American Medical Biographies/Bowditch, Henry Ingersoll
Bowditch, Henry Ingersoll (1808–1892)
Henry Ingersoll Bowditch, chairman of the first Massachusetts State Board of Health, pioneer specialist in diseases of the chest; introducer of "paracentesis thoracis," was the third son of the celebrated mathematician, Nathaniel Bowditch, and of Mary Ingersoll, his wife. He was born in Salem, Massachusetts, August 9, 1808, his early life being spent in Salem; but in 1823 his father moved to Boston, which became his permanent home. The old house in which he lived at first was at 8 Otis Place, now Winthrop Square, at the junction of Devonshire and Otis Streets in the present heart of the business section of Boston, at that time a quiet residential section of the city. In 1859 he moved to 113 Boylston Street (afterwards numbered 324), opposite the Public Garden, where he remained until his death thirty-three years later, in 1892.
He graduated from Harvard College in the Class of 1828, and subsequently began his medical studies in the Harvard Medical School, receiving an A.M. and M.D. in 1832. Later he was house officer in the Massachusetts General Hospital under the tutelage of his revered master, Dr. James Jackson (q. v.), for whose character and skill he always felt the deepest reverence. In 1832 he went abroad to study in Paris, and was fortunate in becoming associated with the great Louis. For the greater part of two years he was under the latter's guidance in the hospital of La Pitié in the Quartier Latin. With Louis, he became deeply interested in the teachings of Laennerc in examinations of the chest by auscultation and percussion; and he became so proficient that his contemporaries prophesied that he would be fitting successor of Dr. James Jackson, who was the leading physician in Boston in this special line of work at that time.
This was the beginning of his subsequent fame as a specialist in diseases of the chest and gave him the inspiration for the important work with which his name will be always associated, namely, thoracentesis (aspiration of the chest in pleuritic effusions by the aspirating needle and trocar), and his studies upon the probable predisposing causes of pulmonary tuberculosis, at that time usually spoken of as "consumption" or "phthisis."
Previous to his return to Boston in 1834, he visited the hospitals of Great Britain but found always his chief inspiration in Paris under the men who at that time were leaders in the medical world, the palm always being given by him and others to the great Louis.
After his return to Boston he began practice in general medicine, although he never practised surgery. During the early years he wrote and published "The Young Stethoscopist," a little book even now often referred to as containing most valuable instruction in the art of auscultation and percussion of the chest.
In 1835, when he had become a member of theMedical Society, he founded with Dr. John Ware the Boston Society of Medical Observation, a similar organization to that under the leadership of Louis in Paris. It existed as a student society for two years when it was discontinued, then revived again by Dr. Bowditch and seven others, the organization being merged many years afterwards into the Boston Society for Medical Improvement. From the Society of Medical Observation, the Boston Medical Library Association took its birth, the first meeting of the association being held in Dr. Bowditch's office, December 21, 1874, six gentlemen being present, and in 1878 he made an address at the dedication of the Library in Boylston Place and took the keenest interest in its growth from that time.
Incidentally, immediately after his return from Europe he witnessed the so-called "Broadcloth Mob," in which William Lloyd Garrison was mobbed by respectable citizens of Boston at the Old State House for his burning denunciation of slavery. Instantly, Dr. Bowditch with the fire which was one of his marked characteristics, espoused the cause of the Abolitionists headed by Garrison, and took active part in all the auxiliary work in Massachusetts until slavery was abolished by the Civil War. This enthusiasm for the cause of the slave was followed by his being ostracized socially by many of the aristocratic members of Boston society. Such opposition only seemed to fire him to even stronger endeavors, and at the risk of loss of practice, and in spite of vehement denunciations of his course by some of the press in Boston, he resolutely held to his convictions undaunted.
His numerous journals, extracts from which were published by his son in 1902 in the "Life and Correspondence of Henry Ingersoll Bow-ditch," give vivid proof of Dr. Bowditch's active part in what he used to call the "Thirty Years' War of Antislavery." They form deeply interesting records of the history of that great movement in the United States.
In 1838 Dr. Bowditch was married to Miss Olivia Yardley of London, England, whom he had first met in Paris six years before, and to whom he had become deeply attached: a perfect union which lasted up to her death, fifty-two years later. They had four children.
Notwithstanding the calls upon his time for anti-slavery work, he was always deeply interested in his researches in medicine. His work on the ova of the lymnea (common snails) was an illustration of his great attention to detail in any scientific work. Under the microscope, he, for months, daily watched the development of the ova, and with the help of his wife succeeded in illustrating by exquisite drawings the growth of the snail from its earliest stages. This work is a classic which has been often referred to by eminent men in recent times.
