A Key to PHARMACEUTICAL AND MEDICINAL ... - ACS Publications

Indexing Methods as a Means of Increasing the Fertility Factor of Medical Literature C. E. BRINDLEY, M.D.

Downloaded by UNIV LAVAL on July 11, 2016 | http://pubs.acs.org Publication Date: January 1, 1956 | doi: 10.1021/ba-1956-0016.ch010

Merck & Co., Inc., Rahway, N. J.

The assumption is made that the basic purpose of a system of cataloging or indexing of scientific literature in the field of pharmaceutical medicine is to make available a collection of data that will serve as a culture medium for the growth of scientific theory and lead to its fruition in the development of new methods of treatment and the discovery of new drugs. With this basic premise in mind, the practical aspects are presented, with emphasis on the employment and enlargement of the "Standard Nomenclature of Diseases and Operations" into a workable numerical index system specifically adapted to handle medical, pharmaceutical, pharmacologic, physiologic, and biochemical literature. Stress is placed on the practical aspects of such a numerical coding system, the use of the punch card and the mechanical sorter, and on the results that can be expected from the intelligent use of such a combination.

T h e basic purpose of a system of cataloging or indexing scientific literature i n the field of medicine is to make available a collection of data which may serve as a culture medium for the growth of scientific theory and its f r u i t i o n i n the develop^ ment of new methods of treatment and the discovery of new therapeutic agents. It has been stated that ". . . the science of medicine is a collective endeavor progressing as a result of the ideas and observations of many men, and that on occasion significant ideas and observations rise from obscure quarters" (3). Obscure bits of data are important not only as isolated points of take-off into the uncharted field of new ideas and new areas for further exploration, but even more important is the correlation of related materials buried i n the unwieldy mass of technical reports that the modern methods of p r i n t i n g and publishing have produced. It is no exaggeration to say that most of us feel, on occasion, that, i n the search for the r i g h t answer to a scientific problem, we have been buried under an avalanche of technical data. In a discussion (1) of the need for mechanized systems for literature searching, held recently at the Massachusetts Institute of Technology, attention was called to the magnitude of the problem. It was stated that the volume of technical information is growing at an exponential rate and that 20 years is about the average period of doubling. Scott, of the Interdepartmental Committee on Scientific Development of the U . S. Government, called attention to the fact that the expense of handling rises as the volume of information increases. In fact, there would seem to be danger of serious encroachment by literature-searching demands on the total man-hours available for research. Swedish investigators have estimated that literature searching accounts for about one t h i r d of the total cost of research. E i t h e r we must painfully d i g our way out from under this staggering load by spending uncountable hours and large sums of money i n sorting and evaluating or some means of escape must be devised i n which mechanical aids can be enlisted. The collection of periodicals and monographs that make up a medical l i b r a r y plus the files of personal communications and assorted w r i t t e n materials that make up the factual tools of research laboratories and technical industries such as the 50

A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.


BRINDLEY—INDEXING MEDICAL

LITERATURE

51

pharmaceutical industry, may be looked upon as a "collective memory" for a l l the work that has been done i n this particular field. P a r t and parcel of " m e m o r y " as a concept is the ability to recall. The data must be classified i n an orderly fashion so that any piece of the whole is easily and quickly accessible. F u r t h e r i t is not enough to be able to find a single fact. The data must be so arranged that a l l closely related facts are equally available. Then, i n the event there is no exact answer, a choice of possible solutions is available. There are a number of ways to build up and put i n working order this "collective memory" of medical, pharmaceutical, pharmacological, chemical, and other related data but the solution that we have worked out serves our particular needs aston ishingly well. W i t h i n a matter of hours, and frequently w i t h i n a matter of minutes, a group of abstracts or a l l the available references i n the current litera ture on a given subject can be obtained whether it is the mechanism of action of a given drug on a specific disease process or the currently used methods of treat i n g a given type of dermatitis. Specific, isolated, informational queries can be answered, bibliographic data can be supplied, clinical research data can be classified and correlated, collections of abstracts on any desired subject can be compiled for use i n planning research, i n formation can be located f o r the practicing physician who has a problem, and informational material can be made available to those engaged i n advertising and selling the firm's products. A l l this can be accomplished by the integration of three working elements: punch cards and a mechanical sorter, a complex but u n derstandable numerical code, and trained personnel. Punch Cards and the Mechanical Sorter

The punch cards and the mechanical sorter are at the same time the most spec tacular and the least troubling of the three w o r k i n g elements. W e use 27 verti cal columns of twelve spaces each out of a possible eighty columns on the punch card. V e r t i c a l lines have been overprinted to divide the card into sections and headings suited to o u r particular needs have been inserted. The position and number of holes punched i n the g r i d of spaces are determined by the coding num bers used i n indexing the original data. Thus the card, after i t has been punched, takes on individual characteristics which make i t possible to feed an unsorted stack of cards into an electrical sorter which automatically distinguishes one group from a l l the others. The Coding System

