John Shaw Billings: Science and Medicine in the Gilded Age (review)

John Shaw Billings is best known as a great American librarian—founder of the Army Medical Library, which evolved into the National Library of Medicine—and as a key builder of the New York Public Library. That he had a very wide range of other activities, both during and after his thirty-year career in the Surgeon-General's office, such as playing a key role as a designer of Johns Hopkins and other hospitals, has also been recognized in the standard works on Billings. These are Fielding H. Garrison's John Shaw Billings: A Memoir (1915) and Carleton B. Chapman's Order out of Chaos: John Shaw Billings and America's Coming of Age (1994).¹ On the surface, neither book seems to shortchange its subject. If anything, the Billings biographies are excessively hagiographic.

For James H. Cassedy, who had a long and productive career at the National Library of Medicine, the primary weakness of the biographical material on Billings is its failure to portray the astonishing breadth of Billings's activities and to ground that breadth in Billings's passion to expand scientifically based knowledge throughout public and private institutions. Cassedy's short monograph, John Shaw Billings: Science and Medicine in the Gilded Age, is not so much a new biography as it is a supplement to the existing ones. Drawing on the Billings Papers in the New York Public Library and the remarkable amount of institutional history that has been written about U.S. government agencies after the Civil War, Cassedy provides a linked series of essays aimed at showing Billings as "a participant in and major exponent of the period's substantially growing federal presence, specifically the expansion of federal authority in health policy, medical institution-forming, and scientific ventures" (p. 7).

So we learn more than we have previously known about Billings's early interest in hygiene in the U.S. Army, the models of the hospitals he designed, his interest in ventilation and other sanitary issues, his service on the aborted National Board of Health, his passion for statistics and major contributions to the modernization of the U.S. census, and his service to a wide range of medical and scientific organizations. Billings was so incredibly hardworking, so dedicated, so versatile, such a straight-shooting public servant (at least ostensibly) that the mere recounting of his activities is exhausting to a merely human reader—and, not surprisingly, leans toward becoming a dry compendium of detail. Billings was indeed a great builder, a nineteenth-century public entrepreneur, one of the small band of public servants who laid the foundation for the rise of American eminence in medicine, science, and higher education.

Cassedy is conscious of but does not dwell upon some of the less attractive of Billings's traits—his ambition, his neglect of his family, his penchant for political manipulation (Billings made many enemies, and never became Surgeon-General), his tendency to spread himself too thinly and burn out. Perhaps this is fair enough. Cassedy clearly subscribes to the view of Billings as one of the best in an age when all the best men in American science and medicine lived in five cities on the eastern seaboard, all knew one another, and never doubted that collectively they were giving enlightened leadership to the American people. Perhaps now that we see how much Billings achieved, we can reconsider how to set his work more fully in the context of his life and times. A major new Billings biography might be the next step.