Public Health – Page 5 – The Indiana History Blog

From Drunkometer to Breathalyzer: How Indiana Scientists Crusaded Against Drunk Driving

Wired magazine aptly noted “Inebriation is apparently a subject of some interest in Indiana.” Indeed, one of the greatest deterrents against drunk driving has roots with Indiana University School of Medicine’s professor Dr. Rolla N. Harger. The professor taught biochemistry and toxicology from 1922-1960 and headed the school’s department of biochemistry and pharmacology from 1933-1956. Harger began developing the first successful breath-testing instrument in the 1930s, descriptively dubbing it the Drunkometer. Although a somewhat bulky device, it proved innovative in the rapid detection of alcohol consumption. After subjects breathed into a balloon, a chemical solution was applied to the air, darkening in color according to the amount of alcohol detected.

Wired elaborated that:

From there, the level of alcohol in the person’s bloodstream was estimated using a mathematical formula, which Harger also developed. As he pushed for his patent, Harger also pushed to outlaw drunk driving, which, in the wake of Prohibition’s end, was becoming more than a nuisance.

Harger’s Drunkometer was patented in 1936 and Indianapolis police successfully tested the device on New Years Eve of 1938. Harger’s crusade against inebriated drivers didn’t end there. He served as a member of a subcommittee of the National Safety Council that drafted an act to use chemical tests as evidence of impaired driving. The subcommittee also established limits for motorist alcohol consumption, which went into effect nationally.

drunk diagram — Diagram of the Drunkometer, image courtesy of Huffington Post.

Harger’s invention was foundational to the Breathalyzer, invented by Hoosier Robert F. Borkenstein. Born on August 31, 1912, Borkenstein grew up in Fort Wayne. He entered the work force as a photographic technician. During the early 1930s he developed a color printing process, which was received favorably by the commercial market.

In 1936, Borkenstein took a position with the Indiana State Police and became involved with the early research and development of lie detector technology. Eventually this work led to his being named captain and head of laboratory services. It was then that he noticed the importance of the Drunkometer technology, but also recognized the difficulty in operating it effectively in the field.

Borkenstein enrolled at IU and began his collaboration with Dr. Harger in advancing the Drunkometer. By 1954, Borkenstein independently invented a more practical, user-friendly means of detecting Blood Alcohol Content (BAC), now known as the Breathalyzer. His ingenuity served him well and when he had earned a Bachelor of Arts degree in 1958 from IU, Borkenstein was named a professor in the school’s Department of Forensic Studies that same year. When IU formed its department of Police Administration he was named its chairman.

The Breathalyzer revolutionized law enforcement’s efforts to measure alcohol in the blood when investigating an accident and suspecting drink as the culprit. By exhaling, breath alcohol vapors can be proportionally measured. The Breathalyzer instrument can calculate the proportion of alcohol in the blood.

When Borkenstein was elected to the National Safety Council’s Safety and Health Hall of Fame International in 1988, the Council noted that,

“This technological innovation enabled traffic enforcement authorities to determine and quantify blood alcohol concentrations with sufficient accuracy to meet the demands of legal evidence.”

hasdv — The instruments not only confirmed driver inebriation, but exonerated those falsely accused, Waterloo (Iowa) Daily Courier, November 17, 1954, courtesy of NewspaperArchive.com.

Borkenstein continued to invent devices that could combat drunk driving by determining BAC. According to an IU Archives blog post, in 1970 he “introduced a coin-operated Breathalyzer that could be installed in cocktail lounges. For 25 cents, a person could blow into a straw that popped out of the machine.” Depending on the BAC, the machine would provide users with the messages: “Be a safe driver,” “Be a good walker,” or “You’re a passenger.”

iwatch — The pioneering work of Harger and Borkenstein set the precedent for practical BAC detection, now in such convenient formats as Apple Watches. Image courtesy of Oddity Mall.

Borkenstein devoted his life’s work to prohibiting drunk driving, serving president of the Academy of Criminal Justice Services, as well as the International Committee on Alcohol, Drugs and Traffic Safety and consultant to the President’s Task Force on Highway Safety. He supervised a 1981 liquor sturdy which revealed that driving with less than two ounces of alcohol prove less dangerous than a driver who abstained. The study concluded that a little alcohol could possibly assist a driver by relaxing him behind the wheel.

