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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
"Clinical Anatomy Associates, Inc., and the contributors of "Medical Terminology Daily" wish to thank all individuals who donate their bodies and tissues for the advancement of education and research”.
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The [pubococcygeus muscle] is one of the muscles that forms the pelvic diaphragm. It is the deepest and one of the two muscular components of the levator ani muscle, the other one being the iliococcygeus muscle.
The pubococcygeus muscle attaches anteriorly to the posterior aspect of the body of the os pubis or pubic bone, leaving a gap or hiatus anteriorly which allows passageway of the deep dorsal vein of the penis in the male or the deep dorsal vein of the clitoris in the female.
Anterolaterally, the pubococcygeus muscle attaches to a thickening of the deep fascia of the obturator internus muscle called the Arcus Tendineous Levator Ani (ATLA).
As its name implies, the pubococcygeus attaches posteriorly to the sacrococcygeal region and posteromedially it attaches to a medial ligamentous structure that stretches between the anal canal and the coccyx, the anococcygeal ligament or anococcygeal raphe.
Several subcomponents are described in the pubococcygeus muscle, one of them being the puborectalis muscle. This muscle is the medial component of the pubococcygeus, it attaches anteriorly to the pubic bone and arches posterior to the anal canal, kinking it and being one of the components of fecal continence.
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Dura Mater: Latin terms meaning [tough mother]. The dura mater is the outermost of the three meninges. It is quite tough, forming a sac containing the spinal cord and brain, known as the dural sac or thecal sac. The image, from a book by Andreas Vesalius, shows a head with the dura mater in situ (label "A").
For more information on the meninges, click here.
Original images from Andreas Vesalius '"De Humani Corporis Fabrica; Libri Septem" (1543)
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This suffix [-(o)centesis] arises from the Greek [kentesis], meaning "to tap" or "to perforate", referring to a needle or trocar. In practical terms, this suffix means "needle aspiration of". Examples of its use are:
- Pericardiocenteses: Needle aspiration of the pericardium
- Thoracocentesis: Needle aspiration of the thorax. The use of the term "thoracentesis" is wrong!
- Amniocentesis: Needle aspiration of the amniotic sac
- Arthrocentesis: Needle aspiration of a joint
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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.

Ephraim McDowell
Ephraim McDowell (1771- 1830). American surgeon, Ephraim McDowell was born in 1771 in the Augusta County of Virginia. His family moved to the “frontier”, which at that time was Kentucky, where his father was a judge. McDowell studied in Kentucky and returned to Virginia to serve as an apprentice to Dr. Alexander Humphreys. Following Dr. Humphrey’s advice McDowell went to Edinburgh to finish his formal medical training, which he did not finish, taking chemistry, anatomy, and then a private medical course with Dr. John Bell.
Returning to America, he settled in the Ohio River Valley, and had a successful practice as a frontier surgeon in the city of Danville, Kentucky. This was before the advent of anesthesia and antisepsis.
On Christmas Day 1809, Dr. McDowell performed the first recorded ovariotomy to drain a massive ovarian cyst from Mrs. Mary Jane Crawford, who had to ride a horse for sixty miles to get to Dr. McDowell’s office where he performed the ovariotomy without anesthesia. Mrs. Crawford had been diagnosed as “pregnant” by two other physicians. Dr. McDowell’s hand-written report states that he performed a nine-inch abdominal incision, the operation lasted about twenty five minutes, and they removed “fifteen pounds of a dirty gelatinous substance” and “extracted the sac, which weighed seven and a half pounds”.
Mrs. Crawford survived the operation, was ambulatory in five days, and lived for 33 additional years, until she was 78 years old. Research has been made as to the reason for the survival at a time when the norm for an operation that penetrated the peritoneal cavity was death. Othersen (2004) states that his research indicated that Dr. McDowell was “meticulous, neat and scrupulously clean”.
Because of the times, and because Dr. McDowell was not into writing, the achievement was not known for many years, until 1817. Dr. McDowell later performed a lithotomy on James Polk, who would eventually become president of the United States. In 1825, his achievements were recognized and he received an honorary MD degree by the University of Maryland.
Dr. McDowell’s house in Danville, KY is today a museum, and his name is remembered by the “Ephraim McDowell Health System” a group of integrated healthcare based in the same city. For more information on Mary Jane Crawford, click here.
PERSONAL NOTE: On February 19, 2017 I was able to go visit this place. Click here for a series of articles and pictures of this visit. Dr. Miranda
Sources:
1. “Ephraim McDowell (1771-1830) Kentucky Surgeon” JAMA. 1963;186 (9):861-862
2. “Ephraim McDowell: The Qualities of a Good Surgeon” Othersen, HB Ann Surg. 2004; 239(5): 648–650
3. “Ephraim McDowell (1771-1830): pioneer of ovariotomy” Tan,SY & Wong, C. Singapore Med J 2005; 46(1) : 4
4. “Ephraim McDowell, the First Ovariotomy, and the Birth of Abdominal Surgery” Horn, L and Johnson, DH. J Clin Onco 2010: 28; 7 1262-1268
5. "Surgeon of the wilderness: Ephraim McDowell" Haggard, WD. Presidential Address, ACS 1933. FACS archives 1934, 58: 415-4198
Image in Public Domain. Courtesy of the National Library of Medicine.
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Anteroinferior view of the liver and stomach
The [lesser omentum] is a double-layered peritoneal membrane found between the stomach and the first portion of the duodenum and the liver.
Between the two layers of the lesser omentum there is a small amount of fat, the coronary vein, the arteries of the lesser curvature vascular arcade, the gastroduodenal artery, and the structures of the portal triad: Portal vein, common bile duct, and proper hepatic artery.
The lesser omentum is divided into two subcomponents:
- The gastrohepatic ligament, the larger component, found between the lesser curvature and the liver. It includes the pylorus.
- The gastroduodenal ligament, the smaller component, found between the first portion of the duodenum (superior portion, duodenal ampulla) and the liver. The common bile duct is found between the layers of the omentum.
Image property of: CAA.Inc. Photographer: David M. Klein
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The word [celiac] is the American version of the more internationally used term [cæliac]. It derives from the New Latin word [c?liacus] which means "pertaining to the bowels". This term in turn arises from an older Greek term [koilus] which means "hollow", "cave", or "cavity". By extension the words celiac or cæliac have come to mean "pertaining to the abdominal cavity".
In embryology, the term [celomic cavity] (a redundancy) is used to denote the combined abdominal and thoracic cavities in the embryo before the respiratory diaphragm separates these two into two separate bodily cavities.
The term [celiac] is used in other words such as:
- Celiac trunk: one of the unpaired branches of the abdominal aorta
- Celiac disease: an abdominal pathology characterized by distention and retention
- Celiac plexus: a plexus of autonomic nerves found around the celiac trunk.




