Elias Cooper was ever an enthusiastic supporter of medical associations and, in spite of the sharp criticism he endured in the Peoria and Illinois State Medical Societies, he made the founding of a State Medical Association one of the prime objectives of his California campaign. His temerity in beginning such an effort in 1855 only three months after his arrival on the Pacific Coast is a token of his zeal to widen contacts and gain prominence within the profession. He doubtless also thought that the strong national trend in the East to organize State medical societies made such a move timely in the West.
San Francisco Medical Societies prior to 1855
Local medical societies are normally the precursors of state-wide associations and San Francisco had seen the organization of three such local societies prior to 1855:
(1) the First San Francisco Medical Society in 1850;
(2) the Pathological Society in 1851; and
(3) the Second San Francisco Medical Society in 1853.
The medical activities of these societies were of little consequence and they apparently never considered organizing a State association. Their membership consisted mostly of the pioneer physicians who were the first to practice in the city, a distinction that led some members to consider themselves the medical elite. Cooper was the kind of aggressive interloper to offend their sense of propriety by challenging their supremacy. The following is a brief account of each of these early societies.
The First San Francisco Medical Society
It was just two years after the beginning of the Gold Rush, and San Francisco had leapt from a village of 900 to a chaotic tent city of 35,000, when 32 of the local physicians met on 17 June 1850 to organize the first San Francisco Medical Society. They promptly adopted a Constitution consisting of the usual pledge to maintain high standards and oppose quackery, and enacted a set of ten By-Laws. Number eight of the By-Laws stated: "There shall be established by the Society a Fee Bill, which shall govern the members in their charges for professional services." It appears that the primary reason for organizing the Society was to establish a schedule of allowable charges. The following fees specified in the Fee Bill were recorded with the Constitution and By-Laws. The basic unit to be used in calculating charges for medical visits was $16, the value of an ounce of gold dust. A first visit to the office was listed as $32 and a follow-up visit as $16. The obstetrical charge for normal delivery was $150; for application of forceps, $300; and if turning of the baby was required, $500. Surgical fees were $500 to $1000 for removal of a bladder stone or repairing a strangulated hernia; operation for cataract or making an opening in the skull (trephining) cost $1000. But you could have an arm or a leg amputated for only $300.
Although these seem like exorbitant fees for that era, the Gold Rush was a period of such scarcity, inflation and economic turmoil in San Francisco that we have no idea what a fair charge for medical service would have been at the time. We do have the witness of Dr. Thomas M Logan of Sacramento (whose letter to his brother-in-law we quoted earlier) that the gold country was grossly over-stocked with doctors of both the regular and irregular variety and that the rapacity of some had created mistrust of the profession generally. The founders of the Society were doubtless seeking to establish a reasonable level of fees, but there was certainly no consensus among the members and the Fee Bill was so divisive an issue that it wrecked the organization. By the end of October it had ceased to exist after a short and factious life of only four and a half months. The Alta California for October 27, 1850 had the following last words: [1]
| The members of the medical faculty appear to have fallen out most completely with each other, and the citizens have certainly fallen out with many of them. The pretentious claims of the members who have constituted themselves into a Medical Society, and prescribed rules for the government of the profession, have disgusted the majority of respectable physicians in our midst. They have, as it were, ostracized those who have not subscribed their names to the Constitution and By-Laws, and in point of fact pronounced them mere quacks and pretenders. Now we are quite as much opposed to "quacks," who assume nothing more than to sell "patent medicines" and combine nostrums, as any regular diploma'd (sic) medica can possibly be, but we are equally opposed to those who assume to be regular practitioners, and who are neither fitted by nature nor application for the science of medicine theoretically or by practice....Their "fee bill" was simply an outrage, but we are happy to say that of the twenty-eight members, several have repudiated it, and desired their names be stricken from the roll. |
After that cold blast from the press, nothing further was heard from this first Medical Society to be organized in San Francisco. [2]
The Pathological Society of San Francisco
The second medical association to be established by the pioneer physicians of San Francisco prior to 1855 was the Pathological Society. Organized in 1851 "for the promotion of Medical Science," the Society held together for about six years and during that period always had the same officers: A.J. Bowie, M.D., President and A.B. Stout, M.D., Secretary. Its activities were apparently of a mainly social nature and this may account for its relative longevity in comparison with other medical societies of the period. There is no indication that Medical Science was ever promoted, but there is evidence that the members maintained a lively interest in medical politics. They were active in the founding convention of 1856 and the first two annual meetings of the California State Medical Society, a subject to which we shall later return. In addition to Drs. Bowie and Stout, the membership the Pathological Society also included Drs. H. M. Gray, William Hammond and J.P. Whitney whose names will come up again. as we follow the career of Dr. Cooper. [3]
Since the Pathological Society will figure prominently in our continuing narrative, this is an appropriate juncture to tell how the Society's perennial officers, Drs. Bowie and Stout, arrived on the California scene.
