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Applies for a village appointment—Disappointment—Brother's
help to further studies—Dispensary assistant—Obtains University M.D.,
1832—Thesis—Assistant to the Professor of Pathology—Turns to
obstetrics—Attends Professor Hamilton's lectures again—Royal Medical and
Royal Physical Societies—Edward Forbes—The Oineromathic Society—Foreign
tour—Visits Liverpool and meets Miss Jessie Grind lay—His characteristics,
principles, and methods, with extracts from addresses.
There now came the first crisis in Simpson's medical career.
After his father's death he felt that having obtained his qualification to
practise it was his duty to relieve his family of the burden of supporting
him through more extended studies. After due deliberation he applied for a
small appointment which would have served as a nucleus for private practice,
that of parish surgeon to a small village on the banks of the Clyde. Those
in whose hands the appointment lay were not impressed with his fitness for
the post, and he was not elected. "I felt," he afterwards said, "a deeper
amount of chagrin and disappoint ment
than I have ever experienced since that date. If chosen, I would probably
have been working there as a village doctor still." Although such a
commencement might have delayed his ultimate rise to eminence, it cannot be
agreed that it could possibly have prevented it. It was at this crisis that
what he tenderly referred to as "the ceaseless love and kindness of a dear
elder brother" came to his rescue, and by Alexander's or, as he
affectionately called him, "Sandy's" help, he returned to Edinburgh to
resume his studies in the winter session, 1830-31. His other brother, David,
had started in business as a baker at Stockbridge, close to Edinburgh, and
James boarded with him there for a time. His qualification enabled him to
become assistant to a Dr. Gairdner in dispensary practice, a class of work
he had had some experience of in the previous year while staying with Dr.
Girdwood at Falkirk during the summer. Dr. Gairdner was much struck with
Simpson's abilities, which he stated, "promised the most flattering
expectations." In the course of his first experiences of actual practice he
became impressed with the necessity for a knowledge of obstetrics, and
therefore attended lectures on" the subject by Dr. Thatcher, an extra-mural
teacher of repute, who subsequently applied for the University chair of
midwifery when Simpson was the successful candidate.
His chief object, however, was to qualify for the degree of
Doctor of Medicine of the University, and this he succeeded in doing in
1832. The regulations for this coveted degree were, for the times,
wonderfully complete ; it was held in such high estimation and such large
numbers qualified annually—in 1827 there were one hundred and sixty
graduates — that the authorities felt justified in being stringent. The
length of the course of study necessary for graduation had been fixed at
four years, and required the candidate to have attended classes in Anatomy,
Surgery, Materia Medica, and Pharmacy, the Theory and Practice of Medicine,
Clinical Medicine, Midwifery, Chemistry, and Botany, as well as a three
months' course in any two of the following:— Practical Anatomy, Natural
History, Medical Jurisprudence, Clinical Surgery, and Military Surgery. The
first step in examination took place at the house of one of the professors
where the candidate was questioned in literary subjects, chiefly Latin, and
in the different branches of Medicine and Surgery. If he passed this
satisfactorily he was examined more minutely by two professors in the
presence of the others, and was subsequently given two Aphorisms of
Hippocrates to explain and illustrate in writing and to defend before the
faculty, as well as two cases with questions attached. The last step was the
presenting of a thesis which was read by one of the faculty and was publicly
defended by the candidate on the day of graduation. All this examination was
conducted in Latin. Simpson's thesis was entitled : "De
causa mortis in quibusdam inflammationibus proximo" He
was amongst the last graduates who were examined through the medium of
Latin, for after 1833 the language was optional, and English soon became the
only one used; at the same time the examinations were differently arranged,
and made to consist of more thorough and prolonged written and oral stages.
Being on a pathological subject, Simpson's thesis was allotted to Thomson,
the professor of Pathology, to examine, who not only recommended the author
for the degree, but was so impressed by the ability displayed in the
dissertation that he sought him out and promptly offered him the post of
assistant,, which Simpson as promptly accepted. This appointment was most
welcome. Not only did it give him a much desired opportunity for
pathological work, but the salary of £50 a year enabled him to free his
family from the immediate necessity of supporting him.
If to MacArthur and John Reid was due the credit of first
directing Simpson's thoughts to the study of medicine, to Professor John
Thomson belongs the credit of having made him an obstetrician. "At Dr.
Thomson's earnest suggestion and advice," says Simpson, "I first turned more
especially to the study of midwifery with the view of becoming a teacher of
this department of medical science." He lost no time in throwing himself
heartily into the work that was nearest to him, and became almost
indispensable to his chief. Most of his time was spent in the
Pathological Museum, busily engaged in arranging,
classifying, and describing the preparations, but he also assisted in
preparing the professor's lectures. He took up more readily than Thomson the
then new mode of study by the microscope, and it is related that once he
composed a lecture for his chief on this subject which Thomson delivered
without previous perusal. Several times as Thompson read the lecture to the
class he looked up to glare at his assistant, and when they returned to the
side room he shook his fist in his face, saying, "I don't believe one d—d
word of it."