Borkenstein retired from IU professorship in the late 1980s. According to the Chicago Tribune, he “helped launch a class on alcohol and highway safety that became a requirement for law-enforcement personnel and forensic specialists in many jurisdictions. The university calls it the Borkenstein Course.” Despite his 1981 study, Borkenstein advocated abstinence of any drink prior to driving, before he died in Bloomington on August 15, 2002.

Dr. Harvey “Old Borax” Wiley and His Poison Squad

hwwiley-02 — Harvey Washington Wiley, M.D. Image courtesy of U.S. Food and Drug Administration.

For many people, the first thing that comes to mind when thinking of the early Pure Food movement is Upton Sinclair’s 1906 book The Jungle. However, Hoosier Harvey Wiley’s work in the field was already at its apex when Sinclair’s exposé was released. When Dr. Wiley started his career in the mid- to late-19th century, the production of processed foods in the US was on the rise due to the increasing number of urban dwellers unable to produce their own fresh food. With little to no federal regulation in this manufacturing, food adulteration was rampant. Dr. Wiley made it his mission prove the importance of food regulation. With the help of a group of men known as the Poison Squad, he did just that.

Harvey Washington Wiley was born on a small farmstead near Kent, Indiana on October 18, 1844. He attended Hanover College from 1863-1867, with the exception of a few months in 1864 when he served in Company I of 137^th Indiana Volunteers during the Civil War. After graduating in 1867, Wiley moved to Indianapolis and began teaching at Butler University while earning his Ph.D. from the Medical College of Indiana. It was in 1874 that Dr. Wiley began his work as a chemist at Purdue University, where he developed an interest in adulterated food. Wiley argued that mass-produced food, as opposed to food produced locally in small quantities, contained harmful additives and preservatives and misled consumers about what they were actually eating. In the coming decades, Wiley would prove that this theory was correct and serve as one of the public faces of the pure food movement. As a 1917 advertisement in The (New York) Sun put it:

“Dr. Wiley it was who, at Washington, first roused the country to an appreciation of purity and wholesomeness in foods. He has been the one conspicuous figure in food betterment and food conservation in the present generation.”

In 1883, Wiley was appointed Chief Chemist of the Bureau of Chemistry, a division of the United States Department of Agriculture. While serving in this capacity, Wiley made the establishment of federal standards of food, beverages, and medication his priority. To this end, governmental testing of food, beverages, and ingredients began in 1902. The most famous of these tests were the “hygienic table trials,” better known by the name given to them by the media: “The Poison Squad.”

The Poison Squad — The “twelve young clerks, vigorous and voracious,” who made up the Poison Squad, sit six to a table. Image courtesy of U.S. Food and Drug Administration Flickr page.

During these trials, “twelve young clerks, vigorous and voracious” were fed and boarded in the basement of the Agricultural Department building in Washington D.C. Before each meal the men would strip and be weighed, any alteration in their condition being noted. At any one time, six of the group would be fed wholesome, unadulterated food. The other six were fed food laced with commonly used additives such as borax and formaldehyde. Every two weeks, the two groups would be switched. While the position of poison squad member may sound like it would be a hard one to fill, volunteers were lining up to participate in the tests, even writing letters such as the following to Dr. Wiley:

Image courtesy of U.S. Food and Drug Administration Flickr page.

The experiments commenced in November of 1902 and by Christmas, spirits among the Squad members were low. According to a Washington Post article from December 26,

“The borax diet is beginning to show its effect on Dr. Wiley’s government-fed boarders at the Bureau of Chemistry, and last night when the official weights were taken just before the Christmas dinner the six guests who are taking the chemical course showed a slight decrease in avoirdupois . . . To have lost flesh on Christmas Day, when probably everybody else in Washington gained more or less from feasting, was regarded by the boarders themselves as doubly significant.”

A look at the “unprinted and unofficial menu” from the Christmas meal, also printed in the Post, sheds some light on what may have given the boarders pause in their Christmas feasting.

Image courtesy of The Washington Post: Dec 26, 1902; ProQuest Historical Newspapers: The Washington Post pg. 2.

Much of the information reported by the press during this time came from the members of the squad themselves, until “Old Borax” as Wiley came to be known, issued a gag-order in order to preserve the sanctity of the scientific studies happening. Despite the order, public interest had been peaked and tongues and pens wagged around the country. As one Columbia University scholar put it, “Supreme County justices could be heard jesting about the Squad in public, and even minstrel shows got in on the act.” There were even poems and songs written about the trials.