Augustus Jesse Bowie (1815-1887). San Franciscans appeared to regard Dr. Bowie as highly for his conversational style as for his surgical skill, and in both respects his attainments were exceptional. Legend had it that sometimes patient's feigned illness and took to bed in order to have the pleasure of a visit from the genial and courtly doctor. Levi Cooper Lane considered him a conversationalist without rival because of his scholarly grasp of the works of Virgil, Ovid and Horace from which he quoted freely (and accurately) on appropriate occasions. Where Dr. Bowie received such a thorough grounding in the humanities remains a mystery for little is known of his early schooling, leaving us to assume that native ability and innate refinement of taste guided him in a personal study of the classics.
The urbane and considerate manner that claimed for Dr. Bowie the esteem and approbation of both patients and his peers marked him as a native of the South, as indeed he was - born at Annapolis, Maryland, on 23 October 1815, son of an attorney. It is said that he was a descendant of the Earl of Clarendon, a staunch Loyalist who was influential in putting Charles II on the throne after Cromwell's death. His American ancestors were among the settlers who, with Lord Baltimore, laid the foundations of the Colony of Maryland. Bowie is thought by one historian to have attended school only until thirteen years of age, suggesting a meager formal exposure to Latin authors. Levi Cooper Lane, without citing his source, expressed a different view of Bowie's education when he wrote: "Dr. Bowie had the advantage of a thorough, early education; an education in which the 'humanities' had a full place."
There is also lingering mystery as to the sequence of events in Bowie's professional career prior to his settling in San Francisco. The facts are probably somewhat as follows. He studied medicine under a preceptor before attending the University of Maryland where he received an M.D. Degree in 1842. He also had a career in the U. S. Navy which began in 1837 when he shipped out on the frigate Independence as Assistant Surgeon. Then followed cruises to Russia, many South American countries, and to the Orient. Navy Surgeon Bowie first arrived in San Francisco harbor at the height of the Gold Rush on 1 April 1849 aboard the sidewheeler Oregon, one of the first steamships to join the East and West Coasts by water. He came with orders to select a site for the Marine Hospital. While accomplishing this, he became so impressed by the future prospects of San Francisco that he returned in 1852 to become surgeon of the Marine Hospital, and to make the city his permanent home. The hospital position requiring only part of his time, he opened an office in downtown San Francisco to engage in general practice with a chief interest in surgery. At some early but uncertain date he was elected President and Doctor A. B. Stout, Secretary, of the organization of pioneer doctors known as the Pathological Society. [4] [5]
Dr. Bowie had a long and honorable career as a surgeon and we shall have occasion later to refer to his relationship with Cooper. Among other notable associations, Bowie succeeded Cooper as Chair of Surgery in the Medical Department of the University of the Pacific in 1863 after the latter's death. In a memorial tribute in 1877, Lane made a final assessment of Bowie's surgical contributions:
| As a surgeon he did much praiseworthy work, which, if published, would have placed him among the leading surgeons of our country. In his operative work he was cool, bold, self-poised and dexterous. . . Still, so free was he from the ambition that inspires most men, that he has left in writing almost no record of his splendid achievements in the field of operative surgery. |
Augustus Bowie is hardly remembered In the annals of medical education, the generous-hearted and convivial doctor being among the earliest of the far western academics to confirm the axiom: "Publish or perish."
