Sir James Y Simpson
By Eve Blantyre Simpson 1896
Famous Scots Series
published by Oliphant, Anderson and Ferrier, Edinburgh and London
Preface
James Y. Simpson was not merely the best of fathers, but the best of men.
Chapter 1
My father, the seventh son, was born on the 7th of June 1811, at Bathgate, Linlithgowshire. His father, David Simpson, was the village baker. His forebears were of labouring farmer stock. James’s grandfather, Alexander Simpson of Slackend, near Torphichen, along with his farming, practised farriery. James’s father, settled as a distiller at Glenmavis, close to Bathgate. For a time he prospered there in partnership with his brother Thomas. But the distillery failed because of the new excise law; the failure of the laird of Balbardie to allow the premises to be enlarged; the Peninsular War; and the consequent dearness of corn. David Simpson next tried brewing, but that did not pay, so he turned his attention to the manufacture of sugar of lead. He lost heavily in this venture so set up as a baker in Main Street, Bathgate. The Bathgate of these days was very different from what it is now. The click of the weaver’s shuttle echoed through its quaint, steep streets. Main Street, up which the coaches used to pass on their journeys between Edinburgh and Glasgow, is falling into disrepair.
In 1792, while living at Glenmavis, David married Mary Jervay, daughter of his neighbour the farmer of Balbardie Mains. On her father’s side, Mary Jervay was of direct Huguenot extraction. Some Gervaises left Guienne and fled for religious liberty to Holland, from whence they sailed to Grangemouth, and settled at Torwood for a while, till they removed to Boghall, close to Bathgate.
James’s first school was kept by a man called Henderson. Mr Henderson had a wooden leg so was known as Timmerleg. James was called the wise wean. At Balbardie House, where James delivered morning rolls, he was known as the bonnie callant.
The Bathgate of his day was a weaving, not, as now, a mining village. The weavers were, more than ordinarily is the case, an intelligent class. When James was nine, his mother died. Her only daughter, Mary, became James’s second mother. The eldest brother, Alexander, also took a special pride in looking after James.
At this time, many believed in the works of witches, warlocks and bogles. It is recorded that when Alexander Simpson failed to heal his four-legged patients, he concluded that the witches were interfering with his work. A murrain fell upon the cattle around Torphichen and Alexander was unable to save them. He decided therefore that to frustrate the malignant devices of the Evil One a cow must be interred alive. David Simpson, who assisted at this barbarous piece of superstition, told James he was afterwards haunted by the remembrance of the earth heaving after the grave was closed in.
It was to his grand-uncle, George Jervay, that James owed his interest in archaeology. George Jervay kept the Brewery Inn at Bathgate. A street in Bathgate bears his name. George was fond of collecting antique things.
Chapter 2
At the age of fourteen, James was enrolled as a student in the Arts Classes of Edinburgh University. Urged on by Professor Pillans, James won the Stuart Bursary of £10 annually for three years. He lodged in Adam Street in the same rooms as John Reid and Mr MacArthur. John Reid of Bathgate later became professor of anatomy at the University of St Andrews. He was two years older than James Simpson. Mr MacArthur had been a teacher in Bathgate. Like Reid, he was studying medicine. Influenced by Reid and MacArthur, James decided to study medicine. Reid took James to hear lectures by Dr Knox. James’s medical studies began in 1827. In holiday time, James assisted Dr Dawson in Bathgate. When James’s mother had gone into labour in 1811, Dr Dawson had been called out but the baby had been born before he arrived. At the age of seventeen, James attended an old friend as his first patient. This patient, now eighty-four years old, told me of the consultation.
Shortly before James’s final examination, his father became ill. He died in 1830. The oldest son Sandy (Alexander) kept the home together. Sandy married in 1832. James passed his finals and before he was out of his teens became a Member of the Royal College of Surgeons, Edinburgh. His brother David had opened a baker’s business in Stockbridge and James moved in with him in 1831. James became assistant to Dr Gairdner in dispensary work then assistant to Dr Thomson, Professor of Pathology, at £50 a year. Professor Thomson suggested that James should take up obstetrics as his specialism. His brothers, Alexander and John, gave him funds for a foreign tour which he took in the company of Andrew Douglas Maclagan (1812-1900). Maclagan was to become Professor of Medical Jurisprudence at the University of Edinburgh. In 1835, James set up a practice in Teviot Row, Edinburgh. In that year, too, he was elected senior President of the Royal Medical Society. In 1836, James obtained a hospital appointment which added to his experience.
Chapter 3
In 1838, James became lecturer in obstetric medicine in the Extra-Mural School. He moved to 1 Dean Terrace. In 1839, Dr Hamilton resigned the Chair of Midwifery. In pursuit of this Chair, his youth and bachelorhood counted against him. As it happens, his grandfather Alexander of Slackend, had married a Grindlay from Bo’ness. On coming back from his foreign tour, James had called on his cousin Walter Grindlay who was now working in the shipping trade in Liverpool. Here, James met Jessie Grindlay, daughter of Walter, and they were married on Boxing Day, 1839. In February 1840, James became Professor of Midwifery at the University of Edinburgh at the age of twenty-nine. He was a voracious reader. As he said, he never wasted an “orra moment”.
James never forgot his native town and the friends of his youth. James’s first lecture as professor in November, 1840. He insisted on Dr Dawson of Bathgate, whom he looked on as his earliest friend, coming in to hear how the Bathgate bairn would meet his class. In October 1840 his eldest child, Maggie, was born. Unfortunately, she died at the age of four. In 1845, James bought 52 Queen Street. Early in his forties he began to write on archaeology.
His rise to fame was rapid. Many aristocratic women, including the wife of the Duke of Hamilton, the Marchioness of Breadalbane, and the Countess of Lincoln. In 1847, the Duchess of Sutherland wrote telling him that the Queen had appointed him one of Her Majesty’s physicians for Scotland.
