Guardians of Medical Knowledge: The Genesis of the Medical Library Association (review)

Jennifer Connor. Guardians of Medical Knowledge: The Genesis of the Medical Library Association. Edited by Beryl Glitz. Lanham, Md.: Medical Library Association; London: Scarecrow Press, 2000. xi + 190 pp. Ill. $65.00 (0-8108-3470-7).

The development of this book was stimulated by the centennial of the Medical Library Association in 1998. Rather than providing a chronological description of the full history of that association, however, it focuses on the early years and on forces that contributed to three divergent developments: medical librarianship, clinical records administration, and the academic discipline of the history of medicine. Also of interest in this early period were events and personalities that contributed to a distinct separation between medical and other types of libraries.

The generally agreed-upon origin of the MLA was an 1898 meeting called by George M. Gould, ophthalmologist and editor of the Philadelphia Medical Journal. The group that attended included four physicians and four librarians representing major medical libraries of the day, and they came to hear Gould's ideas for enhancing library collections by sharing duplicate materials, the service that came to be called the Exchange. Gould became the first president of the MLA; he was followed by surgeon William Osler, who steered the organization to a considerable degree toward humanism and the study of the history of medicine. This focus, along with the formation of local medical historical clubs, was certainly a factor in the development of the history of medicine as an academic discipline and the establishment of the American Association for the History of Medicine in the 1920s. A third active member of the early MLA was Grace Meyers, who managed both the library and the records department of the Massachusetts General Hospital for thirty years. In 1912 she set up regular meetings of record clerks, and these sessions led to the creation of a national organization, the Association of Record Librarians of North America, in 1924.

There was some tension in the early Medical Library Association between the physicians, predominantly men, and the librarians, predominantly women. Throughout the first half of the twentieth century, most of the presidents of the organization were physicians, and even as the presidency began to be held by librarians a position of medical honorary vice president was established that would last into the mid-1960s. This factor, combined with the multiple interests represented in the organization, meant that meetings of the group did not always deal with the practice of medical librarianship in any depth. In fact, early on, a group of librarians who felt that the meetings did not give sufficient time to the consideration of library methods and library use set up a parallel set of meetings to address these topics. It was not until the second half of the twentieth century that the Medical Library Association evolved into a closer match with the subject of its name.

The period that preceded the founding of the MLA was a time of significant growth in the science of medicine and an increasing interest in the use of libraries to organize and maintain medical information. Surgeon John Shaw Billings masterminded two major medical institutions in the United States: the Surgeon General's Office library in Washington, which would ultimately lead to the National Library of Medicine, and the Johns Hopkins Hospital and Medical School in Baltimore. By creating systems for the cataloging and indexing of the medical literature, Billings brought to the medical library field a systematization and an accessibility that would serve as a model within librarianship. He went on to involvement in a larger library arena, including heading the New York Public Library, serving as president of the American Library Association, and playing an instrumental role in a large gift to that organization from Andrew Carnegie. Yet for a variety of reasons, Billings played no role in the emerging Medical Library Association--thus...