- Email: [email protected]
Foreword: The Medical Schools of San Francisco
Symposium on Progress in Obstetrics and Gynecology FOREWORD
·The Medical Schools of San Francisco
THE EIGHTEEN-FIFTIES saw the beginning of medical education in San Francisco during colorful but violent times. The discovery of gold had resulted in a mass migration to the shores of the Pacific and by 1856 the city had a population of some 75,000 persons. They were mostly engaged in lawful pursuits, but a minority were sheer adventurers embroiled in constant strife. Many were ex-convicts, thieves, gamblers, pimps and murderers, and far from seeking work C. FREDERIC FLUHMANN, M.D. in the gold mines they remained in the city continuing their nefarious pursuits in which they were invariably abetted by the existing law. ,-A climax was reached when James King of William, a courageous newspaper editor conducting a campaign against the vices of the city, was murdered in cold blood on the afternoon of May fourteenth 1856 as he was crossing the street. Although he did not die until a few days later this crime was the spark which caused the citizens to arise and take action against the unlawful elements. At first mobs assembled and there were cries for a wholesale lynching, but gradually the Vigilance Committee, which had previously made sporadic appearances, was 833
834
Foreword
firmly reorganized and established its headquarters in Fort Gunny Bags, an office building shielded with sandbags. Among the newcomers to the city were many physicians and the inevitable rabble of cheats and quacks. There were some 80 physicians on the staff of the Grand Marshall of the Vigilance Committee, and many had received sound basic training in medical schools, not only of the East and South but in Europe. There was no peace among the members of the profession in those days, however, and it is difficult to picture the intense animosities which existed between Yarious cliques. Several events also precipitated crises which forced physicians to chom:e sides, as for example in the classic debate as to the necessity for inserting a sponge to control the bleeding from the wound inflicted on James King of William, and the controversy over the propriety of the procedures followed during the first successful cesarean section performed in San Francisco. Nevertheless the profession prospered, medical societies were formed, and several members became outstanding not only for their surgical and medical skills but for their ability to assume leadership. Hugh Huger Toland was born in South Carolina and in 1828 graduated at the head of his class from the University of Transylvania, Lexington, Kentucky. He spent two years in postgraduate study in Paris and in 1852 emigrated to California. For a time he ran a quartz mill but under his guidance it proved a failure although when it passed into other hands some six million dollars in gold were extracted from the property. However, he found another gold mine in San Francisco where he opened an office and saw private patients in the morning, and free patients in the afternoon. There are records of 581,000 prescriptions written by him over a period of fifteen years, which were filled by the only pharmacist who could interpret his handwriting. This pharmacy was owned by Toland, the drugs were sold at a fixed charge of five dollars, and it is little wonder that his estate eventually amounted to two million dollars. Even medicine in those days had its robber barons. The first physician to reach James King of William at the time of his assassination was Robert Kennedy Nuttall, and he is worthy of note because of the results of his obstetrical practice over a period of 15 years. Between 1850 and 1865 he attended the birth of 3002 children, and his son, who later became a member of the faculty at Johns Hopkins, relates that during this time the fetal mortality was 2 per cent and the mothers who died during labor or within 15 days thereafter were one-half of 1 per cent. Richard Beverly Cole, a Virginian and also a medical graduate from Kentucky, was a stormy petrel who made himself heard and took an active part in the development of both medical schools. He aroused a
Foreword
835
clamor when he appeared before the State Medical Society expressing the opinion that James King of William had died, not from the gunshot wound, but from the ministrations of his physicians. Cole had been chosen as Surgeon-in-Chief to the Vigilance Committee and in 1858 he again got into serious difficulties and narrowly escaped expulsion from the State Medical Society. While discussing the ravages of salpingitis he asserted that "two in every three females who have reached the age of fifteen" were "the victims of this dissipation and fashionable life." The greatest rival to Toland, howeYer, was Elias Samuel Cooper, who founded "Cooper's Eye, Ear and Orthopaedic Infirmary." He was a graduate of the University of St. Louis and also had visited several European Clinics before coming to San Francisco. He had an unbounded surgical ambition and in 1817 he performed a cesarean section from which both mother and b~_by survived. ALthough he was sued for malpractice for the operation, the jury was unable to reach a verdict. The first medical school of San Francisco was established in 1858 "by a few medical gentlemen earnest in their desire for mutual improvement; anxious to increase their store of knowledge; and like true scientists the world over, ever willing, eyen eag<'r, to impart their