The coding system to be used w i t h punch cards and the numerical sorter is, from the user's point of view, the most complex part of the entire problem. Numerical codes are, without question, the most concise and accurate means of indexing i n dividual, isolated facts and, at the same time, groups of related data. I t should be emphasized, however, that the system is only as good as the code. B y and large, the system w i l l stand or f a l l on the suitability and the adaptability of the numerical code chosen and on the accuracy w i t h which the coding is done. The importance of suitability is obvious. The need for flexibility is readily apparent, too, but i t has more hidden dangers. N o t only is the subject matter of science itself continually changing but the interests of the individuals using this "collective memory" of medical and related data are continually i n a state of flux. L i t t l e specific advice can be given on how to achieve and maintain the flexibility of such a system other than to point out the need for i t and to emphasize the importance of keeping i t always i n mind, not only by those who plan the numerical code (the numbers used must be as flexible as possible) but also by those who do the abstracting, indexing, and coding day by day. Simplicity and uniformity are also of great importance. When the coding system now i n use i n the Medical Division of Merck & Co., Inc., was first planned, existing classifications of medical information were ex amined. The decision was made to use the " S t a n d a r d Nomenclature of Diseases and Operations," published by the American Medical Association (2), as the basis for the coding system. It should be pointed out that any already existing classi fication chosen as a foundation for a numerical code, designed to fit a specific but new need, w i l l present problems of adaption. The essential t h i n g is to choose a classification coming closest to the apparent needs. A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.

A D V A N C E S IN

52

CHEMISTRY SERIES


Standard Nomenclature. The "Standard Nomenclature" was worked out originally by a large group of individuals, insurance companies, and medical organizations, cooperating w i t h the National Conference on Nomenclature and Disease, from 1928 until the first edition was published i n 1932. Continual revision has been carried on and the fourth edition of the " S t a n d a r d Nomenclature" appeared i n 1952. It is p r i m a r i l y designed for the use of physicians, specialists, and hospital personnel, so that a uniform and standard terminology may be used i n the recording of diagnoses. Thus, it was designed for its own specific job, and not intended to serve as a means of indexing data i n clinical and experimental medicine, physiology, pharmacology, and the like. It is essential that hospital records be as uniform as possible i f cases are to be available for study, review, and research, not only i n each individual hospital but also on a nation-wide scale. The following statement appears i n the " S t a n d a r d Nomenclature" (page 848): Basically a medical nomenclature is a list or catalogue of approved terms for describing and recording clinical and pathological conditions. To serve its f u l l function, i t should be extensive, so that any pathological condition can be accurately recorded. A s medical science advances, a nomenclature must expand to include new terms necessary to record new observations. A n y morbid condition that can be specifically described w i l l need a specific designation i n a nomenclature. It is further stated that The purpose of the system of classifying disease employed i n this book is to present a logical clinical nomenclature. The " S t a n d a r d Nomenclature" attempts to include every disease which is clinically recognizable and to avoid repetition and overlapping. . . . It has been designed p r i m a r i l y for use by clinicians, as the clinical diagnosis is a most i m portant source of information on prevalence and distribution of the disease. The problem of indexing of informative material has little i n common w i t h the problem of classification confronting the staff physicians and the medical record l i b r a r i a n i n the average hospital. When the two problems are examined carefully i t soon becomes apparent that the most surprising thing is that the system used for the hospital records can be adapted at a l l , much less used efficiently, for the indexing of physiological, pharmacological, and medical information. The explanation for the success of this adaption of the " S t a n d a r d Nomenclature" to the indexing of informational medical material lies i n the fact that the numerical code given i n the "Standard Nomenclature" is built up of two components—the first refers to the part of the body affected and the second to the cause of the disease. These two main divisions themselves have innumerable components. A s a result it is the tremendous number and possible combinations of items that render medical classification the overwhelmingly complex thing it is and yet make possible a logical classification. Description of Numerical Code as Adapted for Use. The numerical code used i n our indexing system is made up of five components: A. B. C. D. E.

D r u g used (this section of the classification was devised by our personnel) 1. Class of drug 2. Specific drug Route of administration (this section also was formulated by our per sonnel) Diseases or disturbances (adapted from " S t a n d a r d Nomenclature") 1. Topography (where the disease process occurs) 2. Etiology (causative factor) Other identifications (formulated by our personnel) 1. This is a miscellaneous group of unrelated designations such as " E x perimental studies," "Metabolic studies," "Review articles," etc. D r u g effects (adapted from a section i n " S t a n d a r d Nomenclature" titled Supplementary Terms)

Coding for Drugs. Designating code numbers for drugs are made up of two parts, a group of two digits connected by a hyphen w i t h a second group of three digits. The first two digits indicate the class of drug and the second group the individual drug.



for

mycosi s

venous,

and

intra-

for A c t i n o -

oral

η

large

rheu

Terramycin

fever

doses,

matic

cortisone

receiving

in

balance

children

compared

Nitrogen

amide

-

a c i d and

studies

of

cretion

effect

ex

orally

and

patients:

geriatric

action

senile

in

acid

discussed

Nicotinic

is

Mode of

dogs.

in

improve

function

to

cortical

muscle

extracts

Adrenal

TO BE INDEXED

SUBJECTS

-

52-012

orally

I.V.

large

00 =

02 =

9y s

08 Ϊ

-030 s

terramycin

antibiotics

08-030

cortisone

doses

in which

-202 :

ally actinomyces

gener

secondarily

the body,

diseases

gener

actinomycosis s mycosis,

affecting

012 :

alized)

(012-2··

012-202 :

predominantly

supporting

a

structure

fecting

the

the

af

principally

inflammatory

acutely

is

diseases

fever

affecting

generally

diseases

reaction

-932 r

body

010 *

dysfunction

010-932 a rheumatic

-79x = s e n i l e

32 a

hormone

senile

syn

brain disease 009 c nervous p s y c h o b i o l o g i c section

with

chronic brain

drome a s s o c .

