We cannot go into the controversy as to which American has the greatest merit in the introduction of sulphuric ether as an anæsthetic. Suffice it to mention that Charles Jackson, a chemist of Boston, who had been present at Wells’ demonstration in 1840, first experimented on himself by inhaling pure sulphuric ether, and having produced insensibility, communicated his discovery to W. T. G. Morton, a dentist who had been present at Wells’ demonstration, and prevailed on him to employ it. Morton afterwards alleged that this step was taken independently on his part.
On September 30, 1846, Morton administered ether to Eben Frost for tooth-drawing with complete success, and in October following it was used in an important operation by Dr. J. C. Warren at the Massachusetts General Hospital. The news arrived in England before the end of 1846, and on December 19th, James Robinson, a dentist of Gower Street, London, was the first to operate under ether in this country for the removal of a tooth. On December 21 Robert Liston employed it most successfully at University College Hospital in an amputation of the thigh and in the removal of a great toe-nail, one of the most exquisitely painful operations. Its general adoption followed in the first few months of 1847. Dr. Simpson, as early as January 9, 1847, after previously inhaling it himself, used it in order to relieve pain in childbirth, and found that its anæsthetic effects produced no stoppage or perceptible alteration in the muscular contractions of the womb. This and other cases of his were quickly published, and justify his claim to having introduced ether in its application to midwifery practice.
The inconveniences occasioned by the smell of sulphuric ether, the considerable doses required to be given, and its tendency to irritate the bronchial tubes, led Simpson to inquire for and to try other analogous liquids. He was recommended, among others by Dr. Gregory, to try chloroform, discovered by Soubeiran in 1831 and Liebig in 1832, and accurately investigated by Dumas in 1835. He concluded after much labour, and the expenditure of some hundreds of pounds, that chloroform, without the unpleasant smell of ether, produced more rapid effects with a smaller dose, and he very soon began to use it in midwifery and to introduce it to his surgical friends for operations. It was brought before the Edinburgh Medico-Chirurgical Society on the 10th November 1847; and so well-known and favoured did it become that in a very short time Simpson’s Edinburgh chemists were manufacturing 7000 doses a day. Here we might almost stop in this record, but for two things, one the controversies Simpson had as to the impropriety and irreligiousness of removing pain, supposed to be one of the Creator’s ordinances which ought not to be mitigated; and the other, the deaths that began to occur under the administration of chloroform. As to the first, a specimen of the objectors is furnished by a clergyman, who wrote “that chloroform was a decoy of Satan, apparently offering itself to bless woman; but in the end it will harden society, and rob God of the deep earnest cries which arise in time of trouble for help.” Even the relief of pain in surgical operations was held by many to be unwarrantable. But a powerful counter-argument was found, in the much greater ease and certainty of success with which surgeons could now perform their operations when the cries and writhings of the patient were removed. The controversy that ensued, however, would fill a volume, and Simpson in it proved himself, as ever, a hard hitter.
For many years scarcely anything but chloroform was used for producing anæsthesia; but gradually numerous unexpected deaths under its administration led many to think that it had too depressing an effect on the action of the heart, in some cases at least, and led to the trial of other agents, including bichloride of methylene, the reintroduction of ether, and nitrous oxide. The two latter are very largely used at present, and so also is a mixture composed of one part by measure of alcohol to two of chloroform and three of ether, also known as the A.C.E. mixture, from the first letters of the three constituents. This is now considered by many to be safer than chloroform. What will be the judgment of future experience we can have no pretensions to decide.
