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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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The root term [-spondyl-] arises from the Greek [spondylos] meaning "vertebra", and suffix [-osis] means "condition", but with the connotation of "many". The word [spondylosis] means " condition of many vertebrae". This does not add much to the use of this word as an indicator of a pathology, but it does indicate that there is excess bone in a vertebral pathology.
Spondylosis is an osteoarthritic degeneration of the vertebrae and the spine characterized by abnormal bony growths on the vertebrae that can impinge on nerves and other structures causing pain and mobility problems. The definition of spondylosis also includes degenerative changes in the intervertebral discs.
The abnormal growth of portions of the vertebral body, usually forms "bone spurs", also referred to as "spondylophytes". The accompanying image shows a lumbar vertebra with spondylophytes.
Image property of: CAA, Inc. Photographer: David M. Klein
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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.
Dr. Rudolph Nissen
Dr. Rudolf Nissen (1896 - 1981). Dr Nissen’s life is extraordinary. Born in the city of Neisse, Germany in 1896, he was the son of a local surgeon. He studied medicine in the Universities of Munich, Marburg, and Breslau. He was the pupil of the Karl Albert Ludwig Aschoff (1866 - 1942) a German physician and cardiovascular researcher. Another of Aschoff's pupil, Dr. Sunao Tawara (1873 - 1952), discovered the atrioventricular node.
Nissen became a professor of surgery in Berlin, and in 1933 moved to Turkey where he was placed in charge of the Department of Surgery of the University of Istanbul. In 1939 he moved to the US, first to the Massachusetts General Hospital and later to the Jewish Hospital in Brooklyn, New York. After becoming a US citizen, he moved again in 1952 to Basel, Switzerland as Chief of the Department of Surgery, where he retired in 1967. He died in 1981.
His contributions to surgery are innumerable. He wrote over 30 books and 450 journal articles. Known for the development in 1956 of what is today known as the “Nissen fundoplication” for esophageal hiatus hernia surgery, Nissen also worked with his assistant, Dr. Mario Rossetti to develop the “floppy Nissen fundoplication”, also known as the “Nissen-Rossetti procedure”. This would be enough to honor this man, still, he (with Sauerbruch) performed the first lung lobectomy and the first pneumonectomy (called then a total pneumonectomy). In 1949 he performed the first esophagectomy with a gastroesophagostomy for lower esophageal cancer.
His personal life is even more interesting. Drafted at 20, he fought in WWI and was wounded several times. In 1933, under the Nazi regime, he was ordered to fire all the Jewish-German assistants under his care. Being Jewish himself, he was told that he would keep his job, Nissen could not take this. He resigned his position and moved out of Germany.
Another little known fact is that he operated on Albert Einstein in 1948. He operated on Einstein because of intestinal cysts. Having found a developing abdominal aortic aneurysm, he reinforced it with cellophane, undoubtedly giving his patient a few extra years to live. Einstein died in 1955.
As a personal side note, our good friend Dr. Aaron Ruhalter scrubbed in with Dr. Nissen while serving as a surgical resident at the Brooklyn Jewish Hospital!
Sources:
1. “Rudolf Nissen: The man behind the fundoplication” Schein et al. Surgery 1999;125:347-53
2. “Rudolf Nissen (1896–1981)-Perspective” Liebermann-Meffert, D. J Gastrointest Surg (2010) 14 (Suppl 1):S58–S61
3. “The Life of Rudolf Nissen: Advancing Surgery Through Science and Principle” Fults, DW; Taussky, P. World J Surg (2011) 35:1402–1408
4. “Total Pneumonectomy” Nissen, R. Ann Thorac Surg 1980; 29:390-394
5. “Historical Development of Pulmonary Surgery” Nissen, R. Am J Surg 80: Jan 1955 9- 15
Image in the public domain, courtesy of the Universitat Basel
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The suffix [-oma] means "tumor", "mass", or "growth". It should be noted that the word [tumor] is originally Latin, and means "swelling" or "bulging". Sometimes the plural form [-omata] can be used.
It is a general misconception that the suffix [-oma] or the term [tumor] are synonymous with "cancer". This is not so. [Tumor] only means a mass and the type of mass, benign or malignant is not implied in the term. A cancerous mass will be denoted by the addition of the root term [-carcin-] meaning "cancer" therefore the combined root and suffix will be [-carcinoma]. There are other root-suffix combinations that also mean "cancerous".
The suffix [-oma] can be found in many medical words, such as:
- Hematoma: from the Greek root [-hem-] meaning "blood". A mass of blood
- Myoma: from the root [-my-] meaning "muscle". A mass, growth, or tumor of muscle
- Fibroma: from the root [-fibr-] meaning "fiber". A mass of fibers
- Fibromyoma: the combining form of "muscle" is [myo-], therefore "a mass of fibers and muscle" (Pl. fibromyomata)
- Adenoma: from the Greek [aden-] meaning "gland". A mass that has a glandular look to it or a mass in a gland
Sources:
1. "The Language of Medicine" John H. Dirckx Pub: Harper & Row 1976
2. "Medical Meanings" Haubrich, William S. Am Coll Phys Philadelphia 1997
3. "The origin of Medical Terms" Skinner, AH, 1970
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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.
