The Books That (Maybe) Hold Up the Building

Our friend, Tyler Cymet, DO, FACP, FACOFP, FFSMB, former MedChi President and current Chair of Medicine and Primary Care and Professor of Medicine at the Illinois College of Osteopathic Medicine at The Chicago School, has written a fascinating article about our stacks

The Books That (Maybe) Hold Up the Building

There is a piece of Baltimore medical lore so exquisitely calibrated to its audience that it feels almost unfair. It involves William Osler. It involves a stately early 20th‑century building. And it suggests—calmly, almost offhandedly—that the books inside may help hold the building up.

The setting is MedChi, the Maryland State Medical Society, whose Cathedral Street headquarters opened in 1909 under Osler’s influence. He left just before it opened, but he was integral to the planning and design.

The story, often told in low, reverent tones, is that the book stacks were designed not merely to store knowledge, but to function as part of the building’s structure itself.

Not symbolically. Literally.

It is exactly the sort of thing physicians want to believe: that our professional ancestors took knowledge so seriously they made it load‑bearing.

And the remarkable thing is that, while the story cannot be proven in its most dramatic form, it sits squarely on top of a very real and very clever architectural truth.

Osler, the bibliophile who built institutions

To understand why this story feels so right, it helps to remember that Osler was not just a clinician and educator. He was, in the most literal sense, a builder of libraries.

Throughout his career, he treated libraries not as background infrastructure but as essential instruments of medicine. He actively expanded collections in Philadelphia, contributed volumes wherever he went, and took a direct role in shaping institutional libraries at Johns Hopkins and within the Maryland medical community. 

He went further than advocacy. He helped found professional organizations devoted to medical libraries, including what became the Medical Library Association, embedding the idea that a modern medical profession required a modern library system.  (No disrespect to Marcia Noyes Crocket, his partner who was also critical to the formation of libraries).

And, in a final flourish that feels almost architectural in spirit, he left behind a personal collection so significant that it became the Osler Library at McGill—still one of the world’s great centers for the history of medicine. 

For Osler, books were not décor. They were infrastructure. They were how medicine thought.

So when he helped shape a building for MedChi, it is not a stretch to imagine that the library was not merely included, but prioritized, organized, and perhaps even physically emphasized in ways that went beyond the ordinary.

When buildings were designed for the weight of knowledge

At precisely the moment MedChi was constructed, architects faced a practical problem that feels almost philosophical: books weigh a lot.

Not metaphorically. Physically. They are heavy.

In response, a generation of engineers and architects developed what might be one of the most quietly radical building systems ever devised: self-supporting metal book stacks. These were multi-level steel frameworks so regular and so strong that they could carry not only the books, but also:

• the floors between tiers,
• the loads of the spaces above,
• and sometimes even portions of the building’s overall weight.

In some cases, the logic of the building was inverted. Instead of floors supporting shelves, the shelves supported the floors, with loads traveling through the stack system down to the foundation. 

This was not obscure experimentation. It appeared in some of the most important libraries of the era, including the Library of Congress, Harvard’s Widener system, and the great stack cores of New York’s research libraries. 

The effect, if you paused to consider it, was extraordinary. These were buildings in which structure and knowledge storage were one and the same.

You were not walking through rooms filled with books.

You were walking through the building’s skeleton—and it just happened to be filled with books.

Chicago, Baltimore, and the library as machine

This architectural moment was not confined to a single city. It spread across the United States just as libraries were expanding rapidly under philanthropic and civic investment.

Chicago is a particularly resonant example. In the late 19th century, the city became a laboratory for new forms of construction—steel framing, elevators, and the early skyscraper. The Newberry Library, completed in 1893, sits squarely in that environment: a monumental research institution designed during the same era that produced structural innovations across the city. 

While the Newberry’s current stacks are housed in a separate modern facility, it emerged from a moment when libraries were being reconceived as systems of storage, access, and structural logic, not merely reading rooms.

Behind many of these projects was a quiet industrial force: companies like Snead & Co., which manufactured modular iron stack systems deployed in libraries across the country and around the world. Their designs emphasized fireproofing, density, and the ability to expand vertically—traits that made them not just furniture, but proto-structural frameworks embedded in buildings from Washington to university campuses and beyond. 

Baltimore, rebuilding and expanding rapidly after the 1904 fire, was part of this same architectural ecosystem. The MedChi building belongs to this moment—a time when civic ambition, medical professionalism, and industrial materials converged in buildings that were, at their core, machines for organizing knowledge.

