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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This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Mark M. Ravitch, MD
Mark M. Ravitch, MD

Mark M. Ravitch M.D.(1910-1989) American surgeon, historian, teacher, author, innovator, and visionary, Mark Mitchell Ravitch was born in 1910 in New York City. His parents were Russian immigrants, allowing to be fluent in Russian, which opened the doors to one of his many contributions to medicine and surgery: modern surgical stapling.

In 1934, Dr. Ravitch obtained his MD from Johns Hopkins, continuing in the same institution as a surgical intern, and later as a pediatrics resident, where he worked with Dr. Alfred Blalock, eventually becoming a professor of Surgery at Johns Hopkins, moving later to the Baltimore City Hospital. From 1943 to 1946 Dr. Ravitch was a surgeon in the Army.

He moved to the University of Chicago where from 1966 to 1969 he was professor of pediatric surgery and chief of pediatric surgery. His later and last move was to Pittsburgh, where he was professor of surgery at the University of Pittsburgh, and surgeon-in-chief at the Montefiore Hospital in Pittsburgh.

Dr. Ravitch is known for many important contributions to surgery, especially pediatric surgery, where he pioneered a procedure (the eponymic Ravitch procedure) to repair pectum excavatum in children, as well as research and develop a of nonoperative procedure to reduce intussuception using hydrostatic pressure reduction with barium enema. For this and many contributions he is known as one of the founding fathers of pediatric surgery.

A prolific writer and visionary, Dr. Ravitch authored 453 papers, 101 book chapters, 22 books, and served as editor of nearly 20 medical journals. In some of his writings he presented his vision for the development of surgery, even to the point of predicting heart transplantation surgery. Dr. Ravitch also was a surgical historian, with a wonderful library that was donated to the University of Pittsburgh upon his death.

In the medical industry Dr. Mark Ravitch is probably best know for bringing to the USA from the then USSR, the technology of surgical stapling. In 1958, while visiting Kiev, Dr. Ravitch and three other American physicians were shown the use in surgery of a bronchial surgical stapler developed in the USSR. They were able to procure one of these devices and bring it back to the USA. An American entrepreneur, Leon Hirsch, obtained the patents for these devices, founded the United States Surgical Corporation (now the Covidien Surgical Devices Division) and continued the development of the reusable and later the disposable surgical staplers. During the research Dr. Ravitch was joined by Dr. Felicien Steichen (1926 - 2011). Both Drs. Ravitch and Steichen were instrumental in the research and development of these modern surgical devices, making them part of the history of surgical stapling. Their work set the stage for the development of surgical stapling in minimally invasive procedures, so common today.

Dr. Ravitch died in 1989, still teaching students from his own hospital bed. His son Dr. Michael M. Ravitch (1943-2004) followed in his steps in medical education as an educational psychologist at Northwestern University's Feinberg School of Medicine.

Personal notes: I regret not having had the opportunity to meet Dr. Ravitch. In 2006 I spent several hours talking with Dr. Felicien Steichen about his trip to the USSR with Dr. Ravitch and the research and development that happened afterwards. When concluding my visit, Dr. Steichen presented me with a signed copy of his and Dr. Ravitch's book that reads:"Mark Ravitch would have enthusiastically applauded your efforts to teach the science of Anatomy that is the basis of the Art of Surgery". With the loss of both Drs. Ravitch and Steichen a wonderful chapter of the history of surgical stapling has closed.

A few years ago I was contacted by the Ravitch family. Knowing of my interest in Medical History, they donated a series of books signed by Dr. Ravitch. Recently the family also donated the personally typed diary of his trip tp Russia in 1958. They will be well cared and hopefully I will be able to have them printed as a book in the future. Dr. Miranda.

Sources:
1. "Naissance des sutures mecaniques modernes en chirurgie: petites et grandes histoires, en hommage a Mark Ravitch" Steichen,FM Chirurgie 1998,123 (6), 616.
2. "The Peaks of Excitement" Ann Surg 192: (1980) 3, 282 - 287
3. "A Century of Surgery, 1880-1980" Ravitch, Mark M.. Philadelphia
4. "Current Practice of Surgical Stapling" Ravitch, W & Steichen, F. 1991 Lea & Febiger USA
5. "Mark Ravitch (1910 - 1989) Editors, "Current Problems in Surgery" 1989
6. "All heart - Mark Ravitch" O'Donell B. J Ped Surg 25:1 (1990) 184
7. "Mark M. Ravitch: Historian and Innovator" Fingerete, AL, et al. J Surg Ed (2011) 155-158
8. "Reduction of intussusception by barium enema : A clinical and experimental study" Ravitch MM, McCune RM.Ann Surg. 1948;128:904-91
9. "The Surgical Curmudgeon" Pittmed, Spring 2013. 18-23