Sacramento Medical Society
Scarcely a year had passed since the demise of the Medico-Chirurgical Association when the Sacramento Medical Society was founded on 30 April 1855. Among the officers were Dr. John F. Morse as a Vice President and Dr. Thomas M. Logan as Corresponding Secretary. The original list of members consisted of 25 physicians, all graduates of recognized medical schools. Holding of a medical degree was a prime requirement for membership in the Society which was established specifically "for the purpose of protecting regular practitioners and the public from innovations and malpractice of uneducated pretenders, who will display their 'shingles' in every community."
At the outset, members of the Society were animated by the conviction that regular meetings devoted to the open and informed discussion of scientific subjects were the Society's central purpose, and that contentious bickering over professional status and competition would threaten its welfare and survival. During the first two years Morse, Logan and others made instructive and interesting medical presentations. Nevertheless, a situation common throughout American medicine of the day caused increasing friction within the Society. There were in Sacramento some practicing physicians who had no medical degree but had gained their professional credentials solely through apprenticeship. This was in accordance with the time-honored but then obsolete practice by which young persons desiring to be a doctor attached themselves to a reputable physician and studied medicine under his tutelage in his offices and at the bedside. These preceptors determined after a few years when students were adequately trained and provided them with a certificate that they were competent to begin practice. Members of the Society who were friends or associates of preceptor-trained doctors pressed for their admission, and other members resisted. The gulf between the parties widened and, in 1863, the Society melted away. 
Thomas Muldrup Logan (1808-1876), as noted above, was elected on 30 April 1855 as the first Corresponding Secretary of the Sacramento Medical Society. The member holding this position in a Medical Society is, in effect, its "Minister of Foreign Affairs" and on this account has exceptional responsibilities and opportunities. This special feature of the post was not lost on either Thomas Logan or Elias Cooper. These two were destined soon to involve their respective medical societies in an enterprise of considerable moment, which we will discuss in detail shortly. But first it would be timely to inquire into Dr. Logan's background.
He was born on 31 July 1808 in Charleston, South Carolina, of Scotch ancestry. His grandfather, Dr. Thomas Logan, a graduate in medicine at Edinburgh in 1773, practiced in Charleston. So did his father, Dr. George Logan, a graduate of the University of Pennsylvania in 1802. He was for some years a leading physician in Charleston.
As might be expected, Thomas Muldrop Logan spent his youth and early manhood attending Charleston schools. He received a classical education at Charleston College and was awarded an MD degree from the Medical College of South Carolina in 1828. He then married and spent several years in medical practice in Clarendon, North Carolina. In 1832 he went to Europe for the usual exposure to the professional culture of Great Britain and France. On his return he entered practice in Charleston and served as a Lecturer on Materia Medica and Therapeutics in a summer course under the auspices of the Medical College of South Carolina. His talent for color engraving, one of his avocations throughout life, was displayed in the first (1834) and second (1836) numbers of Dr. Thomas L. Odgier's Compendium of Operative Surgery for which Logan did the illustrations of operative procedures on arteries. He moved to New Orleans in 1843 where he practiced until the discovery of gold attracted him to California in 1849.
After a long and tempestuous voyage around the Horn in a small schooner, he arrived in San Francisco on January 29th 1850 and promptly entered medical practice. After a few months he moved to Coloma and mined gold until October 1850 when the terrible epidemic of Asiatic cholera broke out in Sacramento. To help care for the victims of that fearful pestilence, he immediately repaired to that city and there remained until the time of his death twenty-six years later. 
