal of their Signifi- cance for Neurologic Theory. XII -f 548 p., 15 fig. (Suppl. ad Vol. 21 "Con- finia Neurologica") S15.00 A. X. Exton-Smith (ed.): SOME ASPECTS OF CLINICAL AND PATHOLOG- ICAL PROBLEMS IN OLD AGE. 68 p., 7 fig., 19 tab. (Suppl. ad Vol. 3 "Gerontologia Clinica") $2.80 M. Allgower (ed.): PROGRESS IN SUR- GERY. Vol. 1. Index: E. Ehrich: Inflam- mation. .4. Altemeier and J. H. Wulsin: Nat- ural Resistance to Infection. ' mk / ,m / wk THE WILLIAMS & WILKINS COMPANY itfk/ 'Hlk/ HHk/ UlL/ BALTIMORE 2, MARYLAND Upon receipt of my Golden Jubilee Edition of Stedman's Medical Dictionary . Medical Dic- I agree to send my ___edition of -------- tionary to Project Hope. I understand that this entitles me to a reduction of $2.00 from the list price. Name. Address. City____ _Zone___State ^m / mk / mk / mk / wk THE WILLIAMS & WILKINS COMPANY BALTIMORE 2, MARYLAND Please send me the new Golden Jubilee (20th) edition of Stedman's Medical Dictionary. □ I accept your Project Hope trade-in offer. Bill me for $12.95 D Bill me for full charge of $14.95. □ I enclose payment. Name. Address. City___ -Zone ___State 83 Summer book announcement. . . Burgin & Emmelhi: PHYSIOLOGY OF THE SALIVARY GLANDS 1961 • 256 pp., 69 figs. • $8.00 Charnley: CLOSED TREATMENT OF COMMON FRACTURES, 3rd ed. 1961 • 284 pp., 434 figs. • $10.00 Garland: SCIENTIFIC ASPECTS OF NEUROLOGY 1961 • 280 pp., 41 figs., 61 pis. (15 col.) • $9.75 Hughes: ELECTROENCEPHALOGRAPHY 1961 • 144 pp., 80 figs. • $7.00 Johnson & Kennedy: RADIOGRAPHIC ANATOMY OF THE HUMAN SKELETON 1961 • 288 pp., 302 figs. (4 col.) • $10.00 Krantz & Carr: PHARMACOLOGIC PRINCIPLES OF MEDICAL PRACTICE, 5th ed. 1961 • 1400 pp., 150 figs., 4 col. pis. • $15.00 McLarty: ILLUSTRATING MEDICINE AND SURGERY 1961 • 167 pp., 288 figs. • $8.50 Novak & Jones: NOVAK'S TEXTBOOK OF GYNECOLOGY, 6th ed. 1961 • 850 pp., many figs., 46 col. pis. • $15.00 Peller: CANCER IN CHILDHOOD AND YOUTH 1961 • 305 pp., 29 figs. • $8.75 Roper: OAKES' DICTIONARY FOR NURSES, llth ed. 1961 • 504 pp., 59 figs. • $2.75 Skinner: ORIGIN OF MEDICAL TERMS, 2nd ed. 1961 • 420 pp., 350 figs. • Price to be announced Woods: ENDOGENOUS INFLAMMATIONS OF THE UVEAL TRACT 1961 • 550 pp., 144 figs., 43 col. pis. • Price to be announced *^4kk / /4kk / /4*m / /». / /^ THE WILLIAMS & WILKINS COMPANY %u mm„z mm>s BALTIMORE 2, MARYLAND, U.S.A. �899 SPRING 1961 LIPPINCOTT MEDICAL BOOKS Ham's HISTOLOGY-v/?r 4th edition By ARTHUR W. HAM, M.B. and Thomas S. LEESON,M.D. Recent advances in tissue study made possible by the electron microscope are included in this. 4th edition of a celebrated,textbook, newly revised and brought up to date. 942 Pages. 589 Figures, 8 Color Plates. 4th Edition, 1961. $11.00 •: ■' Lever's HISTOPATHOLOGY OF THE SKIN —NEW 3rd EDITION By WALTER F. EEVER, M.D, Developments in this field imubg the 7 years since the "publication of its 2nd edition are reflected in the substantial revision of this outstanding text. Includes descriptions of 10 new dermatologic en- tities, 47 new ■photomicrographs. (i50 Pages. 320 Figures, including 8 Color Plates. 3rd Edition, 1901. $15.00. A MIRJffiR UP TO MEDICINE Edited m^A. C. CORCORAN, M_J)., CM. A fascinafflig collection of inediralH^Bmd^tion This anthology of ciminicnt by anu\p5ol^^P>tO[ is both entertaining and instructive. An ideal gi for anyone connected with medicine. 