If ever you should visit the Smithsonian Institute,
Look out that Professor Wiley doesn’t make you a recruit.
He’s got a lot of fellows there that tell him how they feel,
They take a batch of poison every time they eat a meal.
For breakfast they get cyanide of liver, coffin shaped,
For dinner, undertaker’s pie, all trimmed with crepe;
For supper, arsenic fritters, fried in appetizing shade,
And late at night they get a prussic acid lemonade.

They may get over it, but they’ll never look the same.
That kind of a bill of fare would drive most men insane.
Next week he’ll give them moth balls,
a LA Newburgh, or else plain.
They may get over it, but they’ll never look the same.

-Lew Dockstade, “They’ll Never Look the Same”

At the close of the Borax trials in 1903, Wiley began cultivating relationships with some journalists, perhaps in hopes of turning the reports from jovial, and sometimes untrue, conjectures to something more closely resembling the serious work being done.

Along with borax and formaldehyde, the effects of salicylic acid, saccharin, sodium benzoate and copper salts were all studied during the Hygienic Table Trials. The reports generated during the Hygienic Table Trials and the media coverage that followed set the stage for the passage of the Pure Food and Drug Act of 1906, the same year in which the trials were concluded. According to the FDA, the Pure Food and Drug Act of 1906, also known as The Wiley Act, serves the purpose of “preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious foods, drugs, medicines, and liquors, and for regulating traffic therein.”

By requiring companies to clearly indicate what their products contained and setting standards for the labeling and packaging of food and drugs, the Act helped consumers make informed decisions about products that could affect their health. While controversies over additives and government regulations continue to this day, Dr. Harvey Wiley and his Poison Squad played a major role in making the food on our tables safe to eat.

Check out our historical marker and corresponding review report to learn
more about Wiley. marker pic Learn about the history of public health in Indiana and Wiley’s contributions with our publication The Indiana Historian.

Memorial Day Spotlight: Eliza “Mother” George

This post was adapted from a February 2007 article in Fort Wayne Magazine “Along the Heritage Trail with Tom Castaldi.”

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Some of us recall Decoration Day, when we tended the graves of soldiers, sailors, and our families’ burial places. The holiday was established to honor the nation’s Civil War dead by decorating their graves. It was first widely observed on May 30, 1868, by proclamation of General John A. Logan of the Grand Army of the Republic. On May 5th of that year, Logan declared in General Order No. 11 that, among other directives, the 30th of May, 1868, was to be designated for the purpose of strewing with flowers the graves of comrades who died in defense of their country during the late rebellion.

Indiana’s Eliza Hamilton George was among those lost in the Civil War. Born in Bridgeport, Vermont, in 1808, she married W. L. George before coming to Fort Wayne, Indiana sometime prior to 1850. In that year, one of her daughters, also named Eliza, married another young newcomer to the city, Sion Bass, who had arrived from Kentucky in 1849. Sion Bass joined the army in 1861 at the outbreak of the Civil War and helped to organize the 30^th Regiment of Indiana Volunteers; he was chosen to be its first commander. At the battle of Shiloh in April 1862, Sion was killed leading a charge of his regiment against Confederate lines.

button — Official seal of the United States Sanitary Commission, image courtesy of Wikipedia.org.

The loss of Eliza’s son-in-law and the news of the terrible suffering of Union soldiers everywhere made a great impression on Mrs. George. Early in 1863, at 54 years of age, she applied for duty in the Sanitary Commission, the forerunner of the Army Nurse Corps. Her value as a nurse was quickly realized in the rapidly overflowing hospitals in Memphis, her first duty station. Here she soon was commended enthusiastically by those for whom she worked, from the beleaguered doctors in the field to Indiana’s Governor Oliver P. Morton. Her special care of the soldiers caught the imagination of the Indiana press as well.

An Indianapolis newspaper, for example, told of the occasion she sat for twenty hours with a young frightened soldier, holding ice against his bleeding wound. Whenever she tried to have some one relieve her, the boy so painfully begged her to stay that, “she forgot her own weariness and applied the ice again.” When shells were falling in and around the hospital tent, she picked up the wounded and, one by one, in the face of enemy fire carried them in her arms to safety.