We cannot give in detail the subsequent events of Dr. Simpson’s life. It became more busy and active, more benevolent, and more distinctly religious as years went on. He refused advantageous offers to settle in London, and instead patients came from all parts of the world to consult him in Edinburgh. His hospitality was unbounded. His daily breakfasts and luncheons have been graphically described by a well-known poet. “Assembled unceremoniously in a moderate-sized room, with little in common save the wish to meet their host, you found a company drawn together from every latitude and longitude, social and geographical. Of all this motley party there is probably hardly one who is not notable, and the grades and classes of eminence run through the whole gamut of social distinction from duchesses, poets, and earls, down to the author of the last successful book on cookery, the inventor of the oddest new patent, a Greek courtier, a Russian gentleman, or a German count. At your elbow the last survivor of some terrible shipwreck is telling his story to the wife of that northern ambassador, who is meeting, with the softest Scandinavian dialect, the strong maritime Danish of the clever State secretary opposite. Behind you a knot of American physicians, just arrived, are discussing in a loud voice, a speech in Congress, or agreeing, sotto voce , on the particular professional topic upon which they have come to consult the great authority. Turn for a moment from this sculptor, who is waiting to ask the opinion of the many-sided professor on the sketches which he is now showing to that portrait-painter, and to learn which of them shall be done in marble for the nobleman whose attention the doctor has found time to direct to the rising young artist, and you may catch something of yonder violent discussion between those arrivals from Australia, who have come from the land of gold in search of what gold cannot buy.”
But it is by no means only in connection with ether and chloroform that Simpson introduced a new practice. Besides numberless suggestions and novel ideas in midwifery, he brought forward (in 1859, after some years of study) a totally new method of closing arteries after operations and in substitution for ligatures, so often the cause of inflammation. Long before John Hunter had pointed out that needles and pins when passed into and embedded in the living body seldom or never produced any inflammatory action. Simpson was struck with the idea that slender sharp-pointed needles or pins of non-oxidisable iron, somewhat like hare-lip needles, might be used to close together the walls or flaps of wounds, at the same time keeping the blood-vessels closed. These pins could be withdrawn very early, and would greatly favour healing at the earliest possible moment. The new method, called acupressure, of course met with much opposition, and Simpson was severely censured for meddling in a preserve strictly limited to the surgeon. But the help of the Aberdeen surgeons, Keith and Pirrie, was of great service in promoting the fair trial of the practice. His attack on the prevailing hospital system in 1869 was one of his later crusades, and he certainly accumulated a great store of facts showing the unhealthiness of the existing conditions of aggregation in crowded hospitals. His advocacy of a separate system in hospital construction, and of limiting the number of patients close together, of course drew on him further fierce opposition. We cannot here refer to his strong exposure of the fallacies of homœopathy, his vigorous actions in connection with the University of Edinburgh, or the numerous antiquarian papers which his prolific pen gave forth. Every year had crowded into it three times as much research as a very industrious man could manage, ten times as much controversy, and twice as much practice. Honours came thick upon him. In 1856 he was greatly gratified by the French Academy’s award of the Monthyon Prize of 2000 francs for “most important benefits done to humanity.” At the beginning of 1866 he was created a baronet. In 1869 the freedom of Edinburgh was presented to him.
Heavy affliction came now and again to embitter his life. Several children were taken from him in the prime of their life, including his eldest son, who showed great promise of a brilliant medical future, but was cut off within a fortnight after his father was made a baronet. In later life he became an ardent church worker, having joined the Free Church of Scotland when the Disruption took place. 1870 found the vital machine much out of order. Heart pain—angina pectoris —so often the scourge of medical men, came more frequently with its terrible strain. But he never relaxed his work in the intervals, until absolutely compelled. In one of his later conversations he said, “How old am I? Fifty-nine. Well, I have done some work. I wish I had been busier.” One of his expressions showed his distaste for theology. “I like the plain simple Gospel truth, and don’t care to go into questions beyond that.” During almost his last night he was inexpressibly comforted by having with him his brother Alexander, who had watched over him with such tenderness from childhood. He sat on the pillow with Sir James’s head on his knee, and the sufferer again and again slowly uttered the words, “Oh, Sandy, Sandy!” He died on May 6, 1870. He would have been buried in Westminster Abbey but for his own express wish to be buried in Warriston Cemetery, Edinburgh. His funeral was such as Edinburgh had, it is said, never witnessed before, business being generally suspended. His widow survived him but a few weeks, dying on the 17th June following. His eldest surviving son, Walter Grindlay, succeeded him in the baronetcy.
FOOTNOTES:
[5] Memoir of Sir James Y. Simpson, by J. Duns. Edinburgh, 1873.
[6] Scotsman, May 9, 1870.