689

THE KISSAM FAMILY: ITS IMPORTANCE IN MED ICINE* PAUL CUSHMAN, JR. Department of Internal Medicine St. Luke's Hospital Center New York, N. Y.

T HE Kissams were a large and prominent family in during most of the I8th and I9th centuries. Although especially eminent in commerce and in law, they also played a number of interest- ing roles in the history of American medicine.' This communication will present some of the most noteworthy contributions which the early members of the family made either to the development of medical practice or to the evolution of medical institutions. The family has been traced to John Ockasson who arrived in Cow Neck, Long Island (Now Manhasset-Great Neck), in the late I7th century. Since he spelled his surname in a variety of ways-about I8 different versions are recognized in real estate documents2-it is im- probable that his origins will ever be established. His son, Daniel, succeeded to the family farm and established the "Kissam" spelling of the surname. In eight generations that followed (see accompanying figure) 27 descendants of Daniel either practiced medicine or set out to do so by entering school. Of these, all but three bore the surname Kissam. Twenty-two members of the family actually practiced medicine. The accumulation of such a large number of physicians in one family is unique in American medicine to my knowledge. Further, the tendency of the medical Kissams to concentrate in the New York City area is remarkable. Seventeen Kissams were actively engaged in the practice of medicine at one time or another in the New York City area. Therefore the history of the medical Kissams largely peral- lels the history of medicine in New York City. It is not weight of numbers alone that accounts for the historical interest in the Kissams.

*Presented at a meeting of the Section on Historical Medicine, The New York Academy of Medi- cine, February 26, 1969.

Vol. 45, No. 7, July 1969 6 o P. 96 9P CUHANCUSHMANT, JR.R

Bookplate showing the family crest and coat of arms used by Benjamin Kissam and his family in the late 18th century. Reproduced from The Memorial History of the City of New York, vol. 4, Wilson, J. M., ed., New York, N. Y. Historical Press, 1893, p. 115.

A number of important actions were taken by members of the Kissam family in the evolution of medical institutions in the city. This report will consist primarily of detailed accounts of the medi- cal careers of the individual physicians. However, before the individual members of this remarkable family are discussed, we must consider a special instance in which the association of several members of the family with a medical institution resulted in a much greater impact than that suggested by the contributions of single individuals. The relation of the Kissam family to the College of Physicians and Surgeons or to its predecessors is unique in American medicine. Twenty-three members of the family were as- sociated with the college in a variety of ways during almost every

Bull. N. Y. Acad. Med. THE FAMILY I THE KISSAM FAMILY 69 decade of its first century of existence.* Thirteen were physicians who graduated from I 769-when Samuel Kissam received a bachelor of medicine from King's College Medical School in the first graduating class-to i 867, when William Aymar Kissam was awarded his M.D. from the College of Physicians and Surgeons. From i 8o8 to I 890, eight others entered the college or its predecessors but did not receive a degree. And still two others, nongraduates, were appointed to pro- fessorial positions at Columbia College Medical School just after the Revolutionary War. The first medical person in the family was Samuel Kissam (i 746-?) who, along with two others signed the registry of King's College Medi- cal School (antecedent of Columbia) in its first class in I 767. He received the degree of bachelor of medicine in May 1769 together with Robert Tucker in the first graduating class of that medical school. The ceremony was impressive.5 The academic community gathered in Trinity Church on May 22, 1769, along with civilian and military dignitaries led by Governor Sir Henry Moore, bart. Samuel Bard gave the principal address6 in which he decried the prevailing levels of medical ethics and urged the graduates to raise those standards. He also urged them to keep abreast of new knowledge. Samuel Kissam emigrated to Surinam for reasons that are not now clear. He apparently continued his studies with King's College, for he received the doctor of medicine degree in 177i. He was the second in the colonies to secure this degree; Tucker in I770 was the first. As part of the requirement for this degree, Samuel Kissam published a treatise on the use of a South American plant as a treatment for human worm infestation:7 An Inaugural Essay on the Anthelmintic Quality of Phaseolus Zuratensis Siliqua Hirsuta, or Cow-Itch. In this thesis, the first published material to emerge from the new medical school, Kissam described the results of some interesting pharmacologi- cal experiments. He assumed that the earthworm was similar to some of the worms that infest man. He then applied an extract of the plant directly to the earthworms ". . . when motionless and undisturbed. In every instance, the moment cow-itch touched them, they discovered signs of pain, by immediate and brisk agitation, and slow inevitable

