CLIMATOLOGICAL HONORARY MEMBERSHIP: FROM ABOLITION TO IMMIGRATION

INTRODUCTION

A year ago, our president, Andy Schafer, asked me if a foreigner could be a member of the American Clinical and Climatological Association, and what was honorary membership. Those questions resulted in this paper which has three parts. First, a discussion of our original honorary member, then of honorary membership in general, and, finally, of a new moral imperative: immigration.

PART I

On the afternoon of October 21, 1835, our man, having completed caring for patients in his Boston office practice on Washington Street, walked toward the Old State House where he observed a large frenetic crowd (1).

Handbills had been distributed earlier that day suggesting that real trouble was brewing (Figure 1). A British abolitionist, George Donisthorpe Thompson (Figure 2) had been scheduled to speak to the Boston Female Anti-Slavery Society. Because of the anticipated trouble, Thompson's appearance was cancelled, and William Lloyd Garrison (Figure 3), the editor and publisher of The Liberator, was scheduled to speak in his stead. The Liberator was an abolitionist paper published weekly without fail for 1,820 issues from January 1, 1831, to December 29, 1865. (The Thirteenth Amendment was ratified on December 18, 1865 precluding the need for further issues.)

Fig. 1.

Letterpress handbill, 9 × 12.25 inches, handed out by the anti-abolitionist mob. Boston: October 21, 1835.

Fig. 2.

Daguerreotype photograph of abolitionist George Donisthorpe Thompson, 1851. Boston Public Library.

Fig. 3.

William Lloyd Garrison (December 10, 1805–May 24, 1879). Age 35.

Garrison was the son of immigrant parents. Because of his published beliefs, the crowd — composed of many well-known Boston elite, referred to as the “Broadcloth Mob” — was preparing to, at the very least, tar and feather Garrison on whom they now turned their wrath. Some even planned for a lynching. Garrison later recalled, “The whole city was wrought up to a pitch of insanity” (2). Garrison escaped by a rear window from his office but was captured in the loft of a carpenter's shop next door. He was lowered from a second story window into the hands of the mob, estimated to be 3,000 people. Most of his clothes were ripped off, and he was dragged “at the end of a rope” toward Boston Common (3). Those in this Broadcloth Mob were described as “wealthy and respectable,” “the moral worth,” and “the influence and the standing.” The militia was not called out because most of the militia was in the mob. Mayor Theodore Lyman II, the first elected mayor from the Democratic Party of Boston, although an anti-abolitionist himself, had arranged for “30 or 40 thick-set, broad-shouldered men in neat suits” to wrest Garrison from the mob and for a coach to spirit him away to the Leverett Street Jail in West Boston, where, under a trumped-up charge of disturbing the peace, he could be held and protected by the sheriff of Suffolk County.

So, who was our man who witnessed all this? Henry Ingersoll Bowditch (Figure 4) was from a prominent Salem, Massachusetts, family. His father Nathaniel was an acclaimed mathematician and astronomer and is described as the founder of modern maritime navigation. In 1802, he published The New American Practical Navigator (which is often referred to simply as The Bowditch and whose full title is The New American Practical Navigator: Being an Epitome of Navigation; Containing All the Tables Necessary to Be Used With the Nautical Almanac in Determining the Latitude, and the Longitude in Lunar Observations, and Keeping a Complete Reckoning at Sea). This remarkable publication is still in use to this date by those who navigate ocean-going vessels. It has been through over 50 editions, and its publication is now overseen by the US government (Figure 5).

Fig. 4.

Henry Ingersoll Bowditch (August 9, 1808–January 14, 1892). Age 25. From a miniature painted by Daubigny in Paris in 1833. Image from Bowditch VI (2).

Fig. 5.

The Bowditch, 1802 first edition and 2017 edition.

