The International Medical Congress of 1877
Dr. Beverly Cole Offends Dr. Lane. During the planning of the 1887 International Medical Congress by the American Medical Association, Dr. Beverly Cole summarily expelled Dr. Lane from the planning committees. The following account of this unfortunate incident will explain the deteriorating relationship between Lane and Cole, and illuminate the status of organized medicine in America at the time.
The Thirty-Fifth Annual Meeting of the American Medical Association was held in Washington in May 1884. Dr. Austin Flint, Sr., (1812-1886), Professor of Medicine at Bellevue Hospital Medical College in New York, a well-known authority on percussion and auscultation, was President of the Association for that year. In his Presidential Address Dr. Flint reviewed the progress of medical science, and the history of the A. M. A. with special reference to current dissension over its Code of Ethics. [1] [2]
With respect to medical science Dr. Flint mentioned recent developments and made some shrewd predictions: [3]
I do not doubt that the present stage of medical progress will hereafter be cited as an important epoch in its history. For the past quarter of a century, histological and clinical studies have tended to develop more and more our knowledge of the existence of specific agents in the causation of diseases. That, as regards certain diseases, these specific agents are micro-organisms, has been demonstrated. The latest discovery in this direction is that of the bacillus tuberculosis, a discovery which is the leading topic in medical literature at the present time. Recent trustworthy researches go far toward demonstrating the existence of specific organisms in pneumonia, typhoid fever, malarial fever, and epidemic cholera; and, reasoning by analogy, it is a logical conclusion that ere long a host of diseases will be proven to be parasitic. It is easy to perceive how important must be the bearing of these developments in etiology and pathology, on prophylaxis and therapeutics. A new era is about to be inaugurated in these practical departments of medicine. Professor Huxley, in his address at the international Medical Congress in 1881, uttered a prediction in these words: "It will become possible to introduce into the economy a molecular mechanism, which, like a very cunningly contrived torpedo, will find its way to some particular group of living element, and cause an explosion among them, leaving the rest untouched." I would rather say that the time will come when means will be found to destroy morbific agents outside the body, thereby securing the prevention of diseases; and that means will be found to effect the destruction of these agents within the body, thereby arresting the course of diseases. |
In his sketch of the history of the A. M. A. Dr. Flint called special attention to its Code of Ethics, adopted at the Philadelphia Convention of 1847 without dissenting vote, and since then considered one of the most significant accomplishments of the Association: [4]
| It is only within a recent period that there have been anywhere manifestations of a disposition to change materially our National Code of Ethics, or to do away with any code. In 1882, at the annual meeting of the New York Medical Society, by a vote of 52 of 70 members in attendance at the meeting, a new code was summarily substituted for the Code of the American Medical Association. This precipitate and lamentable action has severed the New York State Society from its affiliation with our Association, and has resulted in a division of the members of the profession in the State of New York. |
At the time of Dr. Flint's Presidential Address to the A. M. A. in 1884, a fierce battle was being waged between those physicians in New York and elsewhere who supported the "new code" and the majority of members of the A. M. A. who remained loyal to the original Code of Ethics. In reprisal against the "New Code men", as they were called, the loyalists sought to exclude them from the A. M. A. and all its activities. Herein lies the pretext for an attack by Dr. Cole upon the reputation of Dr. Lane.
