The Second Session of the Medical Society of the State of California met in Sacramento, 11-13 February 1857. This meeting marked the high point of Elias Cooper's success in the furtherance of organized medicine in California. We shall now see how the Society became the focal point of professional discord that made the next few years the most contentious in California's medical history.
The first President of the Society, Dr. B. F. Keene, died on 5 September 1856. Therefore, when some forty-five members of the Society convened in Pioneer Hall at noon on 11 February 1857 for its Second Session, Senior Vice President Elias Cooper, serving as acting president, took the chair and conducted the initial proceedings. Dr. Henry Gibbons was promptly elected next President of the Society and took office during the Session.
Dr. Cooper, as the outgoing acting president, delivered the Annual Presidential Address. He chose a topic on which he had spoken previously at the Illinois State Medical Society in 1854: "Deformities of the Locomotive Apparatus." In this presentation before the California Medical Society, he again described his orthopedic splints and ingenious spring boot for the treatment of deformities of the lower extremities, and once more demonstrated by case reports how walking can be made the primary element in the cure of certain locomotor disabilities. [1] [2]
Consistent with his policy to contribute liberally to scientific programs at medical meetings, Cooper read a second paper in which he reported the case of Frank Travers whose external iliac artery and vein were ligated in December 1855 with successful outcome. We have already referred to this operation and to Dr. H. M. Gray's criticism of Cooper's operative technique. The animosity between Cooper and Gray over this case, which was by this time well-known among the profession, had continued to smoulder. By presenting the Travers case before the Society in convincing detail along with the animal experiments, Cooper succeeded in discrediting the petty views of Gray who was present in the audience. By thus demeaning Gray in a public forum, Cooper made an eventual open clash between them inevitable. [3]
The scientific papers so far published by Cooper, and those to follow during the next five years as listed in his bibliography (Appendix 4), record his significant efforts to define basic surgical principles, particularly in vascular and orthopedic disorders These efforts, and his commitment to dissection, animal experimentation and teaching, served increasingly to set him apart from his California contemporaries.
Even more distinctive and visionary was Cooper's unwavering faith in the ultimate success of his covert plan to establish a medical school in spite of mounting odds. For example, the Committee on Medical Education, chaired by none other than the respected John F. Morse, delivered its first report during the Second Session of the California Medical Society. The conclusion was discouraging. In the view of the Committee, conditions in California were so unfavorable that the issue of medical education was essentially irrelevant: [4]
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The subject of medical education is at all times a source of great interest and of infinite importance to the welfare of the profession, to the success of science, and to the protection of the highest objects of humanity. But still there are circumstances in which the discussion of the question becomes of subordinate importance, and by such circumstances we believe the subject is at present surrounded in this State. We have no schools in which medical science is being taught, nor are there any immediate indications of the practicability of the founding or sustaining of such institutions. When our county hospitals are elevated into institutions worthy of the name of public charities, when the munificent hand of support is so opened to them as to endow them with the means of establishing clinical schools for students and practitioners, then it would be consistent and natural to have an elaborate report upon the subject which you have referred to our consideration. Such, however, is not the condition of our hospitals, and we confess that in our opinion there is little more than a microscopic probability of their becoming so. . . (Therefore, until California provides adequate support for its public hospitals), it will be a useless thing to attempt the establishment of clinical schools of medicine. . . Hence the reason your Committee deemed it unnecessary to trouble you with a very lengthy report. |
Although we have no record of Cooper's reaction to the above report, his future course showed that he ignored it. Perhaps he even welcomed the Medical Education Committee's firm stand against a medical school in California as a deterrent to some rash entrepreneur other than himself attempting to found one.
Administrative decisions by the Second Session which proved to be of significance during the Third Session of the Society in 1858 were the appointment of Dr. Cooper as a member of the Committee on Surgery and of Dr. Beverly Cole as chairman of the Committee on Obstetrics. Also of importance was the decision to hold the Third Session of the Society in San Francisco.
