Stanford University School of Medicine and the Predecessor Schools: An Historical Perspective
Part II. E.S. Cooper in San Francisco

Elias Cooper was ever an enthusiastic supporter of medical associations and, in spite of the sharp criticism he endured in the Peoria and Illinois State Medical Societies, he made the founding of a State Medical Association one of the prime objectives of his California campaign. His temerity in beginning such an effort in 1855 only three months after his arrival on the Pacific Coast is a token of his zeal to widen contacts and gain prominence within the profession. He doubtless also thought that the strong national trend in the East to organize State medical societies made such a move timely in the West.

Local medical societies are normally the precursors of state-wide associations and San Francisco had seen the organization of three such local societies prior to 1855:

• the First San Francisco Medical Society in 1850
• the Pathological Society in 1851
• the Second San Francisco Medical Society in 1853

The medical activities of these societies were of little consequence and they apparently never considered organizing a State association. Their membership consisted mostly of the pioneer physicians who were the first to practice in the city, a distinction that led some members to consider themselves the medical elite. Cooper was the kind of aggressive interloper to offend their sense of propriety by challenging their supremacy. The following is a brief account of each of these early societies.

It was just two years after the beginning of the Gold Rush, and San Francisco had leapt from a village of 900 to a chaotic tent city of 35,000, when 32 of the local physicians met on 17 June 1850 to organize the first San Francisco Medical Society. They promptly adopted a Constitution consisting of the usual pledge to maintain high standards and oppose quackery, and enacted a set of ten By-Laws. Number eight of the By-Laws stated: "There shall be established by the Society a Fee Bill, which shall govern the members in their charges for professional services." It appears that the primary reason for organizing the Society was to establish a schedule of allowable charges. The following fees specified in the Fee Bill were recorded with the Constitution and By-Laws. The basic unit to be used in calculating charges for medical visits was $16, the value of an ounce of gold dust. A first visit to the office was listed as $32 and a follow-up visit as $16. The obstetrical charge for normal delivery was $150; for application of forceps, $300; and if turning of the baby was required, $500. Surgical fees were $500 to $1000 for removal of a bladder stone or repairing a strangulated hernia; operation for cataract or making an opening in the skull (trephining) cost $1000. But you could have an arm or a leg amputated for only $300.

Although these seem like exorbitant fees for that era, the Gold Rush was a period of such scarcity, inflation and economic turmoil in San Francisco that we have no idea what a fair charge for medical service would have been at the time. We do have the witness of Dr. Thomas M Logan of Sacramento (whose letter to his brother-in-law we quoted earlier) that the gold country was grossly over-stocked with doctors of both the regular and irregular variety and that the rapacity of some had created mistrust of the profession generally. The founders of the Society were doubtless seeking to establish a reasonable level of fees, but there was certainly no consensus among the members and the Fee Bill was so divisive an issue that it wrecked the organization. By the end of October it had ceased to exist after a short and factious life of only four and a half months. The Alta California for October 27, 1850 had the following last words:^[1]

After that cold blast from the press, nothing further was heard from this first Medical Society to be organized in San Francisco.^[2]

The second medical association to be established by the pioneer physicians of San Francisco prior to 1855 was the Pathological Society. Organized in 1851 "for the promotion of Medical Science," the Society held together for about six years and during that period always had the same officers: A.J. Bowie, MD, President and A.B. Stout, MD, Secretary. Its activities were apparently of a mainly social nature and this may account for its relative longevity in comparison with other medical societies of the period. There is no indication that Medical Science was ever promoted, but there is evidence that the members maintained a lively interest in medical politics. They were active in the founding convention of 1856 and the first two annual meetings of the California State Medical Society, a subject to which we shall later return. In addition to Drs. Bowie and Stout, the membership the Pathological Society also included Drs. H. M. Gray, William Hammond and J.P. Whitney whose names will come up again. as we follow the career of Dr. Cooper.^[3]

Since the Pathological Society will figure prominently in our continuing narrative, this is an appropriate juncture to tell how the Society's perennial officers, Drs. Bowie and Stout, arrived on the California scene.

Augustus Jesse Bowie (1815-1887)

San Franciscans appeared to regard Dr. Bowie as highly for his conversational style as for his surgical skill, and in both respects his attainments were exceptional. Legend had it that sometimes patient's feigned illness and took to bed in order to have the pleasure of a visit from the genial and courtly doctor. Levi Cooper Lane considered him a conversationalist without rival because of his scholarly grasp of the works of Virgil, Ovid and Horace from which he quoted freely (and accurately) on appropriate occasions. Where Dr. Bowie received such a thorough grounding in the humanities remains a mystery for little is known of his early schooling, leaving us to assume that native ability and innate refinement of taste guided him in a personal study of the classics.

The urbane and considerate manner that claimed for Dr. Bowie the esteem and approbation of both patients and his peers marked him as a native of the South, as indeed he was - born at Annapolis, Maryland, on 23 October 1815, son of an attorney. It is said that he was a descendant of the Earl of Clarendon, a staunch Loyalist who was influential in putting Charles II on the throne after Cromwell's death. His American ancestors were among the settlers who, with Lord Baltimore, laid the foundations of the Colony of Maryland. Bowie is thought by one historian to have attended school only until thirteen years of age, suggesting a meager formal exposure to Latin authors. Levi Cooper Lane, without citing his source, expressed a different view of Bowie's education when he wrote: "Dr. Bowie had the advantage of a thorough, early education; an education in which the 'humanities' had a full place."

There is also lingering mystery as to the sequence of events in Bowie's professional career prior to his settling in San Francisco. The facts are probably somewhat as follows. He studied medicine under a preceptor before attending the University of Maryland where he received an MD Degree in 1842. He also had a career in the U. S. Navy which began in 1837 when he shipped out on the frigate Independence as Assistant Surgeon. Then followed cruises to Russia, many South American countries, and to the Orient. Navy Surgeon Bowie first arrived in San Francisco harbor at the height of the Gold Rush on 1 April 1849 aboard the side-wheeler Oregon, one of the first steamships to join the East and West Coasts by water. He came with orders to select a site for the Marine Hospital. While accomplishing this, he became so impressed by the future prospects of San Francisco that he returned in 1852 to become surgeon of the Marine Hospital, and to make the city his permanent home. The hospital position requiring only part of his time, he opened an office in downtown San Francisco to engage in general practice with a chief interest in surgery. At some early but uncertain date he was elected President and Doctor A. B. Stout, Secretary, of the organization of pioneer doctors known as the Pathological Society.^[4][5]

Dr. Bowie had a long and honorable career as a surgeon and we shall have occasion later to refer to his relationship with Cooper. Among other notable associations, Bowie succeeded Cooper as Chair of Surgery in the Medical Department of the University of the Pacific in 1863 after the latter's death. In a memorial tribute in 1877, Lane made a final assessment of Bowie's surgical contributions:

Augustus Bowie is hardly remembered. In the annals of medical education, the generous-hearted and convivial doctor was among the earliest of the far western academics to confirm the axiom: "Publish or perish."

Arthur Breese Stout (1814-1898)

Dr. Stout, who may be described as a "thinking surgeon," was a close friend and colleague of Augustus Bowie, and a relentless adversary of Elias Cooper. Born in New York City on 29 April 1814, Stout had many advantages in early life, beginning with a family of ample means and more than average intelligence. Samuel F(inley) B(reese) Morse, inventor of the telegraph, was a first cousin with whom Stout shared grandparents and a middle name. Stout's path to a professional career was smooth. and unimpeded. His family saw that he received a classical education before he studied medicine at the College of Physicians and Surgeons in New York where he received an MD degree in 1839.

After earning his degree, he visited Europe, touring England, France and Germany before returning to New York in 1848. Later in the same year, being unmarried and indifferent to the charms of a lifetime in big-city practice, he accepted the position of ship's surgeon on the S. S. California then preparing to depart on her maiden voyage around the Horn to San Francisco. The California was one of three steamships constructed under a special act of Congress in 1847 to carry mail and passengers from the Isthmus of Panama to Astoria, Oregon, and ports between. The other two ships were the Panama and the Oregon, the latter being the ship that brought Doctor Bowie to San Francisco just thirty-two days after Doctor Stout arrived.