*King's College Medical School had its origin in 1767 - Samuel Kissam was entered in the first class-hut medical education ceased in 1775 with the advent of the Revolutionary War. Restarted as Columbia College in 1784, it was absorbed into the independent College of Physicians and Sur- geons in 1811.4 The latter had begun on paper in 1791 and was vigorously activated in 1807.

Vol. 45, No. 7, July 1969 6 9 2 P. CUSHMAN, JR. death." He reported his clinical experiments with the drug and indi- cated that it was effective and apparently well tolerated. Kissam also tried to localize the irritating effect of the drug on himself. Cow-itch produced no irritation either alone or when com- bined with molasses; when mixed with saliva it regularly caused irritation when applied to the skin of the hand. Kissam concluded that the irritant actions of the drug depended on the mucus of the stomach. This study of clinical and experimental pharmacology in the i8th cen- tury has a modern outlook. Although there were a number of New Yorkers in the Dutch West Indies as a result of the continuation of the strong commercial ties between the various Dutch maritime centers, Samuel nevertheless had a difficult time establishing himself there. He wrote to his friend, , chief justice, about his difficulties:

My Dear Jay 1769 My prospects I confess are not the best nor perhaps the worst in the world. I have already some Business & my Friends are not without Hopes of my getting more, & from their encouragement I have a Tollerable flow of Spirits in general. But yet am not entirely free of Intervals of Dejection. I am Dear John yours Saml Kissam8

Two years later, his practice seemed to have improved considerably, as is reflected in his letter to Jay: Dear Jay Surinam io July 1771 My Prospects, my Dear Jay, grow Dayly more flattering and give me reason to hope that a few years will put a Period to the Necessity of my Continuance in this Place. . . . I feel much the want of conversation of a few who used to constitute part of my happiness. Saml Kissam8

Jay replied to this letter:

Bull. N. Y. Acad. Med. THE KISSAM FAMILY 6 9 3

Dr. Kissam New York August 27, 1771 I am glad to hear that your Prospects daily open more fair and hope your success will shortly be adequate to your Merit.... With respect to (my) Business I am as well circumstanced as I have Right to expect.... God Bless you, my Dr. Sam. J. Jay' The outstanding letter in what must have been quite an extensive correspondence was written in I 775: Dear Jay Surinam, Oct 31, 1775 I was particularly happy my Dear Jay when I saw your name in the list of Delegates for the Continental Congress: not only your abilities would encourage you to the most distinguished honors; but because, as I knew your sentiments were favorable to Liberty and the Public Good, it convinced me that the Spirit of Freedom . . . prevailed among those who conferred on you their Suffrage. The distress'd Situation of America has hereto given me uneasiness but by the almost divine conduct of your Congress, the apprehen- sion of danger Begins to diminish, and I think . . . that Great Britain has pass'd the Meridian of her Glory. And why should not America (like the Phenix) arise to a Great Empire from the ashes of its mother. I have no more to say only that I wish you health and Prosperity. Saml Kissam8 After these fascinating and prophetic words Samuel Kissam dis- appeared. Samuel's older brother, Benjamin, born in 1742, had achieved special distinction in Manhattan as a lawyer whose interest in public affairs resulted in his being appointed to the Safety Committee of ioo and to the First and Second Provincial Congresses. However, his association with John Jay makes him perhaps more interesting today. It began when Jay, who had just finished his formal education in 1767, joined Benjamin Kissam as a legal apprentice until he was admitted to the bar four years later. Jay remained a loyal and devoted friend of the Kissams, as their correspondence shows. Years later, while State, he paid tribute to his legal mentor by saying, "He

