Produced by Bryan Ness and the Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive/American Libraries.) Sir James Young Simpson and Chloroform (1811-1870) BY H. LAING GORDON LONDON T. FISHER UNWIN PATERNOSTER SQUARE MDCCCXCVII Copyright by T. Fisher Unwin, 1897, for Great Britain and Longmans Green & Co. for the United States of America MASTERS OF MEDICINE EDITED BY ERNEST HART, D.C.L "HOMINES AD DEOS NULLA IN RE PROPIUS ACCEDUNT QUAM SALUTEM HOMINIBUS DANDO." CICERO. Title. Author. JOHN HUNTER _Stephen Paget_ WILLIAM HARVEY _D'arcy Power_ SIR JAMES SIMPSON _H. Laing Gordon_ EDWARD JENNER _Ernest Hart_ HERMANN VON HELMHOLTZ _John G. McKendrick_ WILLIAM STOKES _Sir William Stokes_ CLAUDE BERNARD _Michael Foster_ SIR BENJAMIN BRODIE _Timothy Holmes_ THOMAS SYDENHAM _J. F. Payne_ VESALIUS _C. Louis Taylor_ [Illustration: J. Simpson] To PROFESSOR ALEXANDER RUSSELL SIMPSON "Him by the hand dear Nature took, Dearest Nature, strong and kind." RALPH WALDO EMERSON. "When Nature has work to be done, she creates a genius to do it." _Id._ PREFACE I have endeavoured to condense the vast amount of matter which has been written concerning this Master of Medicine and his work into the form of a readable narrative, and to represent him in his social and intellectual environment in accordance with the object of this Series. The selections from his own writings illustrate as far as possible his versatility and many-sided character. I have chosen for quotation out of the numerous sketches and memoirs of him those written from undoubted knowledge of the man. I am indebted especially to Professor A. R. Simpson for kind advice, to Mr. Cuthbertson of the Edinburgh University Library for useful help, to Mr. C. Louis Taylor for valuable criticism, and to my wife for assistance in research and compilation. I have also to thank those friends who from time to time have favoured me with personal reminiscences of Sir James. The following are the chief works, in addition to Simpson's own writings, from which my information has been drawn:--(1) "The Jubilee of Anæsthetic Midwifery"; (2) "Keiller and Credé"; (3) "History of the Chair of Midwifery in the University of Edinburgh," being addresses by Professor A. R. Simpson; (4) Miss Eve B. Simpson's "Sir James Simpson"; and her (5) "Dogs of other Days;" (6) "Twenty Years and their Lesson; a Retrospect and Review" (_Scots Observer_, 1891); (7) Dr. Duns's "Memoir of Sir J. Y. Simpson"; (8) Professor Gusserow's "Zur Erinnerung an Sir J. Y. Simpson"; (9) Mr. Cuthbertson's "Student's Pilgrimage"; (10) "The Story of Edinburgh University," by Sir A. Grant; (11) "The Life of Sir Robert Christison"; (12) "The Life of Robert Knox"; and numerous back numbers of the _Century Magazine_, the _Lancet_, the _British Medical Journal_, the _Medical Times and Gazette_, the _Edinburgh Medical Journal_, &c., &c. FOREST HILL, _October, 1897_. CONTENTS CHAP. PAGE. I. Birth and Childhood. (1811-1825) 1 II. Student Days. (1825-1830) 17 III Further Studies. (1830-1835) 36 IV. Early Practice and Professorship. (1835-1840) 52 V. Professor and Physician. (1840-1847) 66 VI. The Discovery of Anæsthetics. (1844-1847) 88 VII. The Fight for Anæsthesia. 1847 onwards 111 VIII. Home Life--Controversies 133 IX. Archæology--Practice 152 X. Personal--Professorial--Professional 164 XI. Further Reforms--Honours 186 XII. Failing Health--Death 202 Appendix 223 Index 227 SIR JAMES SIMPSON CHAPTER I BIRTH AND CHILDHOOD. 1811-1825 The state of the healing art at Simpson's birth--Birthplace--Family superstitions--His father's bakery--His mother's Huguenot descent--Commencement of schooldays--Natural and antiquarian features of Bathgate district--The village hand-loom weavers as antiquarians and naturalists--His interest in Nature and craving for knowledge--Brothers' and sister's care for him--Size of his head--Village doctor's record of his birth--Schooldays cease at age of fourteen--Influence of his environment in developing his character. James Young Simpson, who will ever be remembered as the discoverer of the pain-annulling power of chloroform, was born in the year 1811, at a period when there was room for a hero in the practice of the healing art in the British Islands. It is true that in the seventeenth century Harvey had laid bare the great fact of the circulation of the blood and the practical Thomas Sydenham had swept aside the highly empirical systems and theories of medicine which had successively supplanted each other since Hippocrates first taught, and urged men to found their knowledge upon what they actually saw--on observation and experiment; and that in the eighteenth century men like Cheyne, Heberden, Cullen, and the wonderful Jenner had appreciably assisted in developing medicine at the same time that Hunter was raising surgery nearer to the level of a science. But even while Simpson was growing out of childhood all the powers of such professional giants as Bright, Addison, Abernethy, Astley Cooper, and Charles Bell, were insufficient to dispel the massive cloud of mystery and superstition which enveloped the practice of both medicine and surgery in this country and obscured whatever there was of truth in the teaching of these men. In the first decade or two of this century the medical profession had not yet entirely abandoned the use of the golden-headed cane, nor had what Oliver Wendell Holmes calls the solemn farce of overdrugging yet ceased. "Humours," "impostumes," "iliac passions," and such like were still spoken of--terms now heard only amongst country-folks in remote districts and that rarely, or encountered in curious old medical publications. Messes and abominations, prepared by the apothecaries according to more or less secret recipes handed down through the Middle Ages, were swallowed in good faith; blood-letting was still a panacea; and such remedies as that of holding a live puppy to the body for the relief of colic still had their professional advocates, but happily a decreasing number; whilst those pains "... In the hour, When the veil of the body we feel Rent round us--while torments reveal The motherhood's advent in power" --pains which