Hospitals were not the only medical institutions to develop in San Francisco at mid-century. In 1858 California surgeon Elias Samuel Cooper organized the Medical Department of the University of the Pacific with a board of trustees consisting of ten clergymen and three doctors. The first session opened in May 1859 with a class of ten attending lectures in materia medica, chemistry, physiology, anatomy and medical jurisprudence. Dr. Cooper's death in 1862 brought confusion to the new school and in 1864 the Pacific Medical faculty "suspended" activities and joined Dr. Hugh Toland in his efforts to found a viable medical school in San Francisco.

As San Francisco's population continued to grow, Hugh Toland's influence

Hugh Huger Toland (b. 1806, d. 1880)

and wealth also increased. His surgical results were extraordinary for the time and by 1860 he was making an estimated $40,000 per year. In 1864, he decided to establish a medical school in San Francisco and purchased land for that purpose in North Beach, at Stockton and Steiner, opposite the San Francisco City and County Hospital. A handsome building was soon completed, and Toland Medical College opened in 1864, the year that its only predecessor, the Cooper Medical College of the University of Pacific, closed its doors. Clinical instruction and dissecting experience were the centerpieces of Toland's educational program, reflecting his training and experience in Parisian hospitals where clinical findings were carefully correlated with autopsy findings.

In his inaugural speech, Dr. Toland offered the hope that the school would "spring into usefulness and become an ornament to the city and an honor to the state."

From 1864 to 1872 Toland Medical College benefited from close proximity to the City-County Hospital (adjacent at right).

The school catalogue reflected Toland's insistence on the importance of clinical instruction. Lectures were given at San Francisco County General Hospital where a "senior student examines the patient; announces the diagnosis and prognosis and views about treatment before class, discussion follows, complete clinical histories are kept and there are broad opportunities for autopsies." Just a month after classes began, the state of California approved a dissection law permitting pauper bodies to be studied by accredited physicians, thus opening the way for Toland students to gain experience doing dissection.

Toland's first class consisted of eight students, mostly drawn from the Cooper Medical College. The faculty of this lapsed medical college were asked to serve on the Toland roster ,and Drs. Levi Cooper Lane, Henry Gibbon, Sr., and John F. Morse joined the faculty with some ambivalence. R. Beverly Cole, the Dean and professor of obstetrics and diseases of women and children, was not asked by Toland to join his new faculty. The Toland Medical College quickly prospered; its faculty of eight offered two four-month courses costing $130 and leading to the degree of doctor of medicine. In the valedictory address to the first graduating class of Toland Medical College in 1865, Toland urged his graduates to devote a portion of every day to the study of monographs and medical journals to remain professionally competitive. While boasting that he had built and furnished the school with his own resources, Toland also made a direct pitch to the new alumni to help their alma mater by furnishing the walls with needed standard medical books. "When success crowns your efforts," he urged, "contribute in proportion to your ability and prepare a niche in this institution which will bear your names and transmit them to posterity."

R. Beverly Cole (b. 1829, d. 1902) in uniform of California State Surgeon General

R. Beverly Cole returned from a tour of Europe in 1867 and was appointed Surgeon General of the State of California in recognition of his valuable public health efforts. As a member of the Outside Lands Committee of the San Francisco Board of Supervisors, Cole became a well-known figure in the city's political arena. He supported the establishment of Golden Gate Park on the western edge of the city. Cole simultaneously persuaded the local health board to condemn the old City and County Hospital building, and a new institution was planned at Potrero Nuevo, a site nearly four miles southeast of Toland's College. The impression among San Francisco's medical fraternity was that Cole had finally achieved his revenge for Toland's past rebuffs by weakening the College's vital link to the world of clinical medicine.