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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]
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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- Written by: Efrain A. Miranda, Ph.D.
Sinus rhythm electrocardiogram
Sinus Rhythm (SR), also known as Normal Sinus Rhythm (NSR) is the term used to denote normal cardiac activity. A normal beating heart is in sinus rhythm.
In the normal beating of the heart the left and right atria contract almost simultaneously, followed by the contraction of the left and right ventricles. These atrial and ventricular contractions are separated by a lag time of 1/10th of a second which allows the atria to relax (atrial diastole) while the ventricles contract (ventricular systole). The addition of the normal action of the four heart valves (tricuspid, mitral, aortic, and pulmonary) allows the heart to work as a blood pump and circulate blood within the heart and through the body and lungs.
NSR is coordinated by a complex set of structures. The first part is the conduction system, composed of heart muscle cells (cardiomyocytes) which are characterized by automaticity. It is important to state here something that is known, but many times ignored: The conduction system is not composed of nerves... it is formed by specialized cardiac muscle cells! The description of this cardiomyocyte-based system can be read in a separate article here.
The second component is the cardiac autonomic nervous system (CANS), which acts as a moderator (accelerating or slowing) the cardiomyocyte-based conduction system. The CANS has two components, an extrinsic component formed by nerves and ganglia outside the heart, and an intrinsic component of nerves and ganglia that forms a complex network within the superficial aspect of the heart muscle and fat surrounding the heart. These are the cardiac ganglionated plexuses, and their dysfunction can cause abnormal heart rhythm.
Both these systems, the conduction system, and the CANS form a complex cardiac rhythm control system. For more information click here.
When these two components and their thousands of cardiac muscle cells, ganglia, and nerves are working property, the heart is in sinus rhythm, and beats between 60 to a 100 times per minute.
Personal note: The term Normal Sinus Rhythm (NSR) is redundant. By definition, if the heart is in SR, it is normal. On the other hand, the term Abnormal Sinus Rhythm is also not correct… if the heartbeat is abnormal, the heart is not in SR! (Dr. Miranda)
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Histology image of cardiac muscle*
[UPDATED] Cardiac muscle is one of the three types of muscle found in the human body. It is found exclusively in the heart, where it forms the main component of its middle layer, the myocardium.
[Myo]=combining form for "muscle"; [-card-]=heart; and [-ium]=layer or membrane. The myocardium is the muscle layer of the heart.
Cardiac muscle has distinct striations and intercalated discs (see accompanying image). The cardiac muscle acts as a functional syncytium.
The key characteristic of cardiac muscle is automatism or automaticity, its capacity to contract rhythmically in the absence of an external electrical stimulus. The other two types of muscle (smooth and skeletal) lack this characteristic.
The term [cardiomyocyte] can be used to describe each of these cells as the word is composed of [Card(i)o=combining form for "heart"; [myo]=combining form for "muscle"; and the suffix [-cyte]= cell. A cardiomyocyte is a cardiac muscle cell.
The conduction system of the heart is made exclusively of cardiomyocytes, and is part of a more complex rhythm control system of the heart.

Image modified from the original on YouTube from the British Heart Foundation.
* Original histology image by S, Girod and A. Becker, courtesy of Wikipedia.
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- Written by: Efrain A. Miranda, Ph.D.
[UPDATED] These two root terms mean "heart".
The first one, [-card(i)-] arises from the Greek [καρδιά] pronounced kardiá, and can be seen in medical words such as: cardiac, echocardiogram, cineangiocardiogram, cardioplegia, myocardial infarction, etc.
The second one [-cord(i)-] arises from the Latin [cor] or [cordis] and can be seen in words such as: precordial pain, cordial, commotio cordis, etc.
As a point of interest, the original Greek spelling of [kardium] was used by Nobel prize winner Dr. Willem Einthoven (1860 - 1927) when he invented the electrocardiograph and the electrocardiogram. The German term is [elektrokardiogramm] and the German abbreviation for the procedure is EKG. Since we use the term in English, [electrocardiogram] we use the abbreviation ECG. Both are correct, although if you are speaking English, ECG should be used.
* Image property of:CAA.Inc.. Artist:Victoria G. Ratcliffe
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Vine tendril. Image courtesy of Jon Sullivan
The term [pampiniform] comes from the Latin term [pampinus] meaning "a vine tendril". It refers to a twisted, curved structure as seen in the accompanying image. The second portion of the word also comes from Latin, [forma] means "shape" or "in the shape of".
Pampiniform then means "in or with the shape of a vine tendril"
Although mostly associated with the pampiniform plexuses found in both the testicular veins in the spermatic cord and the ovarian veins found within the infundibulopelvic ligament, the term is also used to denote the coiled aspect of the organ of Rosenmuller, also known as the pampiniform body or paraovarium.
The pampiniform body is a non-functional embryological remnant of the development of the female reproductive system. It is composed of a blind longitudinal duct and 10-15 transverse smaller ducts. It is located in the mesosalpinx, an extension of the broad ligament related to the uterine tube (Fallopian tube).
Thanks to David Van Tol for suggesting this article!
Image courtesy of Jon Sullivan, Public domain, via Wikimedia Commons https://jonsullivan.com/
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UPDATED: The term [plexus] comes from the Latin term [plectere] meaning " to twine, or to braid". In anatomy, the term [plexus] refers to a group of structures that are intertwined or form a meshwork. The plural form is [plexuses], although the Latin plural form [plexi] is also correct. Gabrielle Fallopius used the term to denote "a tangle of nerves"
There are many plexuses described in the human body. Most are formed by nerves, but there are many that are lymphatic or vascular. The best known are the plexuses of nerves formed by the ventral rami of the spinal nerves. These are the cervical plexus, the brachial plexus, the lumbar plexus, and the sacral plexus. The image depicts the brachial plexus. For a larger version, click on the image, and for further information on the cervical and brachial plexuses, click here.
Images and links courtesy of:www.bartleby.com
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- Written by: Efrain A. Miranda, Ph.D.
Sinus rhythm electrocardiogram
A contraction, from the Greek [διαστολη] (systolí) meaning “expansion, dilation, drawing out, or prolongation”, also [διαστέλλειν] (diastéllein) meaning “to open, expansion”. When used in music, it means "a pause".
It refers to the dilation of the heart. If you analyze a normal heartbeat (sinus rhythm), there are two diastoles: an atrial diastole and a ventricular diastole. The term diastoleis usually used in reference to the ventricular diastole.
Diastole was first recognized and named by Herophilus of Alexandria (325-255BC), most probably trough animal vivisection. Herophilus was accused of animal vivisection and the dissection of human cadavers. Because of this, some call Herophilus "The Father of Anatomy".
Galen of Pergamon (129AD - 200AD) used the term [διαστέλλεσθαι] (diastéllesthai), also meaning “expansion”.
The word in English was first used in the 16th century. The modern pronunciation in English follows the Greek pronunciation by ending the word in a long “e” as in “to be”.
Sources
1. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.
2. "Medical Meanings - A Glossary of Word Origins" Haubrich, WD. ACP Philadelphia
3. "Dorlands's Illustrated Medical Dictionary" 26th Ed. W.B. Saunders 1994
4. "Greek anatomist Herophilus: the father of anatomy" Si-Yang, N. Anat Cell Biol. 2010; 43(4): 280–283
Note: Google Translate includes an icon that will allow you to hear the pronunciation of the word