Dr. Flint concluded his Address with the following suggestion: on an entirely different subject: [5]
Our efforts to facilitate and foster friendly intercourse between members of the medical profession, as well as to promote the development and diffusion of medical knowledge, should not be limited to our own country. As the means of union for these objects of the medical profession of all countries, the meetings of the Intentional Medical Congress claim a warm interest. The meeting of the Congress in London, in 1881, will ever be memorable in the retrospections of its members, and they who expect to attend the meeting at Copenhagen in August next, may anticipate much enjoyment as well as improvement. It would prove, as I doubt not, a source of great gratification to the profession of our country if the meeting of the Congress in 1887 were to be held in the United States, and I suggest the propriety of action to be taken now with reference to this desirable end. Inasmuch as an invitation should be in behalf of the profession of the whole country, and not of any particular section, it appropriately should come from the American Medical Association. If the suggestion be favorably received, it seems to me advisable that a committee be appointed with instructions to convey an invitation from this Association through its delegates to the Congress in Copenhagen. The committee may also be empowered to designate the time and place of the meeting of the Congress in 1887, and to take such other preliminary steps as may appear to the committee to be requisite. |
The A. M. A. delegates at the annual meeting of 1884 , to whom Dr. Flint addressed these remarks, followed his recommendations to the letter. They established a "Committee of Eight on the International Medical Congress" chaired by Dr. John S. Billings of the Surgeon-General's Office of the War Department, and including Dr. Flint. The Committee was authorized to invite the Congress to meet at Washington in 1887 and, upon acceptance of the invitation, "to proceed to act as an Executive Committee with full power to fix the time and to make all suitable and necessary arrangements for such Congress and to solicit funds for this purpose." The Committee was also empowered to elect its own officers, add to its membership and perfect its organization.
As ordered, the Billings Committee attended the meeting of the Congress in Copenhagen in August 1884 as a delegation from the A. M. A. Their invitation on behalf of the A. M. A. to hold the next meeting of the Congress in Washington, D. C., in 1887 was promptly accepted.
Trusting in the explicit delegation to it of responsibility "to make all suitable and necessary arrangements" for the Congress of 1887, the Billings Committee of Eight acted independently and so efficiently that it could publish in the J. A. M. A. on 11 April 1885 procedures for the organization and conduct of the Congress of 1887. Also published were the names of the officers of a General Committee on the Preliminary Organization of the Congress, and an extensive list of the many other distinguished American physicians and medical scientists who had agreed to participate in the planning and conduct of the scientific program. The Billings Committee clearly sought to place the Congress under the scientific auspices of the outstanding men in American Medicine and, as they soon learned, were all too successful in doing so.
Among the officers of the General Committee on the Preliminary Organization of the Congress were Dr. Austin Flint, Sr., as President; eleven Vice-Presidents including Dr. Levi C. Lane; and Dr. Billings as Secretary-General. Among the numerous physicians appointed to the nineteen Medical Sections under the General Committee were Dr. Henry Gibbons, Jr., as a member of the Council of the Section on Medical Education, Legislation, and Registration; Dr. Levi C. Lane as a member of the Council of the Section on Surgery; and Dr. John Scott of San Francisco as a member of the Council on Obstetrics. Drs. Gibbons, Lane and Scott were the only physicians from the State of California and the Far West in the entire organizational structure of the Congress. All three were members of the California State Medical Society. It seems a rather pointed omission that Dr. Scott was chosen as the consultant on Obstetrics rather than Dr. Beverly Cole, the most prominent obstetrician in West at the time. [6]
The next annual meeting of the A. M. A. was convened in New Orleans from 28 April through 1 May 1885. There were only two delegates from California in attendance. They were Dr. Beverly Cole, Dean of the Medical Department of the University of California; and Dr. Anabel McGaughey Stuart who graduated from the Medical College of the Pacific in 1878 and was the second woman to graduate from a Cooper school. Both Drs. Cole and Stuart were delegates from the California State Medical Society.
On the first day of the New Orleans meeting Dr. Billings was called upon to make a Progress Report on behalf of the Committee of Eight which had been appointed to invite the International Medical Congress to meet in the United States in 1887, and to make all suitable and necessary arrangements for the Congress. In his Report Dr. Billings described the various steps the Committee had taken during the past year to carry out its mandate from the Association He also provided the delegates with a copy of the policies and procedures for the Congress and a list of the many prominent physicians who had agreed to participate in planning and implementing the program.
Dr. Billings thought that he had every reason to be pleased with the remarkable progress made by the Committee to date, and concluded his verbal presentation of the Report by saying: [7]
| It is anticipated that within the next six months these programmes for the Congress will be approximately completed and, about the 1st of May 1886, the arrangements for the Congress will be in an advanced and definite shape for presentation and publication. |
When his Report on the International Medical Congress was taken up for discussion on the following day, Dr. Billings was stunned by a vigorous protest against the Report. In spite of Association records to the contrary, Delegates from several states insisted that Dr. Billings' original Committee of Eight was only a "committee on arrangements" and had no authority other than to secure acceptance from the International Medical Congress to hold its 1887 meeting in Washington D. C.