Although Simpson was now earning enough by his salary as
assistant to meet his expenses at the time, his family maintained their
loving interest in his welfare. His sister told him he was working too hard
and hurting his health. "Well," he replied, "I am sure it is just to please
you all."
Sandy, who had married in 1832, watched his career carefully,
and when the cholera made its appearance in Scotland he made a will with a
provision for "my dear James" in the event of his death. "I daresay," he
addressed his family therein, "every one of you has a pleasure in doing him
good by stealth as I have had myself."
By Thomson's advice Simpson attended Hamilton's lectures in
the winter session 1833-4, and this time with awakened interest. With the
definite object of devoting himself to Midwifery clearly in view Simpson
worked with all his phenomenal energy during the years from 1832 to 1835,
studying the subject while he was helping Thomson. He entered the front rank
of the young graduates of his day, and was elected a member of the Royal
Medical and "Royal Physical Societies in the same year, 1833. Both these
societies were for the encouragement of scientific study and discussion
among students and young graduates, and to obtain the Presidential chair of
either was a high honour. The Royal Medical Society was the oldest Society
in the University, having been established in 1737 by the great Cullen and
others ; it had always been of great account in the University, and the
originality of the utterances on professional matters which emanated from it
made it then a power to be reckoned with not only in Edinburgh, but
throughout European professional circles. For membership of the Royal
Physical Society he was proposed by Edward Forbes, a brilliant youth, who
subsequently distinguished himself in Natural History, and held the
University Chair in that subject for a brief period until cut down
prematurely at the age of thirty-nine. Forbes was the leader of a set of
able young students who have left a distinct mark in the history of the
University. John Reid was an intimate friend of Forbes, and Simpson was
probably as intimate with him. Forbes was the founder and editor of the best
of all the shortlived literary ventures of Edinburgh undergraduates—The
University Maga which
was issued weekly in 1834; and he was also one of the founders of the
Oineromathic Society, " The brotherhood of the friends of Truth." Forbes
thus described the nature of this Society in song :—
" Some
love to stray through lands far away,
Some love to roam on the sea,
But an antique cell and a college bell,
And a student's life for me.
For palace or cot, for mead or grot
I never would care or pine,
But spend my days in twining lays
To Learning, Love, and Wine."
"Wine, Love, and Learning" was the motto of this curious
brotherhood, and it numbered in its membership many men of the day, who
afterwards became eminent, such as Forbes himself, Reid, George Wilson,
Goodsir, and Bennet. Simpson must have been quite cognisant of this
Society's doings; he was closely associated with its leaders, but his name
does not appear in any of the lists of members still preserved. His
whole-hearted devotion to the MA9H2I2 probably prevented his uniting with
the brotherhood to worship the EPOS and OINOS. The brotherhood was
conspicuously united. In the great snowball riot of 1837, which was quelled
only by the reading of the Riot Act and the marching down at the double from
the Castle of the Cameron Highlanders into the University gates, they fought
shoulder to shoulder.
In 1835 Simpson felt that the time had come to enter into
serious practice and turn his acquired knowledge to account. Fifty pounds a
year was no large income on which to satisfy his craving for learning, and
there was no surplus from which by any means to repay his family for their
assistance. Before taking any decided step, however, he desired to pay a
visit to the Continental centres of medical science and teaching. The funds
for the proposed tour were promptly found by his brothers Alexander and
John; by their assistance he was enabled to visit Paris, Lilge, and
Brussels, as well as London and Oxford. He was accompanied by Dr. (now Sir
Douglas) Maclagan, and kept a journal of the tour, which is an interesting
example of his lively powers of observation. In London he visited the
leading hospitals, and made the acquaintance of the leading physicians and
surgeons, amongst whom were many alumni of
his own alma
mater.
In the journal he freely and concisely criticised the men, their methods,
and their hospitals. In Paris he followed the same plan, going the round of
all the hospitals, and searching for and grasping the principle which guided
each distinguished man's thought and teaching. He took more than a medical
interest in all that he saw, and noted the appearance and habits of the
people of each place that he visited. At the end of his coach ride from
London to Southampton, on the way to Paris, he sat down to write :— " The
ride as far as Windsor Park was delightful, and from the top of the coach we
had two or three most lovely glimpses of English scenery. After passing
Windsor the soil was rather inferior in many parts, and we passed every now
and then large tracts of heath. . . . The neatness and cleanliness of the
English cottages is greatly superior to all that we have in Scotland ; the
little patches of garden ground before, behind, and around them set them off
amazingly. I wish the Scottish peasantry could by some means or other be
excited to a little more love of cleanliness and horticulture. I did not see
above two or three dirty windows, men or women along the whole line of road.
The snow-white smock-frocks of the Hampshire peasantry do actually look well
in my opinion."
At Liége on June 13th he wrote:—"And is it possible that I
here begin a second volume of a journal? . . . I began my journal chiefly
with some distant prospect of teaching myself the important lesson of daily
notation. I am vain enough to flatter myself now that I have partly at least
succeeded. At all events that which was at first a sort of task, at times
rather an annoying task, has now become to me a pleasure. If I had my first
volume to write over again I think I would now write it twenty times better.