Henry graduated Harvard College in 1828, then Harvard Medical School in 1832, after which he then spent 2 years in Paris (4). At the time, Paris' population was 800,000. The medical school, École de Médecine, had a teaching faculty of 26 with a student body of 5,000 — twice that of all United States medical schools combined. The amphitheater (Figure 6) could accommodate 1,000 students, and the library contained more than 30,000 volumes. Furthermore, medicine in France offered two opportunities unavailable in the United States: the ability to examine women, and a plethora of cadavers, which cost as little as $2.50 each (5).

Fig. 6.

Jacques Gondoin, Théâtre d'anatomie. École de Chirurgie (today École de Médecine). Paris. 1769–1775.

For 2 years Bowditch was under the tutelage of Pierre-Charles-Alexandre Louis, MD, (Figure 7) who was in his 40s, tall, soft-spoken, and the brother-in-law of Victor Hugo. Louis was reputed to have been the best physician in Paris using a stethoscope, which had been invented by René Théophile Hyacinthe Laënnec (Figure 8) only 14 years earlier. For an excellent treatise on Laënnec, refer to Herbert Reynold's 2003 President's Address to this association. Although he was said to be only an average student at Harvard, Bowditch was so enthusiastic about pulmonary medicine, anatomy, and pathology that upon leaving the dissecting table late one day, he hid a lung under his cap for further study at home, only to notice bloody liquid oozing down his face (5)! Thirteen years after his return to the United States, Bowditch wrote what he described as a “pamphlet” of 304 pages (Figure 9) titled The Young Stethoscopist: Or the Student's Aid to Auscultation (6).

Fig. 7.

Pierre-Charles-Alexandre Louis (April 14, 1787–August 22, 1872).

Fig. 8.

René Théophile Hyacinthe Laënnec (1781–1826). French physician and inventor of the stethoscope.

Fig. 9.

Title page of The Young Stethoscopist by Henry Ingersoll Bowditch, MD (5).

While in Europe, Bowditch attended the July 29, 1833, funeral of William Wilburforce (Figure 10), the ardent British abolitionist who was a tireless advocate and largely responsible for the abolition of the slave trade by Great Britain, which dominated that mode of commerce. Of the estimated 11 million Africans transported into slavery, approximately 1.4 million died during the voyage (the infamous “middle passage”).

Fig. 10.

Portrait of William Wilberforce (August 24, 1759–July 29, 1833) at age 29, by John Rising.

With the seeds of abolition having been sown for him in Great Britain, and with the shocking experience of witnessing the attempted tarring and feathering and possible lynching of Garrison, Bowditch declared himself an abolitionist: “Then it has come to this, that a man cannot speak on slavery within sight of Faneuil Hall and almost at the foot of Bunker Hill. If this is so, it is time for me to become an Abolitionist” (2). [Faneuil Hall is where Crispus Attucks — an American stevedore described as a “runaway slave” and the first man to die in the American Revolutionary War at the Boston Massacre — lay in state March 5–8, 1770.]

Because of his ardent abolitionist view, Dr. Bowditch reported that he was “ostracized” and that he no longer was asked to attend “many fashionable parties… Pleasant literary coteries were no longer accessible.” He found that friends “would stare and scowl without speaking when we met” (2). A fellow physician told him that he “never would be successful in (his) profession if (he) continued to do as (he) had done…” (2). From 1835–1843, Bowditch was associated with the Warren Street Chapel, which was intended as a meeting place for the children of poor parents. When the chapel adopted the policy of not admitting African-American children, he resigned. In 1841, he also resigned his privileges as an admitting physician at the Massachusetts General Hospital when “a new law, made by the trustees, excluding colored people from the institution,” was enacted (2). When on October 10, 1842, George Latimer, a runaway slave from Virginia was seized, Bowditch wrote that “a high-handed act of injustice had just been perpetrated by the slaveholder on the free soil of the old Bay State” (2). This resulted in the publication of The Latimer Journal, by William F. Channing, Frederick S. Cabot, and Bowditch, in triweekly editions. The Journal led to the passage of a law in Massachusetts forbidding the use of state and town jails for the detention of runaway slaves. This was an enormous blow to the slave hunters. The final effort of Massachusetts to defeat the slave hunter was the promotion of the Anti–Man-Hunting League in 1854. “Let us have a society in the different towns of the state, with secret lodges, and let us seize the hunter and make him, not by doing harm to him, but by holding him captive and carrying him to different places, give up the slave” (2). It was planned to hold the slave hunters hostage in ransom for the captured slaves. Because of the outbreak of the Civil War, the league never undertook its mission.