Simpson was the first truly to relieve by his application of anæsthetics, were gravely said to be alleviated by the swallowing of a concoction of white onions and oil. Surgery was no doubt ahead of medicine; but the early surgical records of this century have little more than a curious interest to modern practitioners. Operations entirely unknown to our professional forefathers less than a century ago are now performed in safety daily. Such mysterious diseases as "icteric irritative fever" and "acute sinking" after operations, dreaded then with the fear that is always inspired by unseen or ill-understood dangers, have vanished before the progress of modern science in which the introduction of anæsthesia was the first great step. The practice of the branch of medicine which Simpson made so peculiarly his own--that of obstetrics--originally in the hands of women only, had been fiercely contested for by the two sexes during two centuries, and such was the feeling against man-midwives in Scotland that the dispute had scarcely ceased at Simpson's birth. The stronger sex, however, was then at last asserting its superiority, and to be an accoucheur was beginning to be considered after all as worthy of a gentleman. The despised art was preparing for its renaissance. Simpson grew to manhood whilst science, aided by precise methods of accurate observation, was shedding new light upon physic, surgery, and obstetrics. In fulfilling his great part in establishing the healing art on a firm scientific basis, Simpson encountered the full force of the ignorance and prejudice of his day both within and without his profession. It was, perhaps, fortunate that he was brought up in a small village and in a rank of life where he would meet from his earliest days with many superstitious beliefs and practices, strange and utterly irrational. A mind such as his would meet, reason, and experiment these out of existence. Probably through these circumstances he conceived the taste for archæology and antiquarian research which were his recreation in later years; but, what was more important, he gained also some training for the struggle with ignorance, untruth, and irrationalism, into which he threw with his eager vigour the whole strength of his manhood. Simpson was born in the village of Bathgate, in Linlithgowshire, where his father, David Simpson, was the local baker. David's father, who died at the ripe age of ninety-one a few years after James's birth, was the descendant of a line of small hard-working farmers, who added to his work and his profit the practice of farriery. Although modern science has, by the aid of bacteriology, proved such practitioners of the rough veterinary medicine of the day to have been right in ascribing to unseen influences many of the diseases of animals which they found themselves powerless to check, the methods they employed for treatment when what they called witchcraft was at work scarcely have the support of present-day practitioners. In one of his addresses upon archæology Simpson records how his grandfather ordered and his own father took part in the burial alive of a cow in order to appease the evil spirit which was spreading the plague of murrain with fatal effect. And the older gentleman was known to have had more than one serious encounter with a witch. On one occasion an old beggar woman, who plied her calling in quite an original method--that of being wheeled in a barrow from farm to farm--hurled curses at old Simpson for ordering a servant to wheel her from his house on to her next calling-place, and vowed an awful vengeance on his family if he did not replace the servant with one of his stalwart sons. The farmer recollected that an ill event had followed the old woman's last visit, and quickly drew a sharp flint from his pocket and made a gash across her forehead with it. "Ah," he exclaimed, "I see what ye're noo, ye auld witch; but I've scored ye aboon the braith and my house is safe." Simpson noted these and many other curious practices and beliefs, and afterwards pointed out in one of his addresses that they were probably, for the most part, relics of the pagan creeds and customs of our ancestors. He urged the making of a collection of the folk-lore of Scotland, ere it utterly disappeared before the march of modern civilisation, and suggested that, perhaps, some archæological Cuvier might one day be able to re-construct from these mythological fragments distinct pictures of the heathen practices, rites, and faiths of our forefathers. In his early boyhood he listened to many stories of local and family superstitions told to him with all the earnestness of a firm believer by his father. He himself was the object of superstitious admiration to the simple villagers all through his boyhood, and they freely foretold great deeds from him in later years; for he was a seventh son, and the good luck which seventh sons were supposed to bring had appeared in the family soon after his birth. Up to the day on which James first saw the light, June 7, 1811, the baker's business had been going steadily from bad to worse, and the shop books showed that on that very day the lowest depths were reached. The baker, David Simpson, seems to have been curiously lacking in business method, although he was a hard-working man. But after James's birth he wisely interested his wife in his affairs, with the result that she energetically and successfully bestirred herself to recoup their fallen fortunes. Mrs. Simpson was directly descended from a fugitive Huguenot family, settled for many years on a farm near Bathgate, and intermarried with well-known families. Through her, indeed, Simpson claimed a distant relationship with the national hero, Sir William Wallace. The cares of her family and the strain of managing the increasing baker's business proved too much for her always delicate constitution, and she died when James was only nine years old. There is no doubt that the youngest child and favourite son had an unusually large share of his mother's society during those years; he was a peculiarly attractive child, "a rosy bairn wi' laughin' mou' and dimpled