Monday, June 29, 2015

Colonel John Shaw Billings: A Many-Sided Genius

By James M. Phalen, Colonel, U. S. Army, Retired


The Army Medical Bulletin, Number 60, January 1942: Beyond question, the name of John Shaw Billings belongs with the most outstanding among the many gifted men who have held membership in the Army Medical Corps. Though his works may not be familiar to the present generation, at the time of his retirement from the Government service he was undoubtedly the foremost medical man of this country if not of the world. Certainly no other American physician ever attained the international prominence that Billings held in his last years at the Army Medical Library.

He was born on March 12, 1838, on a farm in Cotton Township, Switzerland County, in southeastern Indiana. His father, James Billings, born at Saratoga, New York, was a descendant of William Billings, who emigrated from Taunton, England, to Lancaster, Massachusetts, about 1654. His mother, Abby Shaw, of Raynham, Massachusetts, was descended from John Howland, one of the Pilgrims of Plymouth. The family moved to Rhode Island in 1843, but five years later returned to Indiana, to Allensville, where the father became postmaster and operated a general store. At the age of fourteen, the son entered Miami University at Oxford, Ohio, where he graduated in 1857. Following some tutoring and lecturing at the university he entered the Medical College of Ohio, at Cincinnati, in the fall of 1858. When given his medical degree in 1860, he presented a thesis on The surgical treatment of epilepsy which was a creditable survey of the operations then employed and their indications. He settled in Cincinnati for the practice of surgery and was made demonstrator of anatomy at the medical school.

Talk of secession was stirring the southern states. South Carolina began the movement in December and hostilities began in April of the next year. In September 1861 Billings went to Washington for the examination for the regular corps. He was successful but no vacancy existed, so he was appointed a contract surgeon and assigned to duty in Union Hospital in Georgetown. A skillful operator at this time, he did much of the surgical work of the hospital. He developed a reputation for his surgical treatment of urethral strictures.

On April 16, 1862, he was appointed a first lieutenant, and on May 9 he was directed to take charge of the establishment and operation of Cliffburne Hospital, in an old cavalry barracks on the hills back of Georgetown. Union Hospital was abandoned and all equipment and patients moved to this new hospital. With the use of hospital tents, Billings soon had a hospital of one thousand beds.

In late August he received orders for transfer to a new general hospital in West Philadelphia, later known as Satterlee General Hospital. Before joining his new post he was married on September 3, 1862, in St. John’s Church in Georgetown, to Kate M. Stevens, daughter of the Hon. Hester L. Stevens, a former Congressman from Michigan. Billings served as executive officer at the West Philadelphia hospital until the end of March 1863, when he was ordered to the Army of the Potomac, at the time grouped around the village of Falmouth, Virginia, across the Rappahannock from Fredericksburg. Reporting to Medical Director Jonathan Letterman, he was assigned to the 11th Infantry in Sykes’ Division of Meade’s Corps. The Army, under General Hooker, was preparing for a turning movement by way of the upper fords of the Rappahannock and the Rapidan, with a holding attack upon Marye’s Heights back of Fredericksburg, to keep Lee’s army occupied at that point. This maneuver, which resulted in the battle of Chancellorsville, was begun on April 27. Meade’s Corps, crossing the rivers, took a leading part in the battle which filled the first three days of May.

Billings served with the division hospital, alternately occupied with operating upon the wounded and moving them and the hospital equipment to the rear. He speaks feelingly of the difficulties of operating a field hospital and transporting the wounded with a retreating army. The difficulties were the greater because of the alleged inadvisability of bringing the ambulance trains across the river fords. In contrast, the attack on Marye’s Heights was most efficiently served by the ambulance corps.

On May 16, Billings was transferred to the 7th Infantry in the same division. With it he accompanied the Army’s march northward, beginning on June 12, paralleling that of Lee’s army by way of the Shenandoah Valley. The Federal forces passed through Manassas, Centerville, Leesburg, Edward’s Ferry, and Frederick in Maryland. July 1 found Billings with the regiment at Hanover, Pennsylvania, and the whole Fifth Corps nearby. Word of the beginning battle of Gettysburg reached the corps that day with orders to march at once. On the morning of July 2 the Fifth Corps took over the left wing of the Union front around Round Top During the last two days of the battle, Billings operated the field hospital for his division close up behind Round Top at first, and later to the east of Rock Creek on the Baltimore Pike. Sykes’ Division sustained a loss of about thirty percent, causing days of work without end for the hospital.

