The Bockus International Society of Gastroenterology: Historical review

Abstract

The Bockus International Society of Gastroenterology was founded in 1958 in honour of Dr Henry L Bockus (1894–1982) by his former students, residents and fellows at the Graduate School of Medicine of the University of Pennsylvania, Philadelphia, USA. It was a celebrated tribute to Dr Bockus’ outstanding leadership in the development and teaching of clinical gastroenterology as a subspecialty, which was in its infancy in the post-World War II era. He established the first formal training course in clinical gastroenterology in America. His department of gastroenterology became the leading graduate school of clinical gastroenterology in the world, training many clinical gastroenterologists in America and from many regions around the world. For many years, Dr Bockus was the most prominent American in world gastroenterology. The Bockus Society holds biennial scientific congresses in different continents, thus continuing to foster Dr Bockus’ lifelong interest and vision to promote international medical friendship, and excellence in education and research collaboration.

Study the past if you would define the future

– Confucius (551BC – 479BC)

The Bockus International Society of Gastroenterology (Bockus Society) celebrated the 50th anniversary of its foundation in 2008. In the original Constitution and By-laws (circa 1959), it was stated that “those eligible to membership as ACTIVE MEMBERS of this alumni society shall be former students, residents and fellows in Gastroenterology of the Graduate School of Medicine or the Graduate Hospital of the University of Pennsylvania. The privileges of voting and holding office shall be limited to ACTIVE MEMBERS of the society.” With the passage of time, it became an increasing reality that criteria for active membership of the Society needed to broaden to maintain its vitality now and in the future. In his presidential report at the Society’s Annual Digestive Disease Week Luncheon Meeting in 2004, Dr Michael V Sivak Jr recalled that Dr Bockus had voted in favour of trainees of his trainees to become eligible members and, thus, his vision for the Society to carry on in perpetuity. Because the Bockus Society has elected many new members in recent years, it is timely to provide a historical review of the Society so that newer generations of members and of gastroenterologists worldwide may be enriched by some knowledge of its distinguished history. I am indebted to the availability of Dr William S Haubrich’s 1994 Revised Edition of Bockus – His Life, His Work, that he edited under the auspices of The Bockus International Society of Gastroenterology (1).

DR HENRY LEROY BOCKUS (1894–1982)

Dr Henry L Bockus (Figure 1) was born on April 18, 1894, in Newark, Delaware (USA), of English-Welsh descent. His family moved to Pennsylvania (USA), and following high school in Philadelphia, he attended Jefferson Medical College (Pennsylvania, USA), graduating in 1917. He was a lieutenant in the Medical Corps of the United States Marines from 1917 to 1919. He was stationed in Cuba, which might have stimulated his life-long interest in international relations, particularly in Latin America (1). While training in internal medicine at the Lennox Hill Hospital, New York (USA), one of his teachers was Dr Max Einhorn, chief of the Gastrointestinal Service, who was a major influence in his decision to pursue a career in gastroenterology (2). Dr Einhorn was a prolific inventor, creating the ‘gastrodiaphane’ in 1889 for illuminating the lumen of the stomach (before the advent of the x-ray), and many other devices including the duodenal biliary drainage tube (to study gallbladder emptying and pancreatic secretion) and the Einhorn’s string test (to detect the site of upper gastrointestinal bleeding) (2,3).

Figure 1).

Dr Henry Leroy Bockus (1894–1982). Reproduced with permission from Dr WS Haubrich

DR BOCKUS AND THE GRADUATE HOSPITAL, UNIVERSITY OF PENNSYLVANIA

Dr Bockus returned to Philadelphia in 1921, established a ‘Stomach Clinic’ at the Graduate Hospital and was appointed to the faculty of the Graduate School of Medicine at the University of Pennsylvania. There, he became professor of gastroenterology in 1930 and Chairman of the Department of Internal Medicine in 1949. He was regarded as a superb clinician and a most inspiring teacher. Clinical gastroenterology, as a subspecialty, was in its infancy, and there were only occasional postgraduate courses devoted solely to gastroenterology. Under the leadership of Dr Bockus, the first one- or two-year course in clinical gastroenterology in the United States was established (2). Dr JE Berk was one of his earliest faculty members to assist in the teaching schedule. His training program in clinical gastroenterology was, for many years, the only formal program in America. In the post-World War II era, Dr Bockus’ department of gastroenterology at the Graduate Hospital became the outstanding graduate school of clinical gastroenterology in the world, training many of America’s clinical gastroenterologists, as well as numerous physicians from South America, Canada, Europe, Asia and other regions of the world. Among his trainees were Dr Richard D McKenna and Dr Abraham Bogoch from Canada, both founding members of the Canadian Association of Gastroenterology (4). For many years, Dr Bockus was the most prominent American in world gastroenterology (2). He delivered the inaugural Richard D McKenna Lecture of the Annual Meeting of the Canadian Association of Gastroenterology in 1968 and was an honorary member of the Association.

