Book Review

Order out of Chaos: John Shaw Billings and America's coming of age

N Engl J Med 1995; 332:277-278January 26, 1995

Article

Order out of Chaos: John Shaw Billings and America's coming of age
By Carleton B. Chapman. Canton, Mass., Watson, 1994. $28.95. ISBN: 0-88135-187-3

The 19th-century American physician John Shaw Billings (1838-1913) had a remarkable and wide-ranging career. It included work in medical bibliography, hospital administration, medical education, and public health. His accomplishments in these areas demonstrate that he was a key figure in U.S. medicine. For example, he planned and supervised the expansion of the library of the Surgeon General's Office into the country's largest medical library, a collection that evolved into the National Library of Medicine. Billings also developed systems to locate medical literature, such as the Index-Catalogue of the Library of the Surgeon General's Office and the Index Medicus. Yet the man and his work are not well known. As one medical historian has said, Billings is a “forgotten hero of American medicine.” Carleton Chapman's primary objective in this book is to rescue Billings from obscurity.

Chapman traces Billings's personal and professional life, but he focuses on the latter. In 1860 Billings received his medical degree from the Medical College of Ohio in Cincinnati. In 1861 he began a 35-year military career. Initially he worked as a surgeon and hospital administrator for the Union Army. In 1864 he moved to the Surgeon General's Office, where he remained until his retirement in 1896. In this post, he not only made his monumental contributions to medical librarianship but also engaged in other important endeavors. He supervised the compilation of vital statistics for the 1880 and 1890 censuses. He acted as a consultant in hospital construction and drafted the designs for Johns Hopkins and Peter Bent Brigham hospitals. In addition, he had a key role in the development of the curriculum at the Johns Hopkins School of Medicine. After his retirement from the Surgeon General's Office, Billings became the first president of the New York Public Library.

Order out of Chaos is the first book-length biography of Billings that has appeared in 70 years. Not long after his death, two biographies were published. Both were written by men who had worked closely with him. Since its publication in 1915, Fielding Garrison's John Shaw Billings: A Memoir (New York: G.P. Putnam) has been the standard source of information. The book is thorough but not very analytical. Its usefulness is also limited by a lack of footnotes. Harry Miller Lydenberg's John Shaw Billings, Creator of the National Medical Library and Its Catalogue, First Director of the New York Public Library (Chicago: American Library Association) appeared in 1924. It was based in large part on Garrison's work and emphasized Billings's contributions to librarianship. Several articles have been published about Billings, but most have focused on a single aspect of his varied career.

Given the limitations of previous works, a new biography of Billings is certainly needed, and Chapman surely deserves credit for taking on the task. Unfortunately, his effort has not been entirely successful. It is clear that he has done a great deal of research, but an awkward prose style and the inclusion of a dizzying mass of seemingly unrelated details hamper his narrative. Given Billings's many achievements, it is easy to understand why the author admires his subject. Chapman, however, provides unbridled hero worship that obscures rather than enlightens. After reading Order out of Chaos, I was left thinking that I had learned a great deal about Billings's career, but not much about the man.

Vanessa Worthington Gamble, M.D., Ph.D.
University of Wisconsin Medical School, Madison, WI 53706