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Success as a lecturer—Increased
practice—Generosity—Fashionable patients—Memoir on Leprosy—Controversy
concerning the Pathology Chair—Address to the Graduates,
1842—Squabbles—Purchases 52, Queen Street—A great and good physician—Called
to London—Visit to Erskine House—The daily scene at 52, Queen Street—Rangoon
petroleum and Christison—The disruption—His family—Appointed Physician-Accoucheur
to the Queen for Scotland.
SIMPSON had not long been engaged upon his new
duties before the town councillors gladly saw, and his brother professors
were obliged to admit, that the baker's son was bringing a mighty genius to
bear upon the subject of his choice from the chair of his ambition. He
cherished no ill-feeling against those confreres who had actively opposed
his candidature, but set to work amidst his new surroundings conscious that
the best way to obliterate bitter feelings was by gradually creating a
stronger feeling—that of respect for him as a man and a worker. He had dealt
heavy blows himself during the conflict—blows not easily forgotten. The
position demanded tact and patience, and he was not found wanting in either.
He converted many who had worked against him into adherents, admirers, and
even friends.
His lectures speedily attracted students.
Besides those who were entering the profession, grey-headed and grey-bearded
men, whose student days had long since passed away, came to sit at the feet
of this remarkable young man and hear the so recently despised subject dealt
with in his own masterly, scientific manner. Conciseness, clearness, and
directness characterised his delivery; while with illustration and anecdote
he made his dull subject fascinatingly interesting. It was his custom to
write out on a blackboard notes of the subject on which he was about to
speak—concise, pithy headings, which were hung up in the theatre and which
he proceeded methodically to explain and enlarge upon. So successful were
his efforts that even in the first session he was able to make the proud
boast that his class was for the first time in its history the largest in
the University, and this in spite of the fact that one of the leading
professors altered his lecture hour to the same hour as Simpson's, with the
purpose of injuring the attendance at Simpson's class.
A direct result of the reputation obtained
through his course of lectures and improved professional position was the
rapid increase of his practice and the improvement of the class of his
patients, so that pecuniary profit came within his reach. He continued to be
a general practitioner, however, attending to all classes of cases that came
to him ; but his zeal for midwifery and the diseases of women, together with
his renown in those subjects, brought mostly patients of the female sex to
his consulting-room. With the improved position there came necessarily
increased expenditure, which at first exceeded the income; he never stopped
to consider the patients' circumstances or whether he was likely to be paid
for his services. "I prefer to have my reward in the gratitude of my
patients," he said. He treated all that came to him, and his generous nature
was oftentimes taken advantage of by persons very well able to remunerate
him; moreover, at this time, when his pecuniary profit did not equal his
professional reputation, he cheerfully helped many who appealed to him with
amounts he could ill spare.
His father-in-law generously and willingly stood
by him until the fees began to come in more freely—his brother Sandy, who
had supported him hitherto, having now other claims upon his purse. He found
two ordinary but costly steps advisable—first, to move into a better and
more centrally situated house; and, secondly, to obtain a carriage, " both
to support my rank among my wealthier compeers and to save my body from
excess of work." The outlay was justified in the result; the fees from
students and from his private practice very soon enabled him to repay the
debts to his brothers and his father-in-law without inconvenience and with
grateful pleasure. Once and for ever within the first few years of his
professorship he placed himself in a safe position, free from all pecuniary
anxiety.
If he had laboured hard to fit himself for the
front rank of his profession, his work on attaining that position showed
increase rather than abatement. His private practice alone was the work of
more than one ordinary individual, and his professorial duties took up some
of the best hours of his day. In the evenings and at all odd times he busied
himself with absorbing current or ancient literature, or in preparing his
own contributions to both professional and general knowledge either with the
pen or by experiment. "Oh that there were double twenty-four hours in the
day," he sighed at a time when he was working at highest pressure,
practising amongst peers, commoners, and cottagers alike, who all flocked to
his residence or sent long distances for him. When Princess Marie of Baden,
wife of the Duke of Hamilton, came under his special care in 1843 that he
was placed at the top of his profession in Scotland, and must have smilingly
recalled the words of old Dr. Dawson, of Bathgate, when he heard of the
successful contest for the Chair. "It's all very well," he had said, "to
have got the Chair ! But he can never have such a practice as Professor
Hamilton. Why, ladies have been known to come from England to consult him!"
