Charles Rosenberg

Professor of the History of Science and Ernest E. Monrad Professor in the Social Sciences, Harvard University

Founded in 1751 and opened a year later, Pennsylvania Hospital had two purposes: to take care of sick patients and to provide a place for teaching students. The rich gave money, while the poor paid with their bodies for the care they received. Often that care came at a great price, since before the advent of antiseptic and anesthesia, only one in ten patients survived following surgery.

According to Charles Rosenberg, one of the world's leading medical historians, the library historically has been a central feature of hospital institutions, which themselves are an 18th century urban phenomenon.

Why are books so important in medicine? As early as Hippocrates, we see medical practitioners intimately engaging with texts. As late as the 18th century, however, primary doctors were not physicians, but rather family members, midwives, and dabblers. It wasn't until the 1760s that medicine became a more scholarly profession. Books were instrumental in this development. Until then, there were no libraries to go to. Creating one was a mark of learning.

Medical texts offered the intellectual means for physicians to develop a body of knowledge and establish a set of boundaries, a disciplinary jargon and criteria for identifying pathology, that would not only establish a standard way of doing things but also invest the doctor with authority. As the practice of medicine evolved into a profession, part of being a doctor was to be a gentleman. Very old books today are in such good condition because only rich men could afford to collect them.

According to Rosenberg, the key to medical history is the tradition of texts which influence how doctors view patients, the way they are taught, and the models they have in mind. Books facilitate the bringing together of knowledge, the making sense of the seemingly random. This body of knowledge allows for building an understanding of the body. Thus, doctors are simultaneously people of the book and the hospital.

The history of medicine can be traced by looking at accession of books to hospital libraries from 1790-1857. Over time, the way knowlege was managed changed. Literary materials provided evidence of changing interests in subject matters, and enabled American doctors to stay abreast of developments in the rest of the world. However, between 1857-1895, books became more marginal to medicine. Rather, bedside training was emphasized. Today, with the overabundance of multi-media, the book has become less important in the communication of medical practices. The historic collection at the Pennsylvania Hospital is a survival, an accidental one, and as such has become a shrine to different intellectual and medical world.