Vol. 45, No. 7, July 1969 P. CUSHMAN, JR. 69469 4 CUSHMAN, JR. was the best friend I ever had, and the best man I ever knew." In several bits of correspondence between Benjamin Kissam and Jay that have survived, there are two letters of exceptional interest: Dear Jay 25 April 1766 I have been strongly obliged to take a Jaunt with Mr. Inglis to and have consented to go provided my horse is well, as News of the Repeal of the Stamp Act should not arrive in the mean time. As upon the Repeal of the Stamp Act, we shall doubtly have a Luxuriant Harvest of Law, I would not willingly, after the long famine we have had, miss reaping my part of the crop. Benjamin Kissam8

Not being certain if this letter would be delivered and really urging Jay to send his horse down to Philadelphia as soon as possible, he wrote the next day: Dear Jay 26 April I 766 . . . We were last night strangely deluded with a mistaken account of the Repeal of the Stamp Act and all the Bells have been ringing from the Break of Day-upon Enquiring we find-that the intelligence amounts to no more than the first Bill had passed the House of Commons in the 20th of Feby and was to be sent up to the Lords on the 3rd of March. Benjamin Kissam8

The next generation produced several important medical Kissams. The first was Benjamin Kissam, son of Benjamin Kissam, the already mentioned lawyer (1759-1803; M.D., 1783). His ambition to study medicine took him first to King's College as a fledgling medical student in I775. However, the city found itself plunged into the turmoil of revolution soon after his arrival. The medical faculty dispersed and the school ceased functioning completely. In 1783 Benjamin finished his medical education in Edinburgh, where he distin- guished himself as an outstanding student. He returned to America on the ship Eagle in August 1784, ". . . the voyage occupying 6 weeks, and the two hundred passengers aboard passed resolutions thanking him for his attention to them."9

Bull. N. Y. Acad. Med. ,rHE KISSAM FAMILY 69 5 -~~~~~TEKISMFML 9

I | | *~~~~~~~~PHYSICIANS _71ENTERED MEDICAL NON-GRADUATES SCHOOL, * ASSOCIATED WITH P.OS.

1IE m3L L]

Pedigree of the Kissam family, abbreviated to show members of medical interest. Samuel Kissam is in generation IV; Benjamin and Richard Sharpe Kissam are the two fraternal doctors starred on the left in generation V.

Upon his return to New York City he agreed to take part in the attempt to revive the old King's College Medical School, newly re- named Columbia College, ". . . to be consistent with the civil and religious liberty now in effect." He served both as a professor of the Institutes of Medicine (1784-I792) and as a trustee (1787-1803) Of Columbia. However, the medical school was very slow to become established. In fact, it was struggling. Only 34 students were graduated between I784 and i8o8 and then none until 1793. Many of the prospective students were studying abroad or were being instructed privately by local practitioners in a direct return to the old apprentice system. Benjamin's duties at Columbia would therefore appear to have been largely titular. Actually he became associated, in 1788, with Nicholas Romayne (g1756-817) in the latter's private unnamed medical instructional enterprise,-' which had started in a city-financed apothe- cary shop and later spread out to the public ward patients who were used for teaching in the New York Almshouse and Bridewell (predecessors of Bellevue Hospital). Even while retaining their positions as trustees of Columbia College,