BOCKUS’ GASTROENTEROLOGY

“His book” (Figure 2), as Dr Haubrich described it, has been the ‘bible’ of gastroenterology for subsequent generations of clinicians interested in gastrointestinal disorders throughout the world (1). It was regarded as the most comprehensive publication in gastroenterology (2), and was translated from English into Spanish, Portuguese and Japanese. The first edition (1944 to 1946), authored and edited by Dr Bockus, had 14 contributors, and was comprised of three volumes and 125 chapters. The second edition was published from 1963 to 1965, the third edition from 1974 to 1976, the fourth edition in 1985 and the fifth edition in 1994. After Dr Bockus’ death in 1982, Dr J Edward Berk was the Editor-in-Chief of the fourth edition, with 314 contributors, consisting of seven volumes and 256 chapters. Dr William S Haubrich, Dr Fenton Schaffner and Dr Berk were the Editors of the fifth (and final) edition, published in time for the 10th World Congress of Gastroenterology held in Los Angeles, California (USA) in 1994 (1).

Figure 2).

Bockus’ Gastroenterology: Four volumes of the third edition

THE BOCKUS INTERNATIONAL SOCIETY OF GASTROENTEROLOGY – THE EARLY YEARS

May 29, 1958, was the official birthday of the Bockus International Society of Gastroenterology, founded in honour of Dr Bockus by his former students, residents and fellows at the Graduate School of Medicine of the University of Pennsylvania, during the First World Congress of Gastroenterology in Washington, DC (USA), at which Dr Bockus was the president (2,3). It was a celebrated tribute to Dr Bockus for his outstanding achievements as an educator, teacher and promoter of international medical friendship, as described by Dr Francisco Vilardell of Barcelona, Spain (1). Dr Figueiredo Mendes of Brazil was the first president of the Bockus Society. The inaugural meeting of the Society was held at the Barclay Hotel in Philadelphia on June 3, 1959, at which all 105 newly inducted members attended (1). There was a scientific program. The topics discussed were the following: idiopathic ulcerative colitis; amoebic colitis; intestinal schistosomiasis; and colitis due to Shigellosis, Salmonellosis and Candida albicans (1). At the meeting, it was decided that scientific congresses (in even years) (Table 1) would alternate annually with business luncheons (in odd years), the latter in conjunction with the Annual Meeting of the American Gastroenterology Association. On many occasions, the three-day scientific congress took place just before or following a major international meeting such as a World Congress, Pan-American Congress or a European meeting of gastroenterology, on the same continent. There were always special memories of extracurricular activities at each of the Bockus Society meetings. For example, in London, United Kingdom, in July 1978, there was a reception in the House of Lords, and during the banquet at the Café Royale, a detachment of the Queen’s Own Grenadier Guards in full regalia arrived to entertain in rousing martial music! (1). Camaraderie (the word often used by Dr Bockus), good fellowship and pervasive spirit of goodwill have characterized these meetings over the years, as described by Dr Haubrich (1).

TABLE 1.