The California pulled out of New York harbor on 6 October 1848, two months before news of the discovery of gold at Sutter's Mill reached the East Coast. Four and a half months later, on 28 February 1849, she steamed calmly through the Golden Gate to a tumultuous reception by the ships in the Bay who saluted her arrival as the first steamer to make the long sea voyage from New York to California. Bowie and Stout were thus authentic '49ers and both were pillars of the Society of California Pioneers. Stout was not a gregarious and forgiving man and took his seniority in the medical community much more seriously than did the amiable Dr. Bowie.^[6]

Not to be diverted by the allure of gold in the foothills, Stout went immediately into practice in San Francisco and was rewarded by a sufficient yield to allow him to invest in real estate and enjoy financial security. He had a perceptive and analytical mind that was soon recognized not only among his peers in the profession but also by leading citizens of the community. Considering their early arrival in the city and the prominence they soon attained, it is not surprising that both Stout and Bowie were members of the First Vigilance Committee when an aroused civic conscience called it into being on 10 June 1851 for the avowed purpose "to watch, pursue, and bring to justice the outlaws infesting the city, through the regularly constituted courts, if possible, through more summary course, if necessary," The Committee proclaimed that "no thief, burglar, incendiary, or assassin, shall escape punishment, either by the quibbles of the law, the insecurity of prisons, the carelessness or corruption of the police, or a laxity of those who pretend to administer justice."^[7]

Stout was elected a member of the Executive Committee of the Vigilance movement along with Sam Brannan, James King of William and thirty-seven others. During the Committee's deliberations Stout first demonstrated his judicial temperament and medico-legal cast of mind. Although the Committee was determined to intervene directly and restore order when the police and courts were impotent in doing so, it sought, when seizing jurisdiction from the constituted authorities, to proceed in accordance with the rule of law. When the Committee evaded the writ of habeas corpus in the course of apprehending several of its prisoners, the punctilious Stout raised objections. He was then appointed to a committee of three members which advised "that a due circumspection be exercised to maintain the purity and equity of the application of the writ of habeas corpus."^[8]

Stout's experience on the Vigilance Committee may have turned his mind to consideration of legal and social issues. Although he practiced surgery and was Professor of Surgery from 1872 to 1874 in Dr. Hugh Toland's Medical School in San Francisco, most of his writings were of a medico-legal or public health nature as a result of which he was highly respected as an authority on social problems.

He was also actively involved in the organization and direction of the Pathological Society and other early medical associations in California. It was in this arena that he encountered Dr. Cooper whom he held in cold contempt and sought to discredit whenever an opportunity arose for him to do so. In due course we shall return to the subject of Stout's hostility to Cooper.^[9]

According to an article in Alta California, a public meeting, attended by a large number of physicians and other citizens, was held in the City Council Chamber on 17 November 1853 for the purpose of reviving the San Francisco Medical Society. No copy of the Constitution and By-Laws or list of members has been found but the press report states that the object of the association was "to preserve the character of the profession and to prevent the progress of quackery and charlatanism." The City Directory for 1856 further states that "the society has for its object the promotion of Medical Science and the encouragement of the social virtues among the members of the Medical Profession, and is intended to embrace every regular member of the Profession." Presumably, restriction of membership to "regular" physicians meant that only bona fide MDs were eligible, and "irregular" physicians (i.e., practitioners without a genuine degree, generally referred to as "quacks") were excluded.

At mid-century, American Medicine was an embattled profession, there being few effective mechanisms for controlling either the qualifications for or the standards of practice. The disarray within the profession was particularly acute in California because of local conditions. In addition to the holding of an MD degree, one of the few requirements a medical organization could enforce was strict adherence to a code of ethics. Therefore, these early San Francisco societies all called for the MD degree and were on the lookout for the slightest infraction of ethical principles (such as advertising). Cooper seems to have thought that the ethical ground rules of which he ran afoul in Illinois had been suspended in the free-spirited West. He was, of course, mistaken.

There were three candidates for the presidency of the society: Drs. Coit, Harris and Gibbons. The following officers were elected at the first meeting of the revitalized San Francisco Medical Society on 17 November. The president was Dr Benjamin B. Coit whose family name is preserved in the beautiful Coit Tower that overlooks San Francisco, bequeathed to the city by his daughter-in-law in memory of the volunteer firemen. Dr. H.M. Gray was elected first vice president; Dr Valentine Mott, second vice president; Dr. A.B. Stout, secretary. The 63 members enrolled in the Society comprised about half of the physicians estimated to be practicing in San Francisco in 1853. Among the members were the following physicians whom we will encounter later: Doctors Henry Gibbons, Sr., (elected president of the Society in 1855), R. Beverly Cole, J. P. Whitney, W.O. Ayres, J. Morrison and Isaac Rowell. It should be noted that members of the Pathological Society (Gray, Stout and Whitney) also became members of the San Francisco Medical Society.

There are no minutes of the Society's meetings and the only information regarding its activities is found in an editorial written by Cooper in the first issue of the San Francisco Medical Press in 1860:^[10]

The only indication of the duration of the society's existence is found in the City Directory where it was last registered in 1862. It then simply disappeared from the scene.^[11]

The first Sacramento medical societies were organized during the height of the Gold Rush that began in mid 1848. By January 1850 well-nigh 100,000 persons had come to California.^[12]

San Francisco was the golden gate to the new El Dorado, but Sacramento was the epicenter of the gold country. Doctors flocked there out of all proportion to the needs, drawn not by a desire to practice their profession, but to join the gold-hunting horde and return with riches to their former homes. It is estimated that from 1300 to 1500 doctors came to California among the gold seekers. These medical argonauts, mostly doomed to menial tasks for survival, also included physicians of the highest caliber who at great personal sacrifice and under chaotic conditions devoted themselves to the relief of the migratory population.

Jacob David Babcock Stillman (1819-1888), originally of New York State, was one of the most respected of these medical '49ers. Little is known of his early life and even the spelling of his second name is uncertain, sometimes being recorded as "Davis." He was born on 21 February 1819 in Schenectady, New York, where he attended public school and Union College. (Levi Cooper Lane was a student at Union for four months in 1849.) He earned his MD degree from the College of Physicians and Surgeons in New York and then practiced in the city, part of the time on the staff of the Bellevue Hospital. For reasons now unclear, but no doubt in response to the lure of California gold, he embarked in January 1849 on the sailing ship Pacific for San Francisco where he arrived on 5 August 1849. He described his epic sea journey of seven months around Cape Horn, and his experience on the California frontier, in a classic memoir entitled "Seeking the Golden Fleece".^[13][14]

He left the Pacific at San Francisco and set out for the gold mines in September of '49 with five friends. Sailing up the Sacramento River from the Bay of San Francisco in their 24-foot galvanized-iron boat, Stillman's party arrived in the early morning at the "canvas city" of Sacramento:^[15]

On 15 September Stillman's party continued northward up-river toward their destination in the gold fields. For several weeks they struggled against exhaustion, illness, and near-impassable terrain inhabited by Indians who were friendly and grizzly bears who were the chief menace. However, it was not these impediments but the tales of poverty, destitution and death told by the haggard bands of sick and dispirited men whom they met coming down from the mines that blasted the party's hope of riches Within one day's travel of their objective, they took a vote on the question of proceeding and unanimously resolved to return to Sacramento city where Stillman immediately entered the practice of medicine.^[16]

It was in this season of disillusionment with his own prospects in California that he considered the boisterous camaraderie of the gold seekers and their countless acts of generosity to the down-and-out to be more than offset by the prevalence of rapacity and dissolute behavior due to the loosening of moral constraints within the polyglot multitude. One of his letters records these somber reflections in the form of a western parable:^[17]

In Sacramento Stillman went into partnership with Dr. J.F. Morse, another new arrival. They opened a drug store and hospital in a crude new building for which they paid a rent of $1,500 a month. From December 25 in 1849 to April in 1850 their patients were mainly indigent and consequently hospital income was quite insufficient to cover expenses. Furthermore, their two story building was half submerged and nearly swept away during the great flood of January 1850 when patients came by boat and were admitted through a second floor window. All the patients and all the requisites for their care were moved to the second floor of the hospital, and on this second floor the doctors remained with, and cared for, the patients. One of Stillman's letters records the scene:^[18]

After less than four months' operation, the partners were stone broke and in April 1850 were forced to close the hospital, not for wont of patients, but of patients who could pay.^[19]

Later in that same month Stillman and Morse were engaged in the founding of the first medical society in the State of California.

