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

Medical Aspects

Crime in San Francisco subsided briefly following the hangings and deportations of notorious felons by the Vigilance Committee of 1851. But it was not long before lawlessness was again rampant in the streets while embezzlers invaded commercial enterprises, and corrupt public officials undermined confidence in the government. By 1856 conditions had deteriorated to the point that a fearless and independent press was the community's last remaining defense against the criminal elements.

James King of William (1822-1856), editor of the San Francisco Evening Bulletin, dared to expose scoundrels in both public and private domains; and by relentlessly pursuing a campaign against them, he changed the course of history in the beleaguered city. It is of special interest to us that the violence erupting as a result of his biting editorials had extraordinary medical dimensions.

The memory of James King of William continues to be honored in California while, at the same time, his unusual name is still a source of some confusion that we shall promptly dispel.

He was born at Georgetown in the District of Columbia on 28 January 1822, the youngest of a numerous and respectable family. His father was named William and to distinguish himself from a number of other James Kings then living in Georgetown, James took and retained the name of "James King of William," (that is, "James King, son of William").

He was an eager student, acquired a fair knowledge of Latin and English literature, and learned to speak French, Spanish and some German. After a variety of jobs as a clerk, and brief stints on newspapers, he was engaged in 1841 as a bookkeeper in a Washington bank. He was married in 1843 and, in 1848, departed for the Pacific Coast by sea via the Isthmus of Panama to improve his prospects and establish a new home for his family whom he left behind. While en route to the West, word reached him of the discovery of gold in California. Therefore, when he arrived in San Francisco in November 1848 he went directly to the gold fields. After a brief and profitable mining venture at Placerville, and temporary engagement in mercantile business in Sacramento, King returned briefly to the East where he made arrangements to open a banking business in the name of James King of Wm. on Montgomery Street between Clay and Merchant in San Francisco.

King was soon widely known and highly regarded as a banker throughout the State. His wife and four children joined him in 1851 and his successful banking business flourished until 1854. It was at this point that an irresponsible agent, to whom he had entrusted large sums to purchase gold dust, invested the money in worthless stock. As a result, King was forced to close his bank and become an employee of the express firm of Adams and Company. In return for King's depreciated assets, the firm agreed to reimburse all his creditors. However, the tribulations of the honorable James King were far from over. He had not been long in the employ of Adams and Company when he discovered that they were insolvent. When he warned the San Francisco manager of impending ruin and urged him to take steps to protect the depositors, his advice was ignored and on 22 February 1855 the company failed with disastrous losses by thousands of industrious persons throughout the State. Fortunately, King's reputation was unsullied by the bankruptcy for he had always acted in good faith towards creditors, but public sentiment was hostile to banking and his attempt to reenter the field was unsuccessful. With the financial help of some friends he then began publication on 8 October 1855 of the San Francisco Daily Evening Bulletin which he described as "a truly independent journal - one that (would) support the cause of morality, virtue and honesty, whether in public service or private life, and which, regardless of all consequences, would fearlessly and undauntedly maintain its course against the political and social evils of the day."^[1]

The crusading editor began immediately to attack those who he believed to flout moral standards or betray the public trust. It was not long before threats upon his life began to occur, to which the defiant King replied in the November twenty-second issue of the Bulletin:^[2]

To a gambler named Selover, who made threat's against the editor's life following the latter's refusal to meet him in a duel, King responded in the Bulletin of December sixth:^[3]

The purpose of King's contemptuous response to Selover was to rate the gambler as unworthy of consideration as an adversary in a duel, but it also laid out for him and any other enemies, the ground on which the editor could be violently attacked. Given the uncontrollable emotions of the day, and the reckless disregard of life, King's audacious challenge placed him in almost daily jeopardy of deadly assault on the road he usually followed in going home.

When the inevitable confrontation occurred, it was not with the gambler Selover but with a prominent politician and ex-convict known as James P. Casey whose special genius was for the fixing of elections by the stuffing of ballot-boxes. Casey's most recent feat was to gain election as Supervisor of a district of which he was not even a resident. He was thought to have accumulated by various nefarious transactions a fortune that enabled him to start a newspaper, the Sunday Times, regardless of the fact that he was incapable of writing a word for publication. Casey was especially sensitive on two subjects - ballot-stuffing and his term of eighteen months at hard labor in Sing Sing for robbing his mistress.

On 14 May 1856 King published in the Bulletin the following editorial that referred to a Mr. Bagley and his quarrel with Casey: ^[4]

About four o'clock on the afternoon of Wednesday the fourteenth of May, an hour after the Bulletin containing the above editorial appeared on the streets, James P. Casey stormed into King's office and demanded to know: "What do you mean by that article?"^[5]

At five o'clock on the same afternoon, as was his custom, King left his office at Merchant and Montgomery Streets to go home for dinner. As he approached the corner of Washington and Montgomery, Casey stepped into the street from behind a horse and wagon standing in front of the Pacific Express Company and confronted him. According to his own testimony, King was taken utterly by surprise. He heard someone cry out "Come on!" Then, looking up, he saw Casey, only a few paces away, throwing off his short cloak and aiming a revolver. The weapon was fired instantly. King staggered under the impact of the bullet as it drove completely through his left chest, entering in front just below the outer third of the clavicle and exiting from the back. At the same moment a certain Edward (Ned) McGowan, a judge of the Police Court and a good friend of Casey's, was seen hurriedly leaving the vicinity.

Bleeding profusely from his wounds, King was assisted into the Pacific Express Office nearby where the first medical man to arrive and examine his wounds was Dr. R. K. Nuttall, (MD Aberdeen, 1847; Licentiate of the Royal College of Surgeons, Ireland) who had arrived in San Francisco from Australia in 1850. King was by this time unconscious due to shock from loss of blood. The wound was explored with the finger and found to course upwards, inwards and backward through the chest wall. The bleeding was thought to be venous because of the dark color of the blood. There was no pulse at the left wrist and only a weak one at the right. The great question then and later was whether the subclavian artery had been severed.