Vol. 45, No. 7, July 1969 66996 P. CUSHMAN,CUHANRJR. both Benjamin Kissam and Dr. Romayne devoted their energies and talents to the development of this private medical school. In January I79i Romayne actually presented a petition to his fellow agents of the University of the State of New York in behalf of their rival school; both Romayne and Benjamin Kissam were regents as a result of being trustees of Columbia. The petition stated that Doctors Romayne, Kissam, and William Moore had been conducting, in effect, a medical school where all important branches of medicine were being taught, and urged that regents recognize, support, and protect this school in preference to Columbia. A second petition was sent to the regents in February I791 specify- ing that the faculty of this medical school' would include the undersigned Sir James Jay (older brother of John Jay), Benjamin Kissam, Romayne, Moore, Richard Kissam, Samuel Mitchill, and Samuel Nicholas. Samuel Bard, John Rodgers, and William Hammer- sley were also to be invited to join. The regents readily agreed and recommended the establishment of a college of physicians and surgeons. On March 24, I791, the New York State Legislature passed an act establishing such a college. Columbia College fought back vigorously; the trustees appointed a committee to reorganize their medical school and they also requested the legislature to suspend action on the forma- tion of a second medical school while they were in the process of carrying out a major reorganization. Romayne and his colleagues would probably have succeeded in establishing a durable permanent medical school (since they had the only locus in the city that could be used for clinical teaching under their control prior to the opening of New York Hospital), had not an epidemic of yellow fever appeared.14 Not only was there panic and dispersal but the question of founding and funding a new medical school had to be deferred. During the next few months' respite, Samuel Bard (074I-i82I) thoroughly revised the teaching program and staff at Columbia by appointing a faculty of eight: Samuel Bard, dean; Richard Bayley, anatomy; Samuel Nicholas, chemistry; John Rogers, midwifery; William Smith, materia medica; Wright Post, surgery; William Hammersley and a Dr. Beach, institutes of medicine; Nicholas Romayne, the practice of physic; and Richard S. Kissam, botany.10 Furthermore, Bard arranged for the institution of clinical teaching

Bull. N. Y. Acad. Med. THE KISSANI FAMILY 6 9 7 at New York Hospital. In view of this evidence of a vigorous reorgan- ization, the regents were persuaded that it was better to support a strong revival of medical teaching at Columbia than to divide the medical teaching in a city of only 30,000 people. The College of Physicians and Surgeons was left unfunded and became dormant.5 Romayne then resigned from Columbia and took about 36 students with him. This must have been particularly embarrassing to the Columbia authorities, since they requested an immediate public declaration of loyalty by the remaining faculty; the affirmation was signed by Bard, Richard Kissam, and others in March 1792.d Why Benjamin Kissamr was not included in the 1792 revision of the Columbia faculty is not clear. His association with Romayne would not appear to have been a factor, since Romayne himself was appointed to the most prestigious chair in the reorganized school. Further, he was not included in Romayne's private teaching activities beyond I792. Little is known about the last decade of Benjamin Kissam's career. He remained in practice in New York City and presumably continued to take care of patients in the New York Almshouse as well. The minutes of the trustees of Columbia College show that Dr. Kissam attended most of their meetings until his death in I803. In these records he was cited only once as one of three trustees appointed in I797 to study a proposal submitted in letter form by David Hosack* that there was a ". . . necessity for a Botanic Garden and a Library for the use of the Students of Botany." The trustees were sympathetic but declined because they were unable to raise the 300 pounds estimated to be required annually for its maintenance. The third physician was Benjamin's brother, Richard Sharpe Kissam (1763-i822; M.D. Edinburgh 1789), an outstanding surgeon. On his return from Europe in I 791 Richard must have been impressed by the air of uncertainty, change, and opportunity that the rapidly expanding city presented. The medical scene was just as unsettled. Many of the Tory practitioners had left. The only recognized medical school was part of Columbia College. Richard Kissam was immediately plunged into the bitter battle that

*Dr. Hosack, then professor of botany, later purchased a large parcel of land from the public in the outskirts of the city which was named the Elgin Gardens, after the Scottish town from which his father had come. This botanical garden was eventually sold to New York State for use in medical education. In 1811 the regents turned it over to an unenthusiastic College of Physicians and Sur- geons to operate. Years later the land was leased to the Rockefeller Center Corporation for develop- ment into that outstanding commercial enterprise anid is nowv Columbia's most important piece of real estate.