cheeks," and his manner, even when he was little more than an infant, was quiet and affectionate. When physical sufferings overtook the mother, the child's quiet sympathy and engaging manner helped and comforted her. Her own nature was bright, vivacious, and energetic, quick to think and prompt to act; and she was full of love, sympathy, and piety. These maternal traits influenced the youth, and added a soft, refined--delicately refined--tone to the paternal influence, whence he received self-reliance and habits of persevering industry. The boy's school-life began at the age of four years. The orthodox learning came very easily to him; he entered into both work and play so whole-heartedly that he at once became known as the "wise wean," and was at the same time ever sought after by his school-mates as a companion in out-door sports. The parish schoolmaster was one James Taylor, who had considerable ability for the post, and encouraged his pupils by kindly personal interest to develop affection for learning. But for Simpson there were other teachers and greater subjects for study in the countryside around Bathgate. The district was full of rich treasures for the field naturalist and for the antiquarian. Bathgate lies between the Firth of Forth and the Pentland Hills, in a geologically varied district, with a varied and abundant flora and fauna--more so in those days when Bathgate was a small village of hand-loom weavers than latterly, when it was a thriving little town, the centre of a coal, shale, and ironstone mining industry. The archæological features of the neighbourhood were full of interest. There was the famous "Catstane," of Kirkliston, which had puzzled antiquarians even before the establishment of the Scots Society in 1780, and at Kipps was one of the few remaining cromlechs--and that a ruined one--in Scotland; whilst the line of the Roman wall between the Firth of Forth and the Clyde was not far distant. There were traces of a Cistercian monastery founded by David I., and various hills and fields and caves were associated with the names of Sir William Wallace, Robert Bruce, and King Edward I. Simpson thoroughly familiarised himself in boyhood with the natural features, as well as with the antiquarian objects in the district. He continued to investigate them during his vacations when a student at Edinburgh University, and rendered the neighbourhood famous archæologically by masterly monographs written when he was at the height of his fame. Amongst the village hand-loom weavers, a race of peculiarly observant and intelligent men, there were some who studied both the antiquarian objects and the natural history of Linlithgowshire. Simpson used to speak of one man, a daily labourer at the loom, who was able to write, in correct Latin, an accurate description of any plant or animal brought before him, although his earnings at the loom never amounted to fifty pounds a year. These men thoroughly enjoyed the evident interest of the "young philosopher" in their discussions and demonstrations, at the same time kindly directing his mind towards the simple, painstaking, true methods of observing and reflecting upon nature. There was no lack of change in his environment for him; his interest in natural phenomena was roused and kept alive during his drives round the countryside delivering bread to the farmers and cottagers, or in occasional visits to his parents' relations. He daily took his turn behind the shop counter, reading, writing, or drawing in the interval of waiting for customers. He trained himself to read or do his school lessons as readily in a roomful of romping children as in the quiet of the bedroom. It has been said that he never knew an idle moment from the day of his birth onwards, and his was such an indomitable and persevering energy that the remark is no exaggeration. But the pathway to greatness was made specially smooth for James Simpson. He was set upon it, and protected in his childhood, and guided in his youth, with the one definite object always in view. The Simpson family as well as the whole Bathgate community, took it for granted that eminence was to be his in whatever walk of life he entered seriously upon. His sister Mary and his brother Alexander looked upon him as a special care; the former watched over him as a mother, and the latter helped him in the ups and downs of boyhood, just as he constantly stood by him throughout the difficult days of his later career. It had always been a custom in Scots families of humble rank that one child, either from the exhibition of a natural aptitude, or through the ambition of the parents, was singled out to receive the advantages of a fuller education such as is within the reach of every able lad in Scotland. Honour and glory would thus be brought to the family, greatest of all if from the pulpit, while the less favoured members of the family would plod on in the same sphere of life as their parents. The world owes a great deal to the Simpsons, and particularly to Alexander, who cheerfully seconded their father's efforts to help forward their young brother, without a suspicion of jealousy. They knew he would be great some day, and therein they looked for their reward. Happily there were ample means for all their requirements derived from the now prosperous bakery. The money was kept in one drawer, the till where the shop earnings were placed. All the household were free to draw thence supplies for their ordinary wants, James without stint; and he alone was exempted from the condition that he who profited must also contribute by the sweat of his brow. The boy took very full advantage of his fortunate circumstances and drank deeply of all the knowledge that came near and ever hunted for more. With each succeeding year the craving to know, and to know thoroughly, became more and more his ruling passion; by the time his schooldays were over it had gained complete mastery over him; happily for the human race Providence had so endowed him that when knowledge had come wisdom did not linger. He was never in any way led away by the temptations that no doubt beset every boy in a village of