Stillman had a distinctly literary bent and made important contributions to the history of California and the Southwest. He was for one year (1869-70) the senior editor of the second and last volume of the short-lived California Medical Gazette, and he wrote many articles in the Overland Monthly.

He also collaborated with Leland Stanford, an old friend, on the famous book entitled The Horse in Motion. Stillman authored the text of the book which was executed and published under the auspices of Stanford in 1882. Stanford, who had a great interest in horses, raised the question as to whether a horse in motion ever has all four feet off the ground at the same time. In the book's Preface, which he wrote, Stanford said:^[20]

Eadweard J. Muybridge, who used a quick-acting shutter to obtain rapid exposures, took a series of photographs of a trotting horse at exposures of five-thousandth part of a second. The project was carried out on the Stanford farm, site of the present Stanford University Campus. Stanford provided all necessary funds and resources including money for apparatus and horses for the experiment. He also arranged technical help from the engineering staff of the Central Pacific Railroad Company who devised an electrical system of magnetic devices for rapid sequencing of exposures.

By his photographs, Muybridge demonstrated conclusively that intermittently all four of the horses' feet were simultaneously free of the ground. Stanford then engaged Stillman to write a comprehensive text for The Horse in Motion. Stillman's text included no original prints of Muybridge's photographs, only reproductive illustrations. An account of the methods by which the photographs were produced that served as the basis for Stillman's analysis of the experiment was furnished by Muybridge and printed as an Appendix. The book contained a great deal of additional information the result of Stillman's own anatomical dissections and thorough study of the musculoskeletal kinetics of the moving horse.

Muybridge, who claimed both the original idea for the experiment and the technical innovations as his own, copyrighted the photographs. When he discovered that his name did not appear on the title page of the book, and that the text did not give him what he considered to be sufficient credit, he became so incensed that in September 1882 he sued the publisher, Osgood and Company of Boston, for infringement of his copyright. The suit was never brought to trial and was dismissed without prejudice or costs. Failing in this attack, Muybridge brought suit against Stanford directly, seeking $50,000 in damages. Throughout the extensive legal proceedings Stanford maintained that he had conceived the idea for a specific experiment, that he had employed Muybridge to carry it out under his auspices and with his support, and that he therefore had a right to report the results. The court agreed and on 13 February 1885 it rendered judgement in Stanford's favor; thus Muybridge lost his case.

As a posthumous reward for his later extensive pioneering work in the photography of man and animals in motion, which he began initially under the stimulus of Leland Stanford's original idea, Muybridge is heralded by some historians of the cinema as the Father of the Motion Picture.^[21][22][23]

J.D.B Stillman was the father of John Maxson Stillman (1852-1923) who was appointed Professor of Chemistry effective 1 January 1892 as a member of the first faculty at Stanford University. David Starr Jordan, first President of the University, recalled the following circumstances related to Professor Stillman's appointment:^[24]

During the transitional period when Cooper Medical College became the Medical Department of Stanford University, Professor John Maxson Stillman was chairman of the Medical Committee that planned the organization and curriculum of the new Department of Medicine. When the first appointments to the faculty of the Department were made in October 1908, J.M. Stillman, Professor of Chemistry, was among them.^[25]

J.D.B. Stillman was also the father of a younger son, Dr. Stanley Stillman (1861-1934), who graduated from Cooper Medical College in 1889 and became assistant to Dr. Levi Cooper Lane in 1891. Stanley Stillman was appointed Professor of Surgery at Cooper Medical College in 1898 and when Stanford took over the Medical College he was made Professor of Surgery and executive head of the Medical Department at Stanford, positions he held from 1909 until his retirement in 1924.^[26]

The Medico-Chirurgical Association of Sacramento was the first medical society to be organized in the state of California. The initial step toward its formation was a meeting of 20 to 30 physicians at the City Hotel in Sacramento on 24 April 1850. They resolved (1) to organize a Medical Society and (2) to appoint a committee to draft a Constitution, By-Laws, and schedule of professional fees. J.B.D. Stillman was a moving spirit, perhaps the moving spirit, behind the organizational effort. Pursuant to the resolutions adopted on 24 April, the second meeting of the Medico-Chirurgical Association of Sacramento was convened on 2 May 1850, again at the City Hotel. The object of the Association , as set forth in the Constitution, was "the cultivation of science; the promotion of honor, dignity and interest of the profession, and the separation of the regular from the irregular practitioners."

On 5 May 1850 the thirty-one year old Stillman wrote enthusiastically about the new society and spoke of his now more favorable view of California.^[27]

The public was invited to attend the meeting on 22 May and on this auspicious occasion Dr. Morse became the first to deliver a public address on a scientific subject in Sacramento City. The young Association bravely announced that it would hold monthly meetings Yet the ties that bound the disparate membership were soon loosened by lack of common interests and the insistence of some members on separation of "regulars" from "irregulars," as specified in the constitution. Sometime in 1854 or 1855 the Association quietly disbanded.^[28]

Dr. John Frederick Morse (1815-1874), whom we first met in his partnership with Dr. Stillman, is to come later to our attention under so many important circumstances that we should now mention something of his background and interests. He was born in Essex, Chittendon County, Vermont, on 25 December 1815, and reared in staid New England surroundings. He was married in 1843, received his MD degree in 1844 from the University of the City of New York, and began practice in Brooklyn, New York. He was highly regarded as a physician and, in these early years, began a lifetime devotion to the philanthropic work of the fraternal order of Odd Fellows and to many other humanitarian causes.

In 1849, ill health forced him to abandon medical practice. He set sail for California via the Isthmus of Panama on 23 February, hoping to recoup his health on the voyage and his fortunes in the gold fields. Throughout the journey by sea and across the steamy isthmus, he dispensed medical aid freely to his fellow travelers. He even took over the work of the ship's doctor on the long haul up the California coast and organized the passengers to clean up the filthy vessel. Revived by these exertions and good works, he took off for the mines immediately upon arrival at San Francisco in August 1849. Virtually paralleling the course of Stillman, who also reached San Francisco in August, Morse abandoned his quest for the elusive gold after a few months in the Coloma field. Returning to Sacramento, he went into partnership with Stillman. We have already told of their ill-fated venture in opening a hospital in December 1849 that they were forced to close in April 1850 for lack of funds.

Morse was an ardent proponent of medical societies and worked diligently with Stillman in the founding of the Medico-Chirurgical Association in May 1850. He also actively participated in founding other societies, as we shall see. With respect to his medical practice, the fall of 1850 brought to Sacramento a full-blown cholera epidemic to which he unselfishly devoted his professional efforts. He spearheaded a campaign for public sanitation and hospital reform, pleading vainly with the City Council for the formation of a board of health. Due to conditions in Sacramento at the time, his income from medical practice was insufficient to meet his needs.

His business enterprises also met with indifferent success. He turned from banking and real estate (bankrupt within four months) to real estate auctioneering (abandoned after five months), and finally in March 1851 found a more congenial occupation in the editorship of a flourishing Whig paper, the Sacramento Daily Union. Feeling more secure financially, he sent for his wife and daughter to join him. After his monthly salary on the newspaper was reduced from $300 to $200 he resigned the editorship in May 1852. He was then for a few months associated in practice with Dr. Thomas M. Logan when misfortune again sought him out. The store building where he lived and worked was destroyed by fire and his pregnant wife was removed from the flaming structure to the steamer Comanche bound for San Francisco. A son was born en route but Mrs. Morse died before reaching the city. The infant survived, only to succumb at the age of four. Deprived at one cruel blow of his beloved wife and all his worldly possessions, Morse dissolved his partnership with Logan (for lack of income, no doubt) and set up his office over Stanford Brothers' Sacramento store. During his three years' tenancy over the store, he became a close friend of Theodore Judah, Leland Stanford, and others of the future railroad dynasty.