So, what is probably true about MedChi?

Here is the responsible version—the one that preserves the interesting part without overpromising.

There is no widely cited, definitive structural documentation demonstrating that the MedChi stacks alone carry the building in the dramatic way the story suggests.

But given the timing, the typology, and Osler’s influence, it is highly plausible that:

• the building incorporated an advanced, integrated stack system,
• the stacks may have carried significant localized loads,
• and the architecture was intentionally organized around the needs of the library itself.

Which means the popular phrasing—“the books hold up the building”—is likely an embellishment.

But it is an embellishment resting on a very solid foundation.

Which, again, feels appropriate.

If Osler were building MedChi today

This is where the story becomes unintentionally funny.

If we were to reconstruct Osler’s instincts in 2026, we would not get a cathedral of iron stacks. We would get something sleeker, more open, and far less romantic. 

The physical library would shrink. The collaborative space would expand. The phrase “knowledge ecosystem” would appear somewhere in the planning documents.

And structurally? The building would not rely on books.

It would rely on things like:

• server rooms,
• redundant power supplies,
• cooling systems designed with the intensity of an ICU,
• and a Wi‑Fi network whose failure would trigger more panic than a missing monograph ever did.

If the 1909 building flirted with the idea that knowledge could be physically load-bearing, the modern building quietly assumes that knowledge is weightless—but critically dependent on electricity. Plugs, the outlets of electricity, are an accreditation requirement. 

One can imagine Osler touring such a space, peering at a server rack, and being told, “This is where the knowledge lives now.”

He would likely be polite.

He might not be convinced.

The enduring appeal of a structurally meaningful idea

The MedChi story persists because it says something physicians still want to believe.

That knowledge is not just useful. It is not just cumulative. It is not just archived.

It is foundational.

The idea that bookshelves might hold up a building resonates not because it is strictly true, but because it feels correct in a deeper way. It reflects a moment when medicine organized itself—intellectually and physically—around the disciplined collection of knowledge.

And if, in that moment, an architect or engineer found a way to let the shelves do a little structural work as well, it only strengthens the point.

Final diagnosis

So where does this leave us?

The claim that MedChi’s stacks support the building is not definitively proven. But it is consistent with real architectural practices of the time, practices in which shelving systems could and did serve structural roles.

In medical terms, it is best understood as: well-supported lore, with excellent historical plausibility and just enough ambiguity to remain interesting.

Which may be the most Oslerian outcome of all.

Because even if the books are not literally holding up the building, they are still doing something more subtle and perhaps more enduring: They are holding up the idea that medicine is built—carefully, deliberately, and sometimes beautifully—on the things we choose to know.

 

Vaccines Start Early

I was looking through the Annals of Maryland Medicine, 1799-1899, this morning and came across this little reminder of how long we've had vaccines in the United States, and how incredibly important they are. 

In the 1813, the US Government, as mentioned, established the Vaccine Institute. Dr. John Crawford, a faculty member of the new medical school in Baltimore, knew that his brother back in England was vaccinating his patients against cow pox. 

Dr. Crawford's brother soaked some cloth in the pox, dried it and sealed it with varnish. The pox was potent enough that when it finally arrived by letter in Baltimore, the pox was still contagious. Dr. Crawford re-hydrated it and then made a small cut between his patients' thumb and forefinger and ran a thread soaked in the pox through the cut. 

This was a rudimentary vaccine, which went on to prevent thousands of deaths in Baltimore alone. 

Make of this what you will, but we've been vaccinating people in Baltimore for more than two hundred years. 

Marcia Crocker Noyes: The Librarian Who Never Left

I am so pleased to announce the publication of "Marcia Crocker Noyes: The Librarian Who Never Left," a biography of our librarian of 50 years.

Marcia was hired by Dr. William Osler in 1896 to be the first trained librarian for the Faculty, as it was then known. She was required to live and work on the premises, so that if a physician needed a book in the middle of the night, she could get it out of the stacks.

When we built our current building in 1909, she was highly involved in the design of it, as it was also to become her home. Marcia died in 1946 and her funeral was held in Osler Hall, a fitting testimony to her long friendship with Dr. Osler.

Of course, we've all heard stories about how she's never left the building. In fact, in her latter years, she mentioned that she would stay away for a few days, and then come back to haint (haunt) the building. And indeed, she has!

