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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Theo Dirix 
Theo Dirix

Note: The following article was recently published in Dutch by my good friend Theo Dirix. Theo is one of our "Vesaliana" contributors, and he has written or has been part of several of the articles in this website. Theo was kind enough to provide a translation of his publication for this blog. There are footnotes in the original publication and I have added them to the end of this article. Dr. Miranda


Christie’s in New York recently sealed the deal of an exceptional copy of the Fabrica, the masterpiece by Andreas Vesalius. The sound resonated widely: buyers were the alma mater of the doctor, the KULeuven (University of Louvain, Belgium), and the Flemish government.

Earlier, a copy of Vesalius’s 1538 adaptation of a teacher’s manual, with his own notes, had already gone under the hammer. This copy of the second edition of the Fabrica from 1555, also richly annotated by the author, was not allowed to escape.

Vesalius enthusiasts eagerly anticipate seeing this historical wonder with their own eyes, following the promised digitization by the KULeuven and its exhibition in their ‘experience center’.

Non-medical or non-Latinist individuals may also find Vesalius captivating. The allure of such a well-traveled, exceptionally driven, and art-loving man is infectious and timeless. The Inquisition had no control over him, and his free-spirited mind and interactions with those of differing beliefs, such as Protestants or Jews, continues to inspire today.

At the end of the First Book of the Fabrica, there is a list of names for the bones of the skeleton as Vesalius knew them: first as he himself preferred to use them, then in Greek and in the Latin of others, and finally in Hebrew. In a certain way, the latter is also the Arabic translation, so he says, as they are “almost all taken from the Hebrew translation of Avicenna by my good Jewish friend and eminent physician Lazarus de Frigeis (with whom I usually study Avicenna).” 1

The opening print of the Fabrica may even feature an image of his friend.  After all, Vesalius had one of his public dissections illustrated. 2

"A colorful crowd, rows deep, stands, hangs, and drums around the table on which a corpse is being dissected. Three quarters of almost two hundred guests are students, with about fifty doctors and other notables also in attendance."

That is how the German student Baldasar Heseler described in his diary a public dissection in Bologna, conducted by the Flemish anatomist Andreas Vesalius.

Among the attendees were likely curious individuals who also frequented public executions or animal fights. Dissections were not serene practical lessons like today. Sometimes several dissections followed each other, often chaotic and in a festive atmosphere during the carnival period: today a hanged man, tomorrow a prostitute, in between a dog.

The image Vesalius chose for his first version of the Fabrica in 1543 is more symbolic in nature. Various authors see allegories in the ninety characters, as well as historical and contemporary prominent figures and acquaintances. 3

A striking figure who is central yet isolated is a man with a long beard, red in some colored versions, wearing a truncated conical headdress such as a tarboosh or fez. He turns towards his neighbor who whispers or shouts something to him. Or is he responding to the scene unfolding beneath him with the dismissive gesture of his left hand? With understanding or disgust?

Like other guests, he wears a heavy cloak; dissections were preferably performed during the cold winter months. It may be far-fetched, but don’t those stripes on his cloak remind us of the threads of a Jewish prayer shawl? Is this “his good Jewish friend and leading physician Lazarus de Frigeis”?

In the opening print of the second version from 1555, the stripes or threads are less clear. The sharp gaze is also blurred. And isn’t that beard shorter? Things have indeed changed in twelve years.

Title Page 1543 Fabrica

Title Page 1555 Fabrica

For example, the originally naked spectator on the balcony now wears a suit. The dog, bottom right, has a goat or goat next to him: is that perhaps the devil? The pennant of the all-dominating skeleton in the center becomes a scythe in the hands of Death.

Many find the later image less appealing than the original and speculate as to the reasons: Was it created by a different and perhaps less talented artist? Was the initial woodcut set aside because it had already been extensively used? Do the alterations suggest censorship or self-censorship, perhaps with an eye towards the advancing Inquisition?

Vesalius also made numerous changes to the text in the second edition. It remains a mystery how he communicated these changes to his Basel printer, Oporinus. This curiosity extends to his annotations and the third edition he had in mind. For instance, in the second edition, he omitted all references to his friends, retaining only the mention of Lazarus de Frigeis. However, the descriptors ‘Jewish’ and ‘leading physician’ were removed. Lazarus is still described as “his good friend.” Why did the reference to Judaism have to vanish?

One explanation posits that the descriptor ‘Jew’ had become redundant. Following the perspective of a researcher who identifies Lazarus de Frigeis as Lazzaro Freschi, the son of Rabbi Raffaele Fritschke, it is thought that Lazarus converted to Christianity in 1549, assuming the name Giovanni Battista Freschi Olivi. 4

Another explanation suggests that it may have been safer at the time to avoid allusions to Jewish beliefs or conversions. According to the same source, Lazzaro Freschi and his mother moved, or were compelled to move, to the Venice ghetto in 1547.

The word ‘getto’ is Italy’s ‘contribution’ to anti-Semitism, akin to later terms such as ‘pogrom’ from Russian, ‘Endlösung’ from German, and the slogan in English today commonly heard on European streets: “From the River to the Sea”.

Vesalius, however, continued to refer to Lazarus de Frigeis as his good friend. Not only was the anatomist well-traveled, passionate about his work, and an admirer of art, he was also loyal, open-minded, and, above all, courageous.

Theo Dirix

With gratitude to Omer Steeno, Maurits Biesbrouck, and Theodoor Goddeeris

Footnotes:

1. based upon: Maurits Biesbrouck. Nederlandse vertaling van het eerste boek van Andreas Vesalius’ Fabrica 1543, handelend over het Menselijk Skelet. P. 394.
2. with differences in the frontispieces of the Fabrica’s of 1543 and 1555: https://exhibitions.lib.cam.ac.uk/vesalius/
artifacts/coloured-frontispiece-1543/, and https://library.missouri.edu/specialcollections/exhibits/show/vesalius500/fabrica/a-tale-of-two-title-pages
3. for example: C.D. O’Malley. Andreas Vesalius of Brussels 1514-1564, University of California Press, Berkeley and Los
Angeles, 1964, p. 140.
4. Toaff, Ariel. Pasque di sangue, Ebrei d’Europa e omicidi rituali, Societa editrice il Mulino, Bologna, 2007, p. 197 - 198