One rarely finds a love letter written to an index. There is one index that merits such adulation, and, therefore, I am writing to express my admiration for Index Medicus (IM). Many libraries no longer subscribe to the print version because of the availability of MEDLINE, its online counterpart. There is no question that online searching is a boon to busy physicians, students, and librarians, and, yet, the printed volumes were so important for more than a century that I am compelled to offer my praises.
My reason for acknowledging Index Medicus stems from thirty-five years of use. In the early 1960s, the print volumes were constant companions. Neither users nor librarians could have functioned without this medical resource. Along with the Index-Catalogue of the Library of the Surgeon-General's Office, it opened medical resources of all centuries to readers. Index Medicus was begun in 1879. The prospectus in volume one stated that it would be a “complete and accurate index of current medical literature,” [1] and, indeed, it included books, pamphlets, and periodicals. The first year, 1879, included some 20,000 articles from some 570 journals [2]. Today, it indexes only journal articles and covers more than 3,300 titles, adding more citations each month than the total for the first year.
The Index Medicus was the creation of John Shaw Billings, M.D., director of the Library of the Surgeon-General's Office from 1865 to 1895. What he and his associate, Robert Fletcher, M.D., accomplished was nothing short of amazing. Their efforts produced the Index-Catalogue and the Index Medicus, an achievement that Dr. William H. Welch of Johns Hopkins called America's “greatest contribution to medicine” [3].
On the hundredth anniversary of the founding of Index Medicus, Frank B. Rogers, M.D., former director of the National Library of Medicine, stated:
I do not foresee the demise of a printed version of the Index Medicus store; I do, however, believe that inevitably we must see radical changes in the periodicity of publication, and at the same time marked changes in the shape and configuration and relationships of the Index Medicus family membership—the Index Medicus siblings and all the Index Medicus children, and the cousins, too. It is bound to happen that some of them are going to have their lease on printed life rescinded and will remain only as ghosts within the machine [4].
He made this statement in 1979, and we have indeed seen many changes in the years after that celebration. The index grew as medical publishing grew; the online world advanced at a pace hardly thought possible at that time. Also, the children and the cousins have long been titles of the past.
Learning through the Index Medicus
Using the print IM formed the basis of the librarian's medical education. This was where we learned the structure and organization of medicine. Not being physicians, we relied on the subject headings, the subheadings, and the cross references for guidance. The Medical Subject Headings (MeSH) book was our primer, and it changed and developed as has medicine.
Using the print volumes was a logical way to develop techniques that would stand us in good stead for future online searching. The subheadings served as qualifiers, and the tree structures led to additional headings or more pertinent ones. Today, computers make the links, but a basic understanding of how the literature is organized is the best foundation for searching.
Reading the entries under a subject is a vital learning experience. The serendipitous opportunity never ceases to amaze. Just as picking up a journal often reveals an article we would not otherwise have found, so in the print index, our eyes go to the unexpected. When searching manually was the only option, we learned to trust our eyes, and many a marvelous piece was found by accident.
Index Medicus has been a standard for evaluation of journals. The National Library of Medicine follows specified criteria for selecting journals for indexing, and librarians consider this selection a litmus test for selection of titles for their libraries. Using the index and finding the articles helps train both librarians and users to recognize quality in the journal literature.
The day may come when there will not be enough subscribers to justify the print version of Index Medicus. From my perspective, that would be a sad day. The volumes in existence, however, will continue to stand as a valuable resource. Opening any volume provides the list of authors who recorded the medical knowledge of their time. The names are a roster of those whose research and insights helped advance medical science. A search through a subject offers a capsule of the information produced in that year.
We look forward to the yet unknown developments of the digital environment. There will surely be many new technologies to advance our ways of acquiring knowledge. These wonders will not diminish the value of the print Index Medicus. Billings's ideas and creations have served medicine well and will always stand as his monument. The knowledge contained in his works is a lasting tribute to this extraordinary man.
References
- Prospectus. Index Medicus. 1879 Jan 31; 1(0):2. [Google Scholar]
- Rogers FB. “Index Medicus” in the twentieth century. In: Blake JB, ed. Centenary of Index Medicus, 1879–1979. Bethesda, MD: National Library of Medicine, 1980: 53. [Google Scholar]
- Welch WH. Johns Hopkins Historical Club: special meeting May 26, 1913, in memory of Dr. John Shaw Billings. Johns Hopkins Hosp Bull. 1914 Aug; 25(0):252. [Google Scholar]
- Rogers FB. “Index Medicus” in the twentieth century. In: Blake JB, ed. Centenary of Index Medicus, 1879–1979. Bethesda, MD: National Library of Medicine, 1980: 59. [Google Scholar]