Logan's records and commentary on the cholera epidemic of 1850 are an invaluable source of factual data that would otherwise have been lost to posterity. In November 1850 he wrote: 
As I apprehended, our worst fears have been realized - for never, in the history of this cosmopolitan disease, since its first appearance in the Gangentic delta in 1817, and its subsequent progress around the globe, which it has at last encompassed, has any visitation been so destructive and appalling . . . The like mortality is unprecedented, and only to be surpassed by the Black Death and awful plagues of the fourteenth century. Even in Paris, in 1832, when I first encountered the disease, and where the mortality was regarded as excessive - amounting to 18,000 out of a population of 800,000, the proportionate number of deaths was not so great, by more than one-half; there only one in 44 died; but in Sacramento City, one out of 17 inhabitants fell a victim to the scourge and this is a most moderate calculation, based solely upon the mortuary record of the two coffin-makers and undertakers. (Of the ninety physicians embraced in the population not one fled; all remained and) performed their duties with an unflinching firmness and fidelity worthy of all honorable mention.
It was presumably during the cholera epidemic that Logan met John Morse with whom he enjoyed a long association in connection with the affairs of medical organizations to which we shall now return our attention.
San Francisco County Medico-Chirurgical Association
By the summer of 1855 the first San Francisco Medical Society had expired, the Pathological Society was essentially dormant except for social functions, and the second San Francisco Medical Society exhibited only fitful signs of life on its downhill course to extinction in 1860. The time was opportune to establish a vigorous forum for scientific discussions and elevation of the profession in San Francisco.
4 August 1855
Doctors John L. Webster and John P. Macauley took the initiative. On Saturday 4 August 1855 they called a meeting in their office "for the purpose of forming a medical society." In addition to the hosts those present were: B.M. Angle, A. Atkinson, E.S. Cooper, Lorenzo Hubbard, C.A. Kirkpatrick and FP Wierzbicki. Dr. Hubbard was elected as Chairman and Dr. Webster as Secretary of the meeting, and Drs. Hubbard, Macauley and Webster were elected as a Committee to Draft a Constitution. Having disposed of this business with unanimity and dispatch, the group of eight physicians adjourned to meet again on Friday the 10th of August. 
10 August 1855
This second organizational meeting was convened to consider the Constitution prepared during the past week by the drafting Committee. The full constitution was presented. No action on it was taken at this meeting and no list of members in attendance is available. The following sections of the Constitution defined the objectives of the society:
We the undersigned being desirous of forming an Association for the purpose of the advancement of Medical and Surgical Science, of promoting harmony and friendly intercourse among the Members of the Medical Profession in the state of California, and extending comfort, and such pecuniary aid to unfortunate and indigent Brothers, and their families, as their necessities may require, do each for ourselves agree to be governed by the following constitution.
Article. 1. This Association shall be known by the name of the San Francisco County Medico-Chirurgical Association.
Article 2. The members of this Association shall be those who are graduates of some regularly incorporated Medical Institution, or who shall otherwise give satisfactory evidence of their competency to practice the profession of Medicine, and who shall subscribe to this constitution, and pay into the Treasury of the Association such sums as shall be prescribed in the By-Laws, etc.
17 August 1855. (erroneously dated 16 August in the original Minutes. There was no list of the members present.)
At this third meeting of the Association the Constitution was unanimously adopted, and the following officers unanimously elected:
|Vice President:||Miles B. Angle|
|Secretary:||John L Webster|
|Treasurer:||I. W. W. Gordon|
|Corresponding Secretary:||Elias S. Cooper|
|Censors and Trustees:||I. W. W. Gordon
John P. Macauley
Charles A. Kirkpatrick
F. P. Wierzbicki
Elias S. Cooper
Cooper's election as Corresponding Secretary provided him with just the opportunity he needed to move forward as the representative of a local medical association with his plan to organize a State Medical Society.
During this meeting he received the additional important appointment as Chairman of the Committee to Draft By-Laws The committee was composed of Drs. Cooper, Gordon and Webster.
As the last item of business Dr. Cooper offered the following series of eight resolutions which were adopted and ordered to be recorded in the Minutes of the Meeting:
That unanimity of feeling and concurrence of action among the members of the Society are indispensable to its perpetuity.