Eliza described her account of stepping off the hospital train in Kingston, Georgia, writing:

We arrived to witness one of the saddest sights I ever witnessed. An ambulance train brought in 1200 wounded men. A large number were slightly wounded or at least in hands and feet, and some with two fingers carried away, some through the hand, etc. There were 75 with amputated legs and arms some wounded in the head, in feet, in every form and manner.

nurse pic — Nurse Annie Bell with patients in Tennessee after the Battle of Nashville, circa 1864. Mother George would have provided similar service to wounded soldiers. Image courtesy of U.S. Army Heritage & Education Center.

Eliza also lamented the plight of women on the Civil War home front, writing on December 8, 1864:

The wind is whistling round the house, the cannon booming in the distance and my heart is aching for the houseless, homeless, destitute women whose husbands are in the Union Army, fighting for their country’s life. Oh, my children, turn your thoughts away from every vain and superficial wish, that you may have at least a mite to give to the needy. Suffering is no name to apply to the many I see destitute of home and place to lay their head. You know how like a cool draught of water to a thirsty soul, is a letter to me from home; and you know I would write if I could but my time is not my own.

Near the end of the war, “Mother” George – as she had come to be called affectionately by the soldiers – was assigned to the army hospital in Wilmington, North Carolina. There, at the same time, came nearly eleven thousand newly freed Union prisoners of war. Mother George gave herself completely to relieve the suffering of these men, but in an outbreak of typhoid among the troops, the exhausted Mother George contracted the disease and died on May 9, 1865, scarcely a month after the end of the war.

Her body was brought back to Fort Wayne where she was buried with full military honors in Lindenwood Cemetery, the only woman to have been so honored there. Later that same year, the Indiana Sanitary Commission and the Fort Wayne Ladies Aid erected a monument in her memory in the cemetery. A weathered granite shaft with the simple inscription on its face that reads, “Mrs. George” still stands in a triangular space near her actual grave site across the way in the Col. Sion S. Bass family plot. Additionally, in 1965 the Fort Wayne Civil War Round Table placed a marker near the site of her first home in Fort Wayne.

monument mother markr

In 1971, Congress declared Memorial Day, commemorating all fallen men and women who served in the Armed Forces. This Memorial Day we will think of Mother George, who died unaware of her great fame or a legacy that placed her among the important women contributors of the Civil War.

Check out IHB’s markers commemorating Civil War hospitals and nurses. Learn how Indiana Civil War surgeon John Shaw Billings revolutionized medicine due, in part, to his field experience.

John Shaw Billings: “The Many Lives he Has Led”

See Part I for biographical information about John Shaw Billings, his experience as a Civil War surgeon, and his innovatory Surgeon-General library’s Index Catalogue.

clearing hospital — Ground being cleared for Johns Hopkins Hospital, 1877, photo courtesy of Flickr’s Johns Hopkins Medical Archive’s photostream.

John Shaw Billings’s hospital designs, which limited the spread of disease, and his education of the public about hygiene are more relevant than ever, considering the CDC’s recent struggle to combat the spread of Ebola and Enterovirus D68. Despite modern technology, educating the public about methods of contagion and effectively quarantining the ill remains an issue. We have, in large part, Billings (of Allensville, Indiana) to thank for many of the basic preventive measures in hospitals, particularly with the establishment of the Johns Hopkins Hospital.

The Civil War revolutionized the American medical system, as it required personnel to treat large numbers of severely wounded soldiers in rapid fashion. In addition to treatment problems, such as preventing infection, personnel struggled with administrative issues like locating and communicating with medical staff and procuring supplies. Adapting to these obstacles informed medical treatment in the post-war public health sphere, as Billings confirmed in an address:

The war of 1861-1865, and the great influx of immigrants . . . taught us how to build and manage hospitals, so as to greatly lessen the evils which has previously been connected with them, and it also made the great mass of the people familiar with the appearance of, and work in, hospitals, as they had never been before.

His own experience as a Civil War surgeon and his “novel approach” to hospital administration appealed to the trustees of the Johns Hopkins’ fund, tasked with establishing a hospital for the “indigent sick.” After inviting five medical professionals to submit plans for the hospital, they selected Billings’s design in 1876. In their article, A. McGehee Harvey and Susan L. Abrams noted that it “was Billings the man, rather than his proposal” that convinced the trustees to appoint him to the task, as he was extremely knowledgeable about medical education, hygiene, and the “philosophical underpinnings” of hospital construction.

Johns Hopkins Hospital, 1889, the year of its opening. Photo courtesy of Flickr’s Johns Hopkins Medical Archive’s photostream.

new — Johns Hopkins Hospital, 2013, courtesy of ABC News.