On March 18, 1863, Dr. Bowditch received news that his oldest son Nathaniel, a lieutenant in the Union Cavalry under General William Woods Averell, had been wounded in battle the previous day at Kelly's Ford, Virginia; he had been shot in the jaw and abdomen (7). He rushed to Nathaniel's side but was too late. He examined the wounds of his deceased son and concluded that they were not mortal and that his son would have survived had he received proper care on the battlefield. Because of Nathaniel's death, Bowditch pushed for a proper ambulance service and the implementation of an evacuation system called The Letterman Plan, developed by Dr. Jonathan Letterman. This system consisted of three levels of care: 1) field dressing stations located on the battlefield; 2) field hospitals located in nearby homes or barns; and 3) larger hospitals for ongoing and long-term care. Because of the enormous pressure from Bowditch's written entreaties and from his calling on government officials, the Letterman system was not only implemented by the Union Army during the Civil War but also remains in use today.

From 1859 to 1867, Bowditch was the Jackson Professor of Clinical Medicine at Harvard. In 1869, he founded the Massachusetts State Board of Health and served as its chair from 1869 to 1879. He subsequently was elected president of the American Medical Association in 1877. In addition to popularizing the use of the stethoscope, he contributed to the introduction of inductive reasoning into American medical science. He published both Preventive Medicine and the Physician of the Future (8) and Public Hygiene in America (9).

Henry Ingersoll Bowditch (Figure 11), a staunch abolitionist and a visionary physician, was elected the first honorary member of the American Climatological Association in 1889. His paper was titled “Open-Air Travel as a Cure and Preventive of Consumption; as Seen in the History of a New England Family” (10).

Fig. 11.

Portrait of Henry Ingersoll Bowditch from Portraits of American Abolitionists, 1850–1890. Photograph collection of Massachusetts Historical Society.

PART II

Honorary membership was established in our first constitution and by-laws (Figure 12).

Fig. 12.

The American Climatological Association. Transactions of the Annual Meeting of the American Climatological Association. 1884;1:89.

Although Dr. Bowditch was our first honorary member, no criteria are given in the constitution and by-laws for election to honorary membership; nor is there any discussion in the council minutes as to why Bowditch was elected. As we have seen, he had a long and distinguished career. It might also be noted that his son, Vincent Yardley Bowditch, was the president-elect of our association in 1889 when his father was nominated by Alfred L. Loomis [first president of our association in 1884, again president in 1885, and now president in 1888; also the first president of the Association of American Physicians founded in 1885]. The 1889 Transactions state, “On motion of Dr. Loomis, Dr. Henry I. Bowditch of Boston was unanimously elected Honorary member of the Association.”

The following year, Alfred Stillé (Figure 13) of Philadelphia and Henry Clermond Lombard of Geneva, Switzerland were both elected honorary members. Again, no reason was given as to the criteria for their election. Alfred Stillé was born in Philadelphia. He attended Yale, from which he was expelled along with Andrew Calhoun (son of John C. Calhoun) and 43 of the 96 members of his class for participating in the Conic Sections Rebellion of 1830. They had refused to take the mathematics examination without open books. Open book exams had previously been the practice. Yale authorities warned neighboring universities against admitting these expelled students. Despite this, Stillé was admitted to the University of Pennsylvania from which he received an A.B. degree (1832), A.M. degree (1835), and M.D. degree (1836). At Penn, he was professor of medicine from 1864 to 1884 and then Chair of Medicine. Stillé joined William Wood Gerhard and Caspar Wistar Pennock in a study of 120 patients during the 1836 typhus epidemic in Philadelphia that resulted in a classic paper making the distinction between typhus and typhoid fever (11). He was elected to honorary membership in the American Climatological Association in 1890 at the age of 77.