Dr. Nuttall had hardly completed his examination when Dr. Beverly Cole arrived to find King pulseless. Although bleeding was by this time only slight, the patient was still in shock. Cole applied mustard plasters and heat to his extremities to reinstate the circulation and King rallied sufficiently to grasp his hand and plead: "Oh Cole, in the name of God stay by me!"^[6][7][8]

Meanwhile, news of the tragedy spread rapidly among the medical community. Cole and Nuttall were soon joined by Dr. H. M. Gray. Dr. William Hammond was next to arrive. Since he had previously been King's personal physician, he officiously took over control of the patient who had now been laid on a counter in the Pacific Express Office. Although hemorrhage had essentially stopped and Nuttall on making another examination could feel a clot in the wound, it was felt that movement might start bleeding again. Therefore, Gray and Nuttall suggested putting a plug into the wound. The only thing available was a large piece of white sponge. Cole objected to anything being put into the wound. In any case he would use lint rather than sponge which he thought would become adherent in the wound during the healing process and, by blocking drainage, worsen the infection that was bound to occur in such a wound. He was overridden by the others, however, and a piece of sponge the size of a goose egg, too big for the wound on the anterior chest wall, was soaked in water and shoved into the wound with considerable pressure, then secured in place with wet compresses and bandages. There was, of course, no conception of antisepsis in that day and Gray and Nuttal lacked Cole's conviction, based on his surgical experience, that tight closure of a deep and contaminated wound is a recipe for fulminant infection.

At eight o'clock that night King's condition was so poor that Dr. Hugh Toland, popularly considered the foremost surgeon of San Francisco, was called in consultation. He arrived to find an immense crowd within and without the Pacific Express Building. He had to fight his way through the emotional bystanders to the semiconscious patient who was surrounded by fifteen or twenty physicians taking his pulse, making suggestions and filling the air with tobacco smoke. On account of the confusion, Toland did not examine the wound but concluded from general observation and the accounts of Nuttall and others that the subclavian artery might be severed. He feared more bleeding if King were moved and advised that a surgeon be in attendance throughout the night. Hammond agreed to stay until 1 A. M. and Cole volunteered to watch until dawn.

When the morning of the first day, Thursday May fifteenth, came with no improvement in King's condition, Hammond summoned Drs. Gray, C. Bertody and Toland to an urgent consultation at seven A. M. Cole and Nuttall were still there but were pointedly excluded from the conference. Nevertheless, Cole offered the unsolicited advice that the sponge should be removed from the wound and, if the subclavian artery bled, it should be ligated. Nuttall added that the sponge had been inserted only as a temporary measure and also advised that it be removed. The comments of Cole and Nuttall were coldly ignored except for Hammond's haughty remark that: "Well, I guess I have some crude notions on the subject myself."

It was at this point that Elias Cooper entered the sickroom. During the past year he and Cole had become friends and colleagues, Cole frequently attending operations, anatomical dissections and animal experiments at Cooper's Infirmary. He had learned to respect Cooper's knowledge of anatomy and skill as a surgeon, particularly with respect to vascular procedures. Therefore Cole, before he found the King case taken out of his hands by Hammond, sent word to Cooper asking that he come to examine King and give his opinion on management. Cole's invitation was reinforced by a personal request to Cooper from the patient's brother, Thomas King. Nevertheless, when Cooper arrived at the Pacific Express Office on the morning of the fifteenth and sought to speak with Cole, he was not allowed to do so. Cooper was deeply offended by the rude reception he received and gave this account of the incident:^[9]

By this time, Cole was thoroughly outraged by the treatment he had received from Hammond, especially since he had preceded Hammond on the scene and the patient had pled with him to stay. Furthermore, his advice to remove the sponge was being ignored. There was nothing more he could do. Renouncing all responsibility for King's care, Cole withdrew from the case.

The bulletin at the end of the first day, Thursday May fifteenth, announced that the left arm was entirely paralyzed, cold, blue and swollen; that it was pulseless and without sensation or motion; that hemorrhage had stopped;. . . that it was feared the subclavian artery was cut, but that Mr. King's condition was too precarious to permit operation.

During the second day, Friday May sixteenth, there was no improvement and as the day dragged on King's attendants sought to make him more comfortable by moving him to the Montgomery Block, a large office building across the street where a sick room had been made ready for him.

In the days that followed the course was one of mounting sepsis and continuing unwillingness of the doctors to remove the sponge that was plugging the wound for fear of hemorrhage from a severed subclavian artery. On the fourth day, Sunday May eighteenth, a former army surgeon, Dr. John S. Griffin, arrived from Los Angeles as a consultant and advised against removing the sponge, again for fear of hemorrhage from the subclavian artery. By this time the Infection had become so severe that it was necessary on this day to drain considerable pus by an incision in the left armpit under chloroform anesthesia. There was still no improvement.

At the dawning of the sixth day following the wounding, Tuesday May twentieth, King's condition was worse. Following a restless night, his right pulse was now faint and rapid, his breathing labored. At thirty minutes past one o'clock in the afternoon, the last bulletin was posted - James King of William was dead. He left a wife and six young children.

According to the report of the post mortem examination on James King, the subclavian artery was not injured; there was some damage to and considerable phlebitis of the subclavian vein; the nerves of the brachial plexus were torn apart; caseous (tuberculous) masses were found in the lungs; and there was inflammation of the pleura and over a pint of bloody serum in the left chest cavity. By implication, the cause of death was infection.

The momentous consequences of King's death imparted historic significance to the treatment he received. Was his wound by its nature a lethal one, or was its management responsible for the fatal sepsis? Simply put: did the sponge packed into the wound to prevent subclavian artery hemorrhage serve instead to block drainage of the sepsis raging in its depths, with fatal results?