hard-drinkers such as Bathgate was in his youth. Alexander took pains to warn him--"Others may do this, Jamie, but it would break all our hearts and blast all your prospects were you to do it," he said. It was not necessary to make appeals to James to work and fulfil the family predictions; he was as firmly determined to be great as they were sure he would be: He never forgot how much he owed to the loving help of his family, and to the fact that he was the youngest son growing up at a time when the family struggles were fairly over; when instead of its being an effort for the parents to provide the necessary funds for his education, the shop-till was well filled and the elder brothers and the loving sister were at hand eagerly willing to help. In student days when struggles came and the path seemed dark and beset with dangers, the knowledge of the firm faith in his powers of the family at home and of the scarcely smaller faith of the weavers, was a powerful incentive in the moments when he required any other than that of the spirit within him. We cannot feel otherwise than thankful that up to the age of fourteen, when his schooldays ended, he had access to but a limited stock of literature wherewith to gratify his hunger for knowledge. To satisfy his appetite he was driven into the fields and the forests; every sense was stimulated, and became developed through repeated use. Thus he laid the foundation of his phenomenal faculty of rapid and accurate observation, and of his no less phenomenal memory. His imagination was fed with the legends of the district and tales of his remote moss-trooper ancestors told to him of an evening by his father. Though happily saved from being a bookworm to the exclusion of sounder means for acquiring knowledge, he devoured and digested every scrap of literature which came in his way. Like all Scots children of his class he learnt his Bible thoroughly from end to end--a knowledge which served him well in later years. Shakespeare followed the Bible in his own review of his favourite reading as a boy; but a gazetteer or an almanac was quite as acceptable. His taste was for solid fact--fact which he could learn and put to the test; thus the great open book of Nature was the attraction he most readily yielded to. But nothing in book form ever came amiss to him; if between the covers there was useful information to be had, Simpson extracted it and stored it away in his capacious brain. The unusually large size of his head, a source of admiration in manhood, was in childhood an object of wonder to observers. In manhood he wore his hair in long locks, and this was apparently his habit in boyhood. Once a strange barber cut his hair so close that his brother took upon himself to go and rebuke the man. "The callant had suck a muckle head," was the retort, "I was doin' my best to mak' it look respectable." A close-cropped head gave altogether a too sportive appearance to the "young philosopher" in the eyes of the watchful elder brother. There is no evidence that Simpson displayed in his schooldays any special leaning towards the medical profession; it cannot be reasonably urged that his grandfather's rough skill in the treatment of animals fostered any medical tendency in him, for James was but five years old when the old man died. Even had he been of an age to understand them, the methods employed would have scarcely recommended themselves to a youth of Simpson's nature, sufficiently to raise a spirit of emulation within him. It is also not recorded that the village doctor took any special interest in the boy or brought any influence to bear upon him; although his note-book thus gives the earliest record of the future prince of obstetricians:-- 275.--June 7. Simpson, David, baker, Bathgate. Wife, Mary Jarvie. Æ. 40. 8th child, son. _Natus_ 8 o'clock. _Uti veniebam natus._ Paid 10s. 6d. James displayed his superiority so decidedly in the village school that when he reached the age of fourteen it was decided to send him to Edinburgh University without further waste of time. It was no unusual age for boys to commence their University career in Scotland. There was no secondary education in the Scots provinces, but instruction intermediate between that of the parish school and what is ordinarily known as University education was given within the walls of the University itself. Boys of humble rank who aspired to a profession were sent up, as indeed many still are, at the age of fourteen or fifteen, to attend these junior Arts classes in which this instruction was, and still is, imparted. The University was crowded with schoolboys of all ranks of life gathered together from town and country, and consisted of nothing more than a collection of class-rooms devoted to the giving of instruction in lecture form. This stepping-stone of junior classes threw open the higher education to hundreds of youths whose equals in England had no such advantage at that time. Scots University education besides being thorough was decidedly cheap, so that the church, law, and medicine received many recruits from the class out of which Simpson was drawn. His environment up to the age of fourteen was well calculated to train him for the great work that lay before him. The legends of the district, and the sight of the objects of archæological interest which he came across in his rambles out of school hours, were powerful stimuli to his sensations; whilst the accurate observation of natural phenomena in field and hedge which the kindly interested weavers helped him to, was also a valuable educative influence. It is probable that his senses received much of the training which was to lead to his ultimately being the greatest physician of his day by these means, rather than from the instruction imparted to him in the village school, or derived by him independently from the books that came in his way. It was undoubtedly a fortunate circumstance that he was born and bred in an out-of-the-way country district, where he drew his lessons from Nature and the phenomena which lay round him, rather than in a great city where he would have been educated on the stereotyped orthodox