James Young Simpson

1811-1870

British Physician

James Young Simpson was one of the most prominent British physicians of his time. His contributions included many published papers and pamphlets, new surgical procedures, and obstetric forceps still in use today. Simpson campaigned for improvements in medical practice, education, and the design of hospitals. His practice was so well known that patients came from continental Europe to see him. Simpson also discovered and promoted chloroform's anesthetic properties and its use in obstetrics.

Simpson was born on June 7, 1811, in Bathgate, a village between the large Scottish cities of Glasgow and Edinburgh. He was the eighth child of David Simpson, a baker, and Mary Jarvis Simpson; the latter died when he was nine years old. Simpson attended a local school and showed enough promise by age 14 that his family scraped together enough money to send him 18 miles away to the University of Edinburgh. At the university Simpson studied the standard curriculum of rhetoric, mathematics, literature, Greek, and Latin.

Before the end of his first year, a friend persuaded Simpson to attend lectures on anatomy offered by Robert Knox (1791-1862). There Simpson found his calling and began medical studies by 1828. In two years Simpson had finished his courses and begun work on his doctoral thesis when a former pathology professor suggested he specialize in obstetrics. After more coursework, Simpson embarked on the standard tour of European medical centers such as London, Oxford, Paris, and Brussels.

After these travels, Simpson returned to Edinburgh, started an obstetric practice, and began teaching privately. His reputation in both areas grew so quickly that in 1835 he was elected president of the Royal Medical Society and his first speech in office attracted both local and international attention. Yet, despite these achievements and his busy practice and teaching duties, Simpson made little money and had no chance for advancement in his situation. So in 1839, when James Hamilton resigned from the chair of midwifery (obstetrics) at the university, Simpson began an intense campaign for the post despite his youth and relative inexperience. Since his bachelor status might be held against him, Simpson quickly married Jessie Grindlay, a distant relative he had known for several years and whose father had helped defray the cost of his university education. Simpson put his new bride to work cataloging more than 700 medical books and pieces of equipment he had purchased to impress the city officials who would choose Hamilton's successor. Despite serious opposition, Simpson's efforts worked. On February 14, 1840, he became "Professor of Medicine and Midwifery and of the Diseases of Women and Children." Although deep in debt from campaigning, Simpson had a prestigious position that would assure his future fame and fortune.

By the time of his death in London on May 6, 1870, Simpson had become a giant figure in the British medical establishment. According to contemporary accounts, more than 30,000 people lined the streets of Edinburgh as his funeral procession passed. Simpson certainly deserved such adulation. He was acclaimed by patients and students as an excellent clinician and teacher. Simpson designed the long obstetric forceps (that still bear his name) to aid in delivery. He introduced iron wire sutures into surgery, as well as acupressure, a method to stop hemorrhage, or bleeding. Simpson was also known as a harsh critic of hospital conditions of his day, and for his professional publications on fetal pathology and medical history. In recognition of his achievements, Simpson was appointed one of the Queen's physicians for Scotland in 1847; and in 1866 Queen Victoria made him a baronet. Yet Simpson's greatest medical achievement was the discovery and promotion of the anesthetic properties of chloroform.

Inhalation of gases as a therapy for various diseases had been tried since the 1780s, but not until the early 1840s was the concept successfully used for the relief of surgical pain. In 1842 physician Crawford Long (1815-1878) used ether on a few patients in Georgia, and four years later dentist William Morton (1819-1868) administered ether for surgical patients in Boston. Morton's demonstrations, held at the prestigious Massachusetts General Hospital, introduced inhalation anesthesia to the world; within months, anesthesia with ether was being used in countries all over Europe.

On January 19, 1847—just three months after Morton's efforts in Boston and about a month after ether was first used for surgery in Great Britain—Simpson used ether in an obstetric case. Long, in Georgia, began a similar use at about the same time. By the fall of 1847, Simpson began searching for a better agent. Ether had a disagreeable smell and tended to irritate the lungs of patients. Simpson and several friends experimented with various gases before hitting upon chloroform in early November. Simpson quickly began to support use of this gas instead of ether in obstetrics. His reputation and promotional talents eventually helped overcome opposition to anesthesia generally and to its use in obstetrics.

Chloroform and ether have not been used as human anesthetics since the 1950s; in the past few decades synthetic gases with fewer side effects have replaced the older agents. Yet Simpson's work a century and a half ago legitimized the use of medical interventions to relieve the pain of labor. Millions of women around the world whose labor pains have been eased by various types of anesthesia have benefited from Simpson's groundbreaking efforts.

A. J. WRIGHT