Billings’s essay to the trustees reflected his revolutionary ideas about medical treatment and education, asserting that a hospital should not only treat patients, but educate medical professionals. In that period, requirements to receive one’s medical degree were low and medical education often failed to adequately prepare students to practice medicine. Billings sought to change this by wedding the hospital to the university, providing students with hands-on experience. He also sought to raise standards of medical education, so that a diploma ensured the physician could “learn to think and investigate for himself.”

Under Billings’s design, the Johns Hopkins Hospital opened in 1889 and included a training school for nurses, a pathological laboratory for experimental research, and connected to a building with a teaching amphitheatre. In an address at the opening of the hospital, Billings stated that with the hospital he hoped to produce “investigators as well as practitioners” by having physicians “issue papers and reports giving accounts of advances in, and of new methods of acquiring knowledge, obtained in its wards and laboratories, and that thus all scientific men and all physicians shall share in the benefits of the work actually down within these walls.”

Johns Hopkins Hospital raised the standards of medical education, treatment and sanitation, and was modeled by other hospitals. By 1894, The (Washington D.C.) Evening Star dubbed Billings the “foremost authority in the country in municipal hygiene and medical literature.” In addition to revolutionizing hospital administration and design, Billings was an early advocate of what is referred to today as “bedside manner.” In his 1895 Suggestions to Hospitals and Asylum Visitors, he asked readers to consider

Is a spirit of kindness and gentleness apparent in the place? . . . Is the charitable work of the hospital performed in a charitable way? Do the physicians and nurses display that enthusiasm and esprit due corps which are essential to good hospital work?

NYPL old — New York Public Library Central Building. Image courtesy of “A Digitized History of the New York Public Library,” NYPL.org.

Billings’s accomplishments were not relegated to hospitals. In 1896 Billings served as the first director of the New York Public Library (serving until his death in 1913), expanding its collections “without parallel.” He publicly recognized NYPL female employees and at a Women’s University Club meeting lamented that “most of the library work is done by women, and done splendidly, and it is a shame that they are not better paid.” Industrialist and philanthropist Andrew Carnegie solicited Billings’s help with the establishment of a system of branch libraries in New York City and referred to Billings on various educational matters. Additionally, Billings convinced Carnegie to donate millions of dollars to public libraries throughout the United States.

Billings’s original sketch of the NYPL, 1897 (above). Preliminary plan of the NYPL (below). Image courtesy of “A Digitized History of the New York Public Library,” NYPL.org.

Billings also worked with the U.S. Census from 1880 to 1910 to develop vital statistics. He sought to record census data on cards using a hole punch system, which would allow the data to be counted mechanically. Herman Hollerith applied Billings’s concept, devising “‘electrical counting and integrating machines’” employed by the U.S. Census.

Billings passed away March 11, 1913 and was buried in the Arlington National Cemetery. At a meeting to honor Billings’s life at the Stuart Gallery of the New York Public Library, Andrew Carnegie contended of Billings “by his faithful administration of the great tasks committed to him he left the world better than he found it. I never knew a man of whom I could more safely say that.” The Evening Mail summarized the sentiments of many, including the author of this post, stating

“One gasps at the many lives he has led, the many appointments he has filled, and his gigantic work among libraries and hospitals.”

For more about Billings’s pioneering work, as well as his many other accomplishments, see the corresponding Historical Marker Review and the National Medical Library’s extensive John Shaw Billings Bibliography.

Interested in historic hospitals and medical advancements? Stay tuned for our forthcoming marker about Central State Hospital, an Indianapolis mental health facility that opened in 1848 and built a groundbreaking pathology lab in 1896.

John Shaw Billings: “I Could Lie Down and Sleep for Sixteen Hours without Stopping”

John Shaw Billings portrait, n.d. Photo courtesy of the National Library of Medicine.

We all know those people, who accomplish more in one hour than we do all week, who redefine “industrious” and excel at everything they try. Indiana native John Shaw Billings was the archetype, a visionary with seemingly infinite energy who revolutionized medical and bibliographical practices that endure into the 21st century. Billings stands among several Hoosiers who are profoundly influential, yet under recognized, including the inventor of the television Philo T. Farnsworth and creator of one of America’s first automobiles Elwood Haynes.