Fig. 13.

Alfred Stillé (October 30, 1813–September 24, 1900). 1889 portrait photograph. Penn Libraries University Archives Digital Image Collection.

Our third honorary member was Henri-Clermond Lombard of Geneva, Switzerland (1803–1895), an expert on goiter. Dr. Lombard published a study titled “The Influence of Professional Occupations on the Duration of Life.” In order to determine the average age of death by occupation, he reviewed the civil registers of Geneva spanning the period from 1796 to 1830 (Figure 14). The study originally appeared in the Annales d'Hygeine Publique, No. 27, and was subsequently published in The Lancet in 1835 (12).

Fig. 14.

Partial table from Lombard's study that illustrates the average life expectancy by profession. The sample included 8,488 individuals.

In 1897, both Sir Herman Weber and Charles Theodore Williams of London were elected honorary members. Again, there was no comment as to why. In 1898, the category of “corresponding members” was created having been proposed the previous year. With this new category, the association elected members from South Africa, Argentina, Mexico, Switzerland, Great Britain, and Australia. The number of honorary members was later reduced in the constitution and by-laws from 25 to 10. Over the next 20 years, the honorary members who were elected included:

Professor R.F. Stupart — Director, Dominion Meteorological Service, Toronto, Canada

William C. Gorgas — Surgeon General, USA War Department

Charles F. Marvin — Chief of the Weather Bureau

Sir Almroth Wright — St. Mary's, London

Auguste Rollier — Switzerland

Sidney Burwell, who had left his position as chair of medicine at Vanderbilt to become the dean at Harvard, held the association together as president during the war years (1942–1946). There were no meetings during these years; however, Dr. Burwell sent communications to the members.

Following the war (1946), a number of honorary members were elected including Alfred Blalock; Warfield Longcope (previously active in 1912, former chair of medicine at Johns Hopkins, and the association's first Gordon Wilson Lecturer in 1937); Henri Christian; and R.T. Woodyatt. At that same time, A. McGehee Harvey, who became our official historian, was elected to active membership. Discussion was had by Council regarding the possibility of automatically electing Gordon Wilson lecturers to honorary membership. Council felt it more appropriate for Gordon Wilson lecturers to become active members, when possible, instead of honorary. In 1949, James S. Simmons, wartime chief of preventive medicine and Dean of the Harvard School of Public Health, and John McNee, Regius Professor of Medicine at Glasgow, were elected honorary members. In 1963, William B. Castle, director of the Thornedike Laboratory, was elected to honorary membership, as was Arnold R. Rich, professor of pathology at Hopkins. Tinsley Harrison was elected to honorary membership in 1970. Our last honorary member was Sir John W.H. Butterfield of Cambridge, England, who was elected in 1983. With Dr. Butterfield's death in 2000, we lost our last honorary member. Nevertheless, our constitution and by-laws still have that category of membership.

PART III

We have discussed our first honorary member and the moral imperative he felt he faced with slavery. Are we now facing a new moral imperative with immigration? If an individual is more likely to die because he or she is not allowed to leave one country and enter another country, are we complicit in that death by supporting that status quo?

On May 13, 1939, the MS St. Louis (Figure 15) left Hamburg with valid Cuban tourist landing permits purchased from the German shipping line Hapag. While en route to Havana, these permits were invalidated by the Cuban government. Because the quota for German immigrants had been reached and because there was no political asylum for refugees at that time, permission to dock in the United States was not given (13). On board were 907 Jewish refugees from Germany, including then 16-year-old Arno Motulsky (Figure 16) (14). The ship returned to Europe. On May 10, 1940, Nazi Germany invaded Western Europe. Half of those refugees, who had not escaped Europe by the time the Nazis invaded, died during the Holocaust (15).

Fig. 15.

The MS St. Louis, carrying Jewish refugees from Nazi Germany, arrives back in the Belgian port of Antwerp after Cuba, the United States, and Canada denied it entry. June 17, 1939.

Fig. 16.