Why was the sponge not removed? The answer is that the doctors responsible for the patient's care feared bleeding from a severed subclavian artery which they had not the anatomical knowledge and technical ability to expose surgically and ligate. Both Elias Cooper and Beverly Cole accused King's treating physicians of incompetence and malpractice but before returning to their outspoken criticisms, we will provide further information about King's physicians, and report on the civic unrest precipitated by his death.

Dr. William Hammond (1824-1905), who summarily usurped the care of the patient from Drs. Cole and Nuttall on the day of the injury, was born in Hagerstown, Maryland. His father, an army doctor, was transferred in 1843 with his family to Jefferson Barracks in St. Louis where William began the study of medicine by taking courses in chemistry and anatomy at St. Louis University. In the fall of 1844 he continued his medical studies in Baltimore at the Faculty of Physic of the University of Maryland and was granted the MD degree in 1845. In 1847 we find him in Galena, Illinois. He was engaged in general practice but it proved uncongenial and in 1848 he followed his father into the U. S. Army. Under commission as an army surgeon he was posted to the general hospitals in Mexico City and Hualapa until the army evacuated Mexico in 1848. After serving in several army posts around the United States he was ordered to report for duty in Oregon in 1853, but on reaching California he sent in his resignation from the army and remained in San Francisco. There he was successful in a practice devoted principally to medical conditions. It is not evident that he ever had significant practice in the field of surgery. Like Dr. Gray, whom we previously introduced, he was a member of the Pathological Society.^[10][11]

Regarding Dr. Charles Bertody we know little beyond the facts that he graduated from Harvard Medical School in 1838 and was elected Corresponding Secretary of the Second San Francisco Medical Society in 1853. Whatever his accomplishments, they were not such as to leave an imprint on the medical literature of his day. Specifically, there is nothing to suggest that he brought to the King deliberations any special knowledge or experience relevant to the management of gunshot wounds. As for Dr. Toland, we have already sketched his background and remarked on his prominence as a surgeon and his aloofness from medical societies.

Finally, there was the consultant, Dr. John Strother Griffin (1816-1898), a Virginian by birth and fellow Southerner of Toland. Unable to make up his own mind regarding the treatment of King, whose condition was growing worse by the day, Toland requested that Griffin be brought up from Los Angeles to consult and, not incidentally, share the onus for a disaster that Toland was astute enough to suspect was in the offing. Griffin arrived on Sunday May eighteenth, the fourth day after the injury. Specifically, Toland asked him to advise whether to remove the sponge from King's wound as Cole and Nuttall had so unequivocally recommended three days previously.

Griffin was the best known surgeon in the Los Angeles area and because of his prestige was an excellent choice as a consultant. He received his MD degree from the University of Pennsylvania in 1837 and practiced medicine in Louisville, Kentucky, for the next three years. In 1840 he was commissioned as a surgeon in the U.S. Army, a post he held until 1854 when he resigned to settle in Los Angeles.

Griffin's fourteen-year career in the army was distinguished by his service as a medical officer during the occupation of California by U.S. Forces in 1846-47. At that time he was attached to the expeditionary force of General Stephen W. Kearny who set out overland on 25 September 1846 from Santa Fe (New Mexico) with a force of 121 men, including Assistant Surgeon Griffin. Kearny's orders were to join in the pacification of California at this most turbulent and confusing juncture in the State's history.

After a punishing journey across over a thousand miles of mountainous and desert wasteland, guided by Kit Carson, the exhausted troops of General Kearny attacked a cavalry force of rebellious Californians at the Indian village of San Pasqual near San Diego. The encounter took place in the chilling rain and fog on the early morning of December 6th 1846. Although the Californians retreated and the Americans remained in possession of the battlefield, their victory was a pyrrhic one for their attack was ill-conceived and many American lives were recklessly and needlessly sacrificed. A report of American battle casualties is found in the communications of Assistant Surgeon Griffin who listed eighteen killed and eighteen wounded. The Californians were led by Captain Pico. As far as can be determined, none of the Californians were killed and Pico claimed that only 11 were wounded, none seriously. Nevertheless, the battle of San Pasqual was a decisive one and has since been described as the most famous and deadly in California history.

Dr. Griffin's conspicuous army service in Southern California combined with his sterling personal qualities no doubt contributed to his rapid rise to leadership in civic and business affairs in Los Angeles, and to his acquisition of a large surgical practice within a few years. Although memorial statements about his career say that he sought new treatments and was not hesitant to discard old methods, we have no specifics as to the meaning of these generalities and we have no information about his experience with vascular surgery. In any case, we know that he sided with Toland's timid colleagues and advised against removing the sponge. Assuming that it was not already too late to make a difference, we must conclude that it was Griffin's opinion that sealed the fate of James King of William.^{[12][13][14][15][16]}

On the evening of May fourteenth, the news of King's wounding by Casey spread like wildfire. The streets were at once filled with a frenzied mob that surrounded the County Jail on Broadway where Casey was held. "Take the jail! Hang Casey!" was the cry. The militia under the command of Major Isaac Rowell, MD, later Professor of Chemistry in the Medical Department of the University of the Pacific, was summoned to restore order. Casey was greatly alarmed when he learned that Major Rowell and the militia not only refused to guard the jail but that they disbanded and in a body joined the Vigilantes.^[17]

Confusion persisted around the jail until the crowd finally agreed to disperse and to reconvene at nine P.M. that evening in the Plaza. There, and later in permanent headquarters at 41 Sacramento Street, the Vigilance Committee of 1851 was swiftly revived as a formidable military-style force of more than eight thousand members, about three fourths of the adult male population of the city. William T. Coleman, prominent merchant, a man of common sense and determination, was named President of the Vigilance Committee of 1856. The leadership of the Committee differed from their brethren of 1851 in having a sufficient number of solid business men and broad-minded conservatives to control hot-headed radicals who might discredit the proceedings by rash disregard for due process. Dr. Beverly Cole was made Surgeon General of the medical staff of the Vigilance Committee with some eighty physicians under him.