Billings was born April 12, 1838 in Allensville, Indiana; his family moved to the East Coast briefly in 1841 and returned in 1848. Ambitious from a young age, Billings made a deal with his father that, in exchange for forfeiting inherited property, his father would fund his college education. At the age of 14 and after intensive study, he passed the entrance exam for Miami University at Oxford, Ohio, where he incessantly studied philosophy and theology at the college library. After earning his B.A., he entered the Medical College of Ohio at Cincinnati in 1858, where he undertook his thesis “The Surgical Treatment of Epilepsy” that would later inform his monumental bibliographical endeavors.

John Shaw Billings : an autobiographical fragment 1905 (facsimile copy of the original manuscript), courtesy of Archive.org.

Shortly after graduation, Billings’s training coincided with the start of the American Civil War, providing him with opportunities to apply his medical knowledge. In 1861, Billings traveled to Washington, D.C. and became a contract-surgeon with the military. Soon thereafter he was appointed assistant surgeon in the U.S. Army, working at the Union Hospital in Georgetown. While there, his “extraordinary manual skill and boldness in dealing with difficult cases attracted the attention of the surgeon-general,” and he was put in charge of Cliffburne Hospital near Georgetown.

As a Civil War surgeon at several prominent battles–including the Battles of Chancellorsville, Gettysburg, Cold Harbor, and Petersburg–Billings was tasked with establishing field hospitals, operating and treating wounded soldiers for hours while under fire, and transporting waves of injured soldiers from battle sites with limited equipment. Billings lamented the trials of his work, writing to his wife about the Battle of Gettysburg:

“I am utterly exhausted, mentally and physically. I have been operating night and day, and am still hard at work. I have been left in charge of 700 wounded, and have got my hands full. Our division lost terribly, over 30 per cent were killed and wounded. I had my left ear just touched with a ball . . . I am covered with blood, and am tired out almost completely, and can only say that I could lie down and sleep for sixteen hours without stopping. I have been operating all day long, and have got the chief part of the work done in a satisfactory manner.”

After the battle, Billings understandably left field work for a brief period due to “nervous tension and physical exhaustion.” In August 1864, Billings helped edit field reports that became the monumental The Medical and Surgical History of the War and eventually transferred to the Surgeon-General’s Office, where he remained until retirement in 1895.

billings in army — Albumen silver print, ca.1862, courtesy of Smithsonian Libraries blog.

As the war concluded, hospitals submitted surplus operating funds to the Surgeon-General’s Office; these funds were given to Billings to build up the Surgeon-General’s library, which later became the National Library of Medicine. Billings expanded the collection by writing to editors, librarians, physicians, and State Department officials requesting book donations, eventually increasing its holdings from 600 entries in 1865 to 50,000 by 1873. The scope of the collection soon required a guide to help researchers locate desired publications. Billings understood firsthand the difficulty of locating such sources, as his thesis research required intensive time, labor, and travel to libraries in Cincinnati and Philadelphia.

With the assistance of Dr. Robert Fletcher, Billings devised a catalogue for the Surgeon-General library’s holdings, publishing the first volume of the Surgeon General’s Medical Index Catalogue in 1880. He hoped it “would spare medical teachers and writers the drudgery of consulting ten thousand or more different indexes or of turning over the leaves of as many volumes to find the dozen or so references of which they might be in search.” As new medical materials were published, Billings struggled to keep the Catalogue current, so he devised the Index Medicus, a monthly supplement that focused on new and select publications. The Index Medicus was the forerunner to the medical databases MEDLINE and PubMed.

Prior to Billings’s systematic efforts to compile and organize medical literature, researchers and physicians had few methods to effectively locate sources, including medical studies and reports on operations. The Index Catalogue and Medicus served as a nearly comprehensive clearinghouse of medical literature, both current and historical, whose contents could aid in medical education and diagnoses. Dr. Stephen J. Greenberg and Patricia E. Gallagher summarize the magnitude of Billings’s efforts in “The Great Contribution,” contending that “with only ink and index cards, they [Billings and Fletcher] tamed an enormous and complex technical literature in virtually every written language on the planet” and that the indices “paved the way for the great databases that now are the primary underpinnings for the medical research of the future.”

Billings’s efforts at the Surgeon-General’s library served as the beginning of his library work, which would one day lead him to industrialist and philanthropist Andrew Carnegie. For more information on Billings’s Civil War activities and establishment of the Surgeon-General’s library and corresponding Index Catalogue, see the Historical Marker Review.

Check back for Part II: “A New Era of Hospital Construction” about Billings’s involvement in the establishment of Johns Hopkins Hospital and how it revolutionized medical treatment and education.

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