knowledge to others." Although Beverly Cole acted as Dean the central figure was Elias Samuel Cooper and in fact the school evolved from his Infirmary. A charter was received from the University of the Pacific, then located in Santa Clara, and it prospered for a time. However, Cooper became ill and died in 1862, and two years later the young institution saw fit to suspend its classes. It was now Toland's opportunity and he announced the formation of a new school with a faculty of nine professors, some of whom had been associated with the earlier institution. The Toland Medical School held the stage for a number of years, but there was a great deal of bickering among the professors, who became divided into two factions, one of them "the Cooper group." The University of California had been established in 18Gtl and Toland sought to become its 1\Iedical Department by affiliation, but this was bitterly opposed by the Cooper contingent. In 1870 four Cooper members, namely Lane, Gibbons, :Morse and Price, resigned, but Cole was appointed Professor of Obstetrics, a position he held for some 30 years. Since Toland wished to continue the :Medical School under his own name the transactions with the University were prolonged for months and competition for students with the reorganized Cooper group was intense. However, in 1875 the properties of the Toland School were deeded over, and it became the Medical Department of the University of California, which it has remained to this day. The Cooper group in 1870 became the Medical Department of the University of the Pacific, but this relationship was severed the following
836
Foreword
year. Instead it became the Medical Department of University City College, although it was also known as the Medical College of the Pacific. The leader of the reorganized group was Cooper's nephew, Levi Cooper Lane, and in 1882 he contributed $100,000 for the construction of a school building. One condition of this gift was that the school should be renamed the Cooper Medical College. This remarkable decorative five-story red brick structure with its cupolas and turrets has survived, although its days are now numbered. Lane in 1890 also constructed an adjacent hospital, the Lane Hospital, which is still in use although in 1958 it was condemned for patient occupation. The Cooper Medical College in 1908 became the Faculty of Medicine of Stanford University. This arrangement persisted for over 50 years but in 1959 Stanford announced the closing of the medical school in San Francisco and its reopening in an elegant modern building and hospital on its campus in Palo Alto. The transference of Stanford's academic activities was successfully accomplished but it was impossible to move the historic decrepit brick buildings, a large proportion of its clinical faculty, and a spirit reminiscent of the Cooper group of the previous century. The staff remaining in San Francisco, although conscious of their past allegiance and affection, nevertheless desired to find a way to continue their teaching and research interests. Support came to them from the citizens of the city who wished the old "Stanford-Lane Hospital" to survive. Stanford was conscious of these hopes and generously turned over the extensive San Francisco facilities for these purposes to the Presbytery of Northern California. The Presbyterian Medical Center is now an active organization, with a schedule of postgraduate lectures, a house staff representing all specialties, outpatient clinics, and an extensive research program. It has become affiliated with the College of Physicians and Surgeons, which in spite of its name is a well-known School of Dentistry and an ambitious plan has evolved for the construction of a new hospital, research building, professional office building, and dental school. The final status of the Presbyterian Medical Center is uncertain, but persistent rumors linking it with the University of the Pacific of Stockton suggest that history may witness a full circle with the descendants of Cooper returning to the allegiance of their professional forefathers. This number of the SURGICAL CLINICS is contributed by a group of obstetricians, gynecologists, radiologists and surgeons of the San Francisco Bay area. Although graduates of many medical schools the majority are or have been associated with the two Northern California medical schools. It has seemed wise not to restrict the topics to any special category but to allow each one to write along some field in which he has a particular interest. As a result it will be seen that the subjects
837
Foreword
vary from anatomical discussions, unusual case reports, new operative procedures, the treatment of cancer of the breast, to results of obstetrical management. Each writer is an expert in his subject and our thanks are due to all of them for their authoritative contributions.
Guest Editor 655 Sutter Street San Francisco 2, California
REFERENCES 1. Emge, L. A.: San Francisco's First Successful Cesarean Section. West. J. Surg. Obst. & Gynec. 46: 101, 1938. 2. Fluhmann, C. F.: The Department of Obstetrics and Gynecology of Stanford University School of Medicine. Am. J. Obst. & Gynec. 51: 285, 1946. 3. Lyman, G. D.: The Sponge. Ann. Med. Hist. 10:460, 1928. 4. Thompson, W. B.: The Story of the Professorship of Obstetrics at the University of California. West J. Surg. Obst. & Gynec. 58: 500 and 571, 1950. 5. Read, J. M.: A History of the California Academy of Medicine, San Francisco California Acad. Med., 1930.