Chapter 4
In 1846 there came from America the news of the first trial of ether in surgery, and no one hailed it more heartily than Professor Simpson, who was the first man to use it in his own line of practice. He notes: “The first case of midwifery in which sulphuric ether was adopted as an anaesthetic occurred here under my care on January 19, 1847.” But he sought something better than ether. Mr Waldie, a Linlithgow man, first named perchloride of formyle as worthy of a trial. During the summer and autumn of 1847, my father and his assistants, Dr George Keith and Dr Matthews Duncan, tried various narcotic drugs. Mr Waldie promised to send perchloride of formyle but none came so Duncan & Flockhart supplied it.
Contemporary accounts as to its first trial differ slightly. Dr George Keith and my aunt, Miss Grindlay, are the only survivors. My aunt says the Professor came into the dining-room one afternoon, holding a little bottle in his hand, and saying, ‘This will turn the world upside down.’ He then poured some of it into a tumbler, breathed it, and fell unconscious. Miss Petrie, her niece, was much at Queen Street in these days, and in a journal she kept, mentions that my father ‘tried everything on himself first,’ and once, after swallowing some concoction, was insensible for two hours. In experimenting on himself, he was ever ‘bold even to rashness’ as Sir Lyon Playfair in 1883 asserted of him in the House of Commons. James came to Playfair’s laboratory and wanted to sniff an untried liquid. Playfair insisted that the liquid first be tested on rabbits. The rabbits died.
Seeing he was ever recklessly rash in regard to himself, it is not unlikely that he may have had a private trial of chloroform, and laid it aside again, to start fair with his two assistants. Some other compounds were tried that night, and then chloroform, which was lying in its little phial among some papers, was unearthed, and the result of this, its first trial as an anaesthetic, 4th November 1847, is best described in Professor Simpson’s own words in a letter to Mr Waldie.
‘I am sure you will be delighted to see part of the good results of our hasty conversation. I had the chloroform for several days in the house before trying it, as, after seeing it such a heavy, unvolatile-like liquid, I despaired of it, and went on dreaming about others. The first night we took it, Dr Duncan, Dr Keith, and I all tried it simultaneously, and were all “under the table” in a minute or two.’ Dr George Keith, writing to me in 1891, says: ‘We did not all take the chloroform at the same time. This would have been foolish with a new liquid. I inhaled it a few minutes before the others. On seeing the effects on me, and hearing my approval before I went quite over, they both took a dose, and I believe we were all more or less under the table together, much to the alarm of your mother.’ Simpson’s neighbour, Professor Miller says, ‘On awakening, Dr Simpson’s first perception was mental. “This is far stronger and better than ether,” said he to himself. His second was to note that he was prostrate on the floor, and that among the friends about him there was both confusion and alarm. Of his assistants, Dr Duncan he saw snoring heavily, and Dr Keith kicking violently at the table above him. They made several more trials of it that eventful evening, and were so satisfied with the results that the festivities did not end till 3 a.m.’ The onlookers to this scene were my mother, her sister Miss Grindlay, her niece Miss Petrie and her brother-in-law, Captain Petrie.
The Duchess of Argyll, in a letter written before chloroform was a month old, said, ‘ Dear Dr Simpson, It must make you very happy to have discovered so great a boon.’ Mr Hunter of Duncan and Flockhart had to work hard to supply the demand from 52 Queen Street. Production increased rapidly – in 1895 three-quarters of a million doses were made every week. The first woman put under the influence of this new agent was Miss Petrie, my mother’s niece, she boldly trying it on the evening of its new birth. The first child born under its influence was the daughter of a medical contemporary of Professor Simpson’s, and she was christened Anaesthesia. The initiatory public test of chloroform was held on 15th November 1847 within the Infirmary.
Professor Simpson not only found an anaesthetic safer, more manageable, and more effectual than ether, but he had to fight for its use. A storm of invective rose against the new anodyne, on the ground that it undermined religion. Many of the clergy held that to try to remove the primal curse on women was to fight against divine law. [Genesis 3 verse 16 says ‘Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children…] Professor Simpson gathered statistics to show that chloroform saved life, as it saved the shock to the nerves and system before, as well as during, an operation. In The Times of 1895, Mr Lawson Tait reviewed advances in surgery and said, ‘No human being could undergo, in a conscious state, such operations as I have spoken of: I doubt if any human being could nerve himself to perform them. At the head of the list for whom I claim the true credit, I place the name of Simpson, the greatest genius our profession has produced for centuries.’
When a title came to Simpson late in life, he chose for his crest the rod of Aesculapius, [Greek God of Medicine] and for his motto Victo Dolore [Pain has been defeated]. When the news of his death reached the Gynaecological Society of Boston they held a memorial meeting in honour of their ‘late beloved associate’ who was, they said, ‘one of nature’s noblemen’.
Chapter 5
It was difficult to describe Simpson’s appearance. An old wife in Bathgate spoke of him as a ‘bonnie bairn, wi’ rosy cheek and dimpled mou’.’ His first portrait in oil was done by Sir William Fettes-Douglas. In it, he is represented as a firmly built man with broad shoulders, with a thick thatch of auburn hair. A book, as usual, is in his hand. The hands show a curious combination of strength and delicacy of character. In 1853 a newspaper thus described him: ‘In stature the Professor is somewhat under the middle size. His ambrosial locks, dark and almost imperceptibly shaded with red, fall upon his shoulders. The forehead is broad and projecting. There is much firmness about the mouth and lips. The eye is brilliant…There is a fascination in his air, manners, and conversation, an irresistible moral gravitation which elicits and wins the admiration, love and confidence of all who come within the magic circle of its influence.’ In 1848 a medical man thus graphically pictured him in an Indian paper: ‘Decidedly the most wonderful man of the age in which he lives is Simpson of Edinburgh. Nothing baffles his intellect, nothing escapes his penetrating glance, he sticks at nothing, he bungles nothing.’
Simpson described his day in a letter sent in 1844 to his sister Mary in Australia: ‘I generally rise about eight, sometimes at six, or earlier, when urgent letters, new lectures, and addresses have to be written. We breakfast 8.30. I see any patients that may have come here, or receive messages, and afterwards drive off to see folks at their own houses at 9.30. I lecture at the College from 11 to 12; see hospital patients or others in the Old Town; walk here [He was living in Albany Street when the letter was written.] to lunch at one, drive off immediately again to visit sick folk, and generally get here to dinner, or, what I like better, tea, “tousie west-country tea,” about five. The Maggie and Davie come down for fun and frolic. After an hour’s rest I am generally off again, walking always at night, unless distances are such as to require a hackney, and then home to an egg or other supper about eleven or later. Some book is generally devoured with supper, and a few minutes afterwards I am asleep, but ready to wake and start at the slightest tinkle of the night bell.’ The routine of his life changed little from 1844 except to become busier and fuller.