That the members of this Society shall know no contention, save that which prompts us to contend with each other for the highest merits in the cultivation of the literature of our profession, the most skill in its practice, the greatest candor towards each other, and the sincerest devotion to the true interests and dignity of our calling.
That so long as we continue in the organization, it is the duty of each member to vindicate the character of any other, at all times, when unjustly assailed.
That next to candor, punctuality in attending our meetings, and all other appointments, is a cardinal principle, and indispensable to mutual confidence in each other, and harmony in the Society.
That it shall be the duty of every member to treat all other members as if they were in possession of these qualities, unless found to be otherwise.
That this organization gives us duties towards each other, which we do not owe to all other members of the profession.
That the first object of this Society is improvement in the knowledge and skill of our high calling, and that it is the duty of every one to use his utmost endeavors to advance every other member in these respects, and so far as he conceives he justly merits it, to advance his interests in every honorable way.
That want of candor in consultations is, to all intents and purposes, blameworthy, and on being proved against any member of this body rendering him obnoxious to censure, and deserving expulsion.
24 August 1855
There was no list of the members present at this fourth meeting of the Association. Dr. Cooper and other members of the By-Laws Committee must have worked industriously during the previous week for he, as Chairman, was ready with a comprehensive set of statutes for the regulation of the Association. The tone and content of the document suggest that it was chiefly Cooper's handiwork. Aside from routine rules of order for conducting business, the following two Sections from the By-Laws are noteworthy in view of subsequent events.
No member shall be reprimanded, suspended, or expelled except by a vote of two-thirds of the members present at any stated meeting, after a notice of at least one month has been given the accused in writing, and a copy of the same filed in the Journal of the Society.
All flagrant violations of the Code of Ethics of the American Medical Association, shall subject a member to reprimand, suspension, or expulsion, by a vote of two-thirds of Members present at any stated meeting after due notice has been given.
The By-Laws were adopted by unanimous vote.
31 August 1855
Members present at this fifth meeting of the Association were not listed. The Minutes read:
"Dr. Cooper, the Corresponding Secretary, read a communication, which on the motion of Dr. Macauley was received and approved."
This communication was a letter dated 27 August 1855 written by Cooper on behalf of the Association to Thomas N. Logan, MD, Corresponding Secretary of the Sacramento Medical Society, proposing the organization of a State Medical Society. We will return later to this historic proposition.
In a bold move to define the character and mission of the Medico-Chirurgical Association in his own terms, Cooper now took the floor again in order to read a series of twelve resolutions, which he followed by a second series of ten resolutions. Both series were received for the record and carried over to the next meeting for discussion.
7 September 1855
The roll was called at this sixth meeting and the following nine members were present: Drs. Angle, Atkinson, Cooper, Gilbert, Gordon, Kirkpatrick, Macauley, Webster and Wierzbicki.
Dr. Wierzbicki proposed that a committee be appointed to draft resolutions respecting the controversial subject of Medical and Surgical Fees. The proposal elicited a warm discussion from the usually compliant group. Several members objected to a scale of fees being drawn up at present, the Society being but in its infancy. It was finally decided to appoint a committee to prepare a fee bill.
Cooper's two series of resolutions comprising a total of twenty-two, submitted at the previous meeting, were read again, discussed, and unanimously approved. These were in addition to his eight resolutions previously ratified at the third meeting of the Association. It must be a singular occurrence for a medical society in the process of organization to adopt unanimously thirty resolutions from a newcomer to the local profession. Recall that Cooper had at this time been in San Francisco only a little over three months. His campaign to build a practice and begin a teaching program was in full sway. Living alone and associating only with medical men, he maintained his accustomed punishing schedule of dissection and medical studies far into the night, his restless mind focussed on the ultimate goal of founding a medical school. We know, too, that he continued to have nagging symptoms of the mysterious neurological disorder that caused his facial palsy. To what extent this chronic illness influenced his behavior we shall never know. That being the case, Cooper's grim striving and sense of mission best explain his assertiveness and the barrage of 30 resolutions designed to proclaim his personal credo and take aim at emerging critics.