Arno Motulsky, age 16. Photo: Motulsky AG. University of Washington School of Medicine Alumni Magazine 2002; 25, no. 2.

Arno Motulsky received his medical degree from University of Illinois, Chicago, and was for many years a distinguished professor of medicine at the University of Washington. There he became renowned as the father of “pharmacogenetics” before dying earlier this year on January 17, 2018. In John Oates' president's address before this body in 2012, he named Dr. Motulsky as one of the mentors of Nobel Prize winner Joseph Goldstein, the director of the medical genetics program at the University of Texas Southwestern Medical School (16).

The International Organization of Migration, through its Global Migration Project, attempts to document the deaths, employment, ages, gender, country of origin, and country of destination of migrants worldwide. From January 1, 2018, to August 27, 2018, 2,481 migrants died in transit worldwide. Since January 1, 270 died on the U.S.–Mexico border. For all of 2017, 418 died on the U.S.–Mexico border. Of those who died in 2017, the causes of death are unknown for 170 cases; 84 drowned or were presumed to have drowned; 64 perished from hypothermia, hyperthermia, dehydration, or exposure; 12 from vehicle accidents, including falling from a train or being hit by a train; 3 were shot or murdered; 1 died from illness and lack of access to medical care; and 65 deaths were of mixed causes (17).

Each year, the United States Citizenship and Immigration Services receives and adjudicates an average of 7 million petitions and applications (18). Of those 5 million or so who are rejected each year, surely there are Arno Motulskys among them who, either through an early death or lack of educational and economic opportunities available in the United States, will never reach their potential.

Why do we turn away so many? Why do we not let them all in?

There are three main lines of argument for not permitting more immigrants legal entry into the United States: 1) increased crime; 2) economic impact; and 3) cultural change. These are not insignificant arguments.

Immigration and Crime

The current homicide rate in the United States is 5.35 per 100,000 population (19). If allowing additional immigrants were to result in more homicides, then a strong and valid argument exists against letting in more immigrants. Do immigrants actually bring more crime? Data published by the American Immigration Council show that higher immigration is associated with lower crime rates (20). As the number of immigrants in the United States has risen in recent years, crime rates have fallen. Between 1990 and 2013, the foreign-born share of the U.S. population grew from 7.9% to 13.1% (Figure 17) and the number of unauthorized immigrants more than tripled from 3.5 million to 11.2 million. During the same period, Federal Bureau of Investigation data indicate that the violent crime rate declined 48% — which included falling rates of aggravated assault, robbery, rape, and murder (Figure 18). Likewise, the property crime rate decreased by 41%, including declining rates of motor vehicle theft, larceny/robbery, and burglary (Figure 19). This decline in crime rates in the face of high levels of new immigration has been a steady national trend.

Fig. 17.

Foreign-born share of the US population, 1990-2013.

Fig. 18.

US violent crime rates, 1990-2013.

Fig. 19.

US property crime rates, 1990-2013.

Another concrete indication that immigrants are less likely than the native-born to be criminals is the fact that relatively few prisoners in the United States are immigrants. According to an analysis of data from the 2010 American Community Survey, roughly 1.6% of immigrant males ages 18 to 39 years are incarcerated, compared to 3.3% of the native-born. This disparity in incarceration rates has existed for decades (20). Stowell et al. looked at 103 metropolitan statistical areas and found that violent crime rates tended to decrease as the concentration of immigrants increased (21). Studies also concluded that the high immigration rate of the 1990s significantly contributed to the precipitous crime decline in that decade (22). Therefore, the crime argument suffers under scrutiny. Alex Nowrasteh, an immigration expert at the Cato Institute, has stated, “The vast majority of research finds that immigrants do not increase local crime rates and that they are less likely to cause crime and less likely to be incarcerated than their native-born peers” (22). Immigrants do not bring crime. In fact, both documented and undocumented immigrants commit fewer crimes than native-born Americans in the same age groups.