5y the American Canc^^Ba0iety,TEnc. and the National Cancer Institute (U. S.'Public Health Service) ?74d?ages. 217 Figures and 203 Tables. 19(il. Ten Mflbely $9.00. "W MA CLINIC^ 0RTH0PAEJCS #19—Soft- Tissu^fumor*^ *S ANTHONY F*JMtLMt, M.D., Editor-in- Chief i ^H^ The most rec^vt in this continuing series of bound symposiuni'*jB[nies produced under the guidance of the Association of Bone and Joint Surgeons. Authoritative in its presentation of new concepts, amply illustrated. Single copies: $7.50. By sus- taining subscription: $6.00 per volume. AN ATLAS OF OPHTHALMIC SURGERY By CONRgBteERENS, M.D. and JOHN HARRY hWMM.D. Text and facsagStt^rattons combine to give com- plete written and visual coverage of the most practical surgical technics for all phases of eye surgery. Anatomic considerations, precautionary measures and the management of operative and postoperative complications are all discussed. 603 Text Pages. 273 Illustrations. 1961. $28.00. ESSENTIALS OF NEUROLOGY By joii\ v. n:-iLToy,M.n. A fresh approach to (lie teaching. oWneurolo.; avoiding 1 he didactic, emphasizing flu*clinical. Sections cover investigative inethpd|t|iding diag- nosis, analysis, and expjanj#pn of Symptoms and signs, specific diseases'ana syndromes and thera- peutic measures. 422 Pages. 12 Figures. 1961. North American Market Only. $6.75. THE PRACTITIONER'S HANDBOOK Edited by W. A. R. THOMSON, M. D. Provides the physician with an authoritative, con- cise and practical review of those methods of diag- nosis and treatment which have proved Acceptable and reliable in the hard school of clinicarHftactice. 711 Pages. 21 Illustr.itinns. 1961. United States Market Only. $12.50. RaGNOSTIC CYTOLOGY: And Its Histopathologic Bases By LEOPOLD C. KOSS. R. DIRFEE, B.S. The firsjiuttxt to outline of cytologic diagnosis I in of histologic finding-;. Tl to interpret eeliulnr ! terns of disca-c ;> terns with de ever pos.-:Ue .:-■ Plate- I'.Md > I I. . M.D. GRACE explain the principles" on a thorough ^alysis I hors have endeavored >nns of pat- •pt cytologic •changes itions, 6 DISEASE AND INJURY Edited by LEOPOLD BR HIDY, M.D. With 25 Eminent (.oiitrti^K^-s ,:■ Valuable background anJH Hate medical data iieci—in ini'i>|. Z^f^ Hrcipitated or ag- -i,ivat( .1 a di.-i-:i-. -v?^H ^Hustration^.. 1961. >rj.50. ^mW MANUAL OF CLINICAL BACTERIOLOGY By ALEXANDER KIM I ER, Ph.D. "iris - -; i I Each pat hogei with t <■<• li11i< - where feasible, » . mv lerval charts. HI ml. pn- of text provide s|>a< <■ in Pages. 41 Illustration-. I l\ eovered-ma described, ' i don Miction and, Id time in- ith those ies. 201 14.75. CALCULATIONS IN PHARMACY By SUE&t ROUSE, M.S., „„,! M. ('.FORCE WEBBER, Ph.D. The essential material for the study df pharma- ceutical calculations presented simply and ex- plicitly for the student. 234 Pages. 19(ii. $5.00. ■ HAEMAT0L0GY By R. B. THOMPSON, M.D., F.R.C.P. A highly readable account of disorders of the blood and blood-forming organs! 306 pages 27 Illustrations, 6 Plates (4 in Color). lfiok- North American Market Only. $6.00. * J. B. LIPPINCOTT COMPANY East Washington Square, Philadelphia 5, Pennsylvania In Canada: 4865 Western Avenue, Montreal 6, P.TQ. i J! I ft ■■■■■ .^IIi'mII ZMM&bZyZy Hiliii! mm 1 ::::bb|||ii||| iisiiifilSiil r ■'■'■'• 'd!'i';;i'''diib,M;V!m (5 i