·

life

adjustment

late

-x86 *

reaction

comparison

04 r

02 ;

toxicity

to

i n man

birthday)

studies

I3th

23 s c h i l d r e n (up

action

28 s mechanism o f

62 :

ex

blood ft

levels,

cretion)

tissue

(absorp.,

geriatrics Pharmacol,

03 s

in man

studies

29 s

unit,

mechanism o f

action

28 :

02 :

general 1 y

32-010

-010 »

of

experi

the

000 = p s y c h o b i o l o g i c

in

site

disease

instance

IDENTIFICATION

01 m a n i m a l s

OTHER

000-χ86

animals)

mental

drug

of

to denote

action

used

009-79x

amide

in t h i s

muscles

DISEASE

1st 3 numbers o f

(Note:

270- *

-112 s

nicotin

orally

I.V.

of

00 •

02 =

ADMINISTRATION

ASSIGNMENT OF CODE NUMBERS

*55\WUHVi NUMtlMliM. VAJUt UtfclbKM Wild TO F A C T U A L M A T E R I A L

52-112

acid

-012 s n i c o t i n i c

52 Ε v i t a m i n s

hormone

adrenal

cortical

-001

hormones

32-001

32 s

DRUG

WtimjO Mf

excretion

feces

on

bal

emia)

hyperprotein-

-

(original

meaning

ance

nitrogen

5*15 = e f f e c t

in

669 = e x c r e t i o n

in u r i n e

749 «

DRU6 EFFECTS

X

CLASS

X

CODING UN

I Ht

PUNCH CAKU

χ X X

X X

ADMIN:

X

X

X

T0P08.

X

X

X

X

DRUG EFFECTS

OTHER IDENT.

PUNCHED

ETI0L.

DISEASE

MANNER IN Ml ICH CARD IS

SPECIFIC

DRUG

(EACH X.INDICATES A HOLE PUNCHED IN THE CARD.


!

5

ι-

—

A D V A N C E S IN

54


Actual

examples

CHEMISTRY SERIES

are: 010202-009 0303-003 040505-005 0607080909-001

A d r e n o l y t i c agents Amino acids Histidine Elements Calcium Analeptics Analgesics Dro.ni r a n Anesthetics Anthelmintics Antibiotics A - 1 coagulants Dicumarol

ΙΟ Ι 111-003 11-006

Antiepileptics A n t h staminics Antergan Benadryl

28-

Diuretics

31-

Hematinics

5252-003 52-009

Vitamins A s c o r b i c acid F o l i c acid derivativ

-XOO 28-X00

A new d r u g that has no specific number W o u l d , therefore, be a new d r u g that has a diuretic action

Coding to Indicate the Route of Administration of D r u g . Since there is a com paratively small number of possible ways that any single drug can be given, thi** particular category requires only a small section of the punch card. It has been assigned two columns, each of which has twelve possible variations — x, y, and 0 to 9. The following are included: 0Y ox 00 01 02 03 04 05 06 07 08 09

10 12 13 14 15 16 17 18 19 20

Regimens (where emphasized) Other t h a n listed Oral Intramuscular Intravenous Subcutaneous Local Inhalation Rectal Intraspinal Percutaneous Vaginal

6Y

Ocular Intraperitoneal Cardiac Implantation Intra-arterial Intra-articular Intradermal Intrapleural Intramedullary B y stomach tube Long

term

Coding to Indicate Disease or Disturbance. This section of the coding is the most complex of a l l and, when purely clinical studies are indexed, is taken without change except for occasional shortening, from the "Standard Nomenclature." The number used is made up of two groups of digits. The first group of three indicates the location of the disease process (topography) and the second group of four indicates the causative factor (etiology). The first of the three digits which i n dicate the location, refers to the body as a whole or an organ system, the second and t h i r d digits refer to an organ or a part of an organ. There are ten main divisions : 0 1 2 3 4 5 6 7 8 9 X

Body as a whole (includes a n d the body generally) Integumentary system Musculoskeletal system R e s p i r a t o r y system C a r d i o v a s c u l a r system H e m i c a n d l y m p h a t i c system Digestive system U r o g e n i t a l system E n d o c r i n e system Nervous svstem O r g a n s of special sense

the

psyche


BRINDLEY—INDEXING MEDICAL LITERATURE

55

Under the first section (or " S y s t e m " as it is referred to i n "Standard Nomen clature") there are the following subheads: 00 01 02 03