Immigration and the Economy

More recently, arguments suggest that immigrants drive down wages of native born Americans and receive benefits that far exceed their contribution to the economy (23). Data published by the Institute on Taxation and Economic Policy show that undocumented immigrants contribute about $11.6 billion to the economy annually, including nearly $7 billion in sales and excise taxes and $3.6 billion in property taxes. They are, in economic terms, productive citizens, and pay a higher effective tax rate than the top 1% income bracket, dissolving the myth that immigrants do nothing but drain public coffers (24). The US Gross Domestic Product would decrease by 2.6% or $434 billion a year if all undocumented workers were removed from the economy, according to a report by City University of New York researchers. Some states and industries would be more affected than others. Illinois, California, Florida, Texas, New York, and New Jersey would feel the greatest impact under such a scenario (25). Therefore, the assertion that immigration is bad for the economy is patently not true. Study after study shows that immigrants do not drive down wages for native born Americans.

Immigration and the Culture

America has always been a nation of diverse cultures. In every generation, a new wave of immigrants arrives from a different corner of the world. In every generation, there is always a nativist backlash. In the 1750s, Benjamin Franklin argued against immigrants from places other than Britain, describing French, Swedes, and Germans as insufficiently white and too “swarthy” to be Americans (26). In the mid-1800s, the “Know Nothing Party” lashed out against Irish and German immigrants contending that the “indiscriminate bestowment of the rights of citizenship on immigrant foreigners” is “pernicious to our institutions and destructive of our welfare” (27). In the late 1800s, the backlash turned against Chinese immigrants, and in the early 1900s, against Italian immigrants. Each of these groups was, at the time, deemed culturally incompatible with the American way of life. Each of these groups in time, however, became an integral part of the American way of life. Within three generations, immigrant groups learn the language (28), intermarry and become “Americans.”

CONCLUSIONS

1. Is citizenship a requirement for membership? As we are the American Clinical and Climatological Association, may a noncitizen of the United States be elected to membership?

   Absolutely. There is no limitation placed on either citizenship or country of origin in our constitution and by-laws.

2. Our honorary members have been truly honorary from Henry Ingersoll Bowditch (1889) on.

3. Our first international honorary member was Henry C. Lombard of Geneva, Switzerland (elected 1890).

4. Our first international active member, Thomas Benzing of Cologne, Germany, was elected last year in 2017.

5. Immigrants to the United States:

   1. Do not increase the crime rate; in fact, they may decrease it.
   2. Do not result in an economic burden; in fact, they are an economic bonus.
   3. Do not dilute the “American culture”; in fact, they are the “American culture.”

So, as in slavery 200 years ago, will we, citizens of the United States, be on the wrong side of history if we fail to honor the inscription of the Statue of Liberty, “Give me your tired, your poor, Your huddled masses yearning to breathe free; The wretched refuse of your teeming shore”? (Figure 20)

Fig. 20.

Statue of Liberty in New York City.

Or, if we fail to heed the admonition of Martin Luther King, Jr., from his jail cell in Birmingham Alabama in 1963, “Injustice anywhere is a threat to justice everywhere”? (Figure 21)

Fig. 21.

Martin Luther King, Jr., in jail in Birmingham, Alabama, April 1963.

Or, finally, if we spurn the words of William Lloyd Garrison who wrote on the masthead of The Liberator, “Our Country is the World, our Countrymen are all Mankind”? (Figure 22)

Fig. 22.

Image of the front page of The Liberator.

Slavery endangers life and limits location of work, place of residence, access to justice, and union with family. Restrictions on immigration do the same. If slavery was wrong, then is placement of restrictions on immigration not also wrong?

The Climatological has had four immigrant presidents:

• Robin and Catriona Luke, Scotland, 2006 (Figure 23)

• Frank Abboud, Egypt, 2008 (Figure 24)

• Andrew Schafer, Hungary, 2017 (Figure 25)

• Ron Sacher, South Africa, 2018 (Figure 26)

Fig. 23.

Robin and Catriona Luke.

Fig. 24.

Frank Abboud and President George H.W. Bush.

Fig. 25.

Andrew Schafer.

Fig. 26.

Ron and Empress Heather Sacher.