The capacity to laugh as well as to sympathise was a bond of union between him and his children. When a very small child I had been left at Trinity with a nurse and my father often came there to sleep out of the sound of the door bell. My father loved dogs though my mother did not share his taste for them. His favourite was a black and tan terrier called Puck. Puck visited all Simpson’s patients. He got a Dalmatian, called Glen, to accompany his carriage. Billy succeeded him and an American doctor who visited in 1855 says, ‘ He has a Danish spotted coach-dog which the Professor feeds as he eats his lunch and reads his letters. There was also a parrot called John Gray which called Simpson ‘Sir Chames.’ Simpson always had time to pet his patients’ dogs and one patient has a magpie which once landed on Simpson’s head and said. ‘Well?’ My father’s readiness to enter into the tastes of old folks or young, of duchess or fishwife, endeared him to all and sundry. Charles Spurgeon (1834-92) – the renowned Baptist preacher – called him ‘That dear angel of mercy.’ Simpson also taught his students to be kind and considerate towards their patients. He said, ‘An unsympathetic physician is bereft of one of the most potent agencies of treatment and cure.’ Simpson was the most benevolent of men. ‘Very many of us,’ records one of his professional brethren, ‘have grateful occasion to recollect his devoted and unwearied attention to ourselves and to our families in times of suffering.’
Chapter 6
Simpson was very fond of Edinburgh and he loved to go to Bathgate from time to time. Hans Christian Andersen came to Edinburgh and Simpson was his guide through the town.
In 1851 the war that had been smouldering long against homoeopathy broke out in Edinburgh. Simpson bitterly opposed it. Death in these years had devastated the ranks of the friends of his youth. Dr John Reid, after much suffering had died in 1849. His brother John died in 1841. Another brother followed Mary across the seas, and they never met again. Edward Forbes was elected to the Chair of Natural History in the University of Edinburgh but he died in the year of his appointment (1854).
Honours, meantime, came in thick upon him. In 1853 he became an Associate of the Imperial Academy of Medicine Paris. He received the Order of St. Olaf from the King of Sweden. In 1856 he received from the French Academy of Sciences the Monthyon Prize for ‘most important benefits done to humanity.’
Though pleased at having been made a Baronet on January 1st 1866 he said, ‘I have an elder brother who has been a father to me, who is a hundredfold prouder of the distinction than I am myself, and I confess that one of my principal pleasures in it has consisted in witnessing the deep and quiet joy it has given him.’
Simpson was an acute and careful observer. Noting that the men in some tweed factories were more than ordinarily robust, he learned that they had an immunity from chest complaints and skin diseases, which he believed to be due to their working with oily wool and absorbing so much oil through their skins. He wrote on the subject to a medical paper in 1853, and Mr Robert Chambers drew attention to ‘Oil Anointing’ in his own Journal.
Chapter 7
Simpson was seldom off duty during the whole of the thirty-eight years he was an M.D. Even escape from the sound of the never-silent door bell at No. 52 was a relief, and consequently a house at Trinity was an early realised dream of his. He fixed his abode at Viewbank, a square, small house overlooking the sea and the sunsets, with some secluded space around it. It was a great relaxation to him. Viewbank was but a tiny oasis, a brief few hours’ rest in an endless stretch of work. A run to Bathgate he often mentions in letters as a red-letter day, but his farther afield holidays were murderously few. He did go abroad from time to time but he was not fluent in European languages. However, he could converse freely in Latin.
He often went to Inchcolm in the Firth of Forth. Being an excellent archaeologist, he found that the hermit-saint’s cell attracted him more than the abbey. In 1856, he mentions the ‘beautiful Irish chapel’ he found being used as a pigsty, and the same year he writes, anent his vacation prospects: ‘This year I have not had a single holiday, and scarcely expect one now. I write this from Viewbank, which is very pretty this afternoon.’
Chapter 8
The Professor’s next big venture after chloroform in ‘boons to humanity’ was Acupressure, which he perfected and introduced in1859. It was an invention by which veins were pinned, and thereby the use of ligatures after amputation was rendered unnecessary, with the consequent danger of festering flesh.
[From Journal of Medical Biography 2008, vol 16: A lexicon of 1881 describes acupressure as a method of arresting haemorrhage by means of the pressure of a needle. Needles should be long with a sharp point at one end and a head at the other, and should be rendered unoxidisable. Positioned so that it presses down at right angles upon the tissue at one side of the vessel and then secured by passing it through the tissue on the other side. By compressing the vessel, haemorrhage is stopped and coagulation rapid.
Edinburgh professor of surgery, James Syme (1799 -1870) was violently opposed to its use. He tore up one of Simpson’s pamphlets in front of his students and threw the shredded paper into the sawdust beneath the operating table. He said, ‘There, gentlemen, is what acupressure is worth.’ Acupressure was superseded by sterile catgut ligatures introduced by Joseph Lister (1827 – 1912).]
The amiable gentleness he had inherited from his mother had been a goodly endowment to him. He always had time for a word, or a message, or a smile for people, however insignificant. Even in his callow medical days he jotted down in his letters bits he thought would interest the folks at Bathgate, remarks on dress for Sandy’s wife, or agriculture for his brother.
Chapter 9
Simpson was not demanding when it came to payment for his services. My father loved to give, though he was often chary of receiving. He never took a fee from clergymen or their families. When he heard that Spurgeon’s wife was near to death he hurried to London to treat her. He took no fee. A man of money, but who had been kind to one of his elder sons, sent a cheque for professional advice; but he sent it back, ‘for you have done for mine more than I can repay’; and many a sum which came in letters to him , he told his assistants to return, for he knew the senders could ill spare it. He said, ‘I prefer to have my reward in the gratitude of my patients.’
