689 THE KISSAM FAMILY: ITS IMPORTANCE IN NEW YORK 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 New York City 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 Columbia University 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, John Jay, 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.