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SECTION II.
CHAPTER XXIII.
MUSEUM AND LIBRARY DIVISION.
Long before the World War the Museum and Library Division, located in the Museum and Library Building, constituted part of the Surgeon General`s Office. (See Chart XXII.)
ARMY MEDICAL MUSEUM.
The Army Medical Museum was established in 1862. 1 The history of this institution up to our entry into the war (1862-1917) has been carefully prepared. 2 When the European war began it was recognized that there would bean unequaled opportunity for collecting pathological material for the Army Medical Department, and upon our own entry into the war the Museum immediately began to take on new life. Shortly after our declaration of war the Surgeon General issued a circular ordering that pathological material from the war, illustrating the effects of the disease and wounds upon human tissue, be collected and sent to the Army Medical Museum. 3 It was early recognized that a special unit should be organized and sent to France to collect pathological specimens, to supply the graphics of the movement of hospitals and other medical units, and to complete the histories of the medical and surgical cases by supplying moving pictures, still photographs, wax models, and colored sketches of these cases. In July, 1918, a request for such a unit came from the commander in chief, American Expeditionary Forces. 4 Therefore, Museum Unit No. 1 was organized and sent overseas. 5 Members of this unit visited practically every American hospital on the western front, obtained characteristic pictures of the work in each hospital, hundreds of pictures of actual operations in the field. Its photographic section brought back with it over 10,000 still negatives and twice as many prints, with many thousands of feet of moving pictures, illustrating every phase of activity at the front; in addition, the unit collected a large number of weapons and missiles. Between April 7, 1917, and April 7, 1918, over 13,000 pathological specimens, with over 21,000 protocols of autopsies, had been accessioned in the pathological department. Could this material be properly exhibited, it would require a building twice as large as the present Museum, while the entire Museum has been doubled by these accessions, numbering now over 100,000 pathological specimens. 6 Many thousands of gross specimens and histological slides were received from the camps and hos-pitals at home and abroad, covering all the important diseases and injuries observed during the war. As it came in, this material was promptly stored in proper receptacles until the close of the war, when the work of making preparations began. The largest number of specimens illustrated diseases of the respiratory tract, in particular influenza-pneumonia (several hundred specimens), tuberculosis, and the effects of war wounds (mainly amputated extremities), and of gassing.
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Chart XXII.-Army Medical Museum and Library, June, 1918.
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During the early period of the war it was discovered that very few of our medical officers from civil life had been shown how to make autopsies; consequently instruction in this matter had to be given. This was accomplished by circulars, bulletins, orders, and a follow-up system of correspondence. The members of Museum personnel in the department of pathology were trained in the methods of gross and microscopic pathology through an arrangement made by the Surgeon General with the Superintendent of the Government Hospital for the Insane (St. Elizabeths), Washington, D. C., whereby the autopsy service and pathological laboratory of that institution were largely placed under control of the Museum pathologists.6 Several of the personnel were constantly on duty at the laboratory; autopsies in number were performed weekly, this training being set off by lecture courses. By these means it was possible for the Museum officers to accession promptly all material received, to trace lost specimens, and to check histories and protocols. After the signing of the armistice the pathological material began to come in in large quantities and the routine work of cataloguing went on a pace in spite of diminished personnel. The specimens were dissected and displayed so as to show not only the wound or pathological lesion, but also to suggest the best line of treatment. Before being permanently mounted and indexed, every gross specimen was photographed, and photo micro-graphs were made of unusual slides of pathological material. Thus every effort was made to render this large mass of pathological material available for study by the students of pathology and to save for future use the experiences of this war. In order to make room for the ultimate exhibition of this large amount of material, it was necessary to rearrange the cases and specimens of the Army Medical Museum with a view to economy of space. This was ultimately accomplished by segregating the library personnel and material mainly on the west side of the building, while the Museum controlled the rooms and corridors of the east side.
Autopsies were conducted regularly by one of the Museum pathologists at Walter Reed General Hospital, and at the Government Hospital for the Insane (St. Elizabeths), which were attended by the Museum personnel and the classes of the Army Medical School, and courses of 10 practical lectures, each on pathology, were delivered to the monthly classes of military surgeons at Cornell University Medical College, New York City. A valuable study was made of the military aspects of status lymphaticus. Dissections of complex pathological specimens were made for the Museum; at St. Elizabeths Hospital and at Camp Wheeler there were prepared, by means of a special incision following the bronchial tree from behind, remarkably complete specimens of influenza-pneumonia, with corresponding sets of historical slides of all the affected organs, and a valuable series of histological preparations from fatal cases of salvarsan poisoning. As a result of the teaching conducted in the department of pathology, the Museum adopted the plan of presenting the whole pathological picture of a disease rather than portions of the main lesion. Thus the pneumonia specimens included not only those from both lungs but also lesions in the pharvnx, larynx, trachea, bronchi, stomach, lower ileum, spleen, bone marrow, liver, and kidney.