Professor Simpson joined the Free Church movement in 1843, and was of the body that marched down to Tanfield. His face is among the group painted by Mr D. O. Hill to commemorate that great event. He sat under Dr Guthrie whenever he could get to church. Dr Guthrie and he were firm friends.
In 1862 a domestic affliction heavily smote the Queen Street household. ‘Our Jamie died most calmly and peacefully, just before the church bells began to ring,’ my father wrote to Bathgate. This Jamie was the third son and namesake. [He was fifteen years old.] Writing of Jamie, my father said: ‘My assistant, Dr Berryman, and he were great companions. He taught him latterly turning and carpentering, for, though half blind he worked away wonderfully by touch, making boxes, desks, cages, etc., for his little brothers and sisters.’
It was a sad irony of fate that he who healed so many could not ward pain and death from his own fold. His first born, his sweet-souled little Maggie, at four years died in agony, begging for water which her closed throat would not let her swallow. [Maggie seems to have died from diphtheria.] Another daughter, a ‘Mary’ had but a year’s lease of life. Jamie had from infancy been a sufferer, and the darkness of blindness was closing in on him when he was lulled to rest. His sister Jessie had been a special joy to my father. Her doubtful health had given him much anxiety, but he was hopeful she might outgrow it. His eldest son, David, was devoted to his sister too. David came home from foreign studies in 1865, a well-trained M.D., brilliant, popular, full of health, and anxious to take the brunt of work from his father’s overloaded shoulders. On New Year’s Day of 1866 the Professor was offered a baronetcy, the first physician in Scotland to whom the title had been granted. Soon after, David took ill and died and after a few weeks Jessie also died. [David seems to have died from the effects of acute hepatitis. David was twenty-four, Jessie was seventeen.] So, while the year was still little more than a month old, Sir James had two crushing afflictions to face.
Versifying had been a relaxation of my father’s in his student days, and throughout his career he often broke out into ‘doggerel fun’. Here is an excuse for missing an appointment:
Dr. S., with great regret,
Finds himself so much beset
With sickly, dead and dying,
As almost sets his eyes a-crying;
Hence, ye of 23,
Pray don’t wait for him to tea.
My father tells of when a nightingale came to the Bathgate Hills. Some men went up to listen to it but one Bathgate weaver said contemptuously, ‘It’s naething mair that a yellow yoit gane gyte.’
My father was never active in politics except when politics touched on medical reform [From The Oxford Companion to British History: The Medical Act of 1858 created a central governing body and established a register of practitioners. Attempts to have a single portal of entry to the profession were thwarted, and many unqualified practitioners persisted. Simpson was active in making sure that the Bill was properly cast.] He also canvassed for his friend Sir John Pender of Atlantic Cable fame. [In the General election of 1868 in Linlithgowshire, John Pender stood against Peter McLagan. 985 men of substance cast their votes. McLagan had 600 votes while Pender had 385.] Sir James was a Liberal, but in politics, as in religion, he was open-minded and not given to bigotry. He welcomed the pioneers of the lady doctors, while others looked on them with scorn.
Simpson was friendly with Sir David Brewster. Brewster died in 1868 while Principal of the University of Edinburgh. Simpson had some hopes of becoming Principal but the post went to Alexander Grant. Simpson had enemies within the University who acted against him. But in 1868, also, he received the Freedom of the City of Edinburgh from his friend Lord Provost Dr William Chambers.
Chapter 10
This chapter is headed by a poem by T. McK.:
No sculptured stone need carve his fame
Telling his short impressive story,
From heart to lip springs Simpson’s name,
Whene’er we speak of Scotland’s glory.
Sir James had inherited from his ancestors a good constitution. Except in the case of his mother who died at the age of forty-nine, the Jervays were a long-lived race. On their tombstone in the old kirkyard close to their farm of Boghall, this record of them for a century bears witness they were laid to rest well up in years, and they, along with the Simpsons of Slackend, mostly saw over threescore and ten. But James’s heart was overstrained and he fell victim to angina pectoris. In 1867 he was off his class work the first part of the winter session. Early in 1870 he had some train journeys in which he suffered very badly from cold though his sealskin coat gave him some protection. In February 1870 he took to his room. He was very ill in March and he was nursed by his wife, his son, his assistant , and Jarvis his servant. He died on 6th May 1870. For his body a resting place was offered in Westminster Abbey but his wife preferred that he should be laid to rest in Scottish soil. He was buried in Warriston Cemetery and before the daisies had reared their heads on the turf over him, my mother was laid beside him. Edinburgh accorded to the man who had first entered her gates a footsore boy in his teens, a funeral such as she had never given to another citizen. Business was suspended and on the 13th of May, in the city he had worked in, ‘one street alone was crowded – it led to the tomb.’ In the centre of the ground he acquired at Warriston he placed an obelisk. On it he carved ‘Nevertheless I live,’ and above it a butterfly. So there he rests, with the emblem of immortality soaring above him.
From THE BRITISH MEDICAL JOURNAL May 14,1870.
OBITUARY.
SIR JAMES Y. SIMPSON, BART.
AT the dread summons of death, one of the foremost of our craftsmen
has for ever laid down his tools. Of James Young Simpson, it must now
be written that his warfare is accomplished. What a battle his life had
been! Energetic beyond what most men can conceive of, sanguine of
progress, intense in his sympathy with human life, keen of insight, and
endowed with genius which made him believe all good things possible,
he was one whose fellow, either in the present or past, it is not easy to
find. For forty years he rested not at all, but continued ceaselessly industrious in his endeavours to improve medical science, and through it
to advance the general condition of mankind. It is, we believe, true of
him that he has fallen almost literally sword in hand, and that he was
engaged in his favourite work almost up to the day of his death.