As a counterbalance to the Vigilantes, a Law and Order Party was hastily organized including the politicians, lawyers, members of government and the small number of common citizens who opposed the Vigilance Committee. The overwhelming support of the Committee by the people of San Francisco rendered the Party as well as the law enforcement agencies of the City and State largely ineffectual during the Committee's reign.

The Committee immediately turned 41 Sacramento Street into a combined courtroom, jail, armory and command post for its civil and military operations. The stronghold was referred to as Fort Vigilance. Opponents of the Committee dubbed it Fort Gunnybags because of the rampart of sand-filled gunnybags piled to a height of eight or ten feet across the entire frontage as a defense against attack by government forces.

Never had the West seen a popular tribunal that so effectively marshaled the citizens' collective wrath to curb lawlessness. Within hours of its convening the Committee defined its objectives and began to round up known criminals still at large, and to bring in James Casey and Charles Cora from the County Jail. Cora was a gambler and powerful figure in town who shot the unarmed United States Marshal William Richardson dead in the street on 18 November 1855. The reason for the murder? Richardson on the night before had made a slighting remark about Cora's paramour, Belle, the madame of a notorious bordello. Cora pleaded not guilty, his trial ended in a hung jury, and he was sent back to jail awaiting a new trial. His eventual release by the lax San Francisco courts was confidently anticipated until he was swept up with Casey by the wave of public revulsion against actions such as theirs.

At noon on Sunday, May eighteenth, the day of Consultant Griffin's crucial visit to the sickbed of the failing James King, 2600 armed men, divided into 26 companies of 100 each, quietly assembled at Fort Vigilance. Immediately, they began a silent march by different routes to converge upon the County Jail, surrounding it completely with a wall of gleaming bayonets. A loaded artillery piece was drawn up with its muzzle pointed at the front door of the building, and a match lighted as if for instant action. Marshal Doane of the Vigilance force rode up to the prison entrance and demanded of Sheriff Scannell that he surrender the jail. After brief and futile objection, the Sheriff complied with the Marshall's demand in order to avoid bloodshed and Casey and Cora were whisked away by carriage to cells in Fort Vigilance. Their trial by the Committee was conducted in general accordance with judicial process. Unequivocal evidence as to the offenses of the prisoners was presented.

King's death on Tuesday, May twentieth, the sixth day after his injury, plunged the city into general mourning for the courageous editor. His valiant efforts in life to expose crime and corruption in San Francisco, and by opposing end them, have continued through his martyrdom to inspire future generations. Like martyrs before and since, King probably accomplished more in the manner of his passing than he could have hoped for in a longer life.

Two days later, on Thursday May twenty-second, James King of William was borne to his resting place in San Francisco's Lone Mountain Cemetery. The hearse was drawn by four white horses draped in black, followed by a cortege of mourners two miles long. Drs. Hammond and Gray preceded the hearse in a carriage.

At the same hour, a grim drama was in progress at Fort Vigilance. The trials of Casey and Cora were over and they were sentenced to death by hanging. The militia drew up on all sides of Fort Vigilance and scaffolds were extended from two windows on the second floor. While all the bells in the city tolled for James King, the sentences were carried out.^{[18][19][20][21]}

Dr. Charles Bertody was not the only graduate of Harvard Medical School to participate in these violent affairs. Dr. Washington Ayer, also a Harvard graduate, was practicing in San Francisco at the time. His "Personal Recollections of the Vigilance Committee (of 1856)," published thirty years later in the Overland Monthly are the source of many of the details found in the accounts of other historians already cited.^[22]

Washington O. Ayer (1823-1899) was born in Haverhill, Massachusetts, on the 18th of July. Being of a studious nature he completed primary and secondary schooling with an eminently satisfactory record but lacked the means to go on to college. In keeping with the self-reliance and industry of the ambitious youth of his generation he sought to acquire the necessary funds for a higher education by his own efforts, which he devoted to teaching school for three years. His first school in his native town of Haverhill was near the home of the honored Quaker poet John Greenleaf Whittier who, with his sisters, encouraged the young Ayer. It was possibly due to association with the supportive Whittier family that Ayer developed strong literary interests, and even aspirations as a poet which he modestly fulfilled.

Ayer was of delicate health so that both illness and lack of financial resources led him to forego college and enter a preceptorship in medicine with practitioners in nearby Bradford, Massachusetts. This was followed by a successful course of study at Harvard Medical College where he received his MD degree in 1847. While a Harvard medical student he was present at the first public demonstration of ether anesthesia at the Massachusetts General Hospital on 16 October 1846. Ayer's description of the procedure he witnessed that day is a classic rendition of the historic scene.^[23]

Upon graduation from medical school Ayer settled in Lawrence, Massachusetts. Practice came slowly to the eager young doctor until accidental circumstances brought him to the favorable notice of the public. One day when crossing the bridge over the Spigot River, swollen to flood-stage by a recent storm, Ayer saw a woman struggling in the raging torrent. Without a moment's thought he plunged into the stream and rescued the drowning woman whom he resuscitated on the river bank, while many on the bridge above witnessed his bravery and professional skill. Newspapers on the following day were full of praise for his heroic deed. Now widely known in the community for his courage and medical readiness, It was not long before he had an abundance of patients.

When his health, never robust, began to fail again he was forced to seek respite from his busy practice. The opportunity for a change arose when he was invited to go to California as physician to the New England Trading and Mining Association. On 4 February 1849 he sailed from Boston aboard the Association's ship Lenore. She dropped anchor in San Francisco Bay just five months later on 5 July 1849 at the height of the Gold Rush.