system. When we look further back, asking why he saw sermons in stones and books in the running brooks, to which the bulk of his schoolfellows were entirely blind, we are bound to confess that we find no satisfactory answer in his family history, to which it is customary to look for an explanation of such tendencies. Heredity played no great part in making Simpson great; from the paternal side there was imparted to him a vigorous physique; from his mother he received the bright, happy, sympathetic, and alert disposition, which descended through her from his French ancestors. He was provided with a brain of marvellous quality and phenomenal size. But it was the environment which acted upon this brain and brought out the capacities born in him without any apparent hereditary bias, and which might have remained entirely latent under less favourable circumstances. No small part of the development was due to the people among whom he lived; a race of men accustomed to rely upon their senses which were always with them, rather than upon books which they seldom saw, even if they were able to read them; and to observe not only all that lay around them, but also the characteristics of their fellowmen with whom they were brought into contact--the close contact of different classes which obtains in village and rural life. Simpson was taught to study Nature whether in field or fellow-creature first, and the knowledge and opinions of men as expressed in books afterwards. CHAPTER II. STUDENT DAYS. 1825-1830. Visit to Edinburgh--Sent to the University--Takes the Arts classes--Gains a bursary--Influence of MacArthur and Reid--Robert Knox the anatomist--The Burke and Hare murders--Superiority of the extra-mural teachers of the day--Edinburgh an intellectual centre--University life--His mode of living as a student--Apprenticed to a chemist--Studies surgery under Liston--Regularly falls asleep in the obstetric class--Influence of his teachers--Verse writing--Description of the medical student of the day--Vacation work--Death of his father--Obtains qualification to practice at the age of eighteen. Although Edinburgh was only eighteen miles from Bathgate, Simpson visited it only once as a schoolboy; probably he walked all the way, for railroads were as yet unknown and it was not a long walk for a country-bred vigorous youth. He exercised his already formed habit of noting objects of interest during this great event in his boyhood, and in his journal there are copies of old inscriptions from tombs in the famous Greyfriars' Churchyard to which he made his pilgrimage. The boy's nearest and dearest ambition was to become a student at "the College," as Edinburgh University was familiarly termed. It received encouragement in the periodical return to the village of elder boys who had gone up before him. He was specially struck, and afterwards stimulated, by the appearance of one John Reid, his senior by two years, and his former companion in many a country ramble, who came back for the vacations smartened up both physically and mentally by the new life. Although the collegiate life characteristic of Oxford was unknown in Scots Universities, there was social intercourse amongst the boys very different from that of the village. The ancient Edinburgh University attracted students from all parts of the world, mostly for the medical curriculum, but many preceded the professional course with a year or two's attendance on the Arts classes; and it was usual for young Englishmen of good family to spend a session at Edinburgh before going to Oxford or Cambridge. Probably before he entered the medical classes, Simpson rubbed shoulders with lads of all ranks from home and abroad. Pillans was at this time the Professor of Humanity, Wallace held the chair of Mathematics, John Wilson--better known as Christopher North--that of Moral Philosophy, and Dunbar was Professor of Greek. Wallace had begun life as a bookbinder's apprentice, and Dunbar had risen from being a gardener; the example of these men under whose influence he was brought encouraged the baker's son to go and do likewise. The family had sent him off to the College with the mission to be famous, and he was beginning only in an orthodox fashion when he entered himself for the curriculum in Arts. It had been easy for him, with his magnificent brain power, to stand _dux_ of the village school over the ordinary village youth; but here, in Edinburgh, he was brought into competition with the picked boys from other country schools, and intellectually eager youths from town schools where the course of instruction was such as more easily to lead to early University success than that of the Bathgate parish school. At first he found difficulty and desponded. The keen observer with senses all alert was dashed to find so much of the College life to which he had so eagerly looked forward only a magnified repetition of the dull school routine. But he was too intent on ultimate success to be repulsed by his initial disappointment, and soon brought his mind into adjustment with the circumstances he found himself in, reserving leisure time and vacations for the exercise of his faculties as he most loved to exercise them. He did not persevere in the Arts course after he found his tastes led him to other studies; he did not trouble to obtain the Master of Arts degree, which was then conferred in a very lax manner; probably he saw its worthlessness, for it was not until the passing of the Scots Universities Act in 1858 that this degree became really valuable. He recognised, however, the value of laying a good foundation of general knowledge; without straining after any distinction he acquitted himself creditably in all his classes. In the second year of the curriculum he won one of the numerous small bursaries of the value of £10 a year, for which logic was one of the chief subjects of examination; but as candidates were restricted to those who possessed either the name of the founder, Stewart, or that of his wife, Simpson, the competition was not particularly severe. His individuality and natural straightforwardness attracted the attention of some