04 05 06 07 08 09

Psychobiologic u n i t Body as a whole H e a d a n d face N e c k , thorax, thoracic w a l l a n d medias tinum A b d o m e n , a b d o m i n a l w a l l a n d pelvis Other areas of t r u n k P e r i t o n e u m a n d serous sacs S u p e r f i c i a l fossae Subdivided f u r t h e r : U p p e r extremity 080 U p p e r extremity, generally Lower extremity 081 A r m 082 E l b o w 083 F o r e a r m 084 W r i s t 085 H a n d , generally 086 F i n g e r s , generally 089 P a l m 08x I n t r i n s i c vessels

The second group of four digits, which follows the hyphen i n the compound number identifying the disease, indicates the causation of the disturbance. The main classifications are as follows: 0 1 2 3 4 50 55 6 7 8 9 χ y

Diseases due t o p r e n a t a l influence Diseases o r infections due t o a lower p l a n t o r a n i m a l parasite Diseases o r infections due t o a h i g h e r p l a n t o r a n i m a l parasite Diseases due t o i n t o x i c a t i o n Diseases due t o t r a u m a o r p h y s i c a l agent Diseases secondary to c i r c u l a t o r y disturbance Diseases secondary t o disturbance of i n n e r v a t i o n o r of psychic c o n t r o l Diseases due to, o r c o n s i s t i n g of, static m e c h a n i c a l a b n o r m a l i t y Diseases due to disorder of metabolism, g r o w t h , o r n u t r i t i o n N e w growths Diseases due t o u n k n o w n o r u n c e r t a i n cause w i t h t h e s t r u c t u r a l reaction m a n i f e s t ; hereditary a n d f a m i l i a l diseases of t h i s n a t u r e Diseases due t o u n k n o w n o r u n c e r t a i n cause w i t h t h e f u c t i o n a l reaction alone m a n i f e s t ; hereditary a n d f a m i l i a l diseases of t h i s n a t u r e Disease of undetermined cause

A s a concrete example, diabetes mellitus would have the code number 871-785. A n a l y z i n g this number we find that 8 87 871 871-7 871-785

Refers Refers Refers Refers Refers

to disease of t h e endocrine system t o disease of t h e pancreas t o disease of the tissue of t h e Islands of L a n g e r h a n s to diseases due t o metabolic disorders, g r o w t h , o r n u t r i t i o n to diabetes m e l l i t u s

Since the "Standard Nomenclature" was not designed to cover experimental and laboratory work, some provision had to be made to index such studies. The topographic section of the " S t a n d a r d Nomenclature" number is retained i f the idea to be indexed involves an effect on a certain part of the body, and the second part of the compound number is ignored. If, on the other hand, the important point is an effect on a body process, the second half of the compound number is used. The section on etiology of the "Standard Nomenclature" is searched for a number re f e r r i n g to the process involved. A t this time the words "disturbed," "disturbance of," and " a b n o r m a l " i n the "Standard Nomenclature" are disregarded. According to our usage, a code number having a group of three digits con nected by a hyphen to a second group of four digits is used f o r indexing purposes, when an article is concerned w i t h patients or animals w i t h a given disease. I f only the first half of the number is used, the article is concerned w i t h the effects of a drug on a certain section of the body; and i f only the second half of the com pound number is used, the effects of the drug on a certain body process or processes are discussed. Coding Designated as Other Identifications. This category is used by our personnel to indicate a variety of unrelated matters, a miscellaneous group of odds A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.

A D V A N C E S IN

56

CHEMISTRY SERIES

and ends. Two columns of spaces are allowed for this assortment, examples which include: 01 02 03 04


E x p e r i m e n t a l studies, other t h a n m a n Studies i n m a n , e x p e r i m e n t a l or c l i n i c a l Pharmacology (absorption, blood levels, excretion) Toxicity this c o l u m n i n c o n j u n c t i o n w i t h the three spaces effects") indicate: 0 4 ; 000 N o t o x i c effect 04 ; x x x F a t a l 04 ; y . . E x a c e r b a t i o n of s y m p t o m s 0 4 ; . . y P r e c i p i t a t i o n of new symptoms 05 C o n t r a i n d i c a t i o n s 06 Bacteriology 07 C h e m i c a l a n d p h y s i c a l properties 08 H i s t o r y . 09 Reviews a n d general articles 10 N u t r i t i o n 20 A s s a y 23 C h i l d r e n 24 V e t e r i n a r y 29 G e r i a t r i c s 53 A n t a g o n i s m of drugs

of

in

the

last

column

(on

"drug

Coding of D r u g Effects. This group of code numbers has been adapted from the "Standard Nomenclature." Originally it was intended to be used as a means of recording the symptoms of various diseases, but are used i n our system to indi cate the effects of a drug on the patient. This adaptation requires a certain amount of interpretation. F o r example, i n an article on plasma volume extend ers, one would not record "change i n blood volume" after therapy (since that is the purpose of the preparation). However, i f the patient developed a c h i l l each time he received a plasma volume extender, this would be recorded. One instance so recorded might not be important, but several or many probably would have clinical significance. In this category three vertical columns of digits are used. Samples of this; code are as follows: 010 006 008 134 612 311 206

Dehydration Gain i n weight Loss i n w e i g h t Petechiae Anorexia Dyspnea Arthralgia