With the passing years Morse became an increasingly vigorous and persuasive advocate of worthy causes and his eloquence made him a popular speaker. He spoke on many memorable occasions, including the ceremonial driving of the Golden Spike by Leland Stanford and Thomas Durant at Ogden, Utah, on 10 May 1869, closing the last gap in the first transcontinental railroad.^[29][30]

With reference to the final years in the full and eventful life of the valiant doctor, we note that he was appointed to the faculty of the Medical Department of the University of the Pacific in 1863 as Professor of the Theory and Practice of Medicine. During the interval of 1864 to 1869 when the Medical Department temporarily suspended operation, he joined the rival Toland Medical School as Professor of Clinical Medicine and Diagnosis. When the Medical Department reopened he returned as Emeritus Professor of the Principles and Practice of Medicine, a post he held until his death in 1874. In 1870 a Public Dispensary was established in the Pacific Medical College Building through the earnest labors of Professor Morse. The name was changed to the Morse Dispensary in his honor in 1875, a title it retained until renamed the Cooper College Dispensary in 1892.^[31][32]

We should also record that Dr. Morse married again and had a son, John Frederick Morse, Jr. (1857-1898) who graduated from the Medical College of the Pacific in 1878 and became Professor of Clinical Surgery at Cooper Medical College in 1889.^[33]

Scarcely a year had passed since the demise of the Medico-Chirurgical Association when the Sacramento Medical Society was founded on 30 April 1855. Among the officers were Dr. John F. Morse as a Vice President and Dr. Thomas M. Logan as Corresponding Secretary. The original list of members consisted of 25 physicians, all graduates of recognized medical schools. Holding of a medical degree was a prime requirement for membership in the Society which was established specifically "for the purpose of protecting regular practitioners and the public from innovations and malpractice of uneducated pretenders, who will display their 'shingles' in every community."

At the outset, members of the Society were animated by the conviction that regular meetings devoted to the open and informed discussion of scientific subjects were the Society's central purpose, and that contentious bickering over professional status and competition would threaten its welfare and survival. During the first two years Morse, Logan and others made instructive and interesting medical presentations. Nevertheless, a situation common throughout American medicine of the day caused increasing friction within the Society. There were in Sacramento some practicing physicians who had no medical degree but had gained their professional credentials solely through apprenticeship. This was in accordance with the time-honored but then obsolete practice by which young persons desiring to be a doctor attached themselves to a reputable physician and studied medicine under his tutelage in his offices and at the bedside. These preceptors determined after a few years when students were adequately trained and provided them with a certificate that they were competent to begin practice. Members of the Society who were friends or associates of preceptor-trained doctors pressed for their admission, and other members resisted. The gulf between the parties widened and, in 1863, the Society melted away.^[34]

Thomas Muldrup Logan (1808-1876), as noted above, was elected on 30 April 1855 as the first Corresponding Secretary of the Sacramento Medical Society. The member holding this position in a Medical Society is, in effect, its "Minister of Foreign Affairs" and on this account has exceptional responsibilities and opportunities. This special feature of the post was not lost on either Thomas Logan or Elias Cooper. These two were destined soon to involve their respective medical societies in an enterprise of considerable moment, which we will discuss in detail shortly. But first it would be timely to inquire into Dr. Logan's background.

He was born on 31 July 1808 in Charleston, South Carolina, of Scotch ancestry. His grandfather, Dr. Thomas Logan, a graduate in medicine at Edinburgh in 1773, practiced in Charleston. So did his father, Dr. George Logan, a graduate of the University of Pennsylvania in 1802. He was for some years a leading physician in Charleston.

As might be expected, Thomas Muldrop Logan spent his youth and early manhood attending Charleston schools. He received a classical education at Charleston College and was awarded an MD degree from the Medical College of South Carolina in 1828. He then married and spent several years in medical practice in Clarendon, North Carolina. In 1832 he went to Europe for the usual exposure to the professional culture of Great Britain and France. On his return he entered practice in Charleston and served as a Lecturer on Materia Medica and Therapeutics in a summer course under the auspices of the Medical College of South Carolina. His talent for color engraving, one of his avocations throughout life, was displayed in the first (1834) and second (1836) numbers of Dr. Thomas L. Odgier's Compendium of Operative Surgery for which Logan did the illustrations of operative procedures on arteries. He moved to New Orleans in 1843 where he practiced until the discovery of gold attracted him to California in 1849.

After a long and tempestuous voyage around the Horn in a small schooner, he arrived in San Francisco on January 29th 1850 and promptly entered medical practice. After a few months he moved to Coloma and mined gold until October 1850 when the terrible epidemic of Asiatic cholera broke out in Sacramento. To help care for the victims of that fearful pestilence, he immediately repaired to that city and there remained until the time of his death twenty-six years later.^[35]

Logan's records and commentary on the cholera epidemic of 1850 are an invaluable source of factual data that would otherwise have been lost to posterity. In November 1850 he wrote:^[36]

It was presumably during the cholera epidemic that Logan met John Morse with whom he enjoyed a long association in connection with the affairs of medical organizations to which we shall now return our attention.

By the summer of 1855 the first San Francisco Medical Society had expired, the Pathological Society was essentially dormant except for social functions, and the second San Francisco Medical Society exhibited only fitful signs of life on its downhill course to extinction in 1860. The time was opportune to establish a vigorous forum for scientific discussions and elevation of the profession in San Francisco.

4 August 1855

Doctors John L. Webster and John P. Macauley took the initiative. On Saturday 4 August 1855 they called a meeting in their office "for the purpose of forming a medical society." In addition to the hosts those present were: B.M. Angle, A. Atkinson, E.S. Cooper, Lorenzo Hubbard, C.A. Kirkpatrick and FP Wierzbicki. Dr. Hubbard was elected as Chairman and Dr. Webster as Secretary of the meeting, and Drs. Hubbard, Macauley and Webster were elected as a Committee to Draft a Constitution. Having disposed of this business with unanimity and dispatch, the group of eight physicians adjourned to meet again on Friday the 10th of August.^[37]

10 August 1855

This second organizational meeting was convened to consider the Constitution prepared during the past week by the drafting Committee. The full constitution was presented. No action on it was taken at this meeting and no list of members in attendance is available. The following sections of the Constitution defined the objectives of the society:

17 August 1855. (erroneously dated 16 August in the original Minutes. There was no list of the members present.)

At this third meeting of the Association the Constitution was unanimously adopted, and the following officers unanimously elected:

President:	Lorenzo Hubbard
Vice President:	Miles B. Angle
Secretary:	John L Webster
Treasurer:	I. W. W. Gordon
Corresponding Secretary:	Elias S. Cooper
Censors and Trustees:	I. W. W. Gordon John P. Macauley Charles A. Kirkpatrick F. P. Wierzbicki Elias S. Cooper

Cooper's election as Corresponding Secretary provided him with just the opportunity he needed to move forward as the representative of a local medical association with his plan to organize a State Medical Society.

During this meeting he received the additional important appointment as Chairman of the Committee to Draft By-Laws The committee was composed of Drs. Cooper, Gordon and Webster.

As the last item of business Dr. Cooper offered the following series of eight resolutions which were adopted and ordered to be recorded in the Minutes of the Meeting:

24 August 1855

There was no list of the members present at this fourth meeting of the Association. Dr. Cooper and other members of the By-Laws Committee must have worked industriously during the previous week for he, as Chairman, was ready with a comprehensive set of statutes for the regulation of the Association. The tone and content of the document suggest that it was chiefly Cooper's handiwork. Aside from routine rules of order for conducting business, the following two Sections from the By-Laws are noteworthy in view of subsequent events.

The By-Laws were adopted by unanimous vote.

31 August 1855

Members present at this fifth meeting of the Association were not listed. The Minutes read:

This communication was a letter dated 27 August 1855 written by Cooper on behalf of the Association to Thomas N. Logan, MD, Corresponding Secretary of the Sacramento Medical Society, proposing the organization of a State Medical Society. We will return later to this historic proposition.

In a bold move to define the character and mission of the Medico-Chirurgical Association in his own terms, Cooper now took the floor again in order to read a series of twelve resolutions, which he followed by a second series of ten resolutions. Both series were received for the record and carried over to the next meeting for discussion.

7 September 1855

The roll was called at this sixth meeting and the following nine members were present: Drs. Angle, Atkinson, Cooper, Gilbert, Gordon, Kirkpatrick, Macauley, Webster and Wierzbicki.

Dr. Wierzbicki proposed that a committee be appointed to draft resolutions respecting the controversial subject of Medical and Surgical Fees. The proposal elicited a warm discussion from the usually compliant group. Several members objected to a scale of fees being drawn up at present, the Society being but in its infancy. It was finally decided to appoint a committee to prepare a fee bill.

