John Shaw Billings: creator of Index Medicus and medical visionary

John Shaw Billings (1838–1913) – sanitarian, statistician, war surgeon, student, narrator, medical historian, administrator, librarian, teacher and architect – established the groundwork for creating Index Medicus, the first attempt to identify and code the medical literature. But he was a remarkable man beyond his bibliographic achievements. I came across Billings quite by accident while searching for articles about written medical English. I found suggestions to authors of medical articles published by Daroff et al., the editors of Neurology. These suggestions referred to ‘Billings’ rules’, of which I had never heard. The reference was to an article in the BMJ of 1881 entitled ‘An address on our medical literature’. I was expecting to find that the article was the usual (and usually ignored) plea to medical writers to avoid long words and complicated constructions, to write more or less as most people speak and to broaden their reading beyond medicine. I found that Billings’ rules were sensible and admirably succinct: ‘have something to say; say it; stop as soon as you’ve said it’. There was a fourth rule, not quoted in Neurology: ‘give the paper a proper title’. But there was more to the article than that. Medical publishing is not what it was: Billings’ ‘address’ is over six pages long, nearly 7000 words. His advice to authors takes up little more than one paragraph. The rest is packed with medical wisdom. It is a reminder that, whatever details of physiological and medical knowledge have been unearthed since 1881, basic medical insights have not changed. The arrogance of hindsight can curl our lips at the past: occasionally reading the thoughts of our predecessors does us no harm. Billings’ thoughts are magnificent, prescient and beautifully written. He deserves to be better known.