of his professors. The boldness of his original essays provided them with food for comment in a manner dear to the professorial heart. The Arts curriculum served him usefully in helping to develop a literary style and in teaching him how best to express his vigorous thoughts, as well as in strengthening his knowledge of Latin and Greek. According to the record preserved on his class certificates he worked attentively and diligently; but the mere fact that he did not excel is sufficient proof that he did not make an attempt. During his Arts course Simpson lodged at No. 1, Adam Street, along with the John Reid already mentioned, who was now a medical student, and with a Mr. MacArthur, who had been a junior master at the Bathgate school, but had now also commenced to study medicine. MacArthur was a man of dogged determination; he urged Simpson to persist with his Arts course when his spirit seemed to rebel against it, and so long as they were together seems to have maintained some of the authority of the usher over both of the youths. The spirit of work was strong within him. Soon after Simpson joined him he related that he could then do with four hours' sleep, John Reid with six, but he had not been able to break in James yet. What MacArthur and the Arts course could not do, however, the attraction of medicine accomplished without effort, and Simpson soon formed the habit of early rising. It seems remarkable that so much study should have been required when, compared with to-day, the science of the healing art was in but a rudimentary condition. The teachers of the day had, in spite of Sydenham, a great regard for authority, and burdened their students with much that is utterly unknown to the present generation, and, if known, would be regarded as worthless. A very large part of the curriculum consisted of practical and bedside work, so that book study was necessarily left to the evening or early morning. All three students, moreover, were fired with ambition, and thirsted for something more than mere professional knowledge. MacArthur constantly urged on his two young friends, and foretold great things for them if only they would work. When he afterwards heard of their successes he used to say, "Yes, but _how_ they worked." Simpson became the greatest living obstetrician, and Reid rose to be Professor of Physiology in St. Andrew's University. MacArthur never became famous; his name is known only because of the initial impetus which his influence gave to the professional careers of his two young friends. In his close association with two such men as MacArthur and Reid, Simpson was again fortunate in his environment. The art of medicine was also fortunate inasmuch as at the right moment the right influences were at work to direct his mind towards it. While occupied in mastering the laws of hexameter and iambic or in assimilating the prescribed portion of Virgil and Tacitus, he happily now and then, living with two such enthusiastic medical students, got a taste of the more stimulating study of things scientific--food which was more agreeable to his mental palate, more suited to his mental digestion. By peeps into anatomical books, by little demonstrations of specimens in their lodgings, and by occasional visits to some of the lecture rooms or the wards of the Infirmary, his appetite was whetted for that great study of nature which his youthful training at Bathgate had prepared him for, and for which his mental constitution was specially adapted. One can picture the eagerness with which he would cast aside the finished Greek or Latin essay and urge the not unwilling embryo professor to demonstrate a bone or lecture on an anatomical preparation. Sometimes as a special favour he was taken by Reid to hear one of the lectures of the notorious Robert Knox, the extra-academical teacher of anatomy, whose strong personality and unrivalled powers as a lecturer were at that time attracting to Surgeon's Square hundreds of students, while Munro (Tertius) was mechanically repeating his grandfather's lectures from the University chair. It was towards the end of 1828, when Simpson was just about commencing his medical studies that Edinburgh, and in fact the whole of civilised Europe, was horrified by the revelation of the doings of Burke and Hare, when they were at last brought to justice for the long series of crimes perpetrated for the purpose of selling the bodies of their victims to the anatomical schools. Knox having a class of some four hundred students had special difficulty in meeting the demand for "subjects," and it was brought to light at the trial of Burke that the majority of the bodies were disposed of to Knox. As was only natural, a fierce indignation against Knox sprang up in the city. His residence was assailed and his effigy burnt. His life was in danger at the hands of the mob on more than one occasion. Lord Cockburn in his "Memorials of His Time" says that all the Edinburgh anatomists incurred an unjust and very alarming though not an unnatural odium--Dr. Knox in particular, against whom not only the anger of the populace but the condemnation of more intelligent persons was directed. "But," he says, "tried in reference to the invariable and the necessary practice of the profession our anatomists were spotlessly correct and Knox the most correct of them all." These were stirring times in Edinburgh medical circles. The strong, cool demeanour of Knox under the persecutions to which he was subjected, must have made an indelible impression on Simpson's mind, and the memory of it may have served to strengthen him in later years when himself subjected to the unjust accusations of thoughtless and ignorant people. One night when Knox had attracted a large class to hear him on a favourite subject, the crowd in the street mustered in unusual force; the yells and howls from outside were heard distinctly in the class-room. The students got alarmed, and kept looking to the doors of egress. Knox perceiving the restlessness and alarm of his audience paused, and then addressed to them reassuring words, expressing his contempt for the cowardly mob, and reminding