Soon after his arrival Ayer proceeded up the Sacramento River to the heart of the Gold Country where he settled in the town of Vernon, a village on the right bank of the Sacramento at the mouth of the Feather River. During the next five years his seemingly boundless energy was devoted to an extraordinary variety of activities ranging from doctoring to mining, ranching, and the freighting of supplies by wagon and riverboat. He was proudest of the hospital he established at Vernon to serve the mining community where accidents and other emergencies prevailed and fevers, dysentery and infectious diseases were rampant. He was highly successful in his enterprises from the beginning and rapidly acquired valuable holdings in land and profitable businesses. Then disaster struck during the winter of '49-'50. The Feather and Sacramento Rivers rose in a devastating flood that within hours swept away his hospital and other fruits of his toil, leaving him marooned for three weeks atop an Indian Mound, a tiny island in a sea of rushing water.

To recoup his losses Ayer returned to mining but, after prospecting several sites to no avail, he resumed the practice of his profession - first in Sacramento, next in Mokelumne Hill and then in Volcano, Amador County. Finally, in 1854, after a visit of five months to his home in the East, he abandoned the Gold Country and made his permanent residence in San Francisco where he was soon ranked among the ablest practitioners in the city. There he met Elias Cooper and became his good friend and loyal supporter. Years later, in 1893, Ayer read before the San Francisco Medico-Chirurgical Society a glowing eulogy entitled "Reminiscences of the Life and Labors of Elias Samuel Cooper."^{[24][25][26][26][27]}

There is no predicting the course of history had King survived the gunshot wound. It is certain that Casey would not have been hanged. As far as King's treatment is concerned, it is fair to state that neither Cole nor Cooper, had they been in charge of the case, would have hesitated to remove the sponge from King's wound on the first day and that this would likely have forestalled a fatal infection. Both Cole and Cooper were staunch disciples of Joseph Pancoast and thoroughly versed in the surgical approach to the subclavian artery, which is beautifully illustrated in anatomical plates in Pancoast's Treatise on Operative Surgery. Had the artery bled, they could have ligated it. On the other hand, the treating physicians (even Toland) were obviously unprepared to cope with subclavian artery hemorrhage. With these considerations in mind, neither Cooper nor Cole was inclined to overlook what they viewed as the incompetence of King's doctors. We shall refer now to Cooper's verdict on the case, and later to that of Cole.

Cooper resented the affront he suffered when he attempted to consult on James King on May fifteenth, but the treatment of the unfortunate patient by Hammond, Gray, Toland, et al made him furious. His only recourse at the time, about mid-1856, was to make a scathing attack upon King's doctors in a Letter to the Editor of one of the local newspapers. Although Cooper's personal papers contain several drafts of such a Letter, we have no clipping or other evidence to confirm that it was ever published. Nevertheless, the following reconstruction of Cooper's Letter is inserted here in order to convey his surgical views, and underline his increasing hostility toward the medical elite of San Francisco whom he suspected of conspiring against him.^[28]

Cooper's harsh indictment was typical of the bitter exchanges that frequently occurred between individual physicians and medical cliques in his era. Inevitably, the contentious and vindictive spirit endemic within the medical community of San Francisco created instability in personal relations and professional organizations. These conditions constantly threatened to frustrate Cooper's plans but, mirabile dictu, failed to do so. As we suggested earlier, the reason for Cooper's ultimate success in spite of severe impediments, was the respect and loyalty he inspired in able associates who supported his efforts. It was during the Vigilante period that Beverly Cole emerged as one of the most valuable of these associates. Therefore, let us return to the operations of the Vigilance Committee of 1856 and the extraordinary services rendered to it by Surgeon General Cole.

In the course of the drive to rid San Francisco of its criminal elements, the Vigilance Committee encountered growing resistance from the Law and Order Party, aroused to action by such anti-Vigilance partisans as Judge David Terry, Justice of the State Supreme Court. Terry already had earned the reputation of a vicious bully by previous assaults on various citizens - on J. D. Purdy of San Francisco, on a Mr. Evans of Stockton, on a Mr. King at the charter election at Stockton, and on a Mr. Broadhurst in the Stockton Court house.

In addition to the threats and rumblings of the Law and Order Party, the vacillating Governor of the State, John Neely Johnson, declared San Francisco to be in a state of insurrection on 3 June 1856, twelve days after King's funeral. The Governor then ordered Major General William T. Sherman to restore government control of the city. General Sherman, saying that he lacked the forces needed to disarm the Vigilantes, resigned his Commission. Fortunately for the Vigilantes and for the outcome of their brief reign in San Francisco, the government never acquired sufficient military strength to engage them. The streets were actually safer during the Vigilance Committee's tenure than they had been before.

During the first three weeks in June the situation grew increasingly tense as the Vigilantes consolidated their control of the city by seizing the arms being imported for use by government troops. In a daring raid on the night of June 20-21 a small band of Vigilantes confiscated a large shipment of government guns and sabers from the sloop Julia as she lay over for the night in the lee of a small group of islands called "The Sisters" in San Pablo Bay. Reuben Maloney who had chartered the boat and two other crew members were drunk and sound asleep. They were in no condition to resist the raiders who transported them back to Fort Vigilance with the arms. The Committee sequestered the arms but ordered Maloney's release because he had committed no crime. However, when he grossly abused their clemency by making boisterous threats against various members of the Committee, the order immediately went out to bring him back to the Fort.

The assignment for the seizure of Rube Maloney was given to Sterling A. Hopkins, the dependable and unflinching man who had already carried out for the Committee a most unenviable task - he served as the hangman of Cora and Casey. In the afternoon of Saturday, June twenty-first, he set out with three or four followers in search of Maloney. Hopkins found him in the office of the United States Navy Agent, Dr. H. P. Ashe. Also present with Ashe were Judge Terry and several companions who cocked their guns and ordered Hopkins to leave, which he hastened to do in order to obtain reinforcements.