The Bockus International Society of Gastroenterology Biennial Scientific Congresses

Year	Location	Local host(s)
1960	Rio de Janeiro, Brazil	Dr Flavio Miquez
1962	Geneva, Switzerland	Dr Bernard Wissmer
1964	Medellin, Colombia	Dr Jóse Antonio Jácome
1966	Honolulu, United States	Dr Richard KC Chang
1968	Philadelphia, United States	Dr James Roth
1970	Amsterdam, Netherlands	Dr Adolf Wiebenga
1972	Guatemala City, Guatemala	Dr Rosendo Gordillo
1974	Morelia, Mexico	Dr José Villalobos
1976	Dorado Beach, Puerto Rico	Dr Federico Hernandes Morales, Dr Ramon Sifre and Dr José Berio
1978	London, England	Dr Charles Foster Cooper and Dr Margot Shiner
1980	Caracas, Venezuela	Dr Simón Beker
1982	Reykjavik, Iceland	Dr Tomas Jonasson
1984	Coimbra, Portugal	Dr José de Gouveia Monteiro
1986	Rio de Janeiro, Brazil	Dr Geraldo Siffert
1988	San Marino, Italy	Dr Bernard Schuman
1990	Cairns, Australia	Dr Bernard Schuman
1992	Nice, France	Dr Jean-Pierre Delmont
1994	Vancouver, Canada	Dr Hugh Chaun
1996	Dublin, Ireland	Dr Colm O’Morain
1998	Graz, Austria	Dr Guenter Krejs
2000	Barcelona, Spain	Dr Juan Malagelada
2002	Bangkok, Thailand	Dr Varocha Mahachai
2004	Brno, Czech Republic	Dr Petr Dite
2006	Casa de Campo, Dominican Republic	Dr Fernando Contreras
2008	Budapest, Hungary	Dr Ferenc Szalay
2010	Marrakech, Morocco	Mr Hamid Bouab and Dr David Bernstein
2011	Dublin, Ireland	Dr Colm O’Morain

From 1962 to 1973, 27 postgraduate courses were organized and sponsored by the Bockus Society in 20 different cities and 10 countries including Brazil, Colombia, Argentina, Chile, Venezuela, Mexico, Ecuador, Peru, Dominican Republic and Panama, supported by local medical societies and faculties (Table 2). The aim was to provide opportunities to exchange medical knowledge in gastroenterology and, at the same time, to create international relations and to foster goodwill, understanding, respect and friendship (1).

TABLE 2.

Postgraduate courses sponsored by the Bockus International Society of Gastroenterology, 1962 to 1973

Year	City	Country
1962	Porto Alegre	Brazil
	Belo Horizonte	Brazil
	Manizales	Colombia
1963	Santa Marta	Colombia
1964	Buenos Aires	Argentina
	Santiago	Chile
1965	Rio de Janeiro	Brazil
	Belo Horizonte	Brazil
	Caracas	Venezuela
1966	Monterrey	Mexico
	Mexico City	Mexico
	Caracas	Venezuela
1967	Cali	Colombia
	Guayaquil	Ecuador
	Lima	Peru
1968	Caracas	Venezuela
	Rio de Janeiro	Brazil
	Brazilia	Brazil
	Belo Horizonte	Brazil
1969	Monterrey	Mexico
	Guadalajara	Mexico
	Santo Domingo	Dominican Republic
1970	St Luis Potosi	Mexico
	Panama City	Panama
1971	Cali	Colombia
1972	Barranquilla	Colombia
1973	Buenos Aires	Argentina

Data from reference 1

THE BOCKUS SOCIETY – THE PAST 25 YEARS

Annual Bockus Society Digestive Disease Week Luncheon Meeting

In the early days of the Society, the business luncheons were held during alternate (odd) years. Now, the luncheon meeting takes place annually on a pre-arranged date at a hotel location during the Digestive Disease Week. It is the Annual General Meeting of the Society.

The Biennial Scientific Congresses (Table 3)

TABLE 3.

Scientific Congresses of the Bockus International Society of Gastroenterology, 1986 to 2011