·The Medical Schools of San Francisco
THE EIGHTEEN-FIFTIES saw the beginning of medical education in San Francisco during colorful but violent times. The discovery of gold had resulted in a mass migration to the shores of the Pacific and by 1856 the city had a population of some 75,000 persons. They were mostly engaged in lawful pursuits, but a minority were sheer adventurers embroiled in constant strife. Many were ex-convicts, thieves, gamblers, pimps and murderers, and far from seeking work C. FREDERIC FLUHMANN, M.D. in the gold mines they remained in the city continuing their nefarious pursuits in which they were invariably abetted by the existing law. ,-A climax was reached when James King of William, a courageous newspaper editor conducting a campaign against the vices of the city, was murdered in cold blood on the afternoon of May fourteenth 1856 as he was crossing the street. Although he did not die until a few days later this crime was the spark which caused the citizens to arise and take action against the unlawful elements. At first mobs assembled and there were cries for a wholesale lynching, but gradually the Vigilance Committee, which had previously made sporadic appearances, was 833
834
Foreword
firmly reorganized and established its headquarters in Fort Gunny Bags, an office building shielded with sandbags. Among the newcomers to the city were many physicians and the inevitable rabble of cheats and quacks. There were some 80 physicians on the staff of the Grand Marshall of the Vigilance Committee, and many had received sound basic training in medical schools, not only of the East and South but in Europe. There was no peace among the members of the profession in those days, however, and it is difficult to picture the intense animosities which existed between Yarious cliques. Several events also precipitated crises which forced physicians to chom:e sides, as for example in the classic debate as to the necessity for inserting a sponge to control the bleeding from the wound inflicted on James King of William, and the controversy over the propriety of the procedures followed during the first successful cesarean section performed in San Francisco. Nevertheless the profession prospered, medical societies were formed, and several members became outstanding not only for their surgical and medical skills but for their ability to assume leadership. Hugh Huger Toland was born in South Carolina and in 1828 graduated at the head of his class from the University of Transylvania, Lexington, Kentucky. He spent two years in postgraduate study in Paris and in 1852 emigrated to California. For a time he ran a quartz mill but under his guidance it proved a failure although when it passed into other hands some six million dollars in gold were extracted from the property. However, he found another gold mine in San Francisco where he opened an office and saw private patients in the morning, and free patients in the afternoon. There are records of 581,000 prescriptions written by him over a period of fifteen years, which were filled by the only pharmacist who could interpret his handwriting. This pharmacy was owned by Toland, the drugs were sold at a fixed charge of five dollars, and it is little wonder that his estate eventually amounted to two million dollars. Even medicine in those days had its robber barons. The first physician to reach James King of William at the time of his assassination was Robert Kennedy Nuttall, and he is worthy of note because of the results of his obstetrical practice over a period of 15 years. Between 1850 and 1865 he attended the birth of 3002 children, and his son, who later became a member of the faculty at Johns Hopkins, relates that during this time the fetal mortality was 2 per cent and the mothers who died during labor or within 15 days thereafter were one-half of 1 per cent. Richard Beverly Cole, a Virginian and also a medical graduate from Kentucky, was a stormy petrel who made himself heard and took an active part in the development of both medical schools. He aroused a
Foreword
835
clamor when he appeared before the State Medical Society expressing the opinion that James King of William had died, not from the gunshot wound, but from the ministrations of his physicians. Cole had been chosen as Surgeon-in-Chief to the Vigilance Committee and in 1858 he again got into serious difficulties and narrowly escaped expulsion from the State Medical Society. While discussing the ravages of salpingitis he asserted that "two in every three females who have reached the age of fifteen" were "the victims of this dissipation and fashionable life." The greatest rival to Toland, howeYer, was Elias Samuel Cooper, who founded "Cooper's Eye, Ear and Orthopaedic Infirmary." He was a graduate of the University of St. Louis and also had visited several European Clinics before coming to San Francisco. He had an unbounded surgical ambition and in 1817 he performed a cesarean section from which both mother and b~_by survived. ALthough he was sued for malpractice for the operation, the jury was unable to reach a verdict. The first medical school of San Francisco was established in 1858 "by a few medical gentlemen earnest in their desire for mutual improvement; anxious to increase their store of knowledge; and like true scientists the world over, ever willing, eyen eag<'r, to impart their knowledge to others." Although Beverly Cole acted as Dean the central