Cooper's resolutions in general were mainly noble and harmless platitudes, except for those in the last of the three series he submitted. These have troubling implications. They are obviously directed against certain of San Francisco's pioneer physicians, members of the Pathological Society, who resented Cooper's aggressive tactics and his disrespect for their seniority and competence. On this account they had presumably excluded him from their Society. The following self-righteous litany was nothing less than a defiant challenge to the old guard. By obtaining approval of these resolutions, Cooper involved the Association in his smoldering feud with the Pathological Society.
That ostracism in our profession, practiced among its members, irrespective of merit, deserves the contempt of all high minded and honorable practitioners, and shall meet with scorn from the Society in whomsoever found.
That societies banded together for the purpose of crushing merit, are common enemies of all mankind, and should be treated accordingly.
That we recognize only merit as entitled to our regard, and that we will individually and collectively acknowledge on all opportune occasions and encourage it, wherever found.
That we will fraternize with all other societies of this and other cities in mutual efforts to elevate the Medical Profession, and wage war against all whose known course and practice is unconditional ostracism.
That the members of the so called "Pathological Society" of San Francisco have heretofore pursued a course which, to say the least, is one of doubtful rectitude and requires careful watching by this Association. (This resolution was originally approved unanimously but later disavowed by the Association; and its original handwritten version in the Minutes was crossed out and initialed by the President and two other members.)
That a copy of these Resolutions be sent to any other society or societies of this city whose sympathies are with ours, whose objects are improvement and advancement in Medicine and Surgery, in any honorable way.
That instead of being jealous of, or unfriendly to other societies, whose members are high toned and honorable, we should only regard them in a more favorable light for having pursuits and aspirations congenial to our own.
That the members of other societies, who recognize our feeble efforts in the cause of our profession, and act accordingly, place us under obligations to them, which we are not under to members of the profession generally.
That we consider there is room for all honorable Medical Men, and that we recognize no illiberal selfish policy which does not tend to elevate the Medical Profession generally.
That in elevating the profession by promoting unanimity of feelings, and concurrence of action among its members, we pursue the best course to enhance our own individual and collective interests.
It would be surprising if the above "manifesto" did not provoke a punitive response from members of the Pathological Society. Indeed, we can now regard Dr. H.M. Gray's criticism of Cooper's operation on patient Travers as the opening gun in a campaign by Gray and his associates in the Pathological Society to censure Cooper.
Association Proceedings: The First Year
The Association's first year began on 4 August 1855. It concluded with an Annual Meeting on 7 July 1856 devoted to receiving an Annual Report and electing officers for the coming year. The Association was fortunate during its first year to attract an able and active membership. At the first organizational meeting on 4 August, eight physicians were present. At the third organizational meeting on 17 August, when the Constitution was adopted and officers elected, the same eight physicians were present and probably two additional (Drs. Gilbert and Gordon) for a total of ten in attendance. These can be considered the founding fathers of the Association.
The signatures of the thirty-two members of the Association (including the founders) are appended to the Constitution. Twenty-six members signed before July 1856 and six signed after that date. We can thus say that the membership of the Association increased three-fold (from the original ten to thirty-two). Forty-six weekly meetings were held during the first year. The greatest number of members present at any meeting was twenty, the lowest seven, the average twelve - not a bad record for a community where the vitality of medical societies was low and the mortality high. For a history of the organization more detailed than that available for any other local medical society in that era, we are indebted to the Secretaries of the Association who were careful to preserve the founding documents and the minutes of all meetings up to 18 January 1858. After that date, although the Association continued to meet, the minutes have been lost.