Vol. 45, No. 7, July 1969 P. CUSHMAN, JR. 6986 98 CUSHNIAN, JR. waged for many years between Nicholas Romayne and Columbia, particularly Samuel Bard. Dr. Bard, an outstanding physician, num- bered among his patients Washington and other notables. He was a clever diplomat and a visionary who not only had the skill to conceive and engineer the founding of a major medical school but also was able to help establish a hospital (New York Hospital) where the care of the sick could be combined with the teaching of medicine. Romayne was an extraordinary man, brilliant, erudite, rash, impetuous, and "... crooked in many of his acts." He was called the "stormy petrel" of medicine. Twice he rose to great heights of professional acclaim but sank to such depths as imprisonment and flight overseas. In 1791, when only 28 years old, Richard Kissam evidently was persuaded by Dr. Bard to take the professorship of botany at Columbia, as a part of the reorganization designed to counter the challenge of Romayne's flourishing private institution previously mentioned. How- ever, Richard soon switched his allegiance and resigned from Columbia in 1792 to join Romayne, William Moore, and Benjamin Kissam in the rival medical school, which had reached the stage of being called Queens College Medical School.1' Having been rebuffed by the legisla- ture, Romayne had turned to Queens College, located at New Brunswick, N. J., and later known as Rutgers-The State University, for academic recognition. Although the teaching program was to remain in Manhattan, the New Brunswick college would award the degrees. In its brief existence Queens did actually award several degrees; one, an ad eundum* M. D., was given to Richard Kissam in I793. However, Queens College Medical School did not really become established, and in the same year it closed its doors for lack of funds. Richard then wisely stepped out of these shifting institutional sands and onto more solid ground by joining the New York Hospital staff as one of its four original attending surgeons. Although founded in I77i and constructed shortly afterwards, it had not really functioned as a hospital until I79i because of fire, war, and neglect.5 However, with a strong staff of attending doctors, it was successfully opened for the care of the sick and the teaching of clinical medicines

*Ad eundem degree was a loose arrangement by which one institution would give credit for work carried out elsewhere. fIn 1792 New York Hospital appointed Samuel Bard, M. Treat, and Thomas Jones to be attending physicians, and Richard Bayley, James Tillery, Wright Post, and Richard S. Kissam to be attending surgeons.

Bull. N. Y. Acad. Med. THE KISSAM FAMILY 699

Richard Kissam remained loyal to Romayne, however, and accepted a trusteeship in the College of Physicians and Surgeons from 1807 to i8ii along with over i00 of his fellow members of the state medical society.13 Romayne developed the college into a vigorous, independent school which again overshadowed its older rival. In i8 Ii the regents announced a merger between the two rivals which was met with a stormy reception and much dissension.1 Dr. Kissam in a letter to J. W. Francis declined to serve as a trustee of the merged institution, which was to be called the College of Physicians and Surgeons: Sir May 6, I8I2 I have to acknowledge the receipt of your letter of April io informing me of my having been appointed by the Hon. the Regents of the University of this State at a meeting held in Albany on the i6th of March last-a Trustee in the College of Physicians and Surgeons in this City. I cannot but feel myself flattered by this mark of distinction, yet there are certain considerations that influence me to decline the honour of the appointment. With respect and Esteem I am Sir Yours Richd S. Kissam12

Kissam sought the office of health officer of the city and secured testimonials toward this end: New York February i5, 1796. Being informed that Dr. Richd S. Kissam is a candidate for the appointment of Health Officer of this City and Port, the subscribers take liberty to say that in their opinion, Doctr Kissam from his general character, education, and professional abilities is well quali- fied to execute the important duties of that office. Wm Moore John Charleton David Hosack Thomas Jones Samuel Bard Sam Burrowe Wm Hamersley13

Vol. 45, No. 7, July 1969 0 0 P. CUSHMAN, JR. 7700 P. CUSHMAN, JR.