As soon as Hopkins left, Maloney, Judge Terry, Ashe and the others left the building and sought to escape from the area. Before they had gone far Hopkins returned with a number of aides and, after an exciting chase, caught up with the fleeing group on Jackson Street. In the furious melee that ensued Hopkins wrested a gun from the hands of Judge Terry who reacted by whipping out a bowie knife and plunging it deep into the left side of Hopkins' neck. Blood streaming from his mouth and neck, and reeling from shock and pain, Hopkins was taken by friends to a nearby dwelling while Terry and Maloney eluded their pursuers and found refuge in the Armory of the Blues. Agitated crowds almost instantly thronged the streets and Vigilante troops en masse surrounded the Armory. An ultimatum was issued by the Committee to surrender Terry and Mahoney as well as all arms within the Armory immediately. There was no recourse but to comply. The arms were confiscated without a contest and Terry and Maloney were soon lodged in cells at Fort Vigilance.

With Terry's arrest, danger of attack on the Fort was so far heightened that the Vigilance forces marched out again in battle formation and stripped all remaining armories of their weapons.

This decisive action secured the Committee's position for the present, but the incarceration of a Justice of the California Supreme Court who was also a leader of the Law and Order Party placed the Committee in a difficult predicament. Should Sterling Hopkins die of his wound, must Judge Terry follow Cora and Casey to the gallows? If so, would the de facto legitimacy of the Vigilance Committee, thus far assured by overwhelming public support, then dissolve in a constitutional crisis and bloody conflict in the streets? These were questions that faced the Committee following the incident on Jackson Street.

Dr. Cole, who was almost constantly on duty at the Fort during this period, had no time for such disturbing thoughts as he raced to the aid of Sterling Hopkins. When Cole reached him at three thirty in the afternoon, he found him sitting erect in a chair and bleeding profusely from the mouth. Soon after Cole's arrival, Hopkins fainted due to loss of blood. With the patient briefly unconscious, the doctor was able for the first time to probe the depths of the wound in the left neck and determine that the pharynx and larynx had been slashed open and either the internal carotid or other large artery had been severed. Hoping to gain time that would enable the patient to recover from shock, Cole packed the wound with cotton compresses to stop the bleeding.

This temporizing measure controlled blood loss until around eight P. M. when life-threatening arterial bleeding suddenly recurred, forcing Cole to intervene immediately. Of antisepsis there was none, and there was no time to administer anesthesia, nor was it needed, for Hopkins was barely conscious from loss of blood. Never were Cole's anatomical dissections in the laboratory of Professor Pancoast more gratefully remembered than when he began this emergency operation by flickering candlelight in the semi-darkness of a summer evening. Poor illumination of the operative field forced Cole to rely as much on touch as on sight when locating the jugular vein and vagus nerve and protecting them from injury. This done, he felt the barely pulsating common carotid artery in the depths of the wound and passed a ligature around it. When he tied down the ligature, all bleeding ceased. These were his words: "The plug was now removed from the wound without the least hemorrhage following, establishing in my mind at least, not only the success of the operation, but also the necessity for it." By this memorable operation, performed under most trying conditions, Cole saved not only Hopkins' life but that of Judge Terry as well; and the operation's favorable outcome prevented the unleashing of forces beyond the Vigilance Committee's control.^{[29][30][31][32]}

Hopkins' postoperative course was a stormy one, complicated by wound infection and erysipelas. He had great difficulty eating because of leakage of food out through the neck wound until the opening in his pharynx healed. But his recovery was complete and in five weeks he was attending to business as usual. Judge Terry was therefore not guilty of murder, a charge that would certainly have led to his execution by the Vigilance Committee, so bitterly was he detested by the rank and file of the Vigilantes.

Terry's trial in Fort Vigilance lasted five weeks and one hundred and fifty witnesses were called to testify. Although the trial ended on July twenty-second, the Committee spent another two weeks in deliberation over the disposition of his case. Since he was not a murderer and his victim had recovered, the Committee's only means of punishment was banishment, a penalty that was clearly not enforceable in his case. The Committee finally settled for the passing of a stigmatizing resolution declaring that he was unworthy of the confidence of the people and should resign his judgeship. The vengeful elements among the Vigilantes were so outraged at the leniency of this decision that, in order to protect him from mob violence when he was released, the Committee spirited him out of the Fort on 7 August 1856 at two A.M. with the advice that he leave San Francisco. This the Judge hastened to do and boarded a steamer for Sacramento where he arrived to a hero's welcome from his supporters. Within a few weeks he resumed his seat on the bench of the Supreme Court of California. We have no evidence that he ever acknowledged his debt to Dr. Cole, but the following brief sketch of the Judge's career shows that he was a vicious killer whose narrow escape from the Vigilance Committee chastened him not at all.^[33]

Judge David Smith Terry (1823-1889), native of Kentucky and Texas Ranger in the Mexican War, rode into San Francisco in 1849. He was soon involved in politics and was elected Associate Justice of the California Supreme Court in 1855. When he stabbed Sterling Hopkins he precipitated the most dangerous crisis to occur in the affairs of the Vigilance Committee of 1856, a crisis mitigated only by Dr. Cole's surgical virtuosity. In view of the Judge's singular role in the turbulent events of 1856, it will be of interest to outline the remainder of his career

Terry became Chief Justice of the California Supreme Court in 1857. As an aggressive advocate of California's admission to the Union as a slave state, he came into conflict with David Broderick, vigorous campaigner for the free soil position that finally prevailed. Broderick was elected to the United States Senate for the term 1857 to 1863 on an antislavery platform. During Terry's campaign for reelection to the State Supreme Court, he harshly attacked Broderick's antislavery stance and he and Broderick exchanged charges and personal insults in the manner of the day.