Finally. after much heated debate, the following Resolution was adopted: [8]
| Resolved, That the committee appointed by this Association to arrange for the meeting of the International Medical Congress in America, in 1887, be enlarged by the addition of thirty-eight members, one from each state and territory, the army, navy, and marine hospital service, to be appointed by the chairman at this meeting, and that the committee thus enlarged shall proceed to at once review, alter, and amend the motions of the present committee as it may deem best. |
The Resolution in effect rebuked the Billings Committee by imputing that it had grossly misinterpreted and exceeded its mandate. The reasons given for this controversial action were three. First, the dissidents claimed that the Billings Committee had included too many of its own members on the "General Committee on the Preliminary Organization of the Congress." Second, that some "New Code" men had been carelessly appointed to the General Committee. And third, that the Billings Committee in its zeal to involve the foremost physicians in the nation (these physicians being concentrated in the northeast sector of the country), had created a General Committee that did not reflect the geographic distribution of the A. M. A. membership.
Publication of the Journal of the American Medical Association began in Chicago with Volume 1 in 1883, and the ever-faithful Dr. Nathan S. Davis was elected as the first editor. In a lengthy editorial in the issue for 30 May 1885, Dr. Davis vigorously defended the decision of the delegates to enlarge and redirect the Billings Committee. He also spent an inordinate amount of his time during the ensuing year responding to editorial attacks on the A. M. A. in other medical journals for what was widely considered a politically motivated and egregious error by the Association. Word of the contention crossed the Atlantic and European physicians were highly critical of the unseemly bickering of the Americans. In brief, the Resolution and its aftermath were an international public relations disaster for the A. M. A. [9]
The discussion on the Resolution included the following substitute motion which was rejected by a vote of 88 to 129.
| Resolved, That the actions of the International Congress Committee, so far as they have gone, be approved by this body, provided all new-code men be left out. |
This attempt to exclude "all new-code men" was thus soundly defeated and Dr. Beverly Cole of California, who was one of the discussants of this failed motion, was therefore fully aware that the A. M. A. did not authorize exclusion of "new-code men" from participation in the Congress.
In accordance with the Resolution passed at the New Orleans meeting in April 1885, thirty-eight new members chosen on a geographic basis were added to the original Billings Committee to constitute a new body entitled "The General Committee on the Organization of the Ninth International Congress in 1887." The General Committee assembled at the Palmer House in Chicago on 24 June 1885 "to review, alter and amend the motions" of the Billings Committee. Dr. Beverly Cole was elected Chairman of the General Committee which proceeded to revise the work of the Billings Committee. [10]
Billings was present at the Palmer House meeting and promptly wrote to Dr. Lane informing him of certain actions taken. by the General Committee: [11]
War
Department Dear Doctor Lane: You will see the doings of the Chicago Committee in the Journal of the American Medical Association. It made Cole, President of the Committee of Organization, and Shoemaker, Secretary. All New Code men were dropped. You were dropped at Cole's instance, as being New Code. Drs. Hays, Browne, and myself have resigned from the committee. It's a bad piece of business. Regretting the results of our efforts, I remain, Yours very sincerely, |
Dr. Lane reacted to Cole's arbitrary banishment of him from offices in the Congress by publishing two weeks later a pamphlet entitled Shadows in the Ethics of the International Medical Congress. The following excerpts from the pamphlet reflect his resentment at Dr. Cole's duplicity: [12]
I am not now, nor have I ever been, connected with the New Code movement, either here or elsewhere; in fact, the subject has never been a matter of division on this Coast. I am a member of the American Medical Association, and as a duly accredited delegate, I represented that body not long since in the British Medical Association, and my mission was not dishonored by ostentatious show there or elsewhere, during a sojourn of over two years, during which I met the leading men connected with the medical institutions of Great Britain, Sweden, Russia, France, and Germany. But my offense was quite outside of the New Code. Four years ago I reorganized in this city the first medical school ever established on the Pacific Coast, and to increase its efficiency and permanency, I gave it a property of value greater than any sum ever before given by any physician in this country for the advancement of medical science. This school, by winnowing out improper material by an enforced preliminary examination; and by the thoroughness of the instruction given in it by an educated faculty working in harmony, has naturally become the rival of another medical school in this city, Dr. Cole being connected with the last-mentioned school. Would it not be distrusting the reader's acumen to add further words to connect this paragraph with the subject here in question? |