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In addition to the department of pathology and accessions, the Museum included a department of still photography, moving pictures, anatomical and wax models, veterinary medicine, anatomical art, and entomology.
The photographic department had long existed in the Museum prior to the recent war. Following the Civil War period this department made valuable contributions to photography and microphotography, many of which are found reproduced in the different volumes of the Medical and Surgical History of the War of the Rebellion. After our entry into the European war, this department was greatly enlarged, and through the photographic section of the Museum Unit No. 1, operating in France, collected many thousands of negatives and prints for historical purposes. This department also made enlargements, lantern slides, photos tat prints, photomicrographs, and radiographs, and was charged with filing and indexing the many photographs taken by Medical Department and Signal Corps artists and forwarded to the Museum. Many thousands of X-ray negatives were received from the military hospitals in this country and France, a collection destined to be of greatest importance to radiologists. Aside from X-ray negatives, there were between 50,000 and 70,000 negatives of photographs of medical activities during the war period.
Some months after the declaration of war, a moving-picture department was established in the Museum as part of the unit known as the "instruction laboratory," a field organization attached to the Museum and under the direction of an officer of the Sanitary Corps, who in August, 1918, was designated official photographer for the MedicalDepartment.7 During the period of the activity of this department no less than 137 different subjects were filmed. It was soon found that these films could be made very useful for instruction purposes in camps, hospitals, and schools, and for the propaganda against venereal disease. After the armistice this work of public instruction ceased and was taken over by the Public Health Service. 8 Meanwhile the films manufactured by the instruction laboratory during the war period were kept in circulation and were lent for educational purposes to civilian institutions as well as to branches of the military and public-health service. These films were loaned without charge for two weeks to medical societies, colleges, and preparatory schools.
Finding that lantern slides were inadequate for lecturing on military orthopedic surgery to large audiences at Fort Myer, an officer of the Division of Orthopedic Surgery hit upon the plan of using moving pictures for this purpose. Some 35,000 feet of film were thus produced at the Army Medical Museum, covering 10 lectures on (1) the anatomy and physiology of the foot and leg, (2) footgear and foot inspection, (3) foot strain and flat-foot, (4) foot disabilities and their treatment (including trench foot), (5) splints for transport, (6) tendon and muscle transplantation, (7) bone grafting, (8) application of the temporary pylon for the amputated, (9) the paraffin-plaster socket for the application of artificial legs of the effect of posture on the thoracic and abdominal organs, and (10) osteoclasis and osteotomy.
Two high-class wax modelers were brought into the Museum service, one of them being detailed abroad, where valuable work was done in making models of conditions arising through gassing, war wounds from high explosives or other missiles, dermatological lesions, venereal specimens, X-ray burns, and miscellaneous pathological specimens.
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The first anatomical artist reported for duty on December 12, 1917, and immediately began to make 12 charts, representing orthopedic surgery and a number of pen-and-ink drawings for The Military Surgeon. Owing to the large demand for such material, several artists were soon added and the work of the department soon increased far beyond the capacity of the personnel. Hundreds of charts and lantern slides were made for the Orthopedic Division of the Surgeon General`s Office, for the Commission on Training Camp Activities (Army and Navy), and for the Army Medical Museum proper. Special instruction was given to some of the men in dissecting, hospital experience, didactic anatomy, first aid, and special pathological delineation. By July, 1918, the personnel of this section included 30 men, some of whom were attached to the general hospitals, where they made valuable drawings and paintings for surgical operations performed. Later, members of the art unit made 150 water-color drawings of the pathological effects of gassing and oil paintings of the different general officers of the Medical Department. Toward the end of the war members of this personnel made valuable pictures of specimens of influenza-pneumonia and of the pathological effects of gassing. Several hundred colored and uncolored protocols were forwarded from the Western Front.
The identification of mosquitoes, flies, and other insects infesting the Army posts and camps was made a definite part of the regular program of war work of the Army Medical Museum in October, 1917. 9 Up to November, 1918, identifications of disease-bearing mosquitoes had been made in all the camps and stations except eight.9 With the reorganization which followed the armistice, the Museum activities were merged with those of the Division of Infectious Diseases and Laboratories.(See Chart No. XXIV.)
LIBRARY OF THE SURGEON GENERAL`S OFFICE.
In the Manual for the Medical Department 10 it is stated that "the educational duties of the Medical Department are of a twofold nature--to the public, and to the military services, Regular, Volunteer, and militia. The connection with public education is maintained through the library of the Surgeon General`s Office and the Army Medical Museum."