The biographer of Sir James Simpson (and he must have one) will
undertake no ordinary task. He will have to deal with a man who had
marvellously developed himself in many different directions. He will
have to record his hero’s claims to discoveries in the most various departments of medical science; he will have to estimate him as an obstetrician, pathologist, and operative surgeon, as an archaeologist and historian; whilst he will also have to sympathise with an enthusiasm which developed even in connection with such avocations a social reformer and religious revivalist. Nor was it that Simpson was changeable; on the contrary, he was everything at once. When he assumed the vocation of preacher, he never for a day forgot that of physician; and although each succeeding decade of his life found him engaged in some new and special work, he had laid none of his old ones aside. The study of the
mediaeval records of disease, the cultivation of the new science of anaesthetics, the attempt to find out safer methods of arresting haemorrhage,
and the endeavour to reduce the mortality of hospitals, were subjects
which each in succession claimed from him such zealous work that they
might have easily been supposed likely to shut out all else. So far was
this, however, from being the case, that he drove the whole team at
once, and could say of them all that they were additional to daily pursuits of the most pressing and multiplied character.
Of his youth we as yet know but little, beyond the fact that for a
short time he carried a baker’s basket, and worked in his father’s shop.
He would appear to have been very early of studious habits, for one of
his friends relates that the urchins of the neighbourhood used to amuse
themselves by disturbing “the baker’s lad at his Latin.” When he was
removed from the shop to the University, his character was soon recognised, not only by his fellow-students but by the teachers, amongst
whom the name of Professor Pillans must, we are told, be mentioned as
that of his first patron. At an early age he was elected President of the
Royal Medical Society. A contemporary describes him at this time as
possessing a “a pale, large, rather flattish face, massive brent brows,
from under which shone eyes now piercing as it were your inmost soul,
now melting into almost feminine tenderness, a coarsish nose with dilated
nostrils, and a finely chiselled mouth.” He speaks, also, of his “peculiar rounded soft body and limbs, as if he had retained the infantile form of adolescence.”
We must now refer in somewhat more detail to a few of the principal
of the works in which he engaged; and shall take first that which concerned Anaesthetics. In respect to the discovery of chloroform Sir James has, as is well
known, received from the public a far higher award than he claimed.
The word chloroform has come to be considered synonymous with anaesthetics ; and the discoverer of chloroform has been too often spoken of
as if he were the discoverer of anaesthetics. The real honour of the
application of anaesthetics (suggested by Davy and others) belongs, of
course, to America, and not to England, and to the dental branch of
our profession.
The January number of the Medical Review for I847 had a remarkable
postscript with the then well-known initials J. F. It was headed ” On a
New Means of Rendering Surgical Operations Painless,” and consisted
chiefly of private letters to the editor, from Boston surgeons, relative to
the use of ether. One of these letters, signed John Ware, and dated
Boston, November 26th, 1846, says of it. ” It was brought into use
by a dentist. He has taken out a patent for the discovery, and has
despatched persons to Europe to secure one there also; so you will soon
hear of it.” Another, signed by John C. Warren, mentions its use in
six surgical operations. In the Boston Medical and Surgical Journal of
about the same date was an important paper by Dr. Bigelow on cases
in which ether had been used.
The next number of Dr. Forbes’s Review, April 1847, had, of course,
a long article devoted to the new discovery, which began with the following words.-” One of the most remarkable events in the history of
medicine, regarded as a practical art, is certainly that which has excited
so much attention in Europe and America during the last four months,
-THE EMPLOYMENT OF THE VAPOUR OF ETHER AS A MEANS OF ABOLISHING PAIN in the practice of Surgery, Midwifery, and Medicine.”
The capitals in this quotation are those of the reviewer, and shew clearly
the importance which he attached to the discovery and its precise nature.
As regards the extent to which the American practice had come into use,
the following extract from the same article is good evidence. ” It is
assuredly true that, by means of the new process, not a little of that
dreadful suffering heretofore inseparable from the performance of most
surgical operations, has been abolished in the practice of the most eminent surgeons in Europe and America during the three or four months
just elapsed.”
Simpson began the use of ether inhalation as soon as knowledge of it reached him; and before the early part of 1847 he published a pamphlet on its employment in midwifery. Respecting this, his first published contribution of our knowledge of anaesthetics, we will again quote from the review already mentioned. ” And doubtless, our good friend Professor Simpson, who must be held responsible for the present sacrilegious attempt to do away with the primal curse on womankind, like a legitimate and faithful son of Apollo and Lucina as he is, was well aware of this before he set about preaching the crusade of obstetrical etherisation to his brethren. And, verily, the craft is here in no danger; even if the Professor’s most sanguine anticipations should be realised, which we are told go to this extent – that fifty years hence ether will be so universal in midwifery that pain will be the exception not the rule, and that the mothers of future men will bring forth, not in the travail and the woe
of the mortal couch, but in Elysian dreams on beds of asphodel! Be
this as it may, it is certainly a matter of surpassing interest – need we
not say, of delightful wonder – to know that already, by means of etherisation, many women have been delivered from all the pains and perils
of childbed, in the hands of Professor Simpson and his followers. In
a communication which we have received from Edinburgh, dated
March 22nd, Dr. Simpson states that he had, up to that date, used
etherisation some forty or fifty times with the most perfect safety
and success.” Thus it will be seen that he was a thorough convert
to the practice of anaesthesia before he knew of chloroform and had
written in loud praise of ether. He was, however, not the man to rest
content with merely copying the practice of others, and he at once
set to work with experiments on other agents. Chloroform had been
discovered by Dumas in I834. In the beginning of I847 Flourens experimented with it on animals. It was tried in the human subject by
Simpson in the latter part of 1847. A paper on it was read by him to
the Edinburgh Medico-Chirurgical Society, November 10th. Its trial
had been suggested to him by Dr. Waldie of Liverpool. Many others
were working on the subject of anaesthetics ; and chloric ether had indeed, we believe, been used in London before chloroform in Edinburgh.