Cooper's two series of resolutions comprising a total of twenty-two, submitted at the previous meeting, were read again, discussed, and unanimously approved. These were in addition to his eight resolutions previously ratified at the third meeting of the Association. It must be a singular occurrence for a medical society in the process of organization to adopt unanimously thirty resolutions from a newcomer to the local profession. Recall that Cooper had at this time been in San Francisco only a little over three months. His campaign to build a practice and begin a teaching program was in full sway. Living alone and associating only with medical men, he maintained his accustomed punishing schedule of dissection and medical studies far into the night, his restless mind focussed on the ultimate goal of founding a medical school. We know, too, that he continued to have nagging symptoms of the mysterious neurological disorder that caused his facial palsy. To what extent this chronic illness influenced his behavior we shall never know. That being the case, Cooper's grim striving and sense of mission best explain his assertiveness and the barrage of 30 resolutions designed to proclaim his personal credo and take aim at emerging critics.

Cooper's resolutions in general were mainly noble and harmless platitudes, except for those in the last of the three series he submitted. These have troubling implications. They are obviously directed against certain of San Francisco's pioneer physicians, members of the Pathological Society, who resented Cooper's aggressive tactics and his disrespect for their seniority and competence. On this account they had presumably excluded him from their Society. The following self-righteous litany was nothing less than a defiant challenge to the old guard. By obtaining approval of these resolutions, Cooper involved the Association in his smoldering feud with the Pathological Society.

It would be surprising if the above "manifesto" did not provoke a punitive response from members of the Pathological Society. Indeed, we can now regard Dr. H.M. Gray's criticism of Cooper's operation on patient Travers as the opening gun in a campaign by Gray and his associates in the Pathological Society to censure Cooper.

The Association's first year began on 4 August 1855. It concluded with an Annual Meeting on 7 July 1856 devoted to receiving an Annual Report and electing officers for the coming year. The Association was fortunate during its first year to attract an able and active membership. At the first organizational meeting on 4 August, eight physicians were present. At the third organizational meeting on 17 August, when the Constitution was adopted and officers elected, the same eight physicians were present and probably two additional (Drs. Gilbert and Gordon) for a total of ten in attendance. These can be considered the founding fathers of the Association.

The signatures of the thirty-two members of the Association (including the founders) are appended to the Constitution. Twenty-six members signed before July 1856 and six signed after that date. We can thus say that the membership of the Association increased three-fold (from the original ten to thirty-two). Forty-six weekly meetings were held during the first year. The greatest number of members present at any meeting was twenty, the lowest seven, the average twelve - not a bad record for a community where the vitality of medical societies was low and the mortality high. For a history of the organization more detailed than that available for any other local medical society in that era, we are indebted to the Secretaries of the Association who were careful to preserve the founding documents and the minutes of all meetings up to 18 January 1858. After that date, although the Association continued to meet, the minutes have been lost.

It was Cooper who energized the Association. His special contribution was in rallying the members to participate in the scientific program as the primary objective of the Association. Meetings were devoted to medical rather than social or political issues. He emphasized the presentation of cases and formal reviews of preassigned topics. He himself took active part in discussions, made many reports, and conducted a series of weekly lectures on the anatomy of the arterial system. It can also be assumed from indirect evidence that members frequented his dissecting rooms to profit from his anatomical classes and surgical cases. Uplifted by the high sentiments expressed in Cooper's first series of Resolutions, the enthusiasm for self-improvement among the early members reached such a pitch that the Minutes for 7 September 1855 recorded the following:

The young Association made a serious attempt to achieve high standards and arranged to have its scientific Proceedings for October and November 1855 (unsophisticated as they were) published in the San Francisco Medical Journal, volume 1, number 1 for January1856 (the only issue of the journal ever published). The medical cases described in the Proceedings ranged from remarkable to ridiculous. Here are a few examples to illustrate the level of the discourse.^[38]

Dr. Angle reported that a small company of men were on a cattle drive from Los Angeles to San Francisco in 1854. It was customary to set a watch during the night to ward off predators, human and otherwise. During the night one of the men got up unbeknownst to the watch who, hearing a rustling in the brush, fired a single shot into the dark. When he went to investigate he found his friend shot through the head. The ball entered the left mastoid bone, crossed the base of the skull, and exited through the right eye. The patient was evacuated sixty miles cross-country on horseback and up the coast by steamer from San Luis Obispo to San Francisco. In spite of that harrowing experience, the patient survived and his wounds healed completely in three weeks. As for residual complaints, he was deaf in the left ear and blind in the right eye. According to the Proceedings, the peculiar interest attached to this case was not so much the rapid convalescence of the patient, as that a ball should enter at the base of the skull on one side and pass out through the eye on the other without causing immediate death. Stories like this reinforced the legend of fortitude and hardiness in the American frontiersman.

Dr. Cooper read a communication, translated by him from the French, giving the history of a case wherein a speedy cure of Sciatic Neuralgia was effected by cauterizing the ear. Henry Gibbons, who had joined the Association in October, countered with the story of a bed-ridden patient with Rheumatism. When a showman's monkey came down the chimney covered with soot, the patient was so much alarmed that he hastily arose and walked down the stairs as a well man. Not to be outdone, Dr. Angle related the case of a female with Catalepsy who could only be aroused to consciousness by the melody of a violin, while the harsh tones caused by drawing the bow across the strings without any regard to tune, produced no sensible effect. In further reference to the effect of a stringed instrument, Angle claimed to have repeatedly found in his own personal experience that the notes produced by the violoncello would excite hoarseness. The gist of this small symposium was that the mind has a powerful influence over physical conditions.

According to the Minutes for the meeting of 14 December 1855 Cooper read a paper by Professor Fleming of Queen's College who asserted that pressure on the carotids so as to arrest circulation to the brain would cause anesthesia. There was a lively discussion of the mechanism, safety and practical value of the procedure. Eager to sustain the fervor of his colleagues, and committed to the Hunterian policy of taking surgical problems to the laboratory for study, Cooper invited Drs. Enscore, Hubbard, Angle, Kirkpatrick, Macauley, Austin, Gordon and Wierzbicki to observe the following simple experiment in his animal laboratory. Not caring to risk brain damage by compressing the carotids in man, he ligated both carotids in a dog and all present observed that the procedure caused only the slightest immediate stupor lasting little more than an hour. The experiment demonstrated to the entire satisfaction of the eight physicians who witnessed it that interruption of carotid circulation is not a satisfactory method of producing anesthesia, at least not in the dog. What possible significance can be attributed to this humble and inconclusive laboratory demonstration? Its import lies in its having occurred at all, and in its precedence as a forerunner of laboratory investigation in the farthest outpost of the nation.^[39]

Cooper's lasting friendship with Doctor Henry Gibbons dates from October 1855 when Gibbons joined the Association. We earlier referred to the Quaker background of both Cooper and Gibbons as conducive to the mutual trust that characterized their relationship. Both were tireless in their devotion to medical science and in their cultivation of medical organizations. They were, however, quite different in temperament. Whereas Cooper was openly scornful of incompetence and bristled at criticism, Gibbons - twelve years his senior - was ever the reserved and even-handed medical statesman.

Gibbons traced his American ancestry to the Quaker John Gibbons who left Warminster, England, in 1681 to settle on a grant of land obtained from William Penn in Chester County, Pennsylvania, just south of Philadelphia. The family prospered in the proprietary Colony, being of scholarly inclination and active in public service and the founding of schools. John Gibbons as head of the American line was succeeded by a son, grandson and great grandson, all named James, the last of whom was the father of William Gibbons. William, the youngest of twelve children, received a medical degree from the University of Pennsylvania in 1802 and settled just south of Chester County in Wilmington, Delaware. This Dr. William Gibbons was the father of Henry Gibbons whose descendants include a distinguished line of Henry Gibbonses in California.

The first Henry Gibbons (H. G., Sr.) was born in Wilmington on 20 September 1808, the second of fourteen children. Both Henry's father and grandfather were highly educated men, being well versed in ancient and modern languages, and in natural science. It is evident from published accounts that members of the family carried down through the generations a full share of those traits of inflexibility of purpose, purity of life and simplicity of manners that make for the distinctive individuality of members of the Society of Friends.