Year	Program Chair(s)	Articles presented, n	Special invited lecturers
1986	Prof Geraldo Siffert Jr	35	Dr. Gordon McHardy (Bockus Memorial Lecture)
1988	Dr Michael V Sivak Jr	30	Dr RG Farmer (Bockus Memorial Lecture): “Long-term prognosis of inflammatory bowel disease”
			Dr Conti: “Epidemiology of gastric cancer in San Marino”
			Dr D Wurbs: “Non-surgical management of large bile duct stones”
			Dr L Gandolfi: “Imaging techniques in the diagnosis of focal liver lesions with particular reference to ultrasonography”
1990	Dr Barbara B Frank	22	Dr Fenton Schaffner (Bockus Memorial Lecture): “The liver in obesity”
			Dr J Edward Berk (State of the Art Lecture): “Treatment of pancreatic disease: Changing views and new approaches”
1992	Dr Jean-Pierre Delmont	26	Dr David Carr-Locke (Bockus Memorial Lecture): “Endoscopic management of chronic pancreatitis”
			Prof Colm O’Morain: “Helicobacter pylori: Role in the pathogenesis of peptic disease: Pros and cons. Is anybody being treated?”
1994	Dr Barbara B Frank	22	Dr ABR Thomson: “Epidemiology of inflammatory bowel disease – A Canadian perspective”
			Dr John Mathieson: “Radiology of gastrointestinal diseases in AIDS”
1996	Dr Jacques Van Dam	21	Dr Lawrence Brandt (Bockus Memorial Lecture): “Effects of aging on the gastrointestinal tract”
1998	Dr David Bernstein	23	Prof Guido Tytgat (Bockus Memorial Lecture): “Gastritis revisited”
2000	Dr Fernando Contreras	–	Prof Francisco Vilardell (Bockus Memorial Lecture): “The history of gastroenterology and the role played by Dr Bockus”
2002	Dr Barbara B Frank and Dr ABR Thomson	19	Dr Grace Elta: “The news in endoscopic hepatobiliary interventions”
2004	Dr Fernando Contreras	16	Prof Petr Dite: “Chronic pancreatitis, a gastroenterological challenge”
2006	Dr Fernando Contreras	18	Dr Irving Waxman (Bockus Memorial Lecture): “Endoscopic diagnosis and treatment of Barrett’s esophagus, as good as it gets?”
2008	Dr Fernando Contreras	19	Dr C Richard Boland (Bockus Memorial Lecture): “Progress in understanding hereditary colon cancer”
			Dr Michael Trauner (Berk Memorial Lecture): “Molecular pathogenesis of cholestasis”
2010	Dr Fernando Contreras	22	Dr James Reynolds (Bockus Memorial Lecture): “Immune disorders of the esophagus”
			Dr Gregory Ginsberg (Berk Memorial Lecture): “Intestinal fortitude – the evolution of minimally invasive therapies in GI endoscopy”
2011	Dr Fernando Contreras	22	Dr Roland Valori (Bockus Memorial Lecture): “Defining and delivering high quality colonoscopy”
			Dr Khursheed Jeejeebhoy (Berk Memorial Lecture): “Nutrition and exercise in disease prevention and treatment: Evidence-based”

Social programs at the biennial meetings:

There are always memorable special ‘Bockus moments’ at each biennial meeting. In the Republic of San Marino, Italy (1988), it was a ‘mountain top experience’ (1). In Cairns, Australia (1990), highlights were the Kuranda Rail trip and an excursion to view the wonders of the Great Barrier Reef. In Nice, France (1992), there was the spectacular banquet at the Villa et Jardins Ephrussi de Rothschild, Saint-Jean-Cap-Ferrat, on the final evening. In Vancouver, British Columbia (1994), a harbour cruise for the welcome reception was blessed by a warm and brilliant September evening amid the lighting of a glorious sunset. In Dublin, Ireland (1996), Colm and Marcelle O’Morain magically hosted a superb dinner at their home, and there was a tea reception with the Lord Mayor in the Mansion House. In Graz, Austria (1998), a unique ‘moment’ was the visit to the ancestral Uhlich-Wegschaider home in the historic border town of Bad Radkersburg, hosted by Dr Gustav Uhlich’s sister, Marlies, and Professor Gerfried Zeichen. The meeting in Graz immediately preceded the World Congress of Gastroenterology in Vienna, at which Dr Guenter Krejs was President. In Bangkok, Thailand (2002), members of the Society and their guests were enthralled by visits to some of Thailand’s historical treasures including the Royal Grand Palace and the impressive Wat Pra Kaew, and the Phra Maha That and Wat Para Si Sanphet temples. In Brno, Czech Republic (2004), a highlight was the trip to Telc, a historic UNESCO-protected town with magnificent architecture. At Casa De Campo, Dominican Republic (2006), there was a dinner at Minitas Beach in the warmth of a Caribbean evening, and a Dominican dinner in the hillside town of Altos de Chavón, a charming recreation of a 16th century Mediterranean village, with a small flood-lit church in the town square. In Budapest, Hungary (2008), it was the unforgettable evening at Visegrád where the attendees were entranced by a demonstration of a knights’ tournament in the 800-year-old Solomon’s tower, followed by a dinner of royal dishes at the Renaissance Restaurant while entertained by lute music. In Marrakech (2010), an exotic Moroccan city founded in the 11th century, the majestic spires of the minarets and walks through the souks within its old-walled medina provided a rich memory of many colourful sights and sounds. In Dublin, Ireland (2011), there was the memorable conference banquet in the splendid historic dining hall of Trinity College School of Medicine, celebrating its tercentenary, the meeting fittingly hosted by Professor Colm O’Morain, who was Dean of the Trinity College Faculty of Health Sciences.