It was Cooper who energized the Association. His special contribution was in rallying the members to participate in the scientific program as the primary objective of the Association. Meetings were devoted to medical rather than social or political issues. He emphasized the presentation of cases and formal reviews of preassigned topics. He himself took active part in discussions, made many reports, and conducted a series of weekly lectures on the anatomy of the arterial system. It can also be assumed from indirect evidence that members frequented his dissecting rooms to profit from his anatomical classes and surgical cases. Uplifted by the high sentiments expressed in Cooper's first series of Resolutions, the enthusiasm for self-improvement among the early members reached such a pitch that the Minutes for 7 September 1855 recorded the following:
It was proposed by Dr. Macauley, seconded by Dr. Atkinson, that a fine of two dollars and a half be inflicted on any members who should not attend the dissecting rooms at least once a week. The motion was put to the vote, and not carried, the majority being against it.
The young Association made a serious attempt to achieve high standards and arranged to have its scientific Proceedings for October and November 1855 (unsophisticated as they were) published in the San Francisco Medical Journal, volume 1, number 1 for January1856 (the only issue of the journal ever published). The medical cases described in the Proceedings ranged from remarkable to ridiculous. Here are a few examples to illustrate the level of the discourse. 
Dr. Angle reported that a small company of men were on a cattle drive from Los Angeles to San Francisco in 1854. It was customary to set a watch during the night to ward off predators, human and otherwise. During the night one of the men got up unbeknownst to the watch who, hearing a rustling in the brush, fired a single shot into the dark. When he went to investigate he found his friend shot through the head. The ball entered the left mastoid bone, crossed the base of the skull, and exited through the right eye. The patient was evacuated sixty miles cross-country on horseback and up the coast by steamer from San Luis Obispo to San Francisco. In spite of that harrowing experience, the patient survived and his wounds healed completely in three weeks. As for residual complaints, he was deaf in the left ear and blind in the right eye. According to the Proceedings, the peculiar interest attached to this case was not so much the rapid convalescence of the patient, as that a ball should enter at the base of the skull on one side and pass out through the eye on the other without causing immediate death. Stories like this reinforced the legend of fortitude and hardiness in the American frontiersman.
Dr. Cooper read a communication, translated by him from the French, giving the history of a case wherein a speedy cure of Sciatic Neuralgia was effected by cauterizing the ear. Henry Gibbons, who had joined the Association in October, countered with the story of a bed-ridden patient with Rheumatism. When a showman's monkey came down the chimney covered with soot, the patient was so much alarmed that he hastily arose and walked down the stairs as a well man. Not to be outdone, Dr. Angle related the case of a female with Catalepsy who could only be aroused to consciousness by the melody of a violin, while the harsh tones caused by drawing the bow across the strings without any regard to tune, produced no sensible effect. In further reference to the effect of a stringed instrument, Angle claimed to have repeatedly found in his own personal experience that the notes produced by the violoncello would excite hoarseness. The gist of this small symposium was that the mind has a powerful influence over physical conditions.
According to the Minutes for the meeting of 14 December 1855 Cooper read a paper by Professor Fleming of Queen's College who asserted that pressure on the carotids so as to arrest circulation to the brain would cause anesthesia. There was a lively discussion of the mechanism, safety and practical value of the procedure. Eager to sustain the fervor of his colleagues, and committed to the Hunterian policy of taking surgical problems to the laboratory for study, Cooper invited Drs. Enscore, Hubbard, Angle, Kirkpatrick, Macauley, Austin, Gordon and Wierzbicki to observe the following simple experiment in his animal laboratory. Not caring to risk brain damage by compressing the carotids in man, he ligated both carotids in a dog and all present observed that the procedure caused only the slightest immediate stupor lasting little more than an hour. The experiment demonstrated to the entire satisfaction of the eight physicians who witnessed it that interruption of carotid circulation is not a satisfactory method of producing anesthesia, at least not in the dog. What possible significance can be attributed to this humble and inconclusive laboratory demonstration? Its import lies in its having occurred at all, and in its precedence as a forerunner of laboratory investigation in the farthest outpost of the nation.