The new anaesthetic very rapidly superseded ether, even in the land
of its discovery, and it is an ominous fact that so early as February,
I848, we find that a death from chloroform occurred at Cincinnati. One
or more deaths had already happened in England. The superior convenience of chloroform, however, was such as to secure its position; and
although deaths have never for any long period since its introduction
ceased to occur occasionally, it has, with the exception of certain parts
of the United States, kept its ground. It has been used enormously,
and with a mortality which, in proportion to extent of use, may almost
be considered trivial. The position of Sir James Simpson in reference
to anaesthetics may be easily stated. He had, of course, no claim what
ever to their introduction, nor is it probable that their general acceptance would have waited for his advocacy of their claims. Indeed, as
we have seen, ether had come into very wide use before chloroform was
proposed. Sir James, however, was one of the most diligent workers
in the subject. He hailed the boon with an appreciation which surpassed
that of most. He undertook numberless experiments in the hope of
augmenting its usefulness; some of these were dangerous, and demanded
not only zeal but courage. In the midst of these inquiries, he hit upon
the agent which the verdict of twenty years (still probably not an irrevocable one) has pronounced to be most convenient in practice. He
may also claim the chief share of whatever credit belongs to the recommendation of the general employment of anaesthetics in midwifery practice. He was perhaps one of the first to dare to keep patients for long
periods under their influence. The profession generally has not accepted
to the full his advice in reference to chloroform in obstetrics, but there
can be no doubt that in this department his writings did great good both
directly and indirectly.
We ought next to chronicle his work in respect to the improvement
of Obstetrics; but this subject is really too large. He wrote almost
numberless papers, and brought forward many novelties. To our know
ledge of foetal malformations and of intrauterine diseases he added
largely. He introduced the employment of chloroform for purposes of
abdominal diagnosis; he invented uterine sounds and pessaries; he investigated with the utmost care the new questions relating to ovariotomy,
the closure of vesico-vaginal fistulae, the removal of uterine fibroids, etc.,
etc. There is an impression abroad that, in the field of capital operations of the kind alluded to, his own practice was not remarkably successful; and we believe that it is certain that in later life he operated
propria manu (with his own hand) less frequently. His cases probably suffered somewhat from hospitalism. We believe that he never hesitated to recommend special cases to those of his friends whom he thought specially skilled; and in illustration of this may mention a note we once saw from his hand, which ran as follows.
“ My dear — ,— Be good enough to cure the bearer, and oblige,
” Yours truly, J. Y. SIMPSON.”
The bearer had a large vesico-vaginal fistula; and, twenty years ago,
when this happened, surgeons were less confident in their powers as regards that malady.
We come next to his great work in reference to Acupressure ; of this,
he was himself sanguine that it would be the discovery on which chiefly
his fame would rest. He hoped wholly to supersede the ligature, and
to secure, as a rule, the primary union of wounds. The results reported
by some operators were such as certainly to give great encouragement
to the belief that he had really attained this result. We may be permitted to doubt it, without in the least derogating from the noble zeal
which devoted years of patient and ingenious toil to this task; a task, be
it remembered, quite outside the range of his own practice. His error; if he made one, was chiefly that he exaggerated the ill influence of
the ligature, and had not a correct notion as to the real causes of
pyaemia and the like – causes probably but little connected with the
arteries. His discovery is still on its trial, and it does not want for
those who are enthusiastic in its praise. The first employment of acupressure was made, we believe, at his suggestion, by Dr. Greig, of Dundee, in i86o.
The last and, perhaps, all things considered, really the greatest work
in which Sir James engaged, was his attempt to diminish the mortality
of Surgical Hospitals. In I847 we find him making a note of the following startling fact. ” Out of eighteen cases of primary amputation
performed during four years in the Edinburgh Hospital, and mentioned
in Dr. Peacock’s Report of the Institution (1843), this man and another
patient were the only two out of the eighteen that survived.” His mind
was evidently at this date much occupied with what subsequently took
the name of ” hospitalism”; and, in I848, we find him advocating the
abandonment of the present system of hospital construction in large
blocks, and the erection of villages of small cottages, which could easily
be pulled down and which would give facilities for the isolation of
cases. Having sounded these notes of warning to surgeons that it was
time to set their houses in order, he did not, however, undertake his
crusade until more than ten years later. Meanwhile, he was busy with
acupressure, and sanguine, perhaps, that it was a main means of improvement. A few years before his death he entered with characteristic
energy into the investigation of hospitalism. Before the days of Howard
there were many who knew of the terrible wretchedness of prisons, and
there were many who regretted it. To Howard, however, it was not
only a thing to be bewailed, it was a thing not to be borne; and this
was his merit, that he could not endure that it should longer exist. So
it was with Simpson and his compeers. Many surgeons had done much
to mitigate the evils of hospital wards; but many more submitted to them
as half inevitable, many do still so submit. To our hero it seemed a
thing intolerable that of eighteen amputations but two patients should
get well. He had brooded over it until he could bear it no longer, and
with fierce energy he commenced the war. The weapons which he used
were by no means without flaw. Some of his statistics were of no real
value; and he was too impetuous to avoid all the fallacies which lay
around. The writer of these pages did his best to expose some of
those fallacies, and to show the worthlessness of some of the statistics.
That they were, however, in the main right, that they pointed to a
great truth, he has no doubt. All hospitals are not alike; but that there
were, and that there are, institutions in which ” Hospitalism” prevails
to a frightful extent, no one can doubt. It was an unshaken conviction
.
as to his main truth and as to its immense importance which induced
Sir James to resort with a too unguarded zeal to means which he thought
likely to produce the desired result. He could not bear the attempt to explain away details, when, as he believed, all knew that the
great accusation was correct. He welcomed all facts which seemed to
support his view, the bigger the better, and hurled them at the heads
of his antagonists. Nor was it much to be wondered at, even if it be
regretted, that he thought the question not one for doctors only,
but deemed that he should sooner gain his end by bringing it before
a public tribunal. The result of his labours in this cause is yet to come,
but we may foretell with confidence that it will be very large. lt is impossible, we trust, that hospital surgeons can ever again rest content
with such statistics as have satisfied them in the past. Better facts for
comparison will be obtained, and they will be compared with more care.
They will show that Sir James was fundamentally correct, and then will
follow the resolute determination to secure a remedy. Whether that
remedy will be the use of carbolic acid, the erection of village hospitals,
or the use of isolation wards, or all in combination, we will not prophesy; but that in all future time those who submit to capital operations in our large hospitals will owe a debt of gratitude to Sir James Simpson for a great increase in the chance of recovery, we cannot doubt.