New York I3 Febry 1796 At the request of Dr. Richard Kissam, we the subscribers do Certify that he has been employed as one of the Surgeons at New York Hospital for nearly four years past, during that time, he has paid due attention to the duty of his appointment, excepting the month of October last, when we are informed he fell from a chair which dislocated his ankle and confined him sometime. Theodore Bach, Pres Gerald Watson MD"4 Kissam did not obtain the appointment, which went to Richard Bayley instead. Since the devastating epidemics of yellow fever were to begin the next year, he was spared an enormous public health problem, which claimed the life of Richard Bayley, who had bravely exposed himself on a mosquito-infested ship. During his long association with New York Hospital Richard S. Kissam developed a large and devoted following. Thacher's Medical Biography'5 describes him as a ". . . mind adapted by nature for the practice of the profession, clear, acute and sagacious. He united a firmness of nerve which was equal to any undertaking. Dr. Kissam rose to the heights of celebrity and reputation." Thacher attributed the first puncture of an ovarian cyst in America to him. John W. Francis in Old New York'6 said of him: "Yet I could have wished that some surgical friend had delineated, with more satisfaction than has yet been done, the great career as an operative surgeon of Richard S. Kissam. For 30 years he was one of the surgeons at New York Hospital, a station he was solicited to accept and dis- played in his art resources of practical tact and original genius. ... Society had little attraction for him. He was absorbed in his profession. During the more than 20 years he was the most popular operator the city could boast, and he was often called the man of the people [because] he was very liberal to the poor. He was emulous of surgical glory and he obtained it. . . . He was noted for his lithotomies and speed of operation during the thirty years [he] practiced surgery at New York Hospital. Apparently he only lost three patients out of 65 lithotomies undertaken-a remarkable record indeed." Since Kissim did not publish, we are limited to these testimonials in our appraisal of his importance in either the development of the

Bull. N. Y. Acad. Med. THE KISSAMI FAMILY 7 0 I

surgical arts or in the establishment of surgery in New York Hospital. When it is recalled that New York City had only 24 doctors listed in its registry in 1784 and only I02 in 1798, while the city as a whole ranged from a population of about 30,000 to 5o,ooo, the influence of Benjamin and Richard Sharpe Kissam upon the practice of medicine in the last I5 years of the I8th century must have been important. Further, the fact that at various times they were on both sides in the Romayne-Columbia struggle is an indicator of the unsettled institu- tional activities of the times.

ACKNOWLEDGMENTS I am indebted to the librarians of The New York Academy of Medicine; of the Butler Library, of the Low Memorial Library, and of the library of the College of Physicians and Surgeons, all at Columbia University, for their assistance; and to Miss Gertrude Annan, of the Academy Library for advice and suggestions. The skillful typing of the manuscript was by Miss Catherine McGoey.

R E FE 1 EEN CE S 1. Kissamn, E. The Kissam Family in drews Society of the State of New America from 1644 to 182?5. New 'ork, York, vol. 1. 1756-1806. New York, St. Dempsey and Carroll, 1892. Andrews Society of the State of New 2. Okeson, John, of Hempstead, Long Is- York, 1922, p. 207. land. New York Gen. Biol. Record 91: 10. Columbia College. Minutes of the 2, 1960. Board of Trustees, Low Library, New 3. Colutmbia Aluminni Register. New York, York. Columnbia University Press, 1932. 11. Cowen, D. L. Medical Education: The 4. Gallagher, T. The D)octor's Story. New Queens-Rutgers Experience, 1792-1830. York, Harcourt, Brace, 1967. New Brunswick, Rutgers-The State 5. Stookey, B. A History of Colontial Med- Universitv, 1966. ical Education. Springfield, Ill., Thom- 12. Kissarn, R. S. Letter to J. W. Francis. as, 1962. In special collections, Butler Library, 6. Bard, S. A Discourse oni the I)uties of New York. a Physicani with Some Sentiments on 13. Kissam, Richard S., papers. New York the Usefulness of a Public Hospital. Historical Society. New York, Robertson, 1769. 14. Ms. in Bache collection. Special collec- 7. Kissam, S. The Anthelm-intic Quaility tions, Butler Library, New York. of Pha-seolus Zuratensis Siliqua Hir- 1.5. Thacher, J. American Medical Biog- suta, or "Cow-itch." New York, Inslee, graphy. Boston, Richardson, 1828. 1771. 16. Francis, J. W. Old New York or Rem- 8. John Jay papers. Special Collection, iiiiscences of the Past 60 Years. New Butler Library, New York. York, Widdleton, 1865. 9. Biographical Register of the St. An-

Vol. 45, No. 7, July 1969