Dr. Lane was particularly hurt by Dr. Cole's ingratitude. While en route to the International Medical Congress in London in 1881 Dr. Cole learned of the serious illness of his daughter's husband in San Francisco. He wired his daughter to request Dr. Lane to attend to her husband and Dr. Lane managed the case successfully. He wrote to Dr. Cole informing him that the patient had improved and received from Dr. Cole the following letter of thanks: [13]
London, September 30, 1881 My dear Doctor Lane: Your kind letter of the 8th was received but yesterday. You cannot imagine how much pleasure it gave me to learn directly from you of the permanent improvement of my son-in-law, as also your expression of approbation of the conduct of my dear child in the case. A better child never lived, and in my experience, good children make good wives, and I believe she is one of the best. It is needless, dear Doctor, to presume to attempt to express my gratitude for your unremitting attention. I feel, from what my child has so often repeated - as well as the patient - that you could not have done more had she been of your kin; and to venture to say all I would under the circumstances would result in utter failure, hence I will only request that you reverse our positions, and what you would feel I do feel! With kind remembrances to all mutual friends, in which Mrs. C. unites with me, I remain, Dear
Doctor, |
In addition to this letter, Dr. Lane received two others of similar tenor thanking him for his services, not only to Dr. Cole's son-in-law but also to his daughter. These services embraced a period of nearly three years, including nine months of almost daily visits Besides these house calls, Dr. Cole's daughter and her husband were seen frequently in Dr. Lane's office where they always received preferred attention. Dr. Cole's daughter had actually been under Dr. Lane's care within the past few weeks.
Small wonder that Dr. Lane was astonished and bitter to learn that his colleague and presumed friend had, on a false pretense, stricken his name from the list of Vice Presidents on the Committee for the Preliminary Organization of the Ninth International Medical Congress, and from the Section of Surgery. In his frustration, Dr. Lane unleashed a personal attack on Dr. Cole that left little prospect that their relations could ever be repaired. [14] [15]
One seeks in vain for words to describe such action (as that of Dr. Cole), since such action has been so nearly unheard of as to have rendered it unnecessary to create words for its expression. The honors conferred on me by the original (Billings Committee) were given unasked for. I had already sketched out some work as a contribution on a topic of surgery, in which I have had much experience; besides, I was in negotiation with a man of wealth for the establishment of an international medical prize for researches upon typhoid fever. These facts are here mentioned to show that I had not entered on this labor with an idle hand. But my retirement has the solace of most excellent company; retirement with such men as Drs. Hays, Browne, and Billings can be borne. The first, the worthy heir of an illustrious name in American medicine, is the editor of the veteran mouth-piece of American medicine, viz.: The American Journal of Medical Sciences. The second has long been an ornament to the Surgical Corps of the United States Navy - a body of men second to none in refined culture and scientific attainments. As to the third, he and Dr. Cole were both at the International Medical Congress in London, 1881. and while Dr. Cole, conspicuous in his livery of bombast, was bringing derision on himself and odium upon American medicine by his exaggerations and incredible statements; while he was squandering the golden moments of that learned body, in the parade of his vaginal mechanical jim-cracks, which adverse criticism has already consigned to the lumber-room of oblivion (where a lover of antiquities might have found them years ago) - while this man was strutting and filling the learned ears from all nations with his "sound and fury," there stood there another man of unpretending demeanor, whose learned escutcheon bore the simple inscription, Modesty; and whose able papers, besides partially atoning for his countryman's parade and superficiality, won for their author an enduring place in the literature of the Congress, as well as in the memories of those present, and caused him to be recognized as the tongue, voice, fame, and honor of American representation in that august assembly; and the man was - John Shaw Billings. |