them of the great men who at different times had suffered persecution for the cause of their science. His statement was received with such cheers as resounded beyond the class-room walls and actually cowed the uproarious mob, so loudly did the students applaud the words of the man who, they knew, daily placed his life in danger in order to lecture to them, and whose last hour seemed to have come, so great and threatening was the crowd on this particular evening. If Simpson did not actually witness such a scene as the foregoing--he was not a member of Knox's class until the session 1830-31--he must at least have known full well about it at the time, and shared with the whole body of students the worship of the man as a hero. His fellow lodger, Reid, was not only a distinguished pupil in Knox's class, but became one of Knox's demonstrators in 1833, and was always a prominent Knoxite. We know also that Knox went down to Bathgate to visit Reid's relations there, so that it is justifiable to conclude that Simpson came closely in contact with this remarkable teacher. That the relationship between Reid and Simpson was most intimate we have the former's own words for. At a public dinner given to him when appointed to his professorship in 1841, he said, "In the croupier (Simpson) I recognise my earliest friend, a native of the same village. We were rivals at school and at college. We stood to each other from boyhood upwards in every possible relation, whether of an educational, warlike, delicate, or social character, which the warm and fitful feelings peculiar to boyhood and youth can produce." In the end Knox and Reid quarrelled over a scientific matter. Knox never recovered from the effect of the Burke and Hare incident; in spite of the favourable report of an influential committee appointed to inquire into his share in the proceedings, and his own explicit statements, the public never acquitted him of at least a wilful shutting of his eyes to much that ought to have aroused his suspicions. His crowded class-room gradually became empty during the next few years, and the once brilliant, talented, and determined man became demoralised and left Edinburgh. Christison says that Knox finally died almost destitute in London, and that one of his last occupations was that of showman to a party of travelling Ojibbeway Indians. However the strong personality and attractive lecturing of Knox may have influenced him, it is undoubted that to the personal influence of MacArthur and Reid, acting upon his constant hunger to know nature and truth, stimulated as it was by what he saw of anatomy and physiology, we owe the fact that Simpson decided to enter the medical profession. Although the number of medical students in Edinburgh University reached one of its highest points during the years that Simpson was a student, it is remarkable that with one, or perhaps two, exceptions, the University professors were men of no marked eminence in their various subjects. On the other hand, the extra-mural teachers included men of such wide reputation as Knox, Lizars, and Liston. Syme, who reached the height of his fame as a surgeon about the same time that Simpson became renowned, had just resigned the teaching of anatomy to take up surgery; shut out at first from the wards of the Royal Infirmary by jealous colleagues, he was boldly establishing for himself the little Minto House Hospital, which became the successful nursery of his own unsurpassed system of clinical teaching, and remains in the recollection to this day as the principal scene of Dr. John Brown's pathetic story, "Rab and his Friends." It was chiefly these extra-academical teachers who at that time made the medical school famous, and were raising for it a reputation in surgery such as it had acquired in physic in the days of Cullen. In certain subjects the students would, according to the regulations for the degree, take out their tickets of attendance on the professor's course of lectures, but would put in only a sufficient number of appearances to entitle them to the necessary certificates; the real study of the subject being made under the more accomplished teacher outside the University walls. Edinburgh was at this period much more than the scene of the foremost medical and surgical teaching of the day in the world. It was a striking centre of intellectual activity. Sir Walter Scott, Cockburn, and Jeffrey were famous in literature and politics; Chalmers and Moncrieff in Church affairs; and Aytoun, John Wilson, Sir William Hamilton, and Sir David Brewster were names that attracted men from far and wide to the modern Athens. English and foreign advocates, scholars, artists, squires, and noblemen mingled together to hear or see some of these men. Lord John Russell, Henry Temple--subsequently Lord Palmerston--and Lord Melbourne were amongst the young Englishmen who attended university classes for a session or two; and H.R.H. the Prince of Wales, and his brother the Duke of Edinburgh, each matriculated in later days. When Simpson began his studies Knox was the great lion, without a visit to whose class-room no sojourn in Edinburgh was complete; just as in later years Simpson's house in Queen Street was the resort of all sorts and conditions of distinguished people. The University had little control over her students once they were outside the gates of the quadrangle. There were no residential colleges; each youth found lodgings for himself suitable to his means, and led a perfectly independent life. So long as he conducted himself with propriety within her walls his Alma Mater cared little how he conducted himself or how he fared outside. Before 1858, when the Town Council controlled University affairs, there were sometimes attempts to order the comings and goings of students. It is recorded that in 1635 the Town Council discovered that the scholars of the College were much withdrawn from their studies by "invitations to burials," which "prejudiced their advancement in learning," and they enacted that no student was to be permitted to attend burials except those of University or city worthies. This was at a time when some of