Compelled to take sick leave, Billings rejoined the 7th Infantry in August, and went with the regiment to New York City for duty in connection with the draft vote. Assigned to temporary duty in McDougal Hospital at Fort Schuyler, he was later assigned to this hospital and shortly thereafter was transferred to command of DeCamp Hospital on David’s Island. Transferred from here to the Convalescent Hospital on Bedloe’s Island he was of a commission that sailed on February 5, 1864, to Haiti for the purpose of repatriating several hundred negroes who had been sent to form a colony on the Isle de Vache.

Returned to Alexandria, Virginia, on March 20, Billings asked for relief from hospital duty and assignment with the Army of the Potomac. Reporting to General Meade’s headquarters at Brandy Station, Virginia, he was assigned to duty as assistant to Medical Director Thomas A. McParlin. In this capacity he went through the Wilderness campaign and the subsequent operations up to the investment of Petersburg. On August 22, 1864, he was ordered to Washington, where was maintained a branch office of the medical director of the Army of the Potomac. He served in this office until December 27 when he was transferred to the Office of The Surgeon General. There he remained for over thirty years, until retirement in 1895.

Upon reporting, he was placed in charge “of the organization of the Veteran Reserve Corps of matters pertaining to contract physicians and to all property and disbursing accounts.”

For the next ten years his office hours were filled with the drudgery of requisitions, invoices and receipts, bills of lading, treasury allotments, and auditors’ decisions. After his office day he spent long hours over microscopy, comparative anatomy, the history of medicine, and the German language. In the field of microscopy he investigated the possible cryptogamic origin of certain cattle diseases and published his observations. In August 1868 The Surgeon General issued a circular calling for a detailed semiannual report upon the sanitary condition of his post from each station surgeon, including in the first report a description of the post itself with its buildings and surroundings. From these reports Billings compiled his Report on Barracks and Hospitals (1870) and later his Hygiene of the United States Army (1875). A tribute to his growing reputation was his assignment as a “consulting surgeon” to the Secretary of the Treasury, in 1869, to assist in the reorganization of the Marine Hospital Service. He served in this capacity until 1874. The Secretary gave great credit to Billings for the new organization based upon army standards and for its highly increased efficiency. By this time he was regarded the foremost authority on public hygiene in the country, with a further high reputation  in hospital construction.

Shortly after Billing’s detail in The Surgeon General’s Office he was given charge of the office library, with the property accountability involved. With the rapid growth of the library a clerical organization for its administration grew up in the main office in the Riggs Bank Building on Fifteenth Street and Pennsylvania Avenue, while the library collection was housed in assigned space in the Army Medical Museum, the new name given the old Ford’s Theatre on Tenth Street, under the direct charge of Doctor Thomas A. Wise.

It was not until December 1883, when Billings was appointed curator of the Army Medical Museum and librarian of The Surgeon General’s Office, that the office of the library was moved to the Tenth Street location. In the meantime, the first catalogue of the library to bear his name was issued in 1873, and in 1876 he published the Specimen Fasciculus of a Catalogue of the National Medical Library. The enthusiastic reception of this work by the medical profession of the country spurred the work on the Index Catalogue, the first volume of which appeared in 1880. In this work Billings had for his invaluable assistant Dr. Robert Fletcher, who was appointed to the library on September 1, 1876, and who continued on the editorial work of the Catalogue until shortly before his death in 1912. This is no place to speak of the monumental character of this great work, nor of its epochal influence. The first series of the Catalogue, completed in 1895, will remain a more lasting tribute to Billings’ name than any monument of stone that will be raised in his memory.

With the passing years he had been advanced to a captaincy in the Medical Corps on July 28, 1866, to major on December 2, 1876, and to Lieutenant Colonel on June 16, 1894. He had been given the brevet of lieutenant colonel on March 13, 1865, for his service in the Civil War. In these same passing years the library had grown from a few thousand volumes until it ranked with the largest in the world.