Giovanni Batista Morgagni
Giovanni Battista Morgagni (1682 - 1771). Italian anatomist, physician, and pathologist, Morgagni was born in the city of Forli. He started his medical studies at the University of Bologna, graduating in 1701 with a degree in Medicine and Philosophy. In 1712 he became a professor of anatomy at the University of Padua, Italy, 175 years after Andreas Vesalius. Morgagni was offered and accepted the Chair of Anatomy in 1715 at the University of Padua. Although Morgagni held a position at the anatomy department of the University of Padua, his name is associated mostly with his pathological studies.
Morgagni was interested in the works of Theophile Boneti (1620 - 1689), who started analyzing the correlation between post-mortem anatomical findings and diseases. He tried to establish a relation between the disease and the cause of death. In 1761 Morgagni published his most influential work "De Sedibus et Causis Morburum Per Anatomen Indagatis" (On the Sites and Causes of Diseases, Investigated by Dissection). His work was essential for pathological anatomy to be recognized as a science in itself.
Morgagni was elected to become a member of several Academies of Science and Surgery: The Royal Society of London, The Academy of Science in Paris, The Berlin Academy of Science, and the Imperial Academy of Saint Petersburg in Russia. He is remembered today by several eponyms in anatomy and pathology:
- Morgagni's caruncle or lobe, referring to the middle lobe of the prostate
- Morgagni's columns: the anal (or anorectal) columns
- Morgagni's concha, referring to the superior nasal concha
- Morgagni's foramina: two hiatuses in the respiratory diaphragm allowing for passage of the superior epigastric vessels
- Morgagni's hernia: an hiatal hernia through Morgagni's foramen, in the respiratory diaphragm
- Morgagni's ventricle: an internal pouch or dilation between the true and false vocal cords in the larynx
- Morgagni's nodules: the nodules at the point of coaptation of the leaflets (cusps) of the pulmonary valve. Erroneously called the "nodules of Arantius", which are only found in the aortic valve
Sources:
1. "A Note From History: The First Printed Case Reports of Cancer" Hadju, S.I. Cancer 2010;116:2493–8
2. "Giovanni Battista Morgagni" Klotz, O. Can Med Assoc J 1932 27:3 298-303
3. "Morgagni (1682 -1771)" JAMA 1964 187:12 948-950
Original image in the public domain, courtesy of National Institutes of Health.
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The term [lumen] is Latin and means "light". It is an international measure of light intensity. The plural form is either [lumens] or the Latin version [lumina].
The question is how did this term end up meaning the "internal opening or cavity of a hollow organ"? Dr. J. Dirckx (1976) explains that the term [lumen] in gastrointestinal anatomy was not used until the late 19th century, but it was initially used by microscopists looking at cross sections of small vessels. Since the empty interior of the vessel was represented on the histological slide as a clear, lighted region, they started calling that the "light" of the vessel, or [lumen].
The root term for [lumen] is [-lumin-] and can be found in over 30 words in English and related to light, such as luminosity, luminaria, luminescent, luminous, illumination, illuminator, intraluminal, transluminal, endoluminal, etc.
The correct adjective form for [lumen] is [luminal], as stated by Haubrich (1997). The point is that the use of the term "lumenal" as an adjective form for lumen is not correct. This term can be seen wrongly used in many textbooks today. The proper form for the NOTES acronym is "Natural Orifice Transluminal Endoscopic Surgery"
If you hover over the image you will "illuminate" this article!
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Original image courtesy of Wikipedia.org
An esophageal hiatus hernia (also known as a hiatal hernia) eventually may require surgery. In this case, the objective is three-fold: To bring the abdominal viscera to its proper intraabdominal position (reduction) , to create a pseudovalve to prevent gastroesophageal reflux, and to prevent a recurrence of the herniation.
There have been different procedures developed to this effect. One of the most popular has been the Nissen fundoplication either trough the open surgery approach or by way of a minimally invasive laparoscopic procedure.
This procedure was pioneered by Dr. Rudolf Nissen (1896 - 1981) in 1955. After reducing the hiatal hernia and repairing the dilated esophageal hiatus, the surgeon creates a gastric wrap around the abdominal esophagus by bringing the fundus of the stomach through a retroesophageal passage, and suturing the fundus to the stomach. (see image). One of the concerns of the procedure is the ligation and transection of the short gastric vessels that pass within the gastrosplenic ligament to allow greater mobility of the gastric fundus and prevent potential avulsion of the short gastric vessels.
Since the introduction of this open procedure in 1955 there have been several variations, such as the "Nissen-Rosetti" procedure, a "loose" fundoplication; the "Toupet" procedure, an "incomplete" fundic wrap, and others, including laparoscopic procedures.
The advent of NOTES (Natural Orifice Transluminal Endoscopic Surgery) has brought a new procedure: Transoral Incisionless fundoplication (TIF), where a pseudovalve is created using an endoscope inserted into the esophagus and stomach through the oral cavity without abdominal incisions or trocar ports. For more information on this procedure, click here. Clicking on the inferior image will start a six-minute video of the TIF procedure and the EsophX device.