Sir James Simpson was short in stature, square built, and of large
features. His nose and mouth were both large, his lips expressive, and
his smile was peculiarly winning. He possessed the power of fascinating
in an unusual degree, and was a great favourite with women and children. His head was well formed and large: possibly he had an ounce
or two more brain than any other man in the profession. His very remarkable physiognomy would have attracted immediate attention from
a stranger ; and his carte in an album of celebrities always elicited the inquiry, “Who is that”? The critic might perhaps complain that it did
not indicate the highest refinement, and that a shade too much of suavity
played about his mouth. Energy and benevolence were, however, ex
pressed in the most undoubted manner. He had a prodigious and very
accurate memory; and as he possessed an unusual facility in extracting
information out of all who had it to give, it may be understood that
his stores of knowledge were by no means the result of drudgery. He
has recorded that he had ” neither heart nor habit” for note-taking,
and that he disliked using his pen; and, in point of fact, we believe
that most of his records of cases were done for him by others.
Many are the anecdotes afloat as to the scrapes he got into by the
forgetful neglect of his patients, and of how easily his beguiling manner usually succeeded in helping him out of them. Always overwhelmed
with work of very various kinds, and being of most unmethodical habits,
it happened not unfrequently that important engagements were wholly
forgotten.
Born in the land of thistles, and nurtured in a city where controversy
and partisanship attain most portentous developments, where elections
are always fierce battles, and their intervals times not so much of peace as of preparation, it is not surprising that Sir James had enemies as
well as friends. He had the repute of being “a good hater.” We shall
attempt no judgment or criticism on local or personal feuds, but shall
merely remark that there is clearly something real in the influence of the
northern air, and remind our readers that it was a Scotch dog of whom
it is mentioned that he was moody and unhappy because ” he could no
get eneugh o’ fechting.” That Sir James was not more to blame than
others we believe highly probable; to prove that he was less so, we are
forced to leave to those who are better acquainted with the facts.
The hospitality of Sir James’s house was widely known. All
strangers were welcome, and “at each meal his table was surrounded
by a strange medley of guests, distinguished foreigners, tourists, and
patients. ” A fellow townsman asserts, that “he literally did the
honours of Edinburgh.”
He enjoyed an enormous practice, and might, had he been so disposed, have accumulated immense wealth. He was, however, careless
to a degree in money matters, both as regards receiving and spending.
His benefactions, both public and private, are stated to have been
liberal; and his energies being literally inexhaustible, he amused himself, we believe, with speculations which did not by any means always
prove successes.
ACCOUNT OF SIR JAMES SIMPSON S LAST ILLNESS: AUTOPSY.
The following details respecting Sir James’s last illness are from those
contributed by a medical friend to a local paper.
” Three years previously to his last illness, a severe attack of rheumatism left him with an enfeebled circulation. He had obeyed an unusual number of summonses to distant parts of the country in the beginning of the year; and indeed for nearly a fortnight before his illness almost his only sleep was in a railway-carriage. He was summoned up to London early in February last to give evidence at the Mordaunt trial.
In consequence of the delay in the transmission of a telegram, he had to make the journey twice. He suffered severely from the intense cold
on the way home, and had to confine himself to bed at once on his
return, being alternately shivering and feverish. On the Monday following, he struggled up to the University and delivered his last lecture,
With difficulty he reached his house, which he was never to leave again
in life. Rheumatic pains, principally affecting the muscles of the chest
and arms, set in, and caused great suffering. They, however, yielded
to treatment at first, but the symptoms returned after a short interval,
complicated with fits of dyspnoea and intermission of the heart’s action.
The attacks of breathlessness soon became less severe; but the action
of the heart still evidenced increasing weakness, as shown by dropsy
of the lower limbs. For a time, diuretics and stimulants gave hopes
of relief and recovery; but the Saturday previous to his death the system ceased to respond to stimulants, and began to flag. On Wednesday, the intelligence began to be clouded, the heart not sending sufficient
blood to the brain. From this time he gradually sank, without exhibiting any sign of consciousness, until he expired at ten minutes to eight P.M. of the 6th May, 1870”
The subjoined notes of the autopsy are from the pen of Dr. John Chiene:
“SECTIO CADAVERIS of the late Sir J. Y. Simpson,, Bart, at 52,
Queen Street, Edinburgh, on Sunday, May 8th, I870, at 2.30 P.M.;
forty-three hours after death. The post mortem examination was made by
Dr. J. Bell Pettigrew and myself, in the presence of Drs. Andrew Wood,
Warburton Begbie, and Moir; and Dr. Munro, Sir James Simpson’s
assistant. The following facts were ascertained. The body was well
nourished. Decomposition was commencing in the neck and upper
part of the chest. The dura mater was adherent to the skull-cap. There
was subarachnoid effusion. After reflecting the scalp, the following
measurements of the skull were taken. Circumference round by occipital protuberance and below frontal eminences, 22½ inches; from ear
to ear 13 inches; from occipital protuberance to point between super
ciliary ridges, I3 inches. The weight of the entire brain (cerebrum
and cerebellum) was 54 ounces; the weight of the cerebellum,
the pons, and medulla oblongata, was 5¼ ounces. The convolutions
of their cerebrum were remarkable for their number, depth, and
intricate foldings. This was noticed more particularly in the anterior lobes and the islands of Reil. The brain-substance was congested, otherwise healthy. There were atheromatous deposits in the
arteries at the base. The pericardium and anterior mediastinum
were loaded with fat. The heart weighed 18½ ounces; it contained
no clot; it was enlarged, flaccid, and pale. Both ventricular
cavities were enlarged. The muscular walls of the right ventricle in
some places were almost entirely replaced by fat. The tricuspid and
pulmonary valves were healthy. There was atheromatous deposit in
the septal segment of the mitral valve. The aortic valve was competent; there was atheromatous deposit in one of the cusps and in the
aorta, which was somewhat enlarged. In the ventricular septum, close
to the apex, there was an aneurismal sac, of the size of a pigeon’s egg,
communicating by a large opening with the cavity of the left ventricle;
it was filled with firm fibrinous coagulum, which projected into the
ventricular cavity through the opening. The lungs, liver, kidneys, and
spleen, were deeply congested, with indications in all of extravasation
of blood (apoplexy).”
