How do I search Medline before 1946?

I was recently asked this question by a student who was rather surprised by my answer. I took the student up to the Library’s Wellcome Gallery where we looked at print copies of Index Medicus, going back to volume one, printed in 1879.

Index Medicus was published every month, with details of books and journal articles published on a range of medical topics. They were arranged by topic, so to search for anything published on Malaria in 1879 you had to look up 12 monthly issues and copy the details by hand. Thankfully for the 19^th century academics, there weren’t as many papers published then as there are now.

This got me thinking about how computers have completely changed the way we find information. The collecting and compiling of data for Index Medicus was done by hand by the US National Library of Medicine (NLM) until the mid-1960s. In 1963 they purchased a Minneapolis-Honeywell 800 computer to help automate the process and in 1964 MEDLARS (Medical Literature Analysis and Retrieval System) was born. This greatly speeded up the production of bibliographies and indexes and provided the “first large-scale, computer-based retrospective search service”[i]

However, it wasn’t until 1971 and the advent of MEDLINE (MEDLARS Online) that users could run their own bespoke searches. Librarians and information specialists were trained in how to use the search commands required, with the data first available on subscription via tapes, then available on dial-up. When I was a library student in the mid-1990s, this was how I learnt to do literature searching. The academic would tell the Librarian which topic they needed to run a search for. The Librarian would then plan the search strategy before dialing through to the database and entering the commands. Speed and accuracy was of the essence as the library was charged per second of connection and phoning New York was expensive!

Some of you may remember searching databases on CD-ROMs. The desktop version of MEDLINE, Grateful Med was introduced in 1986, with the advantage that databases could be installed on individual computers and searched directly by the user. As an undergraduate, I can remember searching Grateful Med on one of the four designated CD-ROM computers in St Andrews University Library. When I first started working in medical libraries in the mid-1990s, this was still the way that many databases were delivered, but via networked CD-ROMs which were posted to the library each month and uploaded by library staff.

It wasn’t until 1997 that PubMed was introduced, for the first time, providing free access to the index of medical information to anyone with an internet connection. Was it really only 17 years ago?