The book is available in two formats: an 80-page soft-cover edition for $30.00, and a digital format for $5.00. The funds raised by the sale of the book will be used to support the MedChi archives. 

To purchase the book in either format, either scan or click the QR code below. 

I hope that you will enjoy reading the book as much as I did researching and writing it!

Hopkins School of Medicine Photos in the Osler Years

I was going through some of our old Osler books, as well as the ones I recently acquired (see last post), and scanned in a bunch of pictures. Because of the age of the books, they are all out of copyright, so I am republishing some of them here. 

See how many of the names you recognize from Old Baltimore Medicine days!

The Mistake on the Seal!

I am going to tell you a story about MedChi’s historic seal.

It became part of our “brand” soon after our founding in 1799. Eventually, it was one of several bookplates for book collections that were funded by donors, such as the Frick Family.

It was a rather dour looking piece, with the figure of Aesculapius with his serpent-entwined staff. It was originally rendered in red and black, with deep-set eyes. He was known as “old potato head.”

In our centennial book, there is a slightly different version of the potato head with more hair and more rays emanating from his head.

After we moved into the new building in 1909 and the library continued to grow, we asked the medical illustrator, Max Brödel to design an updated seal for us. You can see the date on Brödel’s original sketch of the seal.

It wasn’t until the 1930’s that it was finally engraved, and hundreds of copies were printed to place in our book collections.

Soon, we received a letter from one of our members, letting us know that there was a mistake on the seal. Around the bottom edge of the seal are a few words in the Greek alphabet. One of the letters is incorrect. 

And because that letter is wrong, it changes the meaning of the sentence! It should read, “A physician is of more value than many other men for the dressing of wounds and the stilling of pain,” from Homer’s Illiad, Book II, Line 514.

The mistake was combining a Greek Z and a Greek X, when there is no such letter. It should have been three parallel lines, with the middle one a little shorter.

The mistake was corrected, and new bookplates were printed.

We still have some digital copies of the mistaken seal, but I try and check to make sure we’re using the correct one.  

Happy Valentine's Day!

I recently found this inscription in a 1940's miniature English-Castilian dictionary, and thought it would be perfect for Valentines Day.

"To Cuddles, from your ever-lovin' bright eyes. 

Till the end of time. 

Your Red Head Doll xxx" 

Some Recent Finds

Recently, I have been cataloguing the rare books, including making notes of where and which bookcases the books are located. 

I recently found the Larousse Medical Illustre', circa 1924 which is delightfully illustrated with numerous colored and engraved plates, some of which are shown here. 

As with many rare books libraries, there are always bad actors lurking around who are notorious for slicing the color and engraved plates from historic and rare books. 

To do our small part in preventing any thefts, we are making a database of what books are in our collections, and any color or engraved plates are marked on the reverse with an indelible MedChi stamp. 

So, as I am making notes on the database as to where the books are located, I am also leafing through them, checking their condition, dusting them off , checking prices, and making notes. 

A Rare Book Mystery

A few days ago, a friend sent me an auction listing for a book that was once owned by our Sir William Osler.

Pasted onto the cover of the book is a letter from Sir William to Marcia Noyes, our librarian. It was written about six months before he died. At the end is a personal PS "Love to you all."

Marcia and Sir William were close friends from the time he hired her in 1896, until his death in 1919.

But how did this, and two other books signed by William Osler, end up at an auction house in Connecticut?

Of course, I had to do some sleuthing. First, I culled through our records, but could find nothing. Next, I looked through the catalogue from Swann's Auction House in NYC, where we'd sold a number of our rare books in the early 2000's. No record.

Then I called the auction house who told me that the consigner was an old client of theirs. They called him and then called me back to tell me that the client had purchased the book from a rare book dealer in Baltimore about 20 years ago.

Something pinged in my brain. About 20 years ago, a low-level staffer had contracted to sell all of the books in our stacks, about 55,000, to a rare book dealer. When the powers-that-be found out, they put a stop to the sale.

But, in the interim, the dealer must have "acquired" some of our books, among them, the three that are in this auction, and that was how the consigner acquired them.

Not everyone appreciates history the way I do, nor understands how important it is to retain items from our past.

Most people won't understand the relationship between Marcia and Dr. Osler. As mentioned above, they were close friends from the time he hired her in 1896 until his death in 1919.