To quote Dr Haubrich, “mere words cannot convey the intangible yet pervasive spirit of goodwill that marks these meetings” (1).

Other Bockus Society events

2005:

A special dinner was organized for members attending the World Congress of Gastroenterology in Montreal, Quebec, on September 11, at La Mareé (Restaurant Français) in Old Montreal, at which 22 members and guests attended.

2007:

A Bockus Society evening reception was held on October 16, at the 2007 American College of Gastroenterology (ACG) Annual Scientific Meeting in Philadelphia, graciously hosted by Dr Barbara Frank and Dr Leonard Frank in their home in historic Rittenhouse Square. Fifteen members, with accompanying guests, enjoyed a delightful evening. There was a prominent display at the ACG registration area of a magnificent historical poster of Dr Henry L Bockus (1894–1982). Contributors to its preparation included Dr Barbara Frank and Dr Vikas Khurana. The poster was later transferred and displayed at the entrance to the Franks’ home for the reception.

2010:

A wine and cheese evening reception, an initiative of Mr Richard Berk, was held on October 19, at the 2010 ACG Annual Scientific Meeting in San Antonio, Texas (USA), at the Grand Hyatt Hotel, the day of the Annual ACG J Edward Berk Lecture. It is planned to have similar receptions for members of the Bockus Society at future ACG Annual Scientific Meetings, on the evening the day before the J Edward Berk Lecture.

The inaugural biennial Berk/Bockus Honorary Lecture at Jefferson Medical College, Philadelphia, on November 17, 2010, was delivered by Dr Peter A Banks entitled ‘Recognition and treatment of severe acute pancreatitis’. The program also included grand rounds, a case conference, and case presentations by fellows and residents. The event was supported by a generous grant provided by Mr Richard Berk and his family in memory of his late father, Dr J Edward Berk and by the Bockus Society.

Officers of the Bockus International Society of Gastroenterology

In accordance with Article IV, Section 1 and Section 2 of the Constitution and By-Laws of the Society, “the officers of the society shall be President, President-Elect, Vice-President, Past President, Secretary-General, and Treasurer. The President, President-Elect, and Vice-President shall be elected for a term of two years. The Secretary-General and Treasurer shall be elected for a term of four years. Tenure of office shall be limited to one term. This limitation shall not apply to the Secretary-General and Treasurer.”

A list of the Presidents of the Bockus Society is presented in Table 4, and a list of Secretary-Generals and Treasurers of the Bockus Society in Table 5. Other officers elected in 2011 include President-Elect Dr David Bernstein (USA) and Vice-President Dr Fernando Contreras (Dominican Republic)

TABLE 4.

Presidents of the Bockus International Society of Gastroenterology, 1989 to 2011

Years	President	Country
1989–1991	Dr Bernard Schuman	United States
1991–1993	Dr Juan Colon-Pagan	Puerto Rico
1993–1995	Dr Harris Clearfield	United States
1995–1997	Dr Moises Guelrud	United States
1997–1999	Dr Jamie Barkin	United States
1999–2001	Dr Thomas Humphries	United States
2001–2003	Dr Juan Malagelada	Spain
2003–2005	Dr Michael V Sivak Jr	United States
2005–2007	Dr Jacques Van Dam	United States
2007–2009	Dr Guenter Krejs	Austria
2009–2011	Dr Barbara Frank	United States
2011–2013	Dr Hugh Chaun	Canada

TABLE 5.