Early in practice he was convinced of the lack of proper treatment for pleuritic effusions, and he watched with deepest regret the death of many a patient from the lack of what he then believed to be the proper surgical procedure in cases of large effusions which gave rise to great Dr. Morrill Wyman (q. v.), of Cambridge, Mass., who had used successfully a trocar and connected with a suction pump on a case in which Dr. Bowditch had been called in consultation, April 17, 1850. Dr. Bowditch's first paper "On Pleuritic Effusions, and the Necessity of Paracentesis for their Removal" was read before the Boston Society for Medical Observation, Oct. 20, 1851, and published in the American Journal of the Medical Sciences, April, 1852. He believed that at last the proper instrument had been found, and from that time to use the method in suitable cases successfully and in spite of great opposition at first. During the following ten years, Dr. Bowditch operated in several hundred cases without a single death and with infinite relief to the patients as a rule. He had advised a slight modification of Dr. Wyman's suction pump, which he always used. Several years after Dr. Bowditch had published the records of many cases in which he had thus aspirated the pleural cavity, (Amer. Jour. Med. Sci., Jan. 1863), Dieulafoy in Paris proclaimed to the world his excellent aspirating instrument, which differed in detail, not in principle, from Dr. Wyman's, but he never made the least allusion to the work done several years before by Dr. Bowditch; an omission which Sir William T. Gairdner of Edinburgh, the eminent clinician and professor of medicine, sharply criticized in a paper published in later years in the Edinburgh Medical Journal. Dr. Bowditch in all of his papers spoke of his debt to Dr. Wyman, who invented the original instrument, but the long and exhaustive study of cases and the successful result of introducing to the medical world the now well-known operation of thoracentesis was due to Dr. Bowditch's persistent effort to compel the profession to adopt this method of treatment.and often death from suffocation. Opening of the chest wall by surgical incision had been occasionally practised at rare intervals in former years, but only in cases of apparent chronic pleurisy. Shrinking from any form of surgery, for which he felt he had no talent, he nevertheless urged surgeons to relieve patients by removal of fluid in acute pleuritic effusions; but in this idea he was strenuously opposed by men of highest reputation, even surgeons. His revered master, Dr. Jackson, told him it was too dangerous, and that absorption by nature's method was the only proper way of removing fluid. One surgeon went so far as to say he "would as soon shoot a bullet into the chest wall" as to follow Dr. Bowditch's suggestion. Convinced of the correctness of his own view, however, Dr. Bowditch persisted, and finally was rewarded by seeing an instrument devised by
At the same period, Dr. Bowditch was making careful investigations also as to the probable causative factors of phthisis pulmonalis ("consumption"), now usually termed pulmonary tuberculosis. For eight years he pursued his investigations by letters written to physicians throughout the state asking for data in regard to the prevalence of consumption in their localities, and the situation of homes in which the disease was most common. The result of these investigations seemed to prove the fact that residence upon a damp soil is a potent factor in the propagation of the disease. The discovery twenty years later of the bacillus tuberculosis by Koch seems in no way to weaken the theory that high dry soil is less prone to the prevalence of tuberculosis than situations in low swampy lands. As orator at the Annual Meeting of the Massachusetts Medical Society in 1862, he presented the paper entitled "Topographical Distribution and Local Origin of Consumption in Massachusetts." This address was received with acclamation by the society and was subsequently distributed in pamphlet form throughout the state.
At almost exactly the same time, Buchanan of London was making similar investigations with like results in England, neither being aware that the other was at work upon the subject.
Dr. Bowditch took the keenest interest in the Massachusetts Medical Society and held important positions; recording secretary 1849 to 1851, corresponding secretary from 1851 to 1854. He attended meetings with marked regularity from 1847 to 1887 when failing health compelled him to cease his attendance. From the time that the subject was first introduced in June, 1875, he advocated strongly the admission of women to the society and afterwards he was chairman of a committee on this subject. He was especially active in matters pertaining to public health projects and the bettering of vital statistics. From 1859 to 1867 he held the position of Jackson Professor of Clinical Medicine at the Harvard Medical School. During his professional career he was at first connected with the Massachusetts General Hospital and afterwards with the Boston City Hospital and the Carney Hospital in South Boston as attending physician.
During the Civil War, 1861–5, Dr. Bowditch gave his services freely to his country. For many months he made examinations at theOffices, and after a visit to the battlefields of the South, where he was shocked and horrified at the shameful lack of an ambulance system, with the consequent fearful and unnecessary suffering of wounded soldiers, he addressed letters to Congress, and especially to Vice-President Johnson, and with characteristic ardor described his personal observations of the condition of our suffering soldiers. The singularly pathetic incident of the agonizing experience of his oldest son, left on the battlefield unaided for twenty-four hours, and his subsequent death following close upon the father's fervent appeal to the country to rectify these errors, was a potent factor in bringing about the desired change not long afterwards. In the midst of his crushing sorrow, Dr. Bowditch strove only more earnestly to rectify these wrongs. Within a comparatively short time afterwards, Congress passed a bill making adequate provision for the wounded and an ambulance system was established.
