The early leaders of the academy were invested in the reform movements of the day and worked to improve public health by focusing on the living conditions of the poor.

[3]: 11  It began on December 8, 1846 with a notice being published in newspapers, requesting the city's doctors to meet three days later at the Lyceum of Natural History.

Early sections included Theory and Practice, Obstetrics and Diseases of Women and Children, Anatomy, Surgery, and Chemistry.

A peripheral fallout of this agreement was that the academy's live-in janitor, Felix Wesstrom, lost his living quarters.

The two gods are also carved into the entranceway's tympanum, attended by dogs, symbolizing vigilance and keeping death and illness away.

[6] The exterior also features many Latin inscriptions from notable authors, including Cicero, Hippocrates, Juvenal, Seneca the Younger, and Virgil.

In addition to the exterior designs, other animals feature as bronze insets of the Levanto marble main lobby floor such as the goat (symbolizing lusty, reproductive power), snakes (the symbol of the god Asclepius, signifying long life and rejuvenation), rooster (emblem of fatherhood and restorer of health), goose (emblem of motherhood), and the mandrake root (believed in folklore to have curative properties).

The walls are made of Mankato marble, and the ceiling is square-beamed with hand-painted Arabesque designs of fauna symbolic of medicine.

The library includes about 550,000 volumes and original writings by Sigmund Freud and a prototype of George Washington's dentures, constructed from actual teeth that were donated.

Not only was the library open to all, including soldiers, it also allowed the use of one of its prime spaces, Hosack Hall, for events related to the war, and additional rooms within the building for Medical Reserve Corps examinations.

[1]: 42 The library holds the Edwin Smith Papyrus, an ancient Egyptian medical text and the oldest known surgical treatise on trauma.

[8] The library also houses the archives of many health-related organizations that serve as primary sources for the history of medical education and practice in New York.