Sir James Young Simpson, 1st Baronet

The Scottish obstetrician Sir James Young Simpson was the first to use chloroform in obstetrics and the first in Britain to use ether. He introduced the terms ovariotomy and occydynia.

Simpson was the youngest of seven sons born to David Simpson, a village baker, and was supposed to follow the same career. He was therefore apprenticed to his father, but spent his spare time working on scientific matters, and, thanks to a scholarship and help from his elder brother, he entered the arts classes of the University of Edinburgh in 1825, at the age of fourteen, an began the study of medicine in 1827.

He studied under Robert Liston (1794-1847) and received his authorisation to practice medicine – licentiate of the Royal College of Surgeons of Edinburgh – in 1830. He was then 19 years old and subsequently worked for some time as a village physician in Inverkop on Clyde. Two years later he returned to Edinburgh where he received his medical doctorate in 1832. The professor of pathology, John Thomson (1765-1846) entrusted him with some lectures, and in 1835 he was made senior president of the Royal Medical Society of Edinburgh.

A brilliant career
Following hard efforts, Simpson in 1839 at the age of only twenty-eight years, was appointed to the chair of obstetrics at the University of Edinburgh, succeeding James Hamilton (1767-1839). Lecturing in obstetrics had been somewhat neglected at the university, but Simpson’s lectures soon attracted large numbers of students, and his popularity as a physician reached such proportions that he could soon count women from all over the world among his patients. Besides his activities as a scientist and teacher he had a very busy – enormous, really – practice.

Simpson was president of the Royal College of Physicians in 1849, in 1852 he was elected president of the Royal Society of Edinburgh, and one year later was elected foreign member of the French academy of medicine. He received several honours and awards, in 1856 the golden medal from the Académie des sciences and a Monthyon prize. In 1847 he was appointed one of the Queen’s physicians for Scotland. In 1866 he was knighted and that year also became doctor of honour of law at the University of Oxford. In 1869 he received the freedom of the city of Edinburgh.

Breathe deeply, please
After the news of the use of ether during surgery reached Scotland in 1846, Simpson tried the novelty in obstetrics on January 19 the next year. He enthusiastically advocated the use of ether, but soon began searching for an anaesthetic that was less irritant. The idea to use chlorofom come from his chemist, David Waldie (1813-1889). Waldie had been a fellow student of Simpson's who had given up his medical practice in Scotland to become a manufacturing chemist in Liverpool. He developed a method of producing a purer preparation of chloroform than had previously been available. Before its use as an anaesthetic, chloroform was an ingredient of a number of remedies, but was contaminated to a varying extent with alcohol.

After some investigations, Simpson found that chloroform would be better for the patient, and thus already on November 15, 1847, he gave the first public demonstration of this new anaesthetic. Already a few days later he published his classic Account of a New Anaesthetic Agent, which was soon heavily attacked. His strong recommendation that chloroform be used to alleviate delivery pains called upon him the wrath of the church and many of his colleagues, one of his fiercest opponents being the American surgeon Henry Jacob Bigelow (1818-1890). Simpson’s demonstration, however, had proved the superiority of chloroform over ether beyond any reasonable doubt. Within weeks of his demonstration in 1847 of the superiority of chloroform, it had almost universally displaced ether as a general anaesthetic.

In 1853 and 1857 John Snow, the royal accoucheur, delievred Queen Victoria's schild with the aid of chloroform.

Simpson introduced iron wire sutures and acupressure, a method of arresting haemorrhage, and developed the long obstetrics forceps that are named for him. He is also known for his writings on medical history, especially on leprosy in Scotland, and on foetal pathology and hermaphroditism.

His reputation was such that he attracted patients from India, America, Australia. As a teacher he captivated his listeners with his performance, his knowledge, richness of details and his extraordinary memory. Simpson was also known for his power over patients, winning their complete confidence at first glance.

Simpson was a thoroughly harmonious person, dedicated to serve mankind. Simpson in 1839 married his cousin, Jessie Grindlay, who survived him only a few weeks. Five of his nine children died before him. In 1866 he was created a baronet and was succeeded to the baronetcy by his son Walter Grindlay. Simpson is buried in Warriston Cemetery (Edinburgh). Around 1700 medical colleagues and public figures joined his funeral procession and more than 100,000 people lined the route to the cemetery. He is remembered by the Simpson Memorial Maternity Pavilion in Edinburgh, together with a statue in Princes Street Gardens and a bust in Westminster Abbey, London.

Being a religious man Simpson was not, however, free of religious dreaming. He also concerned himself with antique studies, particularly of his native country.

"If you follow these the noble objects of your profession in a proper spirit of love and kindness to your race, the pure light of benevolence will shed around the path of your toils and labours a brightness and beauty, that will faithfully cheer you onwards, and keep your steps from being weary in well doing – while, if you practice the art that you profess with a cold-hearted view to its results merely as a matter of lucre and trade, your course will be as dark and miserable as that low and groveling love that dictates it."
Physicians and Physic, Chapter I