Secretary-Generals and Treasurers of the Bockus International Society of Gastroenterology, 1990 to 2011

Secretary-General
Years	Name	Country
–1990	Dr William Haubrich	United States
1990–1995	Dr Thomas Humphries	United States
1995–2003	Dr David Kaufman	United States
2003–2011	Dr Hugh Chaun	Canada
2011–	Dr Eric Goosenberg	United States
Treasurer
Years	Name	Country
1990–1995	Dr Jamie Barkin	United States
1995–1999	Dr Michael V Sivak Jr	United States
1999–	Dr David Bernstein	United States

MEMBERSHIP

Bockus Lifetime Achievement Award

It was recorded in 2000 that previous awardees were Dr J Edward Berk, Dr Wlliam Haubrich, Dr Martin Kalser, Dr Francisco Vilardell, Dr Franz Goldstein, Dr Rudolph Ammann and Dr Harris Clearfield.

Current membership

There are currently 326 names in the Bockus Society membership list, representing 24 countries worldwide.

Among the Canadian members of the Society, six have been past presidents of the Canadian Association of Gastroenterology (4): Dr Richard McKenna, Dr Abraham Bogoch, Dr Ivan Beck, Dr Alan Thomson, Dr Richard Hunt and Dr Desmond Ledden; and one past president of the Canadian Association for the Study of the Liver: Dr Eric Yoshida. Drs McKenna, Beck and Bogoch were founding members of the Canadian Association of Gastroenterology. Dr Hunt was the Henry L Bockus Memorial Lecturer at the 14th World Congress of Gastroenterology in London, United Kingdom, in 2009.

The number of new members elected to the Society since 1996 are presented in Table 6.

TABLE 6.

Number of new members elected to the Bockus International Society of Gastroenterology since 1996

1996–7	1998	1999	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011
7	9	5	6	–	1	4	3	1	2	1	12	6	11
1*	–	–	–	–	–	–	2*	–	–	–	–	2*	–

^*Honorary members

THE BOCKUS INTERNATIONAL SOCIETY OF GASTROENTEROLOGY

Membership Pin

The elegant pin, an innovation of Dr Lawrence Brandt and designed by him, became available in 1999. It has been presented to many members of the Society attending the regular Society meetings, as well as to all newly elected members of the Society in the past decade.

Bockus Society Research Grant Award

The award, consisting of a $10,000 grant to cover a period of two years, was established to support original research in clinical gastroenterology or hepatology by a young investigator. Details of eligibility and the application process are accessible through the Bockus Society website (www.bockus.org).

Previous recipients of the award since 1996 were Dr Richard CK Wong (1996), Patrick Pfau (2000) and Jaime Matta (2001).

Acknowledgement of the Berk family contributions to the Bockus Society

The Bockus Society acknowledges, with immense appreciation and gratitude, the generous donations by Mr Richard Berk, the son of the late Dr J Edward Berk, on behalf of his family, in 2006 for a named award (before Dr Berk’s 95th birthday), in 2007 to establish the J Edward Berk Lectureship Endowment Fund and another in 2008. Dr Berk was one of the founding members of Bockus Society. He served as Editor-in-Chief of the fourth edition of the Bockus textbook, Gastroenterology. He was the founding chairman of the Department of Medicine, University of California at Irvine (UCI, California, USA), and there is now a Berk Center for Medical Education at UCI. He and his family have also contributed generously to Jefferson Medical College (of which he was an alumnus) and to the ACG, among other beneficiaries. In his tribute to Dr Berk (2008), Dr Haubrich stated: “his clinical skills, his scholarship, his good humour, his loyalty, his generosity will not be forgotten”.

CONCLUSION.

In the present attempt to review the history of the Bockus International Society of Gastroenterology, the primary purpose was to familiarize newer generations of gastroenterologists with the huge impact of Dr Henry L Bockus in the teaching, research and practice of clinical gastroenterology, and his emphasis on international friendship, dedication and service. “Non sibi sed toti mundo” (“Not for self alone but for the whole world”), the motto as inscribed in the famous Gold-headed Cane (1). Dr Bockus often referred to the word ‘camaraderie’, which is synonymous with the Bockus Society. The Society was founded in his honour by his former students, residents and fellows on May 29, 1958, during the First World Congress of Gastroenterology in Washington, DC (USA), at which he was the president. The World Congress was the first international meeting of gastroenterology to be held in the United States. The Society strives to maintain its integrity and principles upon which it was founded over half a century ago.