James Young Simpson

Biography

Born at Bathgate in Linlithgowshire to village bakers, Simpson showed early promise as an academic and his family committed themselves to financially supporting his college education. Simpson enrolled at Edinburgh University in 1825, aged fourteen, as an arts student and began his medical studies two years later. In December 1829, his father became terminally ill and Simpson returned home in time for his fathers’ death. Simpson fell into a deep depression and only at the encouragement of his family was he able to return to Edinburgh to complete his studies. In April 1830, Simpson passed his exams at the College of Surgeons, but continued to suffer from depression. In October 1831 Simpson returned again to Edinburgh at the insistence of his family saying that he had only returned “just to please you all.”

In his sojourns at home, Simpson practiced as a country surgeon where he discovered midwifery was a major part of that practice. In 1831, Simpson enrolled in extramural classes on obstetrics and assisted in the work of Edinburgh’s Royal Dispensary for the Poor. In October 1831, Simpson was appointed assistant to the director of the Dispensary, Dr W.T. Gairdner. Simpson went on to complete his MD thesis on inflammation in 1832. In 1835, Simpson joined John Thomson, professor of pathology and his mentor, on a tour of Europe, visiting the leading medical schools of London, Paris, and Belgium. As a consequence of this tour and his close relationship with Thomson, Simpson experienced renewed faith in his abilities as a medical practitioner upon returning to Edinburgh.

Simpson quickly established his own private practice in general medicine and obstetrics. By 1839, Simpson’s practice was rapidly growing in the direction of obstetrics and his patients were no longer the poor of Edinburgh’s Old Town, but the wealthy residents of the New Town. In 1843, Simpson left the Church of Scotland and joined the new Free Church of Scotland.

Despite having quickly made a name for himself in the field of obstetrics, Simpson suffered from continuing financial difficulties. It was only through his private practice that his finances were alleviated and Simpson became able to support his young family. Since Simpson was a licentiate of the College of Surgeons and had been trained by Robert Liston, his skills in obstetrics surpassed every other obstetrician of the time. Simpson’s services as gynaecologist were also in high demand. He quickly caught the attention of the nobility and royalty.

Even though he had reached the top of his career, Simpson wanted more. “Anaesthesia” was a new development in the medical profession, consisting of inhalations of ether and Simpson was quick to recognize the significance of this development. He had always been concerned with the issue of surgical pain and began experimenting with potential solutions. On 19 January 1847, he effectively used ether during a complicated labour, but was not satisfied with the effects. In the summer of 1847, Simpson and his assistants, George Keith and James Matthews Duncan, began the search for new forms of anaesthetic. The three men tested numerous toxic and ineffective compounds before getting their hands on chloroform. They tested inhaling the sample and quickly fell to the ground and upon further attempts agreed chloroform was the solution they had been searching for.

In November 1847, aged 36, Simpson made his “Announcement of a New Anaesthetic Agent,” having already successfully utilized chloroform in minor procedures. Simpson used it in obstetrics for the first time on November 8, 1847. Simpson published an account which was features on the front page of the Scotsman. His pamphlets on the subject were also published in London, alerting the public to an anaesthetic that was better than ether. By the end of the year, manufacturers were struggling to supply the increasing demand for chloroform. Chloroform quickly spread as the anaesthetic of choice; however Simpson was not initially successful in introducing chloroform into obstetrics.

While it was seen as acceptable to utilize chloroform during long and difficult deliveries, many opposed its use during normal childbirth. Many viewed pain during childbirth as natural and unless the delivery involved operative obstetric procedures, commentators saw no need. Simpson ignored these objections and insisted on using chloroform during regular childbirth. Within a year of Simpson’s introduction of chloroform, surgeons and their patients were confident in its usage. Chloroform was the anaesthetic of choice for general surgery, but still not used widely for obstetrics. Chloroform, though arguably more effective and apparently safer than ether, had its own dangers. Overdoses and adverse reactions led to increased regulation and the discovery of safer anaesthetic agents of chloroform. Nonetheless, Simpson must be attributed with the discovery of the use of chloroform as an anaesthetic.

Simpson continued his private practice, his home overflowing everyday with patients. He continued to travel to assist in births almost until his death. Simpson was an attentive father and had close relationships with all of his children. Simpson lost two young daughters and displayed grief at their loss, his wife seemed never to recover from their deaths. Simpson received many accolades for his discovery surrounding chloroform and in 1850 his position in Edinburgh was heightened by various prestigious appointments. (see below)

On 7 April 1853, Queen Victoria gave birth to her eighth child with the successful administration of chloroform. This quickly silenced all opposition to Simpson and his stance on pain-free childbirth. Simpson was subsequently awarded honorary memberships of the most distinguished medical societies in Europe and America and enjoyed more power and influence than ever before. Simpson’s authority now extended well beyond obstetrics and midwifery and his influence extended beyond Scotland. However, Simpson’s professional life continued to centre on his private practice.

Simpson’s later career focused on hospital infection and surgical sepsis, with an emphasis on puerperal fever. Once puerperal fever was recognised, it became accountable for more than half of all maternal deaths. Simpson’s last great contribution to science involved the spread of hospital infections. In 1850, Simpson argued that puerperal fever and surgical fever were one in the same and both were highly contagious. Simpson argued that the spread of infections could be reduced if all medical attendants washed their hands in chlorine before every examination. He argued that both puerperal fever and surgical fever were caused by spreading “poisoned” blood from patient to patient. Simpson advocated for preventative methods such as cleansing hands and instruments against sepsis.

In 1858, Simpson described a new method of controlling blood loss during surgical operations – acupressure. This technique, though developed further and found successful, failed to gain Simpson the recognition he was expecting. In December 1864, Simpson published his book on acupressure. Simpson was successful in creating a vogue for acupressure that lasted at least thirty years, though it did not lessen the mortality rates in British hospitals. Simpson had previously written on the negative effects of overcrowding in hospitals in 1844 to 1846 and subsequently conducted a study on the correlation of poor hospital conditions with mortality rates. Simpson argued that post-operative surgical infection was closely linked to deficiencies in hospital design, ventilation and management, coining the term “hospitalism” to describe those awful conditions. He proposed building better hospitals, but was met with opposition.

Simpson never was able to achieve the same level of acclaim as he had from chloroform again. However his contributions to medicine and obstetrics are undeniable. Simpson achieved rank of baronet in 1866. In 1869, one year before his death, Simpson took up one final cause by promoting the rights of women to enter the medical field. He persuaded the Medical Faculty to allow Sophia Jex-Blake “to attend the class of any professor who was willing to teach her.” Simpson died peacefully on 6 May 1870.