From THE BAPTIST QUARTERLY
Spurgeon and Simpson
The article on Spurgeon and Gladstone has prompted a
further note on what is probably a little-known relationship
between the “Prince of Preachers” and another eminent figure of
the Victorian era.
Sir James Young Simpson, Bart. (1811-70), the first Scottish
Medical baronet, was Professor of Midwifery at the University of
Edinburgh and noted as an archaeologist. Although he is popularly
remembered as the discoverer of the anaesthetic effect of chloro-
form, this was not his real service to the science and art of anaesthesia.
More accurately, he owes his position as one of the seven
foundation stones of anaesthesia to his work and energy as a
propagandist and apologist and as an expositor of the principle that
it is right and proper deliberately and scientifically to allay the pain
of surgical operations and the discomfort and distress of women in
childbirth. Not only did he enter the lists against the majority of his
medical colleagues, but he was quite happy to do battle with the
theologians on their own ground and to investigate Hebrew gram-
mar to prove his points from the Book of Genesis! What is not so
well known is the other aspect of this doughty and intrepid Scot:
Simpson was a staunch Evangelical Churchman. He had written on
the physical causes of the Death of Christ. As a child he was deeply impressed and influenced by a good and God-fearing mother and this influence never deserted him. His daughter tells us that he joined the Free Church movement in
Scotland in 1843 and that whenever he could get to church sat
under the ministry of Dr. Thomas Guthrie the Scots divine.
His biographer Dr. Duns’ states that by 1860 he had come, in spite of his
good and philanthropic works, to an intellectual perception of the
true character of works not done as unto God. He enquired much
into Scripture and was profoundly influenced by the illness of a
close friend “Believe on the Lord Jesus Christ and thou shalt be
saved.” “Lord, I believe,” was the response that Simpson made.
1861was “my first happy Christmas, my only happy one,”
for all his speculative doubts had gone and he became the possessor of a new life. Simpson was, of course, absolutely sincere when he said that his greatest discovery was not the anaesthetic value of chloroform but that he had a Saviour. In 1862 his third son, Jamie, a half-blind, delicate lad, died. “We must all speak for Jesus,” the dying ‘boy had said. Simpson, obeying this
injunction, began to speak from religious platforms, and com-
manded attention, but he quickly came to see that his Christian
vocation lay in a rededication of himself to his medical work and to
his patients.
Mr. Spurgeon and Sir James Young Simpson bore no little re-
semblance to each other physically and mentally and it is not sur-
prising that, given the opportunity, an affectionate friendship should
spring up between them. They first met in 1864 at the house of a
mutual Scottish friend, Mr. William Dickson, and here they continued to meet whenever Spurgeon visited Edinburgh. Quite soon Spurgeon was to become acquainted with the medical and surgical skill of Sir James and to know the warmth and sympathy of their friendship.
In 1867 Simpson learnt of the painful illness of Mrs. Spurgeon
and offered immediately, through Mr. Dickson, his professional
services to Spurgeon in London. “But remember, if I go, it is as a
friend and not as a doctor.” Needless to say this offer was grate-
fully accepted. On the 27th September Spurgeon writes to Mr.
Dickson: “l am no small trouble to you, but what can I do? My
dear wife grows worse. I wrote to Sir James about a week ago …
You will do me a service incalculable and never to be forgotten if
you can see our kind friend and get him to appoint a time.” This
was done, for on the 7th October he writes: “My dear friend, let
me live the age of Methuselah, I shall not forget your goodness.
The Lord reward you, I cannot. This is to bear one another’s bur-
dens and to fulfil the law of Christ.” After Simpson had visited
Mrs. Spurgeon he writes from Nightingale Lane, Clapham, at
1.0 a.m. : “My very Dear friend, I am writing far into the night to tell
friends how my dear wife has sped. That dear angel of mercy, Sir
James Simpson, has been very. successful, as usual, and the operation is well over; patient, very patient, and in good spirits! If you
know ten thousand eloquent men in Scotland I would give them
work for the next hundred years, viz. to praise the Lord for sending
to us such a man, so skilful and so noble a Doctor.” His reply when
Spurgeon raised the matter of fees is typical of his large-heartedness
and generosity: “Well, I suppose it should be a thousand guineas;
and when you are Archbishop of Canterbury, I shall expect you to
pay it. Till then, let us consider it settled by 1ove.” The relief and
laughter in Spurgeon’s face at this answer can be imagined!
In his graduation address to the Edinburgh students in 1868
Simpson spoke as if he knew that death was near. ” At that solemn
hour, as we cross the river of Death, may He by whom ‘all things
were made’ lead and protect and sustain you by the might of His
hand-that hand which hung up the sun in the firmament-which
spun the planets and stars in their courses-which created this
bright and beautiful physical world – and which, in human form
was nailed up to the Cross of Calvary ‘to ransom back the Dark and
Desolate moral world, and atone for man’s transgressions. May the
infinitude of the Saviour’s love guard and claim you then, and now,
and always.” By now he was starting to feel the effects of the disease
(angina pectoris and coronary thrombosis) to which he was soon to
fall a victim and March, 1870, finds him bedridden and awaiting
his end. It was a wonderful sick room. “I could not have believed it
possible that any man could have ‘attained to such familiarity with
the thought of Death and eternity,” says Dr. Duns. 12 The hymn,
” Just as I am without one plea” expressed his, thoughts perfectly
at this time. Ann Ross Cousin’s hymn, “Immanuel’s land” became
one of his favourites and was read to him many times. (She was
later to write a poem on his death.) And now it was Spurgeon’s
turn to help his friend. Simpson was an enthusiastic reader of
Spurgeon’s sermons. Let Duns take up the story again. “I mentioned the subject of Spurgeon’s sermon,’ When they had looked
round about, they saw no man any more, save Jesus only; with
themselves.’ As part of it was read to him Simpson was suffering
a great deal, but his face could light up with animation as he said,
‘That’s nice, read it again.’ It seems fitting that the written words
of the great preacher should help and comfort him at such a time.
Spurgeon had more than repaid the debt to his friend. On May 6th,
1870, Simpson died unconscious at his house at 52, Queen
Street, Edinburgh.
Bathgate Old Times 