The scope and facilities of the library are described as follows:
This has been characterized as "the great, central, medical library of reference of-the Nation"(6 Comp. Dec. 740). Under the provisions of the act of March 3, 1901 (31 Stats. 1039), facilities for study and research therein are afforded to scientific investigators, students, and graduates of institutions of learning in the several States and Territories as well as in the District of Columbia; and its material, under suitable rules and regulations, is available for loan to such persons, and to schools, societies, and public libraries in every State of the Union. It consists DOW of over half a million books and pamphlets, all of which are catalogued and arranged for ready use. Every year a volume of the Index Catalogue is prepared, which, as it deals with both subjects and authors, is itself a comprehensive book of reference. The Index Medicus, published monthly by the Carnegie Institute, is based on the new additions to the library and gives a monthly bibliography of medicine and the allied sciences.
Books that can be readily replaced will be loaned to medical officers of the Army, who will beheld responsible for the safe return of the volumes within two weeks from the day of their receipt. In special cases this time may be extended.
During the war period the librarian, who had been assigned to this detail early in 1913, was on continuous duty, and with the cooperation of the library force was able to carry out the intention of these paragraphs without difficulty.
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The position is an important one and at the same time a pleasant one, since it brings the library in (loser touch with the medical profession, particularly with members thereof who are engaged in research work and investigation. There is perhaps no closer lien between the Medical Department of the Army and the medical profession of the United States than the library of the Surgeon General`s Off ice.
During the fiscal year 1917-18, 547 books and 5,890 pamphlets were added to the library collection, and during the year 1918-19, 2,656 books and 8,923 pamphlets, so that at the end of the fiscal year 1918-19 the library contained 198,900 bound volumes, 35,092 unbound volumes, and 361,455 pamphlets; in all a total of 595,447 volumes and pamphlets with 5,631 portraits of physicians,136 medical engravings and prints, and 316 medical caricatures.12 The number of current medical periodicals received in the library at this date was 1,568, of which 1,480 were kept on the open shelves in the reading room.
The outstanding feature of the library is its unrivaled collection of medical periodicals and serials, including public documents of board of health and other national and official bodies. The war had a remarkable effect upon publications of this kind. Under the stress of war-time conditions, the medical periodicals of Great Britain, France, Russia, and the Scandinavian and Balkan countries became sadly diminished in quality and in some cases difficult to obtain. The medical literature of Belgium was practically extinguished. The medical periodicals of the Central Powers, on the other hand, were kept up without intermission, and with no apparent falling off in quantity or quality. While these continued to flow into the library with regular sequence during the first part of the war period, a falling off began to be noticeable toward the end of 1915, and early in 1916 the German medical periodicals ceased to reach us in any regular manner. It became the duty of the library, therefore, to make such arrangements as it could to keep up the files of these periodicals, since the indexing and classifying of the periodical literature of medicine had been the main functions of this library after the inception of its Index Catalogue. Through the Secretary of State arrangement was made by which a large number of German medical periodicals were purchased and sent to the library through the State Department. 13 Through the courtesy of the librarian of the Boston Medical Library and the editor of the Journal of the American Medical Association such German periodicals as were not contained in these invoices were sent to the librarian in packages, and the contents were indexed and classified by the library force, after which periodicals were returned to the lenders. Yet, in spite of all these experiences, many important periodicals were missing and many individual numbers were lacking from the files for 1915-1918. When the librarian went overseas in the fall of 1918, therefore, he made every effort to secure the missing files through booksellers in Paris and London, and eventually, through the courtesy of Messrs. Kegan Paul, Trench, Trubner & Co. (London), he was able to effect an arrangement for the purchase of German medical periodicals via Switzerland, these periodicals being transmitted directly to tile Surgeon General`s library by the London importers. In this way the files of most of the missing German periodicals and serials for 1915-1919 were obtained. Through the Index Medicus this literature was published in classified form, a large part of it being contained in the War Supplement of this journal (1914-1918), published in 1918.
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During the war period the library was freely consulted by the many officers on duty in the Surgeon General`s Office, and every effort was made to assist them in special work through the use of the subject bibliographies in the library, the loan of books, pamphlets, and journals, and the personal help from the library force.
Through a special order of The Adjutant General 14 the librarian was detailed as the executive officer of the board "to collect and prepare material for the Medical and Surgical History of the American participation in the European war." In connection with this work a glass case exhibit of historical items, illustrating the progress of military medicine, through the ages, was made at the instance of the librarian, and placed in library hall. This exhibit included, among other things, groups of books published in aid of the medical conduct of various wars by medical officers of the Army and civilian physicians, photographs of distinguished medical officers of different armies, and various photographs and objects illustrating the history of military medicine.
The extent to which the war-time service of the Surgeon General`s library has been appreciated by the medical profession is evidenced by the fact that in the spring of 1917 the appropriation made by Congress for the purchase of books by the library was doubled for the ensuing fiscal year, thus placing the library in position to meet the obligation in regard to the huge amount of foreign medical literature accumulated in Europe during the war period.