They came from the furthest parts of Greater
Britain to consult Hamilton's successor, in spite of the old doctor's
prognostication!
The energy as well as the versatility of the man
is well shown in the works which he found time to carry on while he was thus
establishing himself as a teacher and as a practitioner, during the years
from 1840 to 1845. One of his first literary efforts, not wholly
professional, the Memoir on "Leprosy and Leper-Houses," was produced at that
time. It was a work of relaxation and pleasure, for it carried him deeply
into his favourite archaeology. The fascination which this subject always
had for him sprang from his love of nature, and of the greatest work of
nature— man. "The leading object and intent of all the antiquarian's pursuit
is man," he said, "and man's ways and works, his habits and thoughts, from
the earliest dates at which we can find his traces and tracks upon the
earth, onwards and forwards along the journey of past time. During this long
journey he has everywhere left scattered behind him and around him
innumerable relics forming so many permanent impressions and evidences of
his march and progress."
The quantity and quality of the information
concerning leper hospitals which he collected and embodied in his memoir,
contributed to the Edinburgh Medico-Chirurgical Society in March, 1841, was
phenomenal. He had consulted old manuscripts and registers, monastic
chronicles, burgh records, and Acts of Parliament, as well as Works of
antiquity, travel, and history. He gave close upon five hundred references,
as well as a list of one hundred and nineteen leper-houses, whose existence
in Britain and whose history he had traced. The work illustrates the objects
and proper methods of antiquarian research, which twenty years afterwards he
dilated upon in his address from the Chair of the Scottish Society of
Antiquaries. In the course of it he pointed out how vigorously our ancestors
had set to work to stamp out the disease when it spread through Europe
during the period from the tenth to the sixteenth century. The method
adopted was that still employed—segregation ; about the twelfth century
scarcely a town or burgh in France and Britain was without its
leper-hospital. Although we in Britain are happily now freed from its
ravages, other parts of the world are not so fortunate. It is still regarded
popularly as an incurable disease, as it was in 1597, when one Catherine
Livingstone was gravely brought to trial for witchcraft, one instance of
which had been that she dared to state her ability to cure "leprosie, which
the maist expert men in medicine are not abil to do." The indictment set
forth that she "took a reid cock, slew it, baked a bannock with the blude of
it, and gaf the samyn to the leper to eat." The witch's remedy is scarcely
more curious and certainly no less useful than those recommended two
centuries later by John Wesley in his "Primitive Physic," where, moreover,
he cheerfully, if somewhat too briefly to satisfy the modern inquirer,
reports the cure "of a most desperate case " by the drinking of a half-pint
of celery-whey morning and evening.
Scotland was severely smitten by leprosy in the
centuries when it overspread Europe; Robert Bruce fell a victim to it in
1339, and the disease seems to have lingered in the North after it had
almost vanished from England.
Simpson's paper was published in the Edinburgh
Medical and Surgical Journal in three parts in 1841 and 1842, and to this
day is the most valuable contribution to the interesting and important
history of the disease. Some of the information had been collected in his
student days. In his antiquarian researches he had frequently met with
references to the dirty and unwholesome habits and surroundings of Scots
towns in early days. The thought that dirt and disease were directly
connected—a new thought even so recently as fifty years ago—led to his
-investigations. He found that leprosy was most prevalent at the time when
his country was most dirty ; but he was not able to establish his
supposition that the cause of the disease lay in the insanitary surroundings
of the people ; indeed his researches proved that, on the contrary, leprosy
had declined and practically disappeared from the country long before any
material improvement in sanitary conditions took place.
