The Index Medicus

The recent closure of the College of Physicians and Surgeons of BC Library brought back all sorts of library-related memories. My mind went to 1949 when I was a penniless second-year premed student at McGill University. To earn a few extra dollars, I worked at the McGill Medical Library on Thursday afternoons. My task was to push carts heavily loaded with bound volumes of medical journals to their appropriate shelves. Today we click on our computers to perform extensive background research for scientific projects or to resolve clinical dilemmas. In my time as the library–cart pusher, searching for information required a different set of skills. 

The Index Medicus was the heart of McGill Library. The first edition of the Index Medicus was published in 1879. The title was Current Medical Literature of the World. The function of the Index Medicus was to provide access to quality medical literature of the time to people around the world. A committee of world experts identified the best medical journals and had citations created from those journals. The publishers created an indexing language, and the indexers were paid to go through all the articles, identifying key concepts by “terms.”[1] The users would then find the relevant terms to guide them to the citation. To perform a literature search, one would take a volume of Index Medicus off the shelf, look up the key terms, find the relevant article, and write down the details of the reference, then repeat this search in the other volumes of the Index. Finally, they would go to a library’s stacks to get the bound journals from the shelves, hoping they had been put back in the right place. In later years when limited photocopying became available, the user had to then wait in line for their turn at the machine. The process could take hours or days.[2]

The Index Medicus was the idea of John Shaw Billings, head of the Library of the Surgeon General’s Office, United States Army. The Index was published in paper form monthly from 1879 to 2004, suspending publication in occasional years for various reasons. After 1960, the indexing work went digital with databases like MEDLINE (evolving from MEDLARS).

We can proudly remember that, beginning with the 1993 issue, Canadian Family Physician became one of only 10 family practice–related journals worldwide to be listed in the Index Medicus.[3]

In 2021, A History of Medical Libraries and Medical Librarianship from John Shaw Billings to the Digital Era was published by the husband-wife writing team of Michael R. and Jennie Jacobs Kronenfeld.[4] They traced the history of medical librarianship and the development of medical libraries across seven eras. The book starts with the development of the Index Medicus in the late1800s, moves to an era they call “the era of Gentleman Physicians” from 1800 to 1945, when physicians led the development of medical libraries with “lay librarians” taking a lesser role. The professionalization of medical librarianship after 1945 was the next development, followed by the rise of the Internet (1975–1995) and its impact. Finally, the move from print to digital resources takes us to today. The last chapter is concerned with the future of the profession and the role of the medical librarian: this may be a shift from librarian as provider of information to that of research collaborator. The authors emphasize that reviewing the history of medical libraries and librarianship is important so we know where we came from and where we are, because if we don’t know where we are, we might go wrong.[4] Having touched some volumes of the Index Medicus, I almost feel like part of library history. 
—George Szasz, CM, MD

1.    Wikipedia. Index Medicus. Accessed 5 April 2024.
2.    Hardman T. Do you remember Index Medicus? Ramblings of an old fool. Accessed 5 April 2024.
3.    Dixon T. Index Medicus and Canadian Family Physician. Can Fam Physician 1993;39:10-13. 
4.    Kronenfeld MR, Kronenfeld JJ. A history of medical libraries and medical librarianship: From John Shaw Billings to the digital era. Lanham, MD: Rowman & Littlefield; 2011.

This post has not been peer reviewed by the BCMJ Editorial Board.

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