Additional Coding. In using the outlined system it has become desirable to indicate certain other characteristics. Fortunately, it was possible to adapt the system to include these. Different colored cards were used to indicate several broad categories. Brown punch cards, for example, are used for foreign refer ences. This is important because, frequently, requests for information are from individuals l i v i n g outside the United States. Since it is not only natural for some one i n South America, for example, to read Spanish or Portuguese, but also easier for h i m to obtain such journals, an attempt is made to supply the inquirer w i t h references to technical papers appearing i n appropriate language journals. Fortunately, since the cards were set up w i t h eight vertical columns at the left of the punch card used only as space i n which to write i n code numbers, we were able to use one of these columns for foreign journals. Therefore, the proper digit i n that column is punched so that cards referring to articles i n a given language i n periodicals from one country or group of countries, may be sorted mechanically. Thus the seventh vertical column on the cards is used as follows: 1 2 3 4 5 6 7 8 9 χ y 0

England Germany France S p a n i s h - a n d Portuguese-speaking countries, i n c l u d i n g S o u t h A m e r i c a O r i e n t a l countries, i n c l u d i n g I n d i a Italy H o l l a n d , B e l g i u m , L u x e m b o u r g , a n d the S c a n d i n a v i a n countries The N e a r East Russia Unrecognized Miscellaneous B l a n k f o r future use



57

LITERATURE

The decision to leave one space i n the column unused i n keying the foreign ref erences is an excellent example of the type of planning and of the attempt to foresee future happenings that are so essential to the lasting success of a system of this type. The need to plan ahead and leave a margin of safety cannot be overemphasized. Conditions change constantly and i t is entirely possible that within the next five years some country, hitherto unimportant scientifically, m a y suddenly begin producing a sizable amount of technical literature. Under such conditions i t would be highly convenient to have a means of keying those papers. In addition to keying of foreign references, the left hand side of the card i s used for other notations such as reference to abstract sections of journals. Blue punch cards are used for articles not abstracted but indexed on punch cards only, white for articles from A m e r i c a n or Canadian journals that have been ab stracted and for which abstract cards are available, yellow for correspondence files, and so on. Columns five and eight have been used to indicate the year i n which the report appeared and column 11 f o r the month. Downloaded by UNIV LAVAL on July 11, 2016 | http://pubs.acs.org Publication Date: January 1, 1956 | doi: 10.1021/ba-1956-0016.ch010

How Technical Reports Are Coded

The first step i n the process of indexing is to abstract the article. The ab stracter writes the code number on the left-hand part of the punch card of the proper color. The sequence number of the abstract card is also written on the back of the punch card. A t this time the last name of the first author and the literature reference are written on the bottom of the card beneath the last row of spaces. The punch card is then "mark-sensed." This mark-sensing merely means that the proper spaces on the right-hand side of the card corresponding to the code numbers are marked with carbon ink or pencil. The punch card is then ready to be fed into a machine which punches the holes i n a l l spaces so marked. The card is then added to the already existing collection of punch cards ready to be sorted out b y the mechanical sorter when a group of cards must be r u n to answer a specific question. The actual assignment of code numbers to informational material can be best understood only by examining a specific example shown on page 58. The numbers used for the preparation of the punch card for this particular ab stract are indicated i n the right margin. The letters i n parentheses refer to the various sections or vertical columns i n which the proper spaces are punched. The code numbers w i t h their meanings are outlined below. A.

D r u g used 23-003 23Refers to the class carcinolytic agents -003 Refers to the specific drug within the c l a s s . . nitrogen mustard

B.

Method of administration In this case, intravenous injection

C.

Diseases or disturbances (from "Standard Nomenclature")

783190200360-8191 -819.0 190-8191 783-8191 200-819.0 360-819.0 D.

190-8191 783-8191 200-819.0 360-819.0 Refers to the cervex uteri (location or topography) Refers to the breast Refers to bones, generally Refers to lungs, generally Refers to carcinoma (cause or etiology) Refers to neoplasm w i t h metastases Is therefore carcinoma of the breast Is therefore cervical carcinoma Is therefore neoplasm with metastases to the bones Is therefore neoplasm w i t h metastases to the lungs

Other identifications 28 04

02

28 04

Refers to mechanism of action Refers to toxicity


ADVANCES

58

E.

IN

CHEMISTRY SERIES

D r u g effects (adapted from the section "Supplementary T e r m s " i n " S t a n d ard Nomenclature") 006 008 5. . 611 006 Refers to gain i n weight 612 008 Refers to loss i n weight 614 5. . Refers to the blood picture y. 611 Refers to nausea 612 Refers to loss of appetite 614 Refers to vomiting y. . Refers to general deterioration of condition (not from "Standard Nomenclature") Assignment of Code Numbers

Remold,


in

P.,

and S i e g e r t ,

recurrent

metastatic

cervical

10,

"The

57:614

these

studies

the treatment

following

subjective

of

general

factors

effect

149:206,

served

as c r i t e r i a :

the objective

status

a u s c u l t a t i o n and roentgen

finally

d u r i n g and a f t e r

'tris'

nitrogen

the

different

dosage

that

used Heilmayer's

per

kilogram of

day.