Simpson's conduct when Professor Thomson
resigned the Chair of Pathology illustrates the vigour with which he entered
into quite casually arising incidents where he saw that strength and a fight
were necessary to conquer an evil or prevent an abuse, Thomson resigned in
1841 owing to ill-health. The Chair had been established by William IV. in
1831 on the representations of Thomson himself, who succeeded in satisfying
Lord Melbourne that the subject was worthy of the dignity of a separate
Chair, in spite of the protests of the Senatus Academicus, who throughout
the history of the medical faculty generally appear to have been actuated
more by personal considerations and professional jealousies, where new
developments were in process, than by zeal for their Alma Mater. Professors
Syme and Alison actively led an agitation that with Thomson's resignation
the separate teaching of pathology should be brought to an end. Without a
moment's hesitation, in the midst of his hard work, and suffering from
indifferent health, Simpson plunged into a controversy with these
colleagues, in which he silenced at once and for ever the detractors who had
sneered at him as an ignorant, uncultured man-midwife. The controversy as
usual was followed with intense interest by Edinburgh folks, and Simpson
received a first taste of that popular approval which undoubtedly was one of
the enjoyments of his life. The Crown avoided the difficulty of deciding
between the rival petitioners for and against the Chair by transferring its
patronage to the Town Council, who showed the same foresight which had led
them to appoint Simpson, in deciding to maintain its existence.
Unfortunately their wisdom foiled when they elected as Thomson's successor a
man who, although of brilliant attainments, subsequently brought discredit
upon his University and himself by becoming a convert to homoeopathy.
Simpson, who was indirectly instrumental in securing the Chair of Pathology
for this man became his bitterest opponent when he declared himself a
follower of Hahnemann's unorthodox and mistaken doctrines.
In 1842 it fell to Simpson's lot to deliver the.
customary address to the medical graduates after they had received their
degrees at the annual ceremonial on , on the 1st of August. He treated his
listeners to a discourse on the duties of young physicians. When we remember
that he had attained to his then high professional position while he was no
more than a young physician himself, we recognise that he was but setting
forth the ideals and principles which had been and still were his guides in
life and conduct.
After warning his audience against regarding the
gaining of the coveted degree as the end of their student career, instead of
as in reality the opening up of a lifetime of observation and study, he
pointed out that self-patronage was the best of all patronage. "Place from
the first," he said, "all your hopes of advancement upon the breadth and
extent of your medical abilities alone. . . Rather walk by the steady light
of
your own lamp than by the more dazzling, but to
you more uncertain, lustre borrowed from that of others. . . Young
physicians often dream that by extending the circle of their private
acquaintances they thus afford themselves the best chance of extending the
circle of their private patients. . . No man will in any case of doubt and
danger entrust to your professional care the guardianship of his own life or
of the life of those who are near and dear to his heart, merely because you
happen to be on terms of intimacy with him. The self-interest of human
nature forbids it. . . The accomplishments which render you acceptable in
the drawing-room are not always those that would make your visits longed for
or valued in the chamber of sickness and sorrow. . . Give therefore your
whole energies to medicine ; and in its multiplied departments you will
find i ample room and verge enough for the most energetic as well as the
most comprehensive mind. Place your faith in no extrinsic influences. Let
your own professional character be the one great patron to whom you ever
look for your professional advancement." He exhorted the young practitioners
above all to save and economise their time, and to regard it as a property
to be avaricious of and of every item of which they were to render a proper
account to themselves. "It is by carefully preserving, confirming, and
making diligent use of these broken and disjointed portions of it, which
others thoughtlessly waste and destroy, that almost all the highest
reputations in the medical profession have been formed." He strongly urged
the value of a "proper covetousness of time." "Look around, and you will
find that those who have the most to do in the way of business as
practitioners have also apparently the most time to spare as observers and
writers. And why? Because they have all their daily duties perfectly
assorted and arrayed ; they save from loss and destruction £very possible
fragment of time ; and this very industry and precision procures them more
true leisure than indolence can boast of."