Being a Southerner to the core, Terry piously resigned his post as Justice of the Supreme Court before his term expired in order to demand retraction by Broderick or "satisfaction on the field of honor." There followed the most infamous duel in California's bloody history of this mindless rite, a cowardly variant of which had cut down James King of William in his prime. The impending duel attracted so many spectators that it was delayed a day and moved to a secret location south of San Francisco. The duel took place on the early morning of 13 September 1859. Choice of weapons was settled by lot. Terry won the draw and chose that the duel be fought with hair-trigger pistols, a weapon with which he was thoroughly practiced. Faced off at ten paces, on the word to "fire" Broderick's finger barely touched the trigger as he raised his hand to aim and the pistol instantly discharged, its ball ruffling the turf at Terry's feet. The latter poised his weapon, took deadly aim and shot Broderick through the left chest. He survived three days and died on 16 September, another casualty in the long war to end slavery.

As for Terry, there was a vigorous but unsuccessful movement to revive the Vigilance Committee and hang him, because it was feared the courts would set him free - which indeed they did. Terry went through the formality of a trial for murder and was speedily acquitted. But an avenging angel stalked this violent man. Thirty years later he made threats against United States Judge Stephen J. Field who had handed down a decision unfavorable to Terry in a lawsuit. As a result of Terry's threats of bodily harm against Judge Field, the Attorney General of the United States assigned David Neagle to Field as a body guard. On 14 August 1889, while Field and Neagle were having breakfast in a railroad restaurant at Lathrop, California, Terry approached Field and struck him twice. Neagle, taking no chances, with one revolver shot put an end to Terry's troubled career. Neagle was arrested, tried on a charge of murder, and acquitted.^[34][35][36]

On June eighteenth a special committee was appointed to advise on the question of adjournment of the Vigilance Committee of 1856, but the Terry episode delayed action on the subject. With the conclusion of the trial of Judge Terry, the Committee began to urgently consider how to disband while preserving the gains it had made in restoring public order and reforming government agencies. Meanwhile a U.S. Navy Sloop of War, the John Adams under Captain E.B. Boutwell, had dropped anchor at the foot of Sacramento Street. The sloop was only a small single-masted vessel with a mainsail and jib, but Fort Vigilance was within easy range of the artillery pieces on her deck. Furthermore, her position provided ready access to the sewers running beneath the Fort where explosives could be detonated to demolish the Vigilance headquarters. Although the Vigilantes could easily overwhelm the John Adams, an attack upon a U.S. Navy warship, no matter how insignificant the vessel might be, had dire implications that even exceeded those associated with the seizure and trial of a Justice of the California Supreme Court.

In spite of mounting pressure to suspend operations of the Committee after the completion of the trial of Judge Terry on July twenty-second, the Committee brought Philander Brace and Joseph Hetherington to trial for murder. They were both convicted on July twenty-seventh and executed by hanging on July twenty-ninth. The event took place before companies of infantry, artillery and cavalry, and against the backdrop of a multitude of spectators crowding the streets and housetops for many blocks around the Fort.

Its purpose served, the Vigilance Committee of 1856 suspended its functions on August eighteenth. On that date, three months after the Committee assembled in response to the deadly assault on James King, the citizens of San Francisco were treated to a triumphal procession. The thousands of the Committee members marched to martial music in imposing ranks according to their military units, with glittering bayonets, artillery, and cavalry all manifesting readiness and power. The parade that wound through the crowded, flag-decked streets of the city could not but impress the onlookers with the resources of the Vigilantes. The message was implicit that, although the Committee was disbanding, it stood ready to spring to life again if circumstances required.

Failure of medical treatment in the case of James King of William sparked the powerful outburst of popular indignation that led to activation of the grimly determined and widely respected Second Vigilance Committee. Successful treatment in the case of Sterling Hopkins relieved the Committee of the responsibility to execute Judge Terry, and made it possible for the Committee to disband in minimal jeopardy of later criminal indictments against its members for their actions.

The Vigilance Committee of 1856, like that of 1851, was an extra-judicial movement of private citizens democratically organized to administer justice in lieu of government agencies that had failed in this responsibility. These Committees were not common mobs. On the contrary, their deliberations were documented and were conducted in accordance with the rules of evidence and penalties for crime accepted by civilized nations. Importantly, their power was derived from the overwhelming support of the public.

During the three-month period from its revival on 15 May to its adjournment on 18 August 1856, the Second Vigilance Committee executed four murderers (Cora, Casey, Hetherington and Brace). For lesser crimes, twenty-five men were deported and the order for a number of others to leave led to the voluntary departure of some 800 malefactors and vagabonds. Stirred by fear and the example of the Committee, the delinquent government officials hastened to carry out their responsibilities to try and sentence the occupants of the well-filled county jail so that not a single prisoner remained awaiting trial when the Committee retired.

The Committee's objective was not only to put an end to the epidemic of robbery and mayhem by common criminals, but also to wrest the city government from the grip of corrupt interlopers such as Cora. On the approach of the first city election following the retirement of the Committee, some of the members of the Committee organized the People's Party. The Party's slate of candidates was elected and proceeded at once to reform a profligate city government riddled with political tricksters. The new administration was a marvel of economy, efficiency and enlightened public policy, leading to the success of its candidates in the next election also.^[37][38]

Crime never again reached dangerous proportions in the city and respect for its municipal government was restored. At the time of Richard Henry Dana's return visit to San Francisco in 1859, to which we have already referred, the acts of the Second Vigilance Committee were still fresh in the minds of the people and Dana marveled at the changes that had occurred in the city.^[39]