The young Henry received in his native city of Wilmington, Delaware, a good early education from private schools where he had a thorough training in English and French, and acquired a knowledge of Latin and Greek. As an adolescent youth he began a medical apprenticeship in the practice of his father with whom he studied until he entered the Medical Department of the University of Pennsylvania where he received an MD degree in March 1829. He then practiced with his father in Wilmington for twelve years but, attracted by the larger opportunities in the great city, he moved to Philadelphia in 1841. There he was soon invited to accept a professorship at the Philadelphia College of Medicine, a post he held until he departed for California. Meanwhile his scientific interests led him to membership in the Philadelphia Academy of Natural Sciences and in the College of Physicians. Furthermore, he lectured on physiology and other topics at the Franklin Institute and elsewhere, was one of the original members of the American Medical Association, and one of the founders and corporators of the Female Medical College of Philadelphia. In the course of these various endeavors he became a relaxed and effective public speaker and able parliamentarian, attributes that served him well in his later undertakings.

When gold was discovered in California in 1848, Dr. Henry Gibbons was no longer a venturesome young man, but a mature physician of forty with a successful academic career and a promising future of medical practice in the premier medical city of the new nation. Nevertheless, responding to some mid-life compulsion to expand his horizon, he joined the high tide of immigrants flowing to the farthest West where a new society was being created. He and two of his brothers reached San Francisco by sea via the Isthmus of Panama on 20 August 1850. Six feet tall, thin, dark of eyes and hair and sedately dressed, Dr. Gibbons as he disembarked in San Francisco was plainly a professional man and not a restless argonaut bound for Sacramento and the gold fields beyond. He went directly into practice in San Francisco and within a month or two of his arrival was involved in a cholera outbreak in the city. He had previous experience with the disease when it occurred in the eastern states in 1832, 1847 and 1849 and offered his services to the city authorities. Contrary to most, he had no fear of the disease and even slept in the hospital to care for the victims. Since climate was thought to be somehow concerned with the etiology of cholera , and botany with its therapy, he set out to make observations in the virgin field of California meteorology, and aided by his brother, Dr. William P Gibbons (1812-1897), studied native plants. He later published his climatological observations in various journals. From a promising beginning of selfless public service during the cholera epidemic, Henry Gibbons grew steadily in the esteem of the local profession and his medical practice reflected the high regard in which he was held by the public. Another brother, Dr. Edward Gibbons, also came to California and practiced in Oakland.

Dr. Gibbons was eminently a domestic man and ardently attached to his wife and family who joined him in San Francisco in 1851. He had been married in Wilmington, Delaware, in May 1833 to Martha Poole of the same city, daughter of a prominent member of the Society of Friends. They had eight children of whom Henry Gibbons, Jr., (1840-1911), future Dean of Cooper Medical College, was the fourth.

No man in California in his day surpassed Henry Gibbons in zeal and natural aptitude for medical organization. His cool impartiality and parliamentary finesse made him a respected presiding officer and effective mediator in fractious medical assemblies where acrimonious exchanges were prone to get out of hand. His ability in this regard was recognized by his medical colleagues soon after his arrival in San Francisco. As already mentioned, he was one of three candidates nominated for the presidency of the San Francisco County Medical Society when it was resurrected in 1853, and he became president of the Society in 1855. When the San Francisco County Medico-Chirurgical Association was founded in August of 1855, its dynamic program attracted his attention, and he was elected to membership in October. Thereafter he participated faithfully in the Association's activities. We shall have occasion to refer again and again to the roles of Henry Gibbons, Sr., and his son, Henry Gibbons, Jr., in the evolution of medical education on the Pacific Coast.^{[40][41] [42][43][44][45]}

Following the minutes of the Association's regular weekly meeting of 28 December 1855, the Minute Book contains the following curious entry:

We can safely assume that the "enemies" referred to in this New Year's greeting were the members of the Pathological Society anathematized in Cooper's last series of Resolutions.

The assumption that the Pathology Society and the Medico-Chirurgical Association were now engaged in a "cold war" is borne out by a parliamentary maneuver executed by the persistent Cooper in the Spring of 1856. He began his attack by submitting to the Association the following seemingly innocuous resolution:^[46]

The resolution was adopted and Cooper, who was appointed Chairman of the Committee of Inquiry, submitted the following report:

Having engineered this caustic gibe at the Pathological Society, Cooper doubtless saw to it that the Report of the Committee of Inquiry came promptly to the attention of the Society's members. Although his vendetta with the influential Pathological Society was increasingly dangerous to his own standing in the profession, Cooper did not shrink from confrontation with those members of the Society who had now begun openly to assail not only his ethics but also his competence as a surgeon.

From time to time new members were admitted to the Medico-Chirurgical Association which was definitely the most vigorous and progressive of the San Francisco medical societies to be organized up to that time. Two members, Drs. Beverly Cole and Hugh Toland, elected to membership on 25 January 1856, were to have such a lasting influence on medicine and medical education in the West that something of their backgrounds should now be mentioned. Their surgical and other exploits, and their relationship to Cooper, were about to thrust them into the limelight of California history.

Dr. Richard Beverly Cole (1829-1901) arrived in San Francisco aboard the sailing ship Columbia in 1852 after harrowing experiences with epidemic cholera that struck down many of his fellow travelers during transit of the Isthmus of Panama. San Francisco was still a rough and disheveled boomtown with unpaved streets and everywhere the clutter of frenzied building. But the weather was mild and dry and the unkempt population, temporarily chastened by the Vigilance Committee of 1851, was preternaturally well-behaved. Cole wasted no time with mining for gold, but began practice at once by affiliating with a Mr. Little in the pharmacy business and taking an office in his drug store at 137 Montgomery, one of the liveliest streets in the city. Dr. Cole was twenty-three at the time, tall and slender with fair complexion and the blackest of curly hair and beard. Morally and physically fearless, open and sociable in manner, with a remarkably compelling speaking voice and style, he was destined to be an influential figure in what might be called the post-frontier environment of early California.

Although young, Cole was not inexperienced when he set out for California from the port of New York on 24 June 1852 aboard the elegant and spacious side-wheel steamer, the S. S. Cherokee, bound for Panama. He was born in Manchester, Virginia, on 12 August 1829, youngest of the three children of John and Pamelia Wooldrich Cole. When he was an infant in his mother's arms his father died at the age of twenty-seven, leaving his mother penniless. Being a woman of courage and enterprise, she provided for her children by opening a boarding house in Pottstown, Pennsylvania, and with the profits of this venture moved to Philadelphia where she opened a larger establishment. She taught Beverly at home during his childhood because of his delicate health, and sent him to the Delaware College institute in Newark, Delaware, at the age of thirteen where he completed the four-year course in three years, thus finishing his schooling at sixteen. His medical training began with an apprenticeship to Dr. Benjamin Dudley of Lexington, Kentucky - the same Dr. Dudley whose infamous duel with William Richardson and confrontation with Daniel Drake at Transylvania Medical College we have already cited. Cole's formal medical education began with a year at Transylvania Medical College in Lexington, followed by a year at Jefferson Medical College where he received an MD degree in 1849 - at the age of twenty.

Being without funds, Cole worked his way through Jefferson by preparing anatomical dissections to be used in teaching by his anatomy professor, the respected anatomist and surgeon Dr. Joseph Pancoast, author of the classic Treatise on Operative Surgery. In addition to a thorough grounding in anatomy, another legacy of his year at Jefferson was the influence on his impressionable mind of his Professor of Obstetrics, the scientifically myopic and opinionated Charles D. Meigs. It is assumed that Cole's later choice of obstetrics as a specialty can be traced to the Professor's florid lectures.

During his last year in medical school, Cole married Miss Eugenie Bonaffon, not more than fifteen at the time but of rare devotion and fortitude as the passing years were to prove. From the moment when his MD was awarded in 1849, the tempo of the lives of Dr. and Mrs. Cole was changed and tranquility banished, never to return. No sooner had Cole begun practice in Philadelphia than a cholera epidemic descended on the city. As physician in chief of the Pine Street Cholera Hospital - a temporary shanty harboring a near hopeless assemblage of patients - he lived and worked within its four walls during the months until the epidemic subsided in August of 1849. Cole then embarked on the usual hectic round of general medicine with cases ranging from endemic "putrid sore throat" (diphtheria) to "childbed fever" (puerperal sepsis), from bone-setting to (he later claimed) three caesarian sections.

As rumors of gold in California came floating in to stir the imagination of the restless, Cole was immersed in his growing practice. Now he was also obstetrician to three dispensaries and prosector and assistant demonstrator in anatomy under Professor Pancoast at Jefferson. It was in the Spring of 1852 when, without warning, his dreams of a brilliant career in Philadelphia were dissolved by a terrifying hemorrhage from his lungs. Never of robust health since infancy, he saw tuberculosis as a deadly menace that would abate only under the most favorable conditions - by all reports, conditions best found in California where the balmy air would restore his health while he supported his family by a leisurely practice. He departed at once for San Francisco and Eugenie, now pregnant with their first child, would remain in Philadelphia until he sent for her. Such were the circumstances that launched another of the eminent adopted Sons of the West on the journey to a new life in California.

