Medical Terminology Daily - Est. 2012

Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Marcia Crocker Noyes
(1869 – 1946)

Further to my comment on old books and research that started with an interesting bookplate (Ex-Libris). I continued my research and found that the person in charge of the Osler library bookplate was a fascinating individual that today maybe a ghost in the MedChi library and building in Baltimore... This is certainly an article that can be called "A Moment in History"

Marcia Crocker Noyes was the librarian at The Maryland State Medical Society from 1896 to 1946 and was a founding member of the Medical Library Association.[1][2][3]

Sir William Osler, MD. a famous Johns Hopkins surgeon was a noted bibliophile and had a large personal collection of books on various topics. When he became the President of MedChi in 1896, he was dismayed at the condition of the library and knew that with the right person and some stewardship, it could become a significant collection. Sir William asked his friend, Dr. Bernard Steiner, a physician and President of the Enoch Pratt Free Library in Baltimore for suggestions of a librarian, and Dr. Steiner recommended Marcia Crocker Noyes. A native of New York, and a graduate of Hunter College, Marcia had moved to Baltimore for a lengthy visit with her sister, and took a “temporary” position at the Pratt Library, which turned into three years. Although she had no medical experience or background, she was enthusiastic, and most importantly, she was willing to move into the apartment provided for the librarian, who needed to be available 24 hours a day.

The image in this article is Ms. Noyes on her first year on the job. Marcia developed a book classification system for medical books, based on the Index Medicus, and called it the Classification for Medical Literature. The system uses the alphabet with capital letters for the major divisions of medicine and lower-case ones for the sub-sections. The system was used for many years, but it's now dated and the Faculty's original shelving scheme was never changed. The card catalogs still reflect her classification and many of the cards are written in Marcia's back-slanting handwriting.

Marcia knew enough to ask the Faculty's members about medical questions, terminology and literature. She gradually won over the predominantly male membership and they became her greatest allies; Sir William at the start, and then for nearly 40 years, Dr. John Ruhräh, a wealthy pediatrician with no immediate family of his own. She made a point of attending almost every Faculty function, and in 1904, under guidelines from the American Medical Association, Marcia was made the Faculty Secretary. For much of her first 10 years, she was the Faculty's only full-time employee, only being assisted by Mr. Caution, the Faculty's janitor. Later in life Marcia would say that she hired him because of his name!

Within ten years, the library had outgrown its space, and plans, spearheaded by Marcia and Sir William before his move to Oxford, were made to build a headquarters building, mainly to house the library's growing collection of medical books and journals.

Marcia was instrumental in the design and building of the new headquarters. She travelled to Philadelphia, New York and Boston to look at their medical society buildings, and eventually, the Philadelphia architectural firm, Ellicott & Emmart was selected to design and build the new Faculty building. Every detail of the building held her imprimatur, from the graceful staircase, to the light-filled reading room, and all of the myriad details of the millwork, marble tesserae, and most of all, the four-story cast iron stacks. She was on-site, climbing up unfinished staircases, checking out the progress of the building, which was built in less than one year at a cost of $90,000.

Among the features of the new building was a fourth-floor apartment for her. She referred to it as the "first penthouse in Baltimore" and it had a garden and rooftop terrace. The library collection eventually grew to more than 65,000 volumes from medical and specialty societies around the world. Journals were traded back and forth, and physicians eagerly anticipated the arrival of each new issue. At the same time, Marcia was involved in the Medical Library Association as one of eight founding members. The MLA promotes medical libraries and the exchange of information. One of the earliest mandates of the MLA was the Exchange, a distribution and trade service for those who had duplicates or little-used books in their collections. Initially, the Exchange was run out of the Philadelphia medical society, but in 1900 it was moved to Baltimore and Marcia oversaw it. Several hundred periodicals and journals were received and sent each month, a huge amount of work for a tiny staff. In 1904, the Faculty had run out of room to manage the Exchange, so it was moved to the Medical Society of the Kings County (Brooklyn). But without Marcia's excellent administrative skills, it floundered and in 1908, the MLA asked Marcia to take charge once again.

In 1909, when the new Faculty building opened, there was enough room to run the Exchange and with the help of MLA Treasurer, noted bibliophile and close friend, Dr. John Ruhräh, it once again became successful. Additionally, Marcia and Dr. Ruhräh combined forces to revive the MLA's bulletin, which had all but ceased publication in 1908, taking the Exchange with it. This duo maintained editorial control from 1911 until 1926. In 1934, around the time of Dr. Ruhräh's death, Marcia became the first “unmedicated” professional to head the MLA. During her tenure, the MLA incorporated, the first seal was adopted, and the annual meeting was held in Baltimore. Marcia wanted to write the history of the MLA once she retired from full-time work at the Faculty, but her health was beginning to fail. She had back problems and had suffered a serious burn on her shoulder as a young woman, possibly from her time running a summer camp, Camp Seyon, for young ladies in the Adirondack Mountains. In 1946, a celebration was planned to honor Marcia's 50 years at the Faculty. But she was adamant that the physicians wait until November, the actual date of her 50 years. However, they knew she was gravely ill, and might not make it until then, so a huge party was held in April. More than 250 physicians attended the celebration, but the ones she was closest to in the early years, were long gone. She was presented with a suitcase, a sum of money to use for travelling, and her favorite painting of Dr. John Philip Smith, a founder of the Medical College in Winchester, Virginia. It was painted by Edward Caledon Smith, a Virginia painter who had been a student of the painter Thomas Sully.[4] She adored this painting and vowed, jokingly, to take it with her wherever she went.