As planning for the International Congress continued, the international carping against the ousting of the Billings Committee by the A. M. A. gradually subsided, largely due to the constant explaining and coaxing of Dr. Davis's editorials in the JAMA. When Dr. Billings resigned, Dr. Davis succeeded him as Secretary-General of the Congress. When Dr. Flint died on 13 March 1886, Dr. Davis was made President of the Ninth International Medical Congress which he ultimately convened in Washington, D. C., 5-10 September 1887. [16] [17]
When the Congress was over Dr. Davis, who more than anyone else was responsible for its ultimate modest success, was obviously tired of the whole affair. He published an evaluation of the Congress in an editorial in the JAMA which consisted almost entirely of a reprint of a leading article from the London Lancet that bestowed faint praise on the Congress, and referred tastefully to the discord associated with it. [18]
London Lancet, 24 September 1887
pp. 617 and 627
The success of the Ninth international Medical Congress is a matter of thankfulness. The interruption of the series of Congresses would have been little less than a calamity and a disgrace for the profession in all nations. Any serious imperfection in the meeting, either as respects numbers or the character of the discussions would have been but little less unfortunate. But the Congress has been held under most honorable auspices; the famous hospitality of the Unites States has been fully realized; and those who went great distances to attend the Congress have been amply rewarded. . . Those in the United States who have worked to this end, and in spite of much discouragement, well deserve the gratitude which was accorded to them by formal resolution. We have purposely abstained, in our allusions to the Congress, from pointedly referring to the domestic differences among our brethren in the States, which threatened to seriously mar the success of the Congress, if not to prevent it altogether. Those who persevered in spite of all opposition, and who have carried through the Congress so successfully, may well be satisfied. They have done a great service to their country and to their profession in all countries. It is not necessary for us to say that they committed no faults and made no mistakes. Such praise is not for mortals in a world so full of 'spilt saltpetre' as ours. But they have carried through the Congress, and we thank them. |
There is no evidence that Dr. Lane's indignant reproof troubled Dr. Cole in the slightest. Lane was by nature austere, scholarly, upright - and thin of skin. Cole was not a scholar but he was gregarious, witty, and a consummate politician. Following his defection to the Toland College, he was completely devoted to the extinction of all future versions of the original Cooper School that he had helped to found. There can be no doubt that he was motivated in removing Lane from committees of the International Congress by jealousy of Lane's new building and the prosperity of the Cooper institution. Medical politics was Dr. Cole's element and he could not resist the opportunity it gave him to eject Dr. Lane from a position of national prominence.
Dr. Cole's major role in the populist coup against the Billings Committee was a significant achievement in national medical politics. It was also a hefty step on the ladder to the presidency of the A. M. A. to which he was elected in 1895. His fondest hope, however, was to someday have a building to overshadow the expanding medical complex of the obnoxious Cooper College that dared to challenge the hegemony of his State school. At last, in 1898, he literally took the high ground when the State of California fulfilled Toland's expectations of State support by funding construction of the Affiliated Colleges, including a medical school. These buildings, perched on the eminence of donor Adolph Sutro's Parnassian acres, looked west to the Pacific and the Farallones; looked east to the outskirts of San Francisco - and down on the red brick complex of the Cooper Medical Center. [19]
In Dr. Cole's few remaining years, failing health and his declining effectiveness in the deanship sidelined him to a sinecure as Coroner of San Francisco. He held this post until age took its toll. He died of a stroke at seventy-one on 15 January 1901. Dr. Cole's biographer, respected historian Frances T. Gardner, fancied that Dr. Lane relented in the end, and was seen at the last rites: [20]
| Dr. Cole's funeral was a masterpiece of Masonic pomp and ceremony and to it came the great and small of the city in which he had lived so long. Even Lane appeared, strangely downcast that his future held no more zestful squabbles with his ingenious rival. Lane knew that this old pioneer was the symbol of an era that was gone, a period unique in its lusty loves and hates and active lives and sudden deaths. He sighed as he left the church and sighed again as he looked toward the heights where the proud young buildings of the Affiliated Colleges stood alone in the sand dunes. As he turned away again to enter the doors of his own red brick buildings across the city, he shook his head and said as though to himself, "In spite of everything, Cole, God go with you." |
In another short year, Lane was to follow his old adversary to that far country from which no traveler returns.