During his first two years in San Francisco Cole went about unobtrusively cultivating professional colleagues and developing his practice - a process at which he was experienced and adept. His easy good humor and obvious competence gained him wide respect and his low-profile approach was very effective, but it was a near fatal accident that brought him universal recognition. In June 1854 he was in the drug store packing his saddle-bag for a trip by horseback to San Mateo, 19 miles south across the sand dunes. As a deterrent to the brigands who frequented the countryside, he slipped his loaded Colt's revolver with its six-inch barrel into his breast pocket where it would be handy for a quick draw. When he leaned over to arrange his saddle-bag the gun slipped out, caught its hammer on the edge of the table and fired a ball that entered in the left upper quadrant of the abdomen, passed through the stomach, and lodged in the back between the eleventh and twelfth ribs just to the left of the midline - a thoroughly obscure location in those days long before the discovery of x-rays.

Cole's survival after this injury was nothing less than a medical miracle and can be attributed to his having an empty stomach at the time of the wounding, and to the infection remaining localized under the left diaphragm until, after three weeks, it "pointed" at the site on the back where the ball was lodged. Only then did Dr. Tripler turn the patient over and, summoning all his nerve, lance the inflamed area - draining a large sub-diaphragmatic abscess and extracting the ball with one stroke of the scalpel. Nevertheless, it was several years before a gastric fistula at the bullet hole on the abdominal wall in front finally closed and he could comfortably digest a heavy meal. By making a full recovery from a mortal wound whose progress was followed avidly month after month in professional and social circles, Cole gained a celebrity which followed him all his days. But this was the least of his claims to distinction, as we shall see.

Cooper arrived in San Francisco during the latter stage of Cole's illness and their mutual interest in anatomy and surgery led to friendship and cooperation. Cole doubtless joined the Medico-Chirurgical Association on 25 January 1856 at the invitation of Cooper, who shared with him a great respect for Cole's mentor, Professor Pancoast.^[47][48]

Dr. Hugh Huger Toland (1806-1880) was also elected to membership in the Medico-Chirurgical Association on 25 January 1856, and he signed the Constitution, but there is no evidence that he attended the meetings of the Association. Nor does he appear to have participated in any of the other early medical societies in San Francisco. He was evidently not a joiner. He was, however, acknowledged to be the senior surgeon of the city, his grim rectitude and cold self-possession adding weight to his professional opinions. He was about the same age as Henry Gibbons. In terms of technical ability and knowledge of the field, Cooper was the only serious challenge to Toland's supremacy in California surgery.

Toland was born in Guilder's Creek, South Carolina, in 1806. He was the fourth of ten children of John Toland who in early manhood migrated from the north of Ireland to South Carolina where he purchased a large estate and became a prosperous planter. Schooling was limited in rural South Carolina for the young Henry, but he was a bright boy and acquired a good elementary education in English literature, Latin and Greek. His father, recognizing in him an aptitude for medicine, apprenticed him to a Dr. Ross at the age of sixteen and, after a year and a half of Dr. Ross's tutelage, sent him to Transylvania Medical College in Lexington, Kentucky. There he received an MD degree in 1828 at the head of a class of 160 students. Dr. Toland began his medical career in rural Pageville, South Carolina, engaging in general practice and covering a huge backwoods area on horseback. After two and a half years he had acquired $3000 and an urge to improve his surgical skills. To this end he returned to Lexington and, after taking a postgraduate course in dissection and surgery from the now-familiar Dr. Benjamin Dudley, ventured on to Paris in 1832. The French savants were highly impressed by the intelligence and attentiveness of the solemn, unsociable American student who, unlike many of his compatriots, devoted his whole time to study, and to roaming the wards instead of the bistros.

By 1834 Toland was back in South Carolina, engaged in a lucrative practice in Columbia, one of the state's major cities. Over the next eighteen years his income averaged a handsome $20,000 a year. His first wife died and he married again in 1844, this time to Mary Avery. Although he was extraordinarily successful in Columbia, the humdrum routine of his uneventful life grew tedious, conflict over the slavery question loomed, and his wife was unwell. Meanwhile the tales of gold in the rivers and mountains of California grew ever more alluring, promising adventure, a break with the past, and new horizons for those willing to risk their future in the western gold fields. For whatever reason, the ties that bound this stolid, childless citizen to the community gave way. At the age of forty-six he abandoned all he had built up. He cushioned his terminally-ill wife on the bed of a Conestoga prairie schooner, and joined a wagon train at Independence, Missouri, that crossed the plains to California in a record seventy-six days. Three days after arrival, poor Mary died and was buried in a desolate little cemetery at Stockton. One of the theories to account for Toland's cross-country migration in 1852 was that he hoped his ailing wife would benefit from a change of climate.

Toland came West, not as an ordinary adventurer but as an affluent medical gentleman, well-known and respected in the Carolinas. He was not, however, planning to overlook the possibility of adding California gold to the tidy fortune he brought from Columbia. He was soon set up on a claim at Mokelumne Hill, Calaveras County, complete with a quartz mill he sent ahead by boat. However, within a few weeks, under the cold rains of winter in the Sierra foothills Toland like countless argonauts before him discovered his unfitness for the rigors of mining gold. He wisely disposed of his claim and quartz mill, and rode down to San Francisco, arriving there on a wet December day in 1852. The hitherto successful Toland thus began his California career in sorrow and failure. But he was experienced in building a medical practice and within a few years patients thronged to his office at Montgomery and Merchant Streets, buying thousands of prescriptions from the drug store he opened near by for their convenience. Tall and angular with a stern face and downturned line of a mouth, dressed entirely in black with wide-brimmed hat and flowing cape, he was a familiar figure in the consulting rooms of San Francisco. By the time Cooper arrived in 1855, Toland was solidly established. It was inevitable that these proud and opinionated men should clash.^[49][50]

The First Annual Meeting of the San Francisco County Medico-Chirurgical Association was convened in the City Hall, fifteen members being present. The First Annual Report was read and included the following noteworthy comments:

Having received this gratifying summary of the year's activities, the members proceeded to choose a panel of officers for the coming year. Their first action was to elect Doctor E. S. Cooper as President of the Association. In a further deferential gesture to Cooper, his associate C. A. Kirkpatrick was elected Vice President. The new President then took the Chair and spoke:

At this point Cooper's rough draft of the speech, found among his papers, included the following statement that he omitted from his comments to the Association: "While I plead guilty to the fault of much indolence, most of you will I think readily extenuate to some degree at least that fault upon the grounds of (my) almost constant ill health."^[51]

Dr. Cooper then spoke briefly on the unhappy condition in which the Medical Profession of San Francisco is now found for want of unanimity of feeling and concurrence of action, but said that properly conducted Medical Associations can do much in correcting these evils as well as in advancing the skill and knowledge of the members. He concluded his remarks as follows:

Cooper was immensely gratified, only thirteen months after his arrival in San Francisco, to be elected President of the city's now-premier medical society whose success in its first year was due in large measure to his active involvement. His brief acceptance speech had a philosophic and conciliatory tone, reflecting his idealism, the burden of his chronic illness, and the high goals he set for himself. He deplored, as well he might, the ominous rift in San Francisco's medical profession to which his meteoric rise in the profession and open conflict with the Pathological Society were contributing causes. Lastly he referred to the social unrest in the city. While following the course of the Medico-Chirurgical Association during its first year, we necessarily deferred comment on this and other memorable developments during 1855-56, such as the founding of the California State Medical Society, to which we will now turn our attention.