PERSONNEL. a
(April, 1917, to December, 1919.)
MUSEUM.
Craig, C. F., Col., M. C., chief.
Owen, W. O., Col., M. C., chief.
Taylor, R. T., Lieut. Col., M. C.
Allen, H. R., Maj., M. C.
Cattell, Henry W., Maj., M. C.
Coupal, J. F., Maj., M. C.
Evans, Thomas L. W., Maj., S. C.
Herrick, C. Judson, Maj., S. C.
Kinyoun, J. J., Maj., M. C.
Oliver, Jean, Maj., M. C.
Ross, Robert, Maj., S. C.
Shufeldt, Robert W., Maj., M. C.
Haas, S. L., Capt., M. C.
Schwartz, W. T., Capt., S. C.
Silvester, C. F., Capt., Infantry.
Wallis, James F., Capt., M. C.
Wilson, J. F., Capt., M. C.
a In this list have been included the names of those who at one time or another were assigned to the division during the period, April 6,1917, to December 31, 1919.
There are two primary groups-the heads of the division and the assistants. Ii each group names have been arranged alphabetically, by grades, irrespective of chronological sequence of service.
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Bower, Morris L., First Lieut., S. C.
Ellis, Edward B., First Lieut., S. C.
Finney, W. P., First Lieut., M. C.
Hawkes, E. W., First Lieut., S. C.
Lewis, Nolan D. C., First Lieut., M. C.
Muller, H. R., First Lieut., M. C.
Wallach, Charles W., First Lieut., S. C.
Berg, Franz F., Second Lieut., S. C.
Garrity, R. F., Second Lieut., S. C.
Godwin, Francis W., Second Lieut., S. C.
Hirliman, Charles, Second Lieut., S. C.
Hollis, Raymond A., Second Lieut., S. C.
Hoskins, E. R., Second Lieut., S. C.
Matteson, Bartow V., Second Lieut., M. T. C.
Terry, Paul H., Second Lieut., S. C.
Ewing, James, Contract Surg.
Glushak, L., Contract Surg.
LIBRARY.
Noble, Robert E., Maj. Gen., M. D., (librarian) chief.
Winter, F. A., Brig. Gen., M. D., (librarian) chief.
McCulloch, Champe C., jr., Col., M. C., (librarian) chief.
Straub, Paul F., Col., M. C., (librarian) chief.
Garrison, Fielding H., Lieut. Col., M. C.
REFERENCES.
(1) Circular No. 2, S. G. O., May 21, 1862.
(2) Lamb, D. S.: The Army Medical Museum-A History. Washington Medical Annals, January, 1916, xv, 1.
(3) Letter from Surgeon General to officer in charge Army Medical Museum. April 3. 1918. Subject: Neuropathological Material. On file, Record Room. S. G. O., 702.1.
(4) Courier cablegram No. 7, July 20, 1918, from the commander in chief, A. E. F., to The Adjutant General of the Army, par. 2. On file, Record Room, S. G. O., Cablegram File.
(5) Letter from Surgeon General, August 5, 1918, to commanding officer, Museum Unit No. 1. Army Medical Museum, Washington, D. C.; memo., Surgeon General from curator of Army Medical Museum, August 6, 1918; S. O., 186, W. D., August 9, 1918, par. 461; letter to Surgeon General from commanding officer, Museum Unit No. 1. August 10, 1918. On file, Record Room, S. G. O., 322.3 (Museum Unit No. 1) (V).
(6) Weekly reports from Maj. C. Judson Herrick, S. C.. August 8 and 22, 1918. On file, Weekly Report File, Record Room, S. G. 0.
(7) Office order No. 79, S. G. O., August 14, 1918. On file. Record Room, S. G. O., 201 (Evans, Thomas L. W.).
(8) Bull. No. 43, W. D., Chap. XV, secs. 2-7, p. 56, July 22. 1918.
(9) Report on mosquito identification in connection with the work of the Sanitary Division for the year November 1, 1917, to November 1, 1918, by Dr. C. S. Ludlow, entomologist. On file, Historical Division, S. G. O.; Report of the Surgeon General. United States Army, 1918, 277; 1919, Vol. II, 1066.
(10) Manual for the Medical Department (1916), Article II, par. 131, p. 56.
(11) Ibid., pars. 132 and 133, p. 56.
(12) Annual Report of the Surgeon General, United States Army, 1918, 432, and 1919, Vol. 11, 1257.
(13) Correspondence, librarian, Surgeon General`s Library, with State Department. through the Secretary of War. On file, Chief Clerk`s Office, Army Medical Museum and Library, 294.
(14) S. O., No. 198, A. G. O., August 23, 1917. On file, Record Room, S. G. 0.