1. Oscar T. Shuck , ed., Representative and Leading men of the Pacific (San Francisco: Bacon and Company, 1870), pp. 563-579 Lane Library catalog record
2. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), pp. 146-147
3. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), p. 147
4. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), pp. 148-153
5. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), pp. 151-152
6. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), pp. 152-155
7. George D. Lyman , "The sponge: Its effect on the martyrdom of James King of William, the formation of the San Francisco Vigiliancer Committee of 1826, the execution of Casey and Cora for murder and the trial of Edward McGowan for complicity," Annals of Medical History 10, no. 4 (Dec 1928): 460-473 Lane Library catalog record
8. Frances T. Gardner , "King Cole of California," Part 2, Annals of Medical History Third Series vol. 2, no. 4 (July 1940): 319-23 Lane Library catalog record
9. Correspondence, No Date - Box 1, Folders 5 and 6, Elias Samuel Cooper Papers – MS 458, California Historical Society, North Baker Research Library
10. Necrology: "William Hammond," California State Journal of Medicine 3, no. 6 (Jun 1905): 195 Lane Library catalog record
11. William F. Norwood , Medical Education in the United States before the Civil War (Philadelphia: University of Pennsylvania Press, 1944), p. 236 Lane Library catalog record
12. Henry Harris , California's Medical Story (San Francisco: Grabborn Press for J. W. Stacey, Inc., 1932), p. 70
13. Martin Kaufman , Stuart Galishoff , and Todd L. Savitt , eds., Dictionary of American Medical Biography, Vol. 1 (Westport, Connecticut: Greenwood Press, 1984), pp. 307-308 Lane Library catalog record
14. Rockwell D. Hunt and Nellie Van de Grift Sánchez , A Short History of California (New York: Thomas Y. Crowell Co., 1929) pp. 361-364.
15. Hubert H. Bancroft , History of California, Vol. V, 1846-1848, The Works of Hubert Howe Bancroft, Vol. XXII (San Francisco: The History Company, Publishers, 1886), pp. 336-347.
16. "Necrology: John S. Griffin, M.D.," Journal of American Medical Association 31, no. 10 (Sep 3, 1898): 551
17. George D. Lyman , "The sponge: Its effect on the martyrdom of James King of William, the formation of the San Francisco Vigiliancer Committee of 1826, the execution of Casey and Cora for murder and the trial of Edward McGowan for complicity," Annals of Medical History 10, no. 4 (Dec 1928): 470-471 Lane Library catalog record
18. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), pp. 158-192
19. Rockwell D. Hunt and Nellie Van de Grift Sánchez , A Short History of California (New York: Thomas Y Crowell Co., 1929), pp. 442-451
20. Hubert H. Bancroft , History of California, Vol. VI, 1848-1859, The Works of Hubert Howe Bancroft, Vol. XXIII (San Francisco: The History Company, Publishers, 1888), pp. 746-754
21. John S. Hittell , A History of the City of San Francisco and Incidentally of the State of California (San Francisco: A. L. Bancroft and Co., 1878), pp. 241-251 Lane Library catalog record
22. Washington Ayer , "Personal recollections of the Vigilance Committee (of 1856)," Overland Monthly 2nd ser., 8, no. 44 (Aug 1886):160-176 and 330-31
23. Francis R. Packard , History of Medicine in the United States, vol. 2 (New York: Paul B. Hoeber, Inc., 1931), pp. 1092-1095 Lane Library catalog record
24. Alonzo Phelps , ed., Contemporary Biography of California's Representative Men (San Francisco: A. L. Bancroft and Company, Publishers, 1881), s. v. "Washington Ayer," pp. 153-156
25. George D. Lyman , The Scalpel under Three Flags in California (San Francisco: California Historical Society, 1925), pp. 64-66 Lane Library catalog record
26. J. Marion Read , A History of the California Academy of Medicine, 1870 to 1930 (San Francisco: Grabhorn Press, 1930), pp. 32-36 Lane Library catalog record
27. Washington Ayer , "Reminiscences of the life and labors of Elias Samuel Cooper," Occidental Medical Times 7, no. 11 (Nov 1893): 599-608 Lane Library catalog record
28. Correspondence, No Date - Box 1, Folders 5 and 6, Elias Samuel Cooper Papers – MS 458, California Historical Society, North Baker Research Library
29. R. Beverly Cole , "Successful ligation of the common carotid," California State Medical Journal (April 1857): pp. 450-453 Lane Library catalog record
30. R. Beverly Cole , "Successful ligation of the common carotid," Transactions of the Second Session of the Medical Society of the State of California 11-13 (February 1857), pp. 38-41 Lane Library catalog record
31. Stanton A. Coblentz , Villains and Vigilantes: The Story of James King of William and Pioneer Justice in California (New York: Wilson-Erickson, Inc. 1936), pp. 211-230
32. Frances T. Gardner , "King Cole of California," Part 2, Annals of Medical History Third Series, vol. 2, no. 4 (July 1940): 325-329 Lane Library catalog record
33. Frances T. Gardner , "King Cole of California," Part 2, Annals of Medical History Third Series, vol. 2, no. 4 (July 1940): 329-330 Lane Library catalog record
34. Don C. Seitz , Famous American Duels with Some Account of the Causes that Led Up to Them and the Men Engaged (New York: Thomas Y. Crowell Co., 1829), pp. 317-331
35. Rockwell D. Hunt and Nellie Van de Grift Sánchez , A Short History of California (New York: Thomas Y Crowell Co., 1929), pp. 467-471
36. Dumas Malone , ed., Dictionary of American Biography, Vol. 18 (New York: Charles Scribner's Sons, 1943), s. v. "Terry, David Smith," pp. 379-380 Lane Library catalog record
37. Hubert H. Bancroft , History of California, Vol. VI, 1848-1859, The Works of Hubert Howe Bancroft Vol. XXIII (San Francisco: The History Company, Publishers, 1888), pp. 752-754
38. John S. Hittell , A History of the City of San Francisco and Incidentally of the State of California (San Francisco: A. L. Bancroft and Co., 1878), pp. 258-266 Lane Library catalog record
39. Richard H. Dana , Two Years before the Mast (New York: Bantam Books, 1959), p. 308