Deeply interested in all sanitary matters, Dr. Bowditch was appointed in 1869 by the Governor of Massachusetts, with six others, to form a State Board of Health, the first in the United States; and as chairman of the board he gave much time and thought to this work, without salary, for ten years, until the foolish tactics of General Benjamin Butler prevailed and with false notions of economy the Governor then in office combined the Boards of Health, Lunacy, and Charity. The result of this action was such as to destroy all efficiency of work. After a few months of ineffectual attempts to make the Governor change the policy, Dr. Bowditch with deepest regret resigned from the Board in 1879. What the United States owes to the work of Dr. Bowditch and his associates on the Massachusetts Board of Health,—the first to be established in America, and the first to point the way for subsequent similar associations now formed throughout the,—can never be estimated. Their names will stand pre-eminent in the history of preventive medicine in the United States.
The respect which was shown abroad for the establishment of the original board was well shown in a comment made upon Dr. Bow-ditch's first address to the Board in the "Gazette Médicale de Paris."
During his term of service, in 1871, he issued another work, entitled, "Intemperance in New England and How Shall We Prevent It?" This paper was again the result of several years' investigation of the customs in different countries of the world, as to the use of light wines, beer, and liquors. Basing his opinion upon the replies received from innumerable sources, he declared that the use of light wines and beer in moderation was not seriously detrimental, and that total prohibition was not advisable, even going so far as to say that it would be well to advocate the substitution of beer and light wines for liquors, inasmuch as a natural craving for stimulant among human beings would be thus met without serious detriment to health. Whether he would have modified these views towards favoring prohibition in later years, it is impossible to say, although his inclinations were always towards very moderate use of any alcoholic stimulant whatever. His position on this matter at the time brought forth a torrent of abuse from Prohibitionists, one popular preacher going so far as to announce a lecture entitled, "Dr. Bowditch and Free Rum!" an amusing episode to all who knew him upon whom the attack was launched!
In 1874 he published another article for the fifth annual report, entitled, "Preventive Medicine and the Physicians of the Future." After an extensive review of the grand scope of preventive medicine, he finally gives his reasons for placing before the public a brief history of events relative to the subject in Massachusetts.
In 1876, at a meeting of the International Medical Congress in Philadelphia, he gave an address called, "State Medicine and Public Hygiene in America," an exhaustive study of the conditions existing then in the United States, and a discouraging but at the same time stimulating account of the wretched lack of hygienic methods in the country, with suggestions as to what could be done to improve them. This address marked an epoch in the history of hygiene in the United States, and was received with enthusiasm by the Association. At the request of its members, copies of the address were sent broadcast to the various state legislatures and Governors throughout this country and Canada.
Although taking no active part in public affairs of this nature in his later years, Dr. Bowditch never lost his interest in all questions pertaining to the realm of Preventive Medicine. He continued the practice of his profession as a specialist in diseases of the chest until within two or three years of his death. The last paper he ever read was at the meeting of the American Climatological Association in Boston in 1889. In this brilliant and picturesque article entitled "Open-Air Travel as a Cure for Consumption," he gave the history of his own father, who, in 1808, at the age of 35, began to have severe hemorrhages and other symptoms of incipient pulmonary tuberculosis, and adopted as his first means of cure, after the first active symptoms had ceased, a drive lasting several weeks through towns of New England in an open buggy with a friend, the subsequent history being one of entire recovery after change in his methods of life. After his death, at the age of 67, from cancer of the stomach, the healed lesion of the lung was found at autopsy. This article can be regarded almost as a classic in its concrete exposition of the value of hygienic treatment of tuberculosis in a manner little known or understood in those earlier days of New England life.
No biography however short would be complete without allusion to Dr. Bowditch's deeply religious nature. Although devoted to scientific truth, he never swerved from his religious faith which seemed to pervade every action of his life. Although early in life he passed through years of doubt and perplexity in matters relating to forms of religious expression, he came in later years to a serenity of mind on such subjects that never failed. Although a Unitarian in his final beliefs, his breadth of wisdom and tolerance of other views were marked features of his character. Just so long as the expression of any belief was thought by him to be sincere, he gave it that respect which he felt was due to the opinions of others even if they differed wholly from his own. He saw beauty in every form of religious thought while adhering to that which appealed most strongly to him. This breadth of judgment extended to his professional work, and especially to his intercourse with his younger associates who freely turned to him for counsel and advice.
A free and general culture he always strongly advocated to his students as the best means of avoiding the danger of becoming "men of one idea" with consequent detriment to their professional work. He believed in travel and the consequent humanizing effect of the study of men and manners other than our own. His enthusiasm for life extended to his latest years in spite of increasing infirmities and weakness towards the end. The death of his wife, after fifty-two years of an ideally happy union, marked the beginning of the end. Thirteen months later, on January 14, 1892, he died, at the age of 83.
- Le mois dernier on a fondé à Boston un comité de santé publique sous la présidence du docteur Henry Bowditch. Celui-ci, dans son discours inaugural, a tracé tout le programme que le propose le nouveau comité. Ce programme est trés remarquable, par son étendue et par sa haute portèe.