Surgeon General Cole's Report to the Society. When the Society convened in 1857 for its Second Session, only six months had passed since disbandment of the Vigilance Committee of 1856. The medical aspects of the Committee's operations were still a matter of lively debate among the physicians of the State. Anticipating their interest in the subject Dr. Cole, Surgeon General of the Vigilance Committee and delegate to the Second Session from the San Francisco County Medico-Chirurgical Association, read a paper entitled "Successful Ligation of the Common Carotid" in which he described the formidable procedure on Sterling Hopkins to which we have already referred. [5]
Eager for more details on related issues, the members of the Society, by unanimous vote on the final day of the meeting, requested that Cole report "all the facts and points within his knowledge" pertaining to the case of James King of William. The Minutes of the Society contain no mention of this request to Cole and no record of his response to it. This is not surprising for it was not unusual for medical society minutes to omit controversial material, which the remarks of Dr. Cole certainly were. Therefore, we must depend on reports published in the Sacramento and San Francisco press, as reviewed in the excellent articles by Gardner [6] and Lyman [7] , for the following account of Cole's unsparing criticism of King's treatment as delivered extemporaneously before the Society.
Cole told members of the Session how he was among the first to attend to King. He described the injured man as having received a flesh wound that with ordinary care and judgement would not have been life-threatening. Cole further stated that leaving the sponge in the wound for six days was contributory to King's death and he did not hesitate to pronounce it a case of gross malpractice. Dr. William Hammond, King's chief physician, was present at the Session as a delegate from the San Francisco Pathological Society. Also present was one of the consultant's on the King case, Dr. H. M. Gray, who was serving as chairman of the Society's Committee on Surgery.
It is hardly surprising that Cole's charges against King's doctors created an uproar among the medical men present at the Session as well as clamor in the press. On 14 February 1857, the Sacramento State Journal appeared with these glaring headlines: "James Casey innocent of murder. Death of James King caused by doctors." Another paper quoted Cole as saying that King's doctors were ignorant and unprofessional practitioners and that King would have recovered if they had exercised ordinary skill and prudence.
According to Alta California for 5 March 1857, Cole received the following letter immediately upon his return to San Francisco from the Society meeting in Sacramento:
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San Francisco, California, 2 March 1857 To Dr. R. Beverly Cole, Sir: We understand that you related a history of the injury and last illness of the late Jas. King of Wm. before the State Medical Convention of California, at its last session, together with comments upon the treatment instituted in his case. Will you be kind enough to inform us upon what data, and from whence derived, you founded your knowledge of the case? Respectfully, Dr. Hammond Dr. Toland Dr. Bertody Dr. Gray |
Cole replied as follows, not directly but through the columns of Alta California:
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San Francisco, California, 4 March 1857 Gentlemen: Yours of yesterday was received, and in reply I have only to say, that the information upon which was based the history of Mr. King's case, as given by me, without comment, before the State Medical Society, at their last meeting, in Sacramento, was acquired through personal observation and reliable sources. Respectfully, Beverly Cole, M.D. |
To this brief note, Drs. Hammond et al issued a rebuttal in the press claiming that Cole never had an opportunity to make personal observations and that he was never for a single moment in charge of the patient either as an attendant or consultant, nor was there any possibility that he would have been allowed to participate in King's care because of his previous professional misconduct (The nature of Cole's alleged misconduct was not specified and the gratuitous slur was simply a clumsy attempt to discredit him.)
Cole terminated this acrimonious correspondence with a brusque retort, likewise in the press. The Gentlemen were wrong, he wrote, to say that he was not present at any of the examinations of the wound. In fact, he had arrived at the office of the Pacific Express Company only seven minutes after the shot was fired. Dr. Nuttall was the only medical man who preceded him and they were considerably in advance of all other physicians. He and Dr. Nuttall had thoroughly examined the wound digitally and visually, and Nuttall had felt a clot formed in the wound. As to Cole's presence at any subsequent examinations of the wound, he declared: "I should regret to acknowledge any participation in them."