In referring to the relation of practitioner to
patient, he spoke on a subject which has been much discussed in recent years
without altering the principle originally laid down in the oath of
Hippocrates :—"Whatever," said Simpson, "is communicated to you as a matter
of professional confidence, must ever remain buried within your own breasts
in all the silence and secrecy of the grave." He concluded his address with
well-judged remarks on the relation of the physician to his professional
brethren, counselling his hearers to observe the Golden Rule, and, moreover,
" if it be possible, as much as lieth in you, live peaceably with all men;
never allow the darker part of your nature to persuade you to the attempt of
overtaking him who has distanced you in the race of life by any unjust
efforts to lame the character, and thus diminish the speed, of your
adversary. And if such attempts are made upon you by others, have no dread
of them—if you are armed strong in honesty, if you have pursued a line of
irreproachable truth and unbending rectitude of conduct. 'Be thou as pure as
snow thou shalt not escape calumny . . . Your future career is a matter of
your own selection, and will be regulated by the conduct which you choose to
follow. That career may be one of happiness or self-regret, one of honour or
of obscurity, one of wealth or of poverty. The one or other result is not a
matter of chance^ but a matter of choice on your part. Your diligence and
industry for the next few years will almost inevitably secure for you the
one; your apathy and indolence will almost inevitably entail upon you the
other. May God, in His infinite goodness, enable you to select the wiser and
the better path."
In this address, as in that previously quoted,
we hear him exhorting his young listeners to a line of conduct which we know
to have been broadly his own in practice as well as in ideal. During these
early years as professor, Simpson had to ward off many ill-disposed
adversaries, and he met their attack with the determination and powerful
preparedness that characterised his attitude in later years, when he
experienced the hostility so constantly opposed to genuine reformers, and
men who have lived ahead of their times. He sometimes regarded these
encounters regretfully himself; but none the less remembered to
"Bear't that the opposed may beware."
The correspondence pertaining to some of
these disputes was filed and ticketed, with brief contempt, "Squabbles." His
controversy with Professor Syme over a personal matter in 1845 was not to
the credit of either of these great men, and, as Simpson himself confessed,
was equally discreditable to their profession. Simpson had seen, as has been
pointed out, several of his teachers fighting long and strongly for their
own cherished objects; and he doubtless then, in his student days, learnt
the lesson that vigorous persistence had the power to gain much that at
first seemed hopeless; he fought with such energy, that he accomplished in
his own lifetime what the example of others might have led him to think
would have been accomplished only by his successors.
The growth of his practice up to 1847 was short
of phenomenal. In 1845 he purchased No. 52, Queen-street, the house which he
inhabited up to his death, and which became the Mecca of hundreds upon
hundreds of pilgrims from all quarters of the globe. Here, in those years,
he was sought and consulted by unceasing crowds ; in the public mind he was
undoubtedly endowed with more than human powers, and regarded as a magician,
at the wave of whose wand pain and disease would vanish. This caused him
much embarrassment, and brought upon him the abuse of ignorant persons,
irritated to find that, after all, even in Simpson's person, there was a
limit to human powers; or of others with unimportant ailments who were
disappointed to find that, once having made his diagnosis of their
condition, he would have no more of them, preferring to place his time at
the disposal of those whose sufferings were real and capable of relief, or
whose cases were complicated and interesting. The question of remuneration
was always secondary, and so careless was he in pecuniary matters that it is
related that he would wrap up interesting specimens, professional or
antiquarian, in bank notes; and his trusted valet was in the habit of
emptying his pockets at night of the money earned in the day, to prevent its
being lost, mislaid, or given away to undeserving persons. With him work was
first and fee second. Like a great modern teacher he was able to say, " Work
first—you are God's servant; fee first—you are the fiend's." To Simpson
"work was master and the Lord of Work, who is God."
The personal power and attractiveness of the man
were large factors in gaining the practice which he now enjoyed. But he did
not depend for success on these alone, by any means. His professional
reputation was fully won by great work in obstetrics and gynaecology, and by
the introduction of methods and instruments which contributed to the saving
of countless lives. It has been said that he gave a new life to the
obstetric art, and presided at the birth of gynaecology. He had done this
before the great deed was dreamt of which hands his name down to posterity,
before his discovery of the anaesthetic power of chloroform. Simpson was a
great physician, the leading practitioner of the art and exponent of the
science with which his name will always be connected. But many great
physicians have failed to fulfil as Simpson did, Robert Louis Stevenson's
description of the physician :—
"Generosity he has such as is possible to those
who practise an art, never to those who drive a trade; discretion tested by
a hundred secrets; tact tried in a thousand embarrassments; and what are
more Heraclean cheerfulness and courage. So it is that he brings air and
cheer into the sick room, and often enough, though not so often as he
wishes, brings healing."