In June 1876, Billings accepted the position of medical advisor to the trustees of the Johns Hopkins Fund, the purpose of which was the erection in Baltimore of a hospital which was to be the nucleus for a medical school for the University. Skipping details, Billings drew the ground plans for the hospital, made a tour of the famous hospitals of Europe and drew up a detailed memorandum upon the proposed scope of the institution, with a discussion of its departments and services. His plans were adopted practically without change. On account of the decision to build only with the income of the fund the hospital was not completed until May 1889, at a cost of somewhat over a million and a half dollars. Billings’ official connection with this work ended in August 1889. In the meantime, he was carefully drawing plans for the proposed medical school. He was instrumental in securing for the first members of the new faculty, Dr. William H. Welch, of Norfolk, Connecticut, in 1884, and Dr. William Osler, Professor of Medicine at the University of Pennsylvania, in 1889. He had much to do with the selection of the remaining brilliant men who made up the first faculty of the Johns Hopkins Medical School. He himself lectured at the school for a number of years on the history of medicine. Billings’ connection with hospital construction began with various post hospitals of the Army, and included a cooperation in the planning for the Marine Hospital Service, for the National Soldiers’ Home, for the Memphis City Hospital, and for the Peter Bent Brigham Hospital in Boston.

Shortly after the completion of his work on the Johns Hopkins Hospital in 1889, Billings was approached with a proposal that he go to Philadelphia to become director of the hospital of the University of Pennsylvania and of a laboratory of hygiene to be constructed, and that he become professor of hygiene on the University faculty. He accepted the offer with the provision that he should remain with the Washington library until the first series of the Index Catalogue was completed. Under this arrangement, he began, early in 1890, the plans for the laboratory, and, with the 1891-92 session, began his lecture courses on hygiene and vital statistics. The laboratory was completed in February 1892.

With the first series of the Index Catalogue completed in June 1895, and with thirty-three years of service to his credit, Billings was ready to retire from the Army and carry out in full his contract with the University of Pennsylvania. His retirement effected, he moved to Philadelphia in October 1895, where, however, his incumbency of the new post was of short duration.

Prior to May 1895, there existed in New York City three large public libraries, the Astor, the Lenox, and the Tilden, each the gift of an estate to the city. At this time an agreement for consolidation was effected, the combined collections to be known as the New York Public Library. The trustees of the new foundation voted to invite Colonel Billings to accept the post of superintendent. With the consent of the university authorities he resigned his professorship to take effect on June 1, 1896, and accepted the New York position for the same date.

The plans for the library contemplated the erection of a new central building and the establishment of numerous branch lending libraries throughout the city. Colonel Billings moved to New York in September 1896, and began at once upon the plans of administration for the institution. It was not until the spring of 1897 that the site for the new building had been secured, and in the meantime Billings had made careful examinations of the plans of the leading libraries of the United States and Europe. In April 1897, he drafted a pencil sketch for the proposed building, forming the basis upon which the final plans were made and upon which the library was ultimately completed. In the meantime he was faced with the gigantic task of reclassification and recataloguing the consolidated collection of books and pamphlets. In this work he used the system of the Army Medical Library of an author catalogue for official use and an alphabetical index catalogue of both authors and subjects for public use.

In 1900 there was a further consolidation of numerous free city circulating libraries with the New York Public Library, and, in 1901, Billings conducted the negotiations with Andrew Carnegie by which the latter provided something over five million dollars to furnish sixty-five city branches of the main library.

It was not until May 1911 that the new building was opened to the public, and Colonel Billings did not long survive the completion of his cherished plans. The death of his wife on August 19, 1912, was a serious blow to him. During the last two decades of his life he was the subject of two serious surgical conditions, which brought him to the operating table a number of times. A cancer of the lip developed in 1890, which was controlled after two operations. In 1900 he was first operated upon for biliary calculus, and in 1906 the gall bladder was removed. His death on March 11, 1913, was due to pneumonia, following an operation for urinary calculus. After funeral services at St. John’s Church in Georgetown, on March 14, the remains were interred in Arlington Cemetery.

It is impossible in a few words to do justice to the qualities of Colonel Billings. He was a many-sided genius with outstanding qualifications in a number of fields. It will be wondered why this great man was apparently never considered for the post of Surgeon General of the Army. He was the recipient of great honors outside the service at the same time that men of much lesser gifts were made chiefs of the corps. Certainly it was from no lack of administrative ability. Undoubtedly the determining factor was that only shortly before his retirement did he attain a military grade which would warrant his consideration for the position of Surgeon General.

Physically he was a tall man of powerful build and commanding appearance in his prime, with a handsome head, a straight nose, and clear open blue eyes. In manner he was quiet, patient, and businesslike, with a cool detachment, and isolation of mind that gave the impression of a distant manner. When not so preoccupied he showed himself not devoid of humor and possessed of a vast amount of gentle sympathy. His detachment of mind gave him a rare ability to see things exactly as they were, in their proper proportion. Medical history will always give Colonel Billings a high place among the immortals who have practiced the profession.

From: history.amedd.army.mil



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