There are dozens of letters between the two of them, all very friendly and affectionate. There are little cards from bouquets that Osler sent Marcia wishing her a happy birthday, or sending congratulations.

When Osler moved to England in 1905, they stayed in touch and she visited him in Oxford several times. He frequently sent rare books for the Library at MedChi, including two copies of Vesalius Anatomy.

We will bid on the books, but I am sure the final price will exceed my budget. All that I can hope is that the book finds a good home.

A Boom in Historic Medical Book Collecting

Although I have a subscription to the Wall Street Journal, I am usually several days late in reading it. So when I got a few texts about an article in the Weekend Edition, I got right to reading it. Without permission, I am re-printing it here (but using illustrations from our collections). 

PS Please see this post about one of our special books!

The Hot Market for Books About Bloodletting and

Delivering a Baby in 1669

Collectors with a love of medical history are bidding up the price of arcane texts; ‘I don’t need a car, but I certainly need a copy of Vesalius.’

By: Jared S. Hopkins, WSJ

Tim Opler was searching an online jewelry auction for a birthday gift for his wife when he stumbled upon something more interesting. 

The New York investment banker spent the next few hours scanning rare medical books and scooped up about 20 that piqued his interest. Since that day three years ago, he has acquired hundreds more, which he displays on shelves in his Manhattan office and estimates are worth $400,000.

His collection includes one of six copies of a 1669 guide to delivering babies. “Some guy 400 or 500 years ago did this, and I find that just amazing,” Opler said.

Brush off those old guides to bloodletting and treating a gunshot wound with boiling oil. You may be sitting on a gold mine.  

Bankers, doctors and others who share a love for medical history—and the crinkly feel of a centuries-old binding or manuscript—are bidding up the price of texts that illuminate the evolving understanding of human anatomy and treating patients.

More than $26 million in rare medical books are forecast to sell at auction in the 2020s, based on sales through 2024, marking a dramatic increase in demand for texts that had been fetching around $15 million a decade since the 1990s, according to Stifel Financial.

Collectors scour book fairs, travel together to famous libraries and compare notes in text-message groups and weekly Zoom gatherings. They spend thousands of dollars or more at auction to outbid each other and universities. With a heavy dose of admiration and a bit of envy, they recite the years and editions of each other’s texts.

“This is my life, not a hobby,” said Gene Flamm, 88, who fellow collectors consider the dean of the group. 

Flamm has a day job, as professor and chairman emeritus of neurosurgery at Montefiore Einstein Medical Center in New York City. He also finds time to lecture on old medical books and catalog his collection, with entries covering everything from the place where a book was printed to page measurements and the nature of its binding. The database runs 10 gigabytes. 

Flamm got hooked on old texts as a medical student in the 1960s. While a resident, he sold his used Porsche 356 B for $2,500 to pay for a 1555 copy of De Humani Corporis Fabrica Libri Septem by 16th-century Flemish physician Andreas Vesalius.

“I said I don’t need a car, but I certainly need a copy of Vesalius,” Flamm said.

The 700-page-plus Fabrica is the ultimate trophy of rare medical book collectors, who view its illustrations as works of art. It is said to be the first comprehensive text to feature accurate descriptions of the human body based on dissections of dead patients.  

When a text like this becomes available, collectors don’t let anything get in the way of a score. Zlatko Pozeg, a cardiac surgeon in New Brunswick, Canada, once placed bids on a copy while performing a surgery. His nurse held the phone as he gave instructions. He won the auction. 

“I can look at these books and I feel like I’m enveloped by their wisdom, like part of their spirit is in the room with me,” Pozeg said. “It feeds your soul in a crazy way. I kind of have this unequal tranquility and solace that I just can’t get anywhere else.”

The $2.2 million sale last year of a 1555 edition of Fabrica brought international headlines to the world of rare medical book collecting.

The edition, which was sold to a university in Belgium called KU Leuven, contained crossed-out paragraphs, edited drawings, rewriting of text and fixes to punctuation and spelling. A Vesalius expert found the annotations were the work of the author, who was probably preparing a new version.

Gerard Vogrincic, the seller, said he bought the Vesalius edition for $14,520 in 2007. He said he was comfortable selling it, especially to a university where scholars can access it, because he plans to use the proceeds to fund further purchases.  

“I get a lot of excitement from the thrill of the hunt,” said Vogrincic, a retired pathologist in North Vancouver, Canada.