1. J. Roy Jones , Memories, Men and Medicine: A History of Medicine in Sacramento, California (Sacramento: Published by the Sacramento Society for Medical Improvement, 1950), pp. 24-25 Lane Library catalog record
2. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 1-8 Lane Library catalog record
3. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 9-11 Lane Library catalog record
4. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 127-31 Lane Library catalog record
5. Levi C. Lane , "Dr. Augustus J. Bowie: In Memoriam," Pacific Medical and Surgical Journal and Western Lancet 30, no. 8 (Aug 1887): 441-446 Lane Library catalog record
6. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), p. 131 Lane Library catalog record
7. Rockwell D. Hunt and Nellie Van de Grift Sánchez , A Short History of California (New York: Thomas Y. Crowell Co., 1929), p. 439.
8. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), p. 133 Lane Library catalog record
9. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 133-137 Lane Library catalog record
10. Elias S. Cooper , "Editorial: San Francisco Medical Society," San Francisco Medical Press 1, no. 1 (Jan 1860): 56-57 Lane Library catalog record
11. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, >1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 12-15 Lane Library catalog record
12. J. D. B. Stillman , Seeking the Golden Fleece: A Record of Pioneer Life in California (San Francisco: A. Roman and Company, 1877), p. 32 Lane Library catalog record
13. J. D. B. Stillman , Seeking the Golden Fleece: A Record of Pioneer Life in California (San Francisco: A. Roman and Company, 1877), p. 32 Lane Library catalog record
14. J. D. B. Stillman , Around the Horn to California in 1849, Foreword by Kenneth M Johnson (Palo Alto, California: Lewis Osborne, 1967), pp. 5-9.
15. J. D. B. Stillman , Seeking the Golden Fleece: A Record of Pioneer Life in California (San Francisco: A. Roman and Company, 1877), pp. 118-123 and 127-128 Lane Library catalog record
16. J. D. B. Stillman , Seeking the Golden Fleece: A Record of Pioneer Life in California (San Francisco: A. Roman and Company, 1877), pp. 128-139 Lane Library catalog record
17. J. D. B. Stillman , Seeking the Golden Fleece: A Record of Pioneer Life in California (San Francisco: A. Roman and Company, 1877), pp. 144-146 Lane Library catalog record
18. J. D. B. Stillman , Seeking the Golden Fleece: A Record of Pioneer Life in California (San Francisco: A. Roman and Company, 1877), pp. 149-151 Lane Library catalog record
19. J. Roy Jones , Memories, Men and Medicine: A History of Medicine in Sacramento, California (Sacramento: Published by the Sacramento Society for Medical Improvement, 1950), pp. 12-13 and 19-21 Lane Library catalog record
20. J. D. B. Stillman , The Horse in Motion as Shown by Instantaneous Photography with a Study on Animal Mechanics, Executed and Published under the Auspices of Leland Stanford (Boston: James R. Osgood and Company, 1882), p. iii.
21. Robert B. Haas , Muybridge: Man in Motion (Berkeley, California: University of California Press, 1976), pp. 135-144.
22. Gordon Hendricks . Eadweard Muybridge: The Father of the Motion Picture (New York: Grossman Publishers, 1975), pp. 142-152 and p. 218.
23. George D. Lyman , The Scalpel under Three Flags in California (San Francisco: California Historical Society, 1925), p. 49 Lane Library catalog record
24. David Starr Jordan , The Days of a Man, Vol. 1, 1851-1899 (Yonkers-on-Hudson, New York: World Book Company, 1922), pp. 397-98 Lane Library catalog record
25. Orrin L. Elliott , Stanford University: The First Twenty-Five Years (Stanford, California: Stanford University Press, 1937), p. 541 Lane Library catalog record
26. Wilmer C. Allen , ed., The First Hundred Years (Glendale, California: Mirro-Graphic Yearbooks, 1959), pp. 53-55 Lane Library catalog record
27. J. D. B. Stillman , The Gold Rush Letters of J.D.B. Stillman, Introduction by Kenneth Johnson (Palo Alto, California: Lewis Osborne, 1967), pp. 59-61
28. J. Roy Jones , Memories, Men and Medicine: A History of Medicine in Sacramento, California (Sacramento: Published by the Sacramento Society for Medical Improvement, 1950), pp. 22-25 Lane Library catalog record
29. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 143-150 Lane Library catalog record
30. Norman E. Tutorow , Leland Stanford: Man of Many Careers (Menlo Park, California: Pacific Coast Publishers, 1971), p. 90 Lane Library catalog record
31. Annual report of Morse Dispensary of Cooper Medical College Lane Library catalog record
32. Robert O. Whitfield , "Historical Development of the Stanford School of Medicine" (A Thesis submitted to the School of Education and the Committee on Graduate Study of Stanford University in Partial Fulfillment of the Requirements for the Degree of Master of Arts, April 1949. Lane Medical Library, Stanford University School of Medicine), pp. 74-83 Lane Library catalog record
33. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. I, 1850 to 1900 (San Francisco: Published by the San Francisco Medical Society, 1958), pp. 167-169 Lane Library catalog record
34. J. Roy Jones , Memories, Men and Medicine: A History of Medicine in Sacramento, California (Sacramento: Published by the Sacramento Society for Medical Improvement, 1950), pp. 29-31 Lane Library catalog record
35. J. Roy Jones , Memories, Men and Medicine: A History of Medicine in Sacramento, California (Sacramento: Published by the Sacramento Society for Medical Improvement, 1950), pp. 383-385 Lane Library catalog record
36. J. Roy Jones , Memories, Men and Medicine: A History of Medicine in Sacramento, California (Sacramento: Published by the Sacramento Society for Medical Improvement, 1950), pp. 389-390 Lane Library catalog record
37. Minutes and Early Meetings (1 Volume), San Francisco County Medico-Chirurgical Association - MS 3119, California Historical Society. Note: Unless otherwise specified, all information in the section on San Francisco County Medico-Chirurgical Association is derived from these Minutes and Early Meetings of the Association.
38. "San Francisco County Medico-Chirurgical Association: October-November" San Francisco Medical Journal 1, no. 1 (Jan 1856): 10-14 Lane Library catalog record
39. Miscellaneous, Scrapbook #2, No Date - Box 2 Folder 9, Elias Samuel Cooper Papers - MS 458, California Historical Society, North Baker Research Library.
40. J. Marion Read and Mary E. Mathes , History of the San Francisco Medical Society, Vol. 1, 1850 to 1900 (San Francisco: Published by San Francisco Medical Society, 1958), pp. 151-57 Lane Library catalog record
41. Henry Harris , California's Medical Story (San Francisco: J. W. Stacey, Inc., 1932), pp. 347-354 Lane Library catalog record
42. Alonzo Phelps , ed., Contemporary Biography of California's Representative Men (San Francisco: A. L. Bancroft and Co., 1881), vs. Henry Gibbons, pp. 82-84.
43. Levi C. Lane , "Dr. Henry Gibbons: In Memoriam," Pacific Medical and Surgical Journal and Western Lancet 28, no. 2 (Feb 1885): 49-66 Lane Library catalog record
44. "Gibbons Family Geneology" in Manuscript Box: Henry Gibbons, Sr., and Henry Gibbons, Jr., Publications and Geneology. Lane Medical Archives, Stanford.
45. George D. Lyman , "Figure (XX): Medical Office of Dr. Henry Gibson in the Early 50's" , in The Scalpel under Three Flags in California (San Francisco: California Historical Society, 1925), p. 52 Lane Library catalog record
46. Item #10, Correspondence 1857-1862 - Box 1, Folder 4, Elias Samuel Cooper Papers - MS 458, California Historical Society, North Baker Research Library. It has not been possible to determine the date on which Cooper's Committee of Inquiry actually reported to the Medico-Chirurgical Association. The undated text of the Resolution and the Committee's Report are found among Cooper's papers and wrongly filed by CHSL with Correspondence 1857-1862 instead of Correspondence 1856. Considering other events in the period 1855-1858, it is logical to assume that the Committee of Inquiry served during the Spring of 1856 following the first meeting of the California State Medical Association
47. Frances T. Gardner , "King Cole of California," Annals of Medical History 2 (Third Series), no. 3 (May 1949): 245-258 Lane Library catalog record
48. Henry Harris , California's Medical Story (San Francisco: J.W. Stacey, Inc., 1932), pp.355-356 Lane Library catalog record
49. Frances T. Gardner , "The Little Acorn: Hugh Huger Toland, 1806-1880," Bulletin of History of Medicine 24, no. 1 (Jan-Feb 1950): 61-65 Lane Library catalog record
50. Henry Harris , California's Medical Story (San Francisco: J. W. Stacey Inc., 1932), pp. 360-362 Lane Library catalog record
51. Miscellaneous, Scrapbook #1, No Date - Box 2, Folder 9, Elias Samuel Cooper Papers - MS 458, California Historical Society, North Baker Research Library