The steady advance of aseptic surgery has slowly but surely brought about the results which Simpson strove to attain by a radical measure. The enemy 184 which had baffled surgeons for centuries was revealed by Lister. He sent surgeons smiling into the operating-room practically certain of success instead of dreading the terrible onslaught upon their own handiwork of the formerly unseen and unknown destroyer. The death rate of operations is being daily brought nearer and nearer to vanishing point. In his review of the progress of wound treatment during the Victorian Era published in the Diamond Jubilee number of The Practitioner, Mr. Watson Cheyne says the mortality of major operations does not now exceed in hospitals more than three or four per cent., and this is made up practically entirely by cases admitted almost moribund and operated on in extremis with faint hope of survival. The field of surgery, too, has been vastly enlarged, and the term “major operation” includes not merely operations of necessity, undertaken through ages past as the only possible means of saving life, but also operations which have become possible only in recent years—some of them performed merely to make the patient “more comfortable,” or even only “more beautiful.” And this glorious result is due, as Mr. Cheyne truly says, to the immortal genius of Lister.
In 1867 Simpson propounded in the Medical Times and Gazette a proposal for stamping out smallpox and other infectious diseases such as scarlet fever and measles. In spite of vaccination, which, however, was imperfectly carried out, smallpox alone carried off five 185 thousand lives annually in Great Britain. A serious outbreak of rinderpest in the British Islands amongst cattle had recently been arrested and exterminated by the slaughter of all affected animals. The disease spread as smallpox did by contagion, and Simpson fell to wondering why smallpox could not also be exterminated. His paper was a noteworthy contribution to the then infant science of Public Health, and his proposal, which was, however, universally regarded as impracticable, sprang from his courageous enthusiasm as did that concerning hospitals. He suggested that the place of the pole-axe in the extermination of rinderpest might in the arrest of smallpox be taken by complete isolation, and he laid down simple but rigid rules for its enforcement. An attempt was made to utilise these a few years after when an epidemic of fatal violence broke out in Edinburgh. He was in no way an anti-vaccinationist, but his isolation measures were too strong for the people in those days. We are not surprised that he boldly proposed this measure, for he related glaring instances of neglect of the simplest precautions. Beggars held up infants with faces encrusted with active smallpox into the very faces of passers-by in the streets of Edinburgh; and on one occasion a woman was found in Glasgow serving out sweetmeats to the children of a school with her hands and face covered by the disease. He cried aloud for legislation to prevent such gross abuses, which he did not hesitate to stigmatise as little short of criminal.
CHAPTER XI
FURTHER REFORMS—HONOURS
Professional and University Reform—Medical women—Honours—The Imperial Academy of Medicine of France—Baronetcy—Domestic bereavement—The University Principalship—Freedom of the City of Edinburgh—Bigelow of Boston—Views on education—Graduation addresses.
Professor Simpson took a warm interest in medical politics, and made himself heard as a member of the Senatus of the University. That body was not renowned for any spirit of harmony prevailing in its midst; it included the medical professors many of whom were in professional opposition to each other and were actuated by conflicting interests. The rivalry prevailing amongst the leaders of the profession in the Scots capital was amusingly shown in one of Sir James’s letters, where he related how Professor Miller had just given a capital address to the young graduates and recommended them to marry chiefly because Mr. Syme had advised the reverse two years before. “At least,” he said, “so Mr. Syme 187 whispered to me, and so, indeed, did Miller himself state to Dr. Laycock!”
On the principles of Medical Reform and University Reform the professors were, however, practically unanimous, but their interests came into conflict with those of the extra-academical school. The two opposing bodies worked hard to gain their own ends when a Parliamentary Committee was appointed in 1852 to inquire into medical reform. The modern Athens became once more disturbed by wordy warfare. The general ends aimed at by the reformers were the obtaining of a proper standing for qualified practitioners; some satisfactory means of enabling the public to distinguish between regular and irregular, quack, practitioners; and to define the amount of general and professional knowledge necessary for degrees and qualifications. It was also desired to remove the absurd anomaly whereby, although Scots medical education was then ahead of English, Scots graduates had no legal standing in England. The Medical Act which was passed in 1858 carried out many of the best suggestions made before the Committee, and effected desirable improvements both in the status of practitioners and in medical education; but it was inadequate, as time has shown, and the question of reform still burns. Simpson took an active interest in the proceedings before the Committee, and made several dashes up to London to further the projects which he had at heart. The 188 annual meeting of the British Medical Association was held in Edinburgh in July, 1858, at the moment when the fate of the Bill hung in the balance. As the journal of the Association said at the time the fruit of a quarter of a century’s growth was plucked in the midst of the rejoicings. Sir Robert Christison publicly stated that owing to Simpson’s energetic efforts certain far-reaching and objectionable clauses, which had been allowed to creep into the Bill, were expunged at the last moment. Simpson went up to London by the night train, employed the following day in effecting his purpose, and returned the next night; this was when the journey took nearly twice as many hours as now.
The Universities (Scotland) Act was also passed in 1858; by it the complete control of the University, and with it the patronage of many of the Chairs, was lost to its original founders, the Town Council, who had so carefully and successfully guided it through nearly three centuries. The Council did not part from their charge without a struggle; in urging their cause they proudly pointed to the fact that they had appointed Simpson to the Chair of Midwifery against the opposition of the medical faculty. To have elected him, they thought, under such circumstances displayed their discernment, vindicated their existence, and pleaded for the perpetuation of their elective office.
When the question of the admission of women to 189 the study of medicine came up in Edinburgh and divided the ancient city once more into two hostile camps, Simpson’s sympathies appear to have gone with the sex to which he was already a benefactor. He recognised that there was a place, if a small one, within the ranks of the profession for women; and when the question came to the vote he cast his in their favour. The proposal, however, was rejected, and has only quite recently become law in the University.