figure was Elias Samuel Cooper and in fact the school evolved from his Infirmary. A charter was received from the University of the Pacific, then located in Santa Clara, and it prospered for a time. However, Cooper became ill and died in 1862, and two years later the young institution saw fit to suspend its classes. It was now Toland's opportunity and he announced the formation of a new school with a faculty of nine professors, some of whom had been associated with the earlier institution. The Toland Medical School held the stage for a number of years, but there was a great deal of bickering among the professors, who became divided into two factions, one of them "the Cooper group." The University of California had been established in 18Gtl and Toland sought to become its 1\Iedical Department by affiliation, but this was bitterly opposed by the Cooper contingent. In 1870 four Cooper members, namely Lane, Gibbons, :Morse and Price, resigned, but Cole was appointed Professor of Obstetrics, a position he held for some 30 years. Since Toland wished to continue the :Medical School under his own name the transactions with the University were prolonged for months and competition for students with the reorganized Cooper group was intense. However, in 1875 the properties of the Toland School were deeded over, and it became the Medical Department of the University of California, which it has remained to this day. The Cooper group in 1870 became the Medical Department of the University of the Pacific, but this relationship was severed the following
836
Foreword
year. Instead it became the Medical Department of University City College, although it was also known as the Medical College of the Pacific. The leader of the reorganized group was Cooper's nephew, Levi Cooper Lane, and in 1882 he contributed $100,000 for the construction of a school building. One condition of this gift was that the school should be renamed the Cooper Medical College. This remarkable decorative five-story red brick structure with its cupolas and turrets has survived, although its days are now numbered. Lane in 1890 also constructed an adjacent hospital, the Lane Hospital, which is still in use although in 1958 it was condemned for patient occupation. The Cooper Medical College in 1908 became the Faculty of Medicine of Stanford University. This arrangement persisted for over 50 years but in 1959 Stanford announced the closing of the medical school in San Francisco and its reopening in an elegant modern building and hospital on its campus in Palo Alto. The transference of Stanford's academic activities was successfully accomplished but it was impossible to move the historic decrepit brick buildings, a large proportion of its clinical faculty, and a spirit reminiscent of the Cooper group of the previous century. The staff remaining in San Francisco, although conscious of their past allegiance and affection, nevertheless desired to find a way to continue their teaching and research interests. Support came to them from the citizens of the city who wished the old "Stanford-Lane Hospital" to survive. Stanford was conscious of these hopes and generously turned over the extensive San Francisco facilities for these purposes to the Presbytery of Northern California. The Presbyterian Medical Center is now an active organization, with a schedule of postgraduate lectures, a house staff representing all specialties, outpatient clinics, and an extensive research program. It has become affiliated with the College of Physicians and Surgeons, which in spite of its name is a well-known School of Dentistry and an ambitious plan has evolved for the construction of a new hospital, research building, professional office building, and dental school. The final status of the Presbyterian Medical Center is uncertain, but persistent rumors linking it with the University of the Pacific of Stockton suggest that history may witness a full circle with the descendants of Cooper returning to the allegiance of their professional forefathers. This number of the SURGICAL CLINICS is contributed by a group of obstetricians, gynecologists, radiologists and surgeons of the San Francisco Bay area. Although graduates of many medical schools the majority are or have been associated with the two Northern California medical schools. It has seemed wise not to restrict the topics to any special category but to allow each one to write along some field in which he has a particular interest. As a result it will be seen that the subjects
837
Foreword
vary from anatomical discussions, unusual case reports, new operative procedures, the treatment of cancer of the breast, to results of obstetrical management. Each writer is an expert in his subject and our thanks are due to all of them for their authoritative contributions.
Guest Editor 655 Sutter Street San Francisco 2, California
REFERENCES 1. Emge, L. A.: San Francisco's First Successful Cesarean Section. West. J. Surg. Obst. & Gynec. 46: 101, 1938. 2. Fluhmann, C. F.: The Department of Obstetrics and Gynecology of Stanford University School of Medicine. Am. J. Obst. & Gynec. 51: 285, 1946. 3. Lyman, G. D.: The Sponge. Ann. Med. Hist. 10:460, 1928. 4. Thompson, W. B.: The Story of the Professorship of Obstetrics at the University of California. West J. Surg. Obst. & Gynec. 58: 500 and 571, 1950. 5. Read, J. M.: A History of the California Academy of Medicine, San Francisco California Acad. Med., 1930.