Arthur Breese Stout (1814-1898). Dr. Stout, who may be described as a "thinking surgeon," was a close friend and colleague of Augustus Bowie, and a relentless adversary of Elias Cooper. Born in New York City on 29 April 1814, Stout had many advantages in early life, beginning with a family of ample means and more than average intelligence. Samuel F(inley) B(reese) Morse, inventor of the telegraph, was a first cousin with whom Stout shared grandparents and a middle name. Stout's path to a professional career was smooth. and unimpeded. His family saw that he received a classical education before he studied medicine at the College of Physicians and Surgeons in New York where he received an M.D. degree in 1839.
After earning his degree, he visited Europe, touring England, France and Germany before returning to New York in 1848. Later in the same year, being unmarried and indifferent to the charms of a lifetime in big-city practice, he accepted the position of ship's surgeon on the S. S. California then preparing to depart on her maiden voyage around the Horn to San Francisco. The California was one of three steamships constructed under a special act of Congress in 1847 to carry mail and passengers from the Isthmus of Panama to Astoria, Oregon, and ports between. The other two ships were the Panama and the Oregon, the latter being the ship that brought Doctor Bowie to San Francisco just thirty-two days after Doctor Stout arrived.
The California pulled out of New York harbor on 6 October 1848, two months before news of the discovery of gold at Sutter's Mill reached the East Coast. Four and a half months later, on 28 February 1849, she steamed calmly through the Golden Gate to a tumultuous reception by the ships in the Bay who saluted her arrival as the first steamer to make the long sea voyage from New York to California. Bowie and Stout were thus authentic '49ers and both were pillars of the Society of California Pioneers. Stout was not a gregarious and forgiving man and took his seniority in the medical community much more seriously than did the amiable Dr. Bowie. [6]
Not to be diverted by the allure of gold in the foothills, Stout went immediately into practice in San Francisco and was rewarded by a sufficient yield to allow him to invest in real estate and enjoy financial security. He had a perceptive and analytical mind that was soon recognized not only among his peers in the profession but also by leading citizens of the community. Considering their early arrival in the city and the prominence they soon attained, it is not surprising that both Stout and Bowie were members of the First Vigilance Committee when an aroused civic conscience called it into being on 10 June 1851 for the avowed purpose "to watch, pursue, and bring to justice the outlaws infesting the city, through the regularly constituted courts, if possible, through more summary course, if necessary," The Committee proclaimed that "no thief, burglar, incendiary, or assassin, shall escape punishment, either by the quibbles of the law, the insecurity of prisons, the carelessness or corruption of the police, or a laxity of those who pretend to administer justice." [7]
Stout was elected a member of the Executive Committee of the Vigilance movement along with Sam Brannan, James King of William and thirty-seven others. During the Committee's deliberations Stout first demonstrated his judicial temperament and medico-legal cast of mind. Although the Committee was determined to intervene directly and restore order when the police and courts were impotent in doing so, it sought, when seizing jurisdiction from the constituted authorities, to proceed in accordance with the rule of law. When the Committee evaded the writ of habeas corpus in the course of apprehending several of its prisoners, the punctilious Stout raised objections. He was then appointed to a committee of three members which advised "that a due circumspection be exercised to maintain the purity and equity of the application of the writ of habeas corpus." [8]
Stout's experience on the Vigilance Committee may have turned his mind to consideration of legal and social issues. Although he practiced surgery and was Professor of Surgery from 1872 to 1874 in Dr. Hugh Toland's Medical School in San Francisco, most of his writings were of a medico-legal or public health nature as a result of which he was highly respected as an authority on social problems.
He was also actively involved in the organization and direction of the Pathological Society and other early medical associations in California. It was in this arena that he encountered Dr. Cooper whom he held in cold contempt and sought to discredit whenever an opportunity arose for him to do so. In due course we shall return to the subject of Stout's hostility to Cooper. [9]