Great as a man and great as a physician, Simpson
was actually run after by the greatest in the land. In 1845 he was summoned
professionally to London, and gave an interesting description of his kindly
reception by the Duchess of Sutherland and her family in a letter written
from Stafford House. His advent to London was a matter of notoriety, and he
noted that he bought in the street a life of himself which mightily diverted
him and made him laugh until he was sore. A year or more later he was
invited for rest and change to Erskine House by Lord B lantyre, where he
says, "the Duchess of Sutherland, the Marquis and Marchioness of Lome, and
two Ladies Gower have made up with myself all the strangers." "Tell Janet,"
he wrote to his brother, "I think now artificial flowers very ungenteel. The
ladies here wear nothing but real flowers in their hair, and every day they
come down with something new and for us males to guess at. Often the Duchess
wears a simple chaplet of ivy leaves, sometimes a bracken leaf is all she
sports in her head ornaments, and beautifid it looks. Rowans and 4 haws' are
often worn beaded into crowns or flowers or chaplets. Heather is also a
favourite. On Thursday Lady Lome came down with a most beautiful chaplet
tying round and keeping down her braided hair. It was a long bunch of
bramble leaves and half-ripe bramble berries—actual true brambles. They have
been all exceedingly kind to me, and I really feel quite at home among them
though the only untitled personage at table."
The daily scene at 52, Queen Street was now
unique. Those who had the fortune to lunch or breakfast in that hospitable
house never forgot it. Statesmen, noblemen, artists, scientists, clergymen,
and politicians from various countries sat down together and entertained
each other or attempted to do so in their different languages. The host
guided the conversation while he still glanced over the newspaper or some
newly published book, and never failed by skilful leading to entice out of
every one the best knowledge that they possessed. With his quick insight he
rarely failed in his estimate of character, but rapidly perceived even in a
stranger where the conventional ceased and the real man began.
No stranger to Edinburgh omitted to bring or
obtain an introduction to the genial professor; all were welcome, and an
open table was kept. The scene has been described from intimate knowledge in
the columns of the Scots Observer as follows :— " Luncheon is set on the
table, and some ten, twenty, or even fifty people wait the appearance of
their host, who is on his rounds maybe, or in another room ministers to an
urgent case. A stranger who has not learnt that the great Simpson was only
in the broadest sense a punctual man—of minutes, hours, he knew nothing, but
none more reliably punctual, few so unsparingly regular in working while
'tis called to-day —might be prompted by hungry discontent to suggest that
none but the wealthiest can keep the doctor from his guests. The mere
suggestion would be infamous, for rich and ragged alike pay fees or not
exactly as it pleases them. Whatever the cause, the host still lingers, and
the impatient stranger has time to wonder how it is that so odd an
assortment of human beings should be met together in one room. Lords and
Commons rub shoulders at his table ; the salt of the earth sit down side by
side with the savourless; tweed jostles broadcloth; the town-bred Briton
looks askance at his country-bred compatriot, and both unconsciously shudder
at the Briton with no breeding at all. In one room are assembled together
the American of bluest blood ; the Yankee bagman ; the slave-owning
Southerner, and even the man of colour hateful to both alike. The atmosphere
is chill like the grave, each guest, eyeing his neighbour suspiciously,
shrinks into his own social shell; on each face the meanness and snobbery of
humankind is, if not aggressively expressed, at least clearly legible ; when
all at once Simpson bustles in. In a few minutes, under the genial influence
of his presence, all tongues are set a-wagging, and well may you ask whether
the men who leave his house after luncheon are those who half-an-hour ago
regarded each other with cold disdain. For now they are cordial, kindly,
sympathetic; each has been induced to show whatever was attractive in his
nature, or to give the fruits of his experience. If in one short hour
Simpson could thus transform a crowd of frigid, haughty strangers into an
assemblage of decent, amiable human beings, what could he not achieve in a
day, a year, or a life?"
His reception of members of his own profession
was specially cordial, and if those from any one country were more welcome
than others, it was the many who crossed the Atlantic to see and hear him.