A total

body

weight

o f 38 p a t i e n t s

(D) (C)

-> 1 9 0

(O

that

have

or

fifth

with

| i n j e c t i o n |.

nitrogen

objective largely function

It

was f o u n d

mustard produced

(E) (E)

5, .

(E)

611

(E)

—» 612

(E)

used

commenting on been

used,

they

i n w h i c h 0 . 0 5 mg.

treated.

every

second

Secondary

improvement,

only that

neither

but rather

after the

and impairment o f

the nitrogen

decline!.

a definite

mustards

the p a t i e n t ' s The a u t h o r s

the

^1

614

(Ε)

02

(Β)

nor

and (Ε)

hematopoietic

general feel

is inadvisable

third

treatment

subjective

i r r e v e r s i b l e [deterioration 1 of the

with\accelerated with

were n o t e d

(C)

008

^

a rule

(C)

360-

blood

τ a n d Ivom i t i n g j a s

(C)

-819.0

006

o f the

to the

i s administered were

(O

200-

patient's

The a u t h o r s

method,

-8191

determined

weight]and

course

mustard and, after schemes

28 -> 7 8 3 -

examination;

was g i v e n

treatment.

the as

by|body

the further

say

they

of

mustard

t|bone|and[pulmonary|tumors.

Particular attention

the

t h e mode

of nitrogen

c o n d i t i o n as m a n i f e s t e d

picture]and

disease. picture

(A)

f.

r e c u r r e n t ! c e r v i c a l | o r [mammary}-

feeling;

by p a l p a t i o n ,

|blood

Ztschr.

the J.A.M.Α.,

was t o a s c e r t a i n

|carcinomas|and οf{metastatic

the

from

23-003

mustard} and i n

1952.).

aim o f

The

carcinomas

and l u n g s ,

(abstract

j a c t i o n land the t h e r a p e u t i c

in

Use o f | n i t r o g e n

a n d mammary

tumors o f bones

Krebsforsch. May

Α.:

that

condition treatment

.04

and u n j u s t i f i e d . "


(D)

BRINDLEY—INDEXING

MEDICAL LITERATURE

59


Personnel

The personnel responsible for the day to day operation of this type of coding system must be v i t a l l y interested i n the system itself and understand i t not only in detail but from a broad point of view. It would be next to impossible to state how much output can be expected from a certain number of individuals for too much depends on the system itself, on the type of material indexed, and on the needs of the institution served by the system. A t present we have four abstracter-coders, an abstracter's assistant, and a clerk-typist. Since this new system was inaugurated i n A p r i l 1951, over 13,000 abstracts and 22,500 punch cards have been accumulated. Approximately 2500 journals w i l l have been screened, abstracted, and indexed by this method during 1953. The abstracter-coder must have a broad scientific education: some chemistry, some biology, some language, and as much premedical training as possible. In addition, at least one abstracter-coder should have a sense of numbers and ex perience w i t h some type of numbering system. Scientific curiosity and a detective instinct are assets. A n open mind and adaptability are musts. A personal interest in the system and a realization of its potentialities are fundamentally important as well as the possession of a creative attitude and ability to see the system as a whole. It is an absolute necessity that anyone who codes must be able to r u n the mechanical sorter and understand how i t works i n practice. The abstracter's assistant can operate the mechanical sorter for answers to all but the most complicated questions. It is the assistant's job to check the punch cards for accuracy. I n fact, accuracy is the most important qualification for this job. The clerk-typist, i n addition to the usual type of work required, mark-senses the punch cards and is able to operate the mechanical sorter for answers to simple questions. Here again accuracy is required. What Are the Potsntialities of Such a System?

How many individual items can be indexed on a punch card? The system used has twelve to the eightieth power, or a number corresponding roughly to the estimated number of electrons i n the known universe. The limitations of this system are, therefore, the limitations of the human beings who devise the numerical code used and the individuals who do the indexing and coding. How

Does One Go About Setting Up Such a System?

The personnel trained i n the subject matter to be indexed and the specialist i n punch-card systems should cooperate i n installing the system. Some system of nomenclature must be chosen and an estimate made of the number of categories of subject matter involved together w i t h the approximate number of items w i t h i n each category. Once the approximate scope of the coding is determined a punch card can be designed to suit the particular problem. To illustrate, a hypothetical problem i n indexing might be the following: 1.

There are 60,000 ± 500 chemicals of a specific type (all containing the radical X O ) and they can be subdivided into 50 ± 10 classes. These chemicals are very likely to be insecticides and their effectiveness may be indicated by + + + +, ++ + , ++, +, ± , and 0. There are 20,000 species of insect (which can be separated into three groups—flying, crawling, hopping) native to 35 different countries. —

2. 3.

The question then i s — H o w many columns of twelve spaces each (x, y, 0 to 9) are necessary to put a l l possible combinations of this data on punch cards? Would hyphenated numbers be used? H o w would i t look? B y simple arithmetic two vertical columns, of 12 spaces each, furnish 144 possibilities. Three columns furnish 1728, four columns 20,736, fivo columns 248,832, and six columns 2,985,984. Therefore, the punch card would probably need the following: 1.