the students were provided with residences inside the University, but by the beginning of the eighteenth century College residence had ceased. From time to time attempts have been made to render the students conspicuous in the city by the wearing of red gowns, but without success; and those of all faculties continue to be their own masters, in marked contrast to the mode of government in force at Oxford and Cambridge. Recently, in the eighties, a batch of students who had figured in the police-court after a riot in the gallery of a theatre were surprised to find themselves summoned before the Senatus Academicus and rusticated for varying periods; this, however, was but a spasmodic exercise of power. The chief advantage claimed for this custom of leaving the student to his own devices is that it encourages independence and develops each man's individuality better than a system of discipline and control. In men of Simpson's calibre it certainly has had a good effect. Although the family in Bathgate strained every nerve to keep James well supplied with the necessary funds as a student, they were not able to place him in such a pecuniary position as to make it unnecessary for him to exercise economy: He appears to have been very careful indeed of the money which he had; much more careful than when he reckoned his income by thousands. He kept methodical accounts of his expenses down to the most trivial items, and regularly submitted them to his family. His cash-book opened with the following quotation from a small book called the "Economy of Life," which figures at a cost of ninepence:--"Let not thy recreations be expensive lest the pain of purchasing them exceed the pleasure thou hast in their enjoyment"; and to this he added:-- "No trivial gain nor trivial loss despise; Mole-hills, if often heaped, to mountains rise. Weigh every small expense and nothing waste; Farthings long saved amount to pounds at last." It is easy to see here the imprint of a well-known national characteristic, from which, however, he completely shook himself free when prosperity came to him. His share of the rent of the Adam Street lodging amounted to only three shillings a week. The entries in the cash-book show how frugally he lived and how every spare sum was devoted to the purchase of books. His library, the foundation of much of his encyclopedic knowledge, was a curious mixture. Adam's "Antiquities," Milton's Poems, Byron's "Giaour" and "Childe Harold," a Church Bible, Paley's "Natural Theology," Fife's "Anatomy," and "The Fortunes of Nigel," were amongst those entered as purchased. The daily entries were such as the following:--"Subject (anatomical), £2; spoon, 6d.; bread and tart, 1s. 8d. Duncan's Therapeutics, 9d.; snuff; 1-1/2d.; Early Rising, 9-1/2d." He followed out the usual student's custom of the day of learning dispensing by serving for a time in a chemist's shop. The late Dr. Keiller, of Edinburgh, used to relate how, while he himself was so employed in a chemist's shop in Dundas Street, one day "a little fellow with a big head" was brought in and entered as a pupil by a relative. The little fellow was Simpson, and no sooner was he left in the shop than he sat down with a book upon drugs, and turning to the shelves took down drug after drug to read up. The prompt industry of the big-headed fellow deeply impressed Keiller. James attended most of the University classes, but studied surgery under the great Robert Liston, the foremost extra-mural surgeon, daring and skilful as an operator and of great repute as a lecturer, who afterwards filled the post of Professor of Clinical Surgery in University College Hospital, London. Liston was an abrupt-mannered but sincere man, and a keen lover of truth. He was a warm advocate of hospital reform, and was successful in introducing several needed improvements into the Royal Infirmary after a fierce fight. Here again Simpson was brought under the influence of a strong, self-reliant man with a distinct tendency towards controversy; to whom he was also attracted by the fact that Liston was a native of Linlithgowshire. Liston and Syme, after being close colleagues, quarrelled most fiercely, and were bitter rivals until Liston removed to London in 1835. Simpson attended Liston's lectures during three sessions. There is no record of his having obtained great distinction in any of the medical classes, but his certificates show that he worked with pre-eminent diligence in them all, and obtained a characteristic mastery of each subject. If any exception occurred it was in the very subject in which he afterwards earned his greatest scientific fame--that of obstetrics. He attended Professor James Hamilton's course of lectures on that subject early in his career, and apparently felt so little interest--the subject only became a compulsory one for examination for qualification in 1830--that he regularly went to sleep during the lecture. The excuse urged was that the lecture being a late one, three to four in the afternoon, it found him tired out after a long morning of study, lectures, and practical work. But had he been keenly interested he would have been wide awake, for Hamilton was a forcible, if plain, lecturer. Hamilton was another of Simpson's teachers who exhibited the same uncompromising fighting characteristics--eager and strenuous in his efforts to obtain some object--which Simpson himself afterwards displayed. He fought hard for fifteen years to gain recognition for the subject which he taught, and to have it included in those necessary for qualification. He succeeded in the end, but in the course of the struggle had to bring two actions at law against professional brethren. In one the defendant was Dr. Gregory, whose teaching was mainly responsible for the British system of medical practice in the early part of this century, viz., free purging, free bleeding, and frequent blistering, and who was the inventor of that well known household remedy, Gregory's powder. Gregory was also a pugnacious man and
{'title': 'Sir James Young Simpson and Chloroform (1811-1870) by H. Laing Gordon', 'source': 'Project Gutenberg', 'lang': 'en'}