The painting was not to stay with her for very long, for she died in November 1946, and left it to the Faculty in her will. Her funeral was held in the Faculty's Osler Hall, named for her dear friend. More than 60 physicians served as her pallbearers, and she was buried at Baltimore's Green Mount Cemetery. In 1948, the MLA decided to establish an award in the name of Marcia Crocker Noyes. It was for outstanding achievement in medical library field and was to be awarded every two years, or when a truly worthy candidate was submitted. In 2014, the Faculty began giving a bouquet of flowers to the winner of the award in Marcia's name, and in honor of her work. Much evidence exists for this tradition, as we know that the physicians, especially Drs. Osler and Ruhräh, frequently gave her bouquets of flowers. Marcia also cultivated flower gardens at the Faculty and decorated the rooms with her work.

Today, the MedChi building is open for tours and if the rumors are to be believed Ms. Marcia Crocker Noyes is still at work in her beloved library as the "resident ghost" [1][5]

Marcia Noyes handwriting

NOTE: This article has been modified from the original Wikipedia article on Marcia Crocker Noyes. The article itself is well-written with interesting images of the subject. I would encourage you to visit it. The second insert is from book 00736 in my personal library and shows in pencil, the incredibly small handwriting of Marsha C. Noyes.

Sources:
1. "Marcia, Marcia, Marcia" MedChi Archives blog.
2. "Marcia C. Noyes, Medical Librarian" (PDF). Bulletin of the Medical Library Association. 35 (1): 108–109. 1947. PMC 194645
3. Smith, Bernie Todd (1974). "Marcia Crocker Noyes, Medical Librarian: The Shaping of a Career" (PDF). Bulletin of the Medical Library Association. 62 (3): 314–324. PMC 198800Freely accessible. PMID 4619344.
4. Edward Caledon BRUCE (1825-1901)"
5. Behind the scenes tour MedChiBuilding


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Dr. Miranda speaking at the 2023 Vesalius Triennial
Dr. Miranda speaking at the
2023 Vesalius Triennial

I had the honor of being invited by the University of Antwerp in Belgium to speak at the 2023 Vesalius Triennial Meeting in the city of Antwerp. This scientific meeting was presented in conjunction with the 29th Congress of the Association Européenne des Illustrateurs Médicaux et Scientifiques - AEIMS (European Association of Medical and Scientific Illustrators). A three-day program that, alongside the scientific program, included poetry, art, music, sculpture, and painting. All of this celebrating the life and inspiration brought to arts and medical science by Andreas Vesalius Bruxellensis (1514-1564).

The scientific program included lectures by well-known Vesalius scholars, including Vivian Nutton, Robrecht Van Hee, Francis Van Glabbeek, Philip Van Kerrebroeck, Omer Steeno, Maurits Beisbrouck, Theodor Godeeris, Peter Bols, and many others. Personally, it was incredible to be invited to this event and share with these individuals.

One of the events of this meeting was an afternoon concert entitled “Vesalian landscapes in music, poetry, and photographs” by pianist Elke Robersscheuten, and my friend Theo Dirix, who read the poetry. This was accompanied by slides of Vesalian works, and images of the city of Brussels and the island of Zakynthos, Greece. One of the pieces performed by Elke Robersscheuten was “André Vésale”. Ths rare piece of piano sheet music is the topic for a separate article in this blog: An anatomical surprise from a French composer.

My presentation was entitled “Vesalius and Anatomical Megadrawings – A Personal Journey”. This is a topic that touched on my experience with larger (and very small) books and the sentence written by Andreas Vesalius in the two-page letter to Johannes Oporinus printed in the first part of Vesalius’ opus magnum “De Humani Corporis Fabrica, Libri Septem”. Referring to anatomical images, Vesalius states “quod tabulas quæe nunquam satis magna studiosis proponi poterunt”. Daniel H. Garrison in the latest publication of the Fabrica translates this as “illustrations which could never be large enough for students”.

The need for better resolution and the limitation of the printing technology (hand-carved woodblocks) at the time as well as the quality of the paper available forced the need for larger images. The Fabrica is a folio-size book and the images for the first time are labeled with letters, symbols, and characters with a detailed key as to their meaning.

The research for this presentation took me to the largest anatomy book ever printed, the “Anatomiæ Universæ Icones” by Giovanni Paolo Mascagni (1755 – 1815), a double elephant folio size book measuring 40 by 30 inches with two sets of 44 plates. This book was printed in black and white and hand-colored by Antonio Serantoni (1780 – 1837), an Italian engraver and painter. The printing and coloring of this book took ten years between 1823 and 1832. An incredible book of which there are 16 known copies in the world, one of them at the University of Cincinnati.