F o r the chemicals

two columns for the class four columns for the specific chemical The code number would be of the 00-0000 type. A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.

60

A D V A N C E S IN CHEMISTRY

2.

SERIES

F o r the effectiveness of the chemicals as insecticides only one column would be needed and the code numbers would be as follows: 0 +++ + 1 +++ 2 ++ 3 + 4 ± 5

0

3.

F o r the insects one column is needed to indicate whether they were flying, crawling, or hopping, and four columns to indicate the species. Two other columns would more than suffice for the number of countries. Therefore, the card would look like the following chart. Chemicals Class -

Effect

Type

Insects

Species

Country

y y y y

y y y y

y y

X

X X

X

χ

-

X

X

χ

X

0 1 2 3 4 5 6 7 8 9

0 1 2 3 4 5 6 7 8 9

-

0 1 2 3 4 5 6 7 8 9

0 1 2 3 4 5 6 7 8 9

0 1 2 3 4 5 6 7 8 9

0 1 2 3 4 5 6 7 8 9

X X

X

0 0 0 0 1 1 1 1 2 2 2 2 3 3 3 4 4 4 4 5 5 5 5 6 6 6 6 7 7 7 7 8 8 8 8 9 9 9 9

CO


y y

The

Specific

9

0 1 2 3 4 5 6 7 8 9

0 1 2 3 4 5 6 7 8 9

Fourteen of the available vertical columns would thus be utilized. In this instance the χ and y spaces are used as though they were numbers, i.e., no dis tinction is made. O r d i n a r i l y the χ and y spaces are reserved for unusual designa tions. I n our own system, for example, 08-x00 means a new antibiotic which has not been given a specific number. The reason f o r not assigning i t a specific number might be that there was some question as to whether it might not be identi cal w i t h another antibiotic already assigned a code number. Filing of Punch Cards

The filing problem w i t h punch cards varies according to the group using them. In this case, punch cards are filed i n broad groups according to the classi fication number of the drugs involved. Obviously we have a tremendous number of references on such subjects as cortisone, penicillin, streptomycin, and antihistaminics. In answering specific questions i t is time-saving to be able to pick up a group of cards likely to contain the answer for processing w i t h the mechanical sorter. This mechanical sorter can handle 400 cards a minute. To date we have a total of 22,500 cards, some 4620 of which are on cortisone and hydrocortisone. How Questions Are Answered

That the more specific the question the easier it is to obtain an answer is a maxim that must not be forgotten. The basic reason is inherent i n the procedure necessary to get informational data out of the system into which i t has been put. The process consists essentially of coding the question i n the same manner that the data is coded, setting the sorter to pick out a l l the cards punched w i t h the same code numbers as the question and then r u n n i n g the cards through the sorter. Some typical questions which have been answered are : Use of benzodioxane i n the diagnosis and management of pheochromocytoma Effect of cortisone on the mechanism of blood coagulation Use of cortisone i n sprue Use of diamino diphenyl sulfone i n leprosy and lupus erythematosus N a l l i n e , a l l references since J a n u a r y 1952 The first four of these are sufficiently specific to yield themselves to efficient a n d rapid handling. The last of the group, on the other hand, is of the type that can be very troublesome. In this particular case i t does not present such a problem since there is not yet a large number of references on Nalline. I f the question had been a l l the references on cortisone that have appeared since J a n u a r y 1952, i t would A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.

A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956. joints

3 punch c a r d s

used

32-010 agranulocytosis

reaction tissue

yOO ζ topography

unknown

amino

or unspecified

Infection

general

- 1 0 0 * d i s e a s e due t o

y00-100

pyrine

intoxication,

-3152 s d i s e a s e s due t o

(myeloid)

502 r g r a n u l o c y t i c

drug

due t o i n t o x i c a t i o n o r

502-3452 502-300 «

infection

- 0 2 2 r pen i c i 11 in

cortisone

remote

i n f l a m m a t i o n due t o

08-022 08 : a n t i b i o t i c s

-010 :

32 = hormones

lesion:

localized

inflammatory inflammation:

speci f i e d ;

chronic

rheu

and u n -

multiple

-1x0 s g e n e r a l l y

240 r

matoid,

240-1x0 r a r t h r i t i s ,

in man

i n man

14 = p r o p h y l a x i s

02 ζ s t u d i e s

02 ζ s t u d i e s

02 = s t u d i e s in

04 r t o x i c i t y

OTHER

IDENTIFICATION

DESIGNATIONS

ASSIGNMENT OF CODE NUMBERS

c o r t i s o n e and

01 > I . H .

CODE

MATERIAL

NUMERICAL

FACTUAL

ADMINISTRATION

TO

ASSIGNING

pen i c i II in

OF

T r e a t m e n t with

agranulocytosis

-015 r aminopyrine

05-015

05 « a n a l g e s i c s

arthritis,

causing

Aminopyrine, f o r

TO BE INDEXED

SUBJECTS

METHOD

50x :

"granulo leukopenia

cytopenia"

512 s

DRU6 EFFECTS

X

X

CLASS

CODING

X X

ON T H E

PUNCH

CARD

MANNER

X

χ X

ADMIN*

X

X

TOPOG.