Collections can be built at any price point, thanks to the sheer number of books, the deteriorating conditions of some, and the varying significance of many. Fans say they constantly check auctions and booksellers online for new finds. Collections can get so large that owners struggle to store them.

[MedChi Member] Mario Molina, former chief executive of Molina Healthcare who got the collecting bug while a student at Johns Hopkins School of Medicine learning about its co-founder William Osler, stored his 14,000 books in a room in his Los Angeles house until space ran out. 

“I thought, Aha, we have a guesthouse. I can fill my guesthouse up with books. And my wife said, ‘No, you get a room.’” They compromised by putting extra books in his home office. 

Flamm primarily stores his 2,000-book collection in the living room of his Manhattan Upper East Side apartment. It fills floor-to-ceiling glass shelves backed by panels illuminated with fluorescent bulbs to avoid heating the books. 

Before moving to Bloomington-Normal, Ill., recently retired cardiologist Brian Morrison had devoted 12 shelves in his Oregon home to books by a single author: a 16th century English physician named William Harvey who penned De Motu Cordis, the first text to show that blood pumped by the heart circulated throughout the human body.

Now, he is storing those and other books in 139 one-cubic-foot boxes, two larger boxes and six large tubs, while figuring out what to do with them.

Morrison acquired his first copy of Cordis two decades ago. “Then I realized, No, that wasn’t enough. I had to have every edition.” (He pines for the first edition of Cordis, published in 1628, but it hasn’t gone to auction in more than two decades and he says he probably can’t afford it.)

After buying English physician Evan Bedford’s papers at auction in 2020, Morrison discovered Winston Churchill’s electrocardiogram. “The heartbeat of the lion was in this lot,” Morrison said. “As a cardiologist myself I think that’s the coolest thing in the world.”

Horsing Around

As I was shelving books in the Rare Books Room, I found one that really didn't have much anything to do with medicine.

It is the charmingly titled "The Domestic Animal's Friend, or The Complete Virginia and Maryland Farrier, Being a Copious Selection from the Best Treatises on Farriery Now Extant in the United States." Whew! That's quite a title.

The book was published in Winchester, Virginia by J. Foster in 1818.

The book has two illustrations, which look to be woodcuts instead of line engravings.

What's interesting to me is how different the profile of the horse looks in 1818 than a contemporary horse today. 

The skeleton woodcut is in a pull out panel which must have been printed separately from the octavo which made up the rest of the book.  

Honestly, I haven't read the book, so can't comment on its contents, but I found it fascinating that a book on "farriery" is in our library! 

Poisonous Books!

Did you know that some books are actually poisonous? According to a recent article in the Washington Post, green books, printed around the Victorian era, can actually be quite poisonous due to the dyes used to color the cloth covers of the volumes. 

The University of Delaware started the Poison Book Project in 2022 "to identify books still in circulation that were produced using the toxic pigments." The most dangerous of these pigments was arsenic! 

The Washington Post had a big article highlighting the dangers of these special books, and giving advice for how to take care of them so they don't harm the reader. 

The green books are not the only dangerous ones. Chrome yellow is another on the list.

I am pretty sure we have some books bound in green cloth, although I will have to scour the stacks. Apparently, it's only a vivid shade of green, mostly with elaborate illustrations on the covers, not the early 1900's medical journals that we have.

Thanks to the Washington Post, the University of Delaware and the Winterthur Museum for the photos!

Echoes From the Past

A few weeks ago, MedChi hosted a practice session for the Baltimore Symphony Orchestra's Youth Orchestra. During their practice time, I usually do some work in the Rare Books Room, so I can be close by if there are any questions. 

The children that afternoon ranged from eight to twelve years old, and made up the two violin sections which were practicing. As I sat in the Rare Books Room, the sounds of their music came drifting down the marble staircase. It was perfection.

I was mostly looking for illustrations and engravings from older books that we can somehow use in our work. One of the things that I found really charming in the books was the shadows of the images on one page on the opposite page. A lot of old books with illustrations like this have a piece of tissue paper between the image and the page to prevent the shadowing.

Another thing that never ceases to amaze me is the detail in the images in these books, which were mostly printed in the 1800s. I think about the person engraving the prints, and how much talent they must have had. You can just barely see a shadow of something like a deer that has come from the opposite page.

Not only were they artists, they had to have a steady hand, and be able to engrave everything backwards.