Anatomiæ Universæ Icones by Paolo Mascagni at the University of Cincinnati
Anatomiæ Universæ Icones by Paolo Mascagni at the University of Cincinnati

One of the most interesting aspects of this book, besides the large size of each image, is the fact that a 5.9 feet tall human can be constructed if three pages are cut and placed together. Of course, this cannot be done with these incredibly rare and expensive books; but digital technology allows us to scan and lightly correct the background to eliminate imperfections and damage caused by 200 years of use.

With the help of the University of Cincinnati authorities, Gino Pasi (archivist and curator of the Henry R. Winkler Center for the History of the Health Professions at UC), and Samantha Scheck (graphic designer) we were able to access the Mascagni book, measure the images, scan them, and them digitally process them. The result were two large images that I took to Antwerp, receiving incredible feedback from the attendees.

Working with the Mascagni book
Working with the Mascagni book

The life-size anatomy imagined by Mascagni
The life-size anatomy imagined by Mascagni

There is so much more to the life of Paolo Mascagni, before and after his death that include prison, family problems, greed, plagiarism, and a separate individual that is now known for his “dubious character”. I will write separate articles on these topics.

My presentation also touched on the large poster-like drawings (not books) that were used for anatomical teaching before the advent of the 35 mm slide projector and later PowerPoint with halogen light bulb projectors and today large LED monitors. 

The anatomy amphitheater at the University of Chile Medical SchoolThe anatomy amphitheater at the University of Chile Medical School

3 by 4 feet scroll painting by Juan Frutos M.
3 by 4 feet scroll painting by Juan Frutos M.

 My alma mater, the University of Chile Medical School,has a museum and an old wooden amphitheater where I studied anatomy many years ago. As seen in the accompanying image, this auditorium has two incredibly large hand-drawn images that measure 13 feet in height and 5 feet in width.They are copies of the "Traité complet de l’anatomie de l’homme"
by J.M. Bourgery (1831-1854) made by the Chilean painter Juan Frutos M.

The anatomy amphitheater has been deemed National Heritage by the government of Chile and it will be preserved as is. Below the seating area there was a room closed for decades. In it there were found 500 large scrolls that are worthy of research and preservation. These were hand-painted by 47 different authors, some medical students and artists. From the artistic point of view, research needs to be done on the media used as well as the method of painting.

In the time I was a student, these scroll megadrawings were not in use as an old electric arc projector with glass slides were used in its place.

 The information on these drawings can be found in the book “Instituto de Anatomía: Un Recorrido Visual” by Prof. Julio Cárdenas V. My personal thanks to Dr. Cárdenas for facilitating digital images of his book for my presentation. 

 The meeting included an artistic midday soiree entitled “Vesalian Landscapes in music, poetry and photographs” by pianist Elke Robersscheuten and Vesalius expert and taphophile Theo Dirix.

This afternoon concert was followed by scientific poster presentations, an exhibit of anatomical art, and presentation of art and medical books, including “The King’s Anatomist” by my friend Ron Blumenfeld.

As the closure of the meeting, the attendees were invited to a guided tour of the Plantin-Moretus Museum, an institution that preserves the rich history of printing in the 16th century. This tour also deserves a separate article with pictures.

Francis Van Glabbeek, an orthopedic surgeon at the University of Antwerp invited my good friend Dr. Randall Wolf and me to visit his personal rare book collection, which includes not only a 1543 and a 1555 Fabrica, but rarities like books by Bidloo, Cowper, Hyeronimus Fabricio de Aquapendente, and a copy of the “Epistola rationem modumque propinandi radicis Chynae decocti” which was one of the books mentioned in my presentation. A meeting that only collectors of rare books could understand! Later in the day Dr. Van Glabbeek took us to Verrebroek, the city where another famous Flemish anatomist was born: Philippo Verheyen.

 Admiring the title page of the 1543 Fabrica
Admiring the title page of the 1543 Fabrica

With Dr. Van Glabbeek in front of the statue of Philippo Verheyen
Dr. Van Glabbeek and the statue of Philippo Verheyen

Comparing the title pages of the 1543 and 155 editions of the <em>Fabrica</em>
Comparing 1543 and 155 editions

The Platin-Moretus Museum
The Plantin-Moretus Museum

I cannot end this article without reiterating my thanks for the invitation to the organizing committee of this fantastic meeting:

Ann Van de Velde
President AEIMS, University of Antwerp

Pascale Pollier-Green
Past-president AEIMS, University of Antwerp

Francis Van Glabbeek
President BIOMAB, University of Antwerp

Bob Van Hee
Emeritus Professor of Surgery and Medical History
Director of the Lambotte Museum for the History of Health Care, University of Antwerp

Marc de Roeck
University of Antwerp

PERSONAL NOTE: I was invited to deliver a variation of this presentation in November 2023, at the LVIII Chilean Anatomical Society Meeting in Santiago, Chile.