X

IS

X

X X

X

X

X

X

X

X X

X

DRUG EFFECTS

OTHER IDENT.

PUNCHED

ETIOL.

DISEASE

IN WHICH CARD

INDICATES A HOLE PUNCHED' IN THE CARD.)

SPECIFIC

DRUG

(EACH X


73

09

A D V A N C E S IN

62

CHEMISTRY SERIES

have presented quite a different problem. The tremendous number of references forthcoming would have been overwhelming and unwieldy even i f the individual who asked the question intended to do no more than have these references typed i n the form of a bibliography.


What Is Accomplished by

Use

of

Punch Card and

Mechanical Sorter?

The use of the punch card and the mechanical sorter by trained personnel who have been provided with a workable numerical coding system is the most efficient and the most effective practical method we have found to increase the fertility factor of scientific literature or, more specifically, medical literature. A t first glance some might think it unnecessarily complex, others might fear it to be expensive. But on closer examination i t quickly becomes apparent that no index i n g system commonly used can produce a comparable amount or extent of i n formation i n relation to the labor, time, and money invested. F o r example, the title of an article, The use of cortisone and penicillin in the treatment of agranulo cytosis caused by the use of aminopyrine in treating a patient with arthritis, is by no means unique i n length or i n the number of items that should be noted i f the article is to be properly absorbed into the "collective memory" of medical and pharmacotherapeutic literature. The conventional type of card file index would probably include the following separate cards: 1. 2. 3. 4. 5. 6. 7.

Master card g i v i n g complete reference (authors, periodical name, volume, page, date) and probably abstract Author card (this may be a duplicate of card 1) C a r d with the heading Cortisone and referring to card 4=1 C a r d w i t h the heading Agranulocytosis and referring to card =jj=l C a r d with the heading Aminopyrine and referring to card φ ΐ C a r d w i t h the heading Arthritis and referring to card +1 C a r d w i t h the heading Penicillin and referring to card =#=1 Under our adaptation of the punch card system, there would be the following: 1. The same as the master card (+1) above 2. Same type of author card (+2) 3. A punch card coded to indicate Aminopyrine, analgesic, given orally to a patient w i t h rheumatoid arthritis, had a toxic effect, causing agranulocytosis 4. A punch card coded to indicate Cortisone, a hormone given orally, to treat agranulocytosis i n a patient who had developed this condition as a result of receiving aminopyrine 5. A punch card coded to indicate Penicillin, an antibiotic, administered, i n order to prevent infection

The original report is more completely indexed on the five cards used i n the second system than by the seven cards of the first. The more complete the index the easier it is to locate isolated facts. W i t h the nonpunch card system, a l l seven cards must be filed alphabetically i n their proper place and many running feet of card file drawers must be manually handled and visually scanned to locate material. In the second system, the first two are filed i n a similar fashion. The master card is given a number and filed by consecutive number, the second card is filed alphabetically by the last name of the sole author or of the first author listed i n a series. The three punch cards (which also c a r r y on the reverse the number of the master card) are simply placed i n the three filing sections labeled analgesics, hormones, and antibiotics. If a question arises concerning the toxic effects of aminopyrine i n the treatment of a r t h r i t i s , one need only set the mechanical sorter to select all the cards c a r r y i n g references to this, insert the stack of cards from the section on analgesics and await results. Assuming that there may be 1500 punch cards on analgesics, it w i l l take less than five minutes for the machine to find the information accurately. B y comparison, a human being under the old system might have needed hours to search through a large number of cards. Once the punch card, or cards, indexing the desired data, have been selected by the mechanical sorter, only a note of the number written on the back of the punch card needs to be made i f one wishes to locate the abstract i n the master file, or to note the reference written on the punch card i f the circumstances are such that i t seems desirable to consult the original article directly. The punch cards, having served their immediate purpose, are then returned as a group to the d r a w e r — a A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.


LITERATURE

63

much more time-saving process than laboriously refiling individual cards i n specific locations. In addition to being more rapid, the system is f a r more accurate and practically eliminates lost and misplaced (misfiled) index cards. Some indication of the efficiency of this system is that the staff can scan, abstract, code and prepare punch cards f o r pertinent technical data i n at least two hundred separate journals per month. Besides the routine filing away of many hundreds of resulting abstracts answers are supplied regularly i n the form of abstracts and reference lists to between seventy-five and a hundred questions per month. A weekly publication is prepared of the 20-25% of the abstracts deemed of most timely interest to the company personnel. A t the present time (1953), our "collective memory" of data-bearing punch cards is growing at the rate of about 1500 cards per month. Literature Cited


(1) (2) (3)

Chem. Eng. News, 30, 2806-10 (1952). Plunkett, R. J., and Hayden, A . C., " S t a n d a r d Nomenclature of Diseases and Operations," 4th ed., Blakiston, Philadelphia, P a . , 1952. Rogers, F . B., The A r m e d Forces Medical L i b r a r y , Military Surgeon, 112, 246-9 ( A p r i l 1953).

RECEIVED

September

13,

1954.


A Key to PHARMACEUTICAL AND MEDICINAL ... - ACS Publications

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