America had the greatest share in the birth of anaesthetics, and Simpson's
intimacy with so many of the profession in the United States made it easy
for them to welcome his assistance in that great event. Gynaecology, too,
was eagerly taken up in America, and many were Simpson's admirers from that
country who returned home fired by his influence to work out for themselves
valuable additions to that science.
Simpson paid close attention to current events
in other branches of science, in politics, and in religion. Sir Robert
Christison and he were at one time associated in an enterprise which
narrowly escaped being the source of a fortune to him. Rangoon petroleum
which was obtained from pits dug on the banks of the Irawaddy had been
chemically investigated by Christison, and he had isolated from it a
substance which he named petroline; unfortunately, unknown to him, a German
chemist had independently made the same discovery a few months earlier, and
christened the substance paraffin. When, a few years later, it occurred to
Simpson that the crude Rangoon petroleum might serve as a lubricant for
machinery and prove cheaper than those in general use, he applied to
Christison. He met with willing assistance, but a refusal on principle to
have anything to do with a patent, which Christison laughingly suggested,
might be called " Simpson's incomparable antifriction lubricant!"
"When I called for Simpson," says Christison, in
his Recollections, "his two reception rooms were as usual full of patients,
more were seated in the lobby, female faces stared from all the windows in
vacant expectancy, and a lady was ringing the door bell. But the doctor
brushed through the crowd to join me, and left them all kicking their heels
for the next two experiments proved that petroleum was vastly superior\p
sperm oil, the best known and most commonly used lubricant. Simpson
proceeded to take out a patent, having no such scruples as Christison; but
to his chagrin found that he had been forestalled by others, and had to
abandon the subject.
About the period now referred to Scotland was
stirred from end to end by the ecclesiastical movement which culminated in
the crisis known as the Disruption, when, for reasons connected with the
jurisdiction of the National Church, a majority of its members severed their
connection therewith in a public and dramatic fashion, and " came out" to
found the now strong and vigorous Free Kirk. Simpson at first steered clear
of all the squabbles and discussions which the movement gave rise to, but
when affairs approached a crisis he threw his lot in with the leaders of the
new movement, and became a staunch Free Churchman.
Busy as he was, Simpson fully enjoyed his home
and all the inner domestic life. He was a cheery and hearty host to his
intimate friends, and took a pleasure in impromptu entertainments got up by
himself in his own house, when he found time at his disposal for such
amusement. His first child—a daughter—of whom he was mightily proud, was
born in 1840 ; his first son, David, in 1842 5 and the second, Walter, in
1843. In 1844 the young couple, in the midst of their rising prosperity,
suffered the loss of their daughter, who died after a brief illness. Simpson
felt the loss keenly, and wrote pathetically on the subject to his relations
; long afterwards he loved to talk of her and her winning ways.
By 1846 the vast majority of his work lay in
obstetrics and gynaecology, although he himself would no doubt have
indignantly repelled the suggestion that he was a specialist; his mind
recognised the interdependence of all the great branches of the healing art,
and the necessity for any who wished to excel or be useful practitioners to
be au courant with each and every branch. He had early shown that as a
pathologist alone he was worthy of a niche in the temple of fame ; and in
later days he was urged to apply for the vacant chair of Physic in his own
University ; while Professor A. R. Simpson tells us that foreigners working
in the sphere of surgery sometimes spoke of him as a surgeon.
Early in 1847 his good friend, the Duchess or
Sutherland, wrote to inform him that the Queen had much pleasure in
conferring upon him the vacant post of Physician to Her Majesty. In the
Queen's own words, "His high character and abilities made him very fit for
the post." He held this post until his death, under the title of Physician
Accoucheur to the Queen for Scotland.
Thus in his thirty-sixth year, to the pride of
his family and of the whole village community in which he had been born and
received his early training, to the admiration of patients and friends, as
well as to his own conscious satisfaction, the Bathgate baker's son had
risen by his own efforts to the highest attainable position in his native
land. But the work which was to make him one of the most conspicuous figures
in the history of medicine, and raise him to a place of honour in the
grateful estimation of humanity, was scarcely begun. |
