Financing North American medical libraries in the nineteenth century.

Culture not only justifies the existence of libraries but also determines the level of funding libraries receive for development. Cultural appreciation of the importance of libraries encourages their funding; lack of such appreciation discourages it. Medical library development is driven by culture in general and the culture of physicians in particular. Nineteenth-century North American medical library funding reflected the impact of physician culture in three phases: (1) Before the dawn of anesthesia (1840s) and antisepsis (1860s), when the wisdom of elders contained in books was venerated, libraries were well supported. (2) In the last third of the nineteenth century, as modern medicine grew and as physicians emphasized the practical and the present, rather than books, support for medical libraries declined. (3) By the 1890s, this attitude had changed because physicians had come to realize that, without both old and new medical literature readily available, they could not keep up with rapidly changing current clinical practice or research. Thus, "The Medical Library Movement" heralded the turn of the century.