• Marie Jean Pierre Flourens (1794-1867):
  Note touchant l'action de l'ether sur les centres nerveux.
  Comptes rendus de l'Académie des Sciences, Paris, 1847, 24: 340-344.
  On March, 1847, Flourens announced that chloroform had an anaesthetic effect analogous to that of ether. Little note seems to have been taken of his paper, btut late in the year Simpson independently demonstrated the value of chloroform. Works by James Young Simpson:
• Observations on the diseases of the placenta. 1835.
• On peritonitis of the The foetus in utero. 1838.
• Inflammatory origins of some varieties of hernia and malformation in the foetus. 1839.
• Hermaphroditism.
  In, Robert Bentley Todd, et al: The cyclopaedia of anatomy and physiology. 5 volumes, London, 1836- 1859.
• Case of amputation of the neck of the uterus, followed by pregnancy; followed by remarks on the pathology and radical treatment of the cailiflower excrescence from the os uteri. 1842.
• Antiquarian notices of leprosy and leper hospitals in Scotland and England.
  1841. He published a second paper on this topic in 1842.
• On intrauterine cutaneous disease, ichtyosis. 1843.
• Contributions to the pathology and treatment of disease of the uterus.
  The London and Edinburgh Monthly Journal of Medical Science, Edinburgh, 1843, 3: 547-556, 701-715, 1009-1027;
  The London and Edinburgh Monthly Journal of Medical Science, Edinburgh, 1844, 4: 208-217.
• On the alleged infecundity of females born co-twins with males; with some notes on the average proportion of marriages without issue in general society. 1844.
• Dilatation and incision of the cervix uteri in cases of obstructive dysmenorrhoea. 1844.
• The Sex of the Child as a Cause of Difficulty and Death in Parturition.
  The Lancet, London, January 11, 1845, 1: 37.
• Discovery of a new anaesthetic agent, more efficient than sulphuric ether.
  London Medical Gazette, 1847, n.s. 5: 906. Preliminary report.
  London Medical Gazette, 1847, n.s. 5: 934-937.
  The Lancet, London, November 21, 1847, 2: 549-550..
• On the Air Tractor, as a Substitute for the Midwifery Forceps.
  The Lancet, London, March 3, 1849, 1: 236.
• On the nature of the membrane occasionally expelled in dysmenorrhoea. 1847.
• On the attitude and positions of the foetus in utero. 1848.
• Medicated pessaries. 1848.
• Retroversion of the unimpregnated uterus. 1848.
• Anaesthesia; or, The Employment of Chloroform and Ether in Surgery, Midwifery, etc.
  Philadelphia, 1849. This work, which was never published in book form in Great Britain, is a collection of his writings and speeches on his experiences in the use of chloroform and ether.
• Local Anæsthesia; Notes on its artificial production by chloroform, etc., in the lower animals and in man. The Lancet, London, July 8, 1848, 2: 39-42.
• On the discovery and construction of the air-tractor. 1849.
• Intrauterine small-pox. 1849.
• On the detection and treatment of intrauterine polypi. 1850.
• Spurious pregnancy. 1850.
• On turning as a substitute for craniotomy and the long forceps.
• On the analogy between puerperal and surgical fever. 1850.
• Was the Roman army provided with medical officers? 1851.
• Homoeopathy, its tenets and tendencies, theoretical, theological, and therapeutical. Third edition, 1853.
• Therapeutic action of the salts of cerium. 1854.
• The determining cause of parturition. 1854.
• Artificial anaesthesia as a means of facilitating uterine diagnosis. 1855.
• Perinaeal fistula left by the transit of the foetus through the perinaeum. 1855.
• The obstetric memoirs and contributions edited by Prietstley and Storer.
  A collection of various treatises. 2 volumes; Edinburgh, 1855-1856.
• Observations on carbonic acid gas as a local anaesthetic in uterine diseases etc. 1856.
• Proposed removal of tumours by injecting irritants into their substance. 1857.
• Notice of albumen in a case of puerperal mania. 1857.
• Notice of chloride of amyl as an anaesthetic. 1857.
• Iron-thread sutures and splints in vesico-vaginal fistulae. 1858.
• Treatment of hydrocele by iron-wire seton. 1858.
• On acupressure in amputations.
  Medical Times and Gazette, London, 1860.
• Notice on the appearance of syphilis in Scotland and the last years of the 15th century. 1860.
• Letter disclaiming the originality of coccygectomy. 1861.
• Clinical lectures on acupressure.
  Medical Times and Gazette, London, 1864.
• Tangle-tents. 1864.
• Acupressure, a new method of arresting surgical haemorrhage and of accelerating the healing of wounds. 1864. A compilation of the two above works.
• On the existende in the human subject of organs unprovided with nerves, lymphatics, or capillaries. 1868.
• Some propositions on hospitalism. Lancet, 1869.
• Hospitalism; its influence upon limb amputation in the London hospitals.
  British Medical Journal, London, 1869.
• Our existing system of hospitalism and its effects. Edinburgh Medical Journal, 1869.
• Hospitalism: its effects on the results of surgical operations.
  Edinburgh Medical Journal, 1869.
• On the anaesthetic and sedative properties of bichloride of carbon or chlorocarbon.
  Medical Times and Gazette, London, 1875 Simpsons series of smaller lectures during the years 1859-1861 and published in the Medical Times and Gazette, London,, were reprinted in America in one volume as Clinical lectures on diseases of women. Philadelphia, 1863; New York, 1872.
• Adolf Ludwig Sigismund Gusserow (1836-1906):
  Zur Erinnerung an Sir James Young Simpson. Address, etc, Berlin, 1871.
• J. Duns:
  Memoir of Sir James Young Simpson. Bart. Edinburgh, 1873; 8.
• Henry Laing Gordon:
  Sir James Young Simpson and Chloroform (1811-1870).
  London: T. Fisher Unwin, 1897. xii + 233 pages.
• J. A. Shepard:
  Simpson and Syme of Edinburgh.Edinburgh: Livingstone, 1969: 85, 77-102.