In writing a journal 'tis needless to think of making no blunders in the way
of blots and bad grammar or of crooked sentences. We, or at least I, have
occasionally felt so confoundedly tired at night that if I had been obliged
to attend to such minutiae I certainly would not have been able to advance
above two sentences.
"This morning rose by half-past seven—dressed and breakfasted
on coffee and rolls, read the Liege
Courier,
and by nine o'clock called on Professor Fohman with a copy of Dr. Reid's
paper on the glands of the whale, which I had promised him yesterday. The
Professor kept us until five minutes to ten, lecturing us on his discoveries
upon the original elementary tubular structure of animal tissues. Somebody
has remarked that no person ever entered into or at least came out of the
study of the Book of Revelation without being either mad before or mad after
it. I would not choose to say that Dr. F.'s case is perfectly analogous, but
has it not some analogy ? He seems to run wild on elementary tubular
texture; .... he hates Lippi and his researches with a perfect hatred. Lippi
has been preferred to him by the Parisian Academy. Is he not working against
Lippi, and it may be against truth, if they happen to go together, which I
do not believe?
"We have taken our seats in the diligence tomorrow for
Louvain, and on leaving Liege I must confess that I leave one of the most
lovely places I have seen on the Continent. 'Tis rich, populous, busy ; the
town in itself is old and good, though not so neat and clean as Mons; its
environs wild and romantic. Besides it seems full of good-natured gash old
wives, and sonsy, laughing-faced, good-looking, nay, some of them very
good-looking girls."
The homeward journey was made via Birmingham, Liverpool,
and Glasgow. In Liverpool he called upon a distant relative named Grindlay,
established there as a shipper, and laid the foundation of a life-long
friendship with the family. He also then for the first time met Miss Jessie
Grindlay who afterwards became his wife.
With the end of this tour, Simpson brought to a close the
more strictly student part of his career, although it remained true of him,
as of all eminent scientific men, that he was a student to the end of his
days. He felt himself now fully equipped to enter into the professional
battle, and he stepped into the arena, not only full of vigorous life and
hope, but possessed of highly trained faculties, keen senses, and lofty
ideals. It was his strong, personal characteristics, apart from his
accomplishments, which at once placed him head and shoulders above his
fellows. "He had a great heart," says a recent writer, "and a marvellous
personal influence, calling forth, not only the sympathy and love of his
fellowmen, but capable of kindling enthusiasm in others almost at first
sight." It is impossible to overestimate this personal influence in
analysing the elements of his ultimate success, and it is more impossible
for those who did not feel it to realise its nature ; but that he became the
beloved as well as the trusted physician is due to this influence. "He had
no acquaintances," says the writer already quoted; "none could come into
contact with him and stop short of friendship." This was a powerful trait to
possess; it cannot be denied that he was fully aware of it and its value;
and used it with good effect in establishing himself as the greatest
physician of his day.
As a scientist he started with an eager desire for knowledge
and reverence for truth, to which was added the highly developed power of
mental concentration born of early self-training. When most men would be
waiting in what they would term enforced idleness, Simpson would be busy
with book or pen, deeply attentive to his occupation despite surrounding
distractions or temptations to frivolous idleness. He took the full measure
of the value of Time and handled his moments as another would a precious
metal. "At all times," he said himself, "on all occasions, and amidst the
numerous disturbing influences to which the medical man is so constantly
subjected, he should be able to control and command his undivided mental
attention to the case or object that he may have before him. ... In the
power of concentrating and keeping concentrated all the energies of
attention and thought upon any given subject, consists the power of thinking
strongly and successfully upon that subject. The possession or the want of
this quality of the mind constitutes the main distinction between the
possession or the want of what the world designates 4 mental
abilities and talents.'"
His high ideals, his conception of the functions of the
physician, and the strivings of the scientist are best shown in his own
words:—"Other pursuits become insignificant in their objects when placed in
contrast with ours. The agriculturist bestows all his professional care and
study on the rearing of crops and cattle ; the merchant spends his energies
and attention on his goods and his commissions ; the engineer upon his
iron-wheels and rails ; the sailor upon his ships and freights; the banker
upon his bills and his bonds; and the manufacturer upon his spindles and
their products. But what after all are machinery and merchandise, shares and
stocks, consols and prices-current, or the rates of cargoes and cattle, of
corns and cottons, in comparison with the inestimable value and importance
of the very lives of these fellowmen who everywhere move and breath and
speak and act around us? What are any, or what are all these objects when
contrasted with the most precious and valued gift of God— human life? And
what would not the greatest and most successful followers of such varied
callings give out of their own professional stores for the restoration of
health and for the prolongation of life—if the first were once lost to them,
or if the other were merely menaced by the dreaded and blighting finger of
disease?"
In one of his addresses of later years he urged upon his
students the objects and motives which had been his in early professional
life:—"The objects and powers of your art are alike great and elevated," he
said. "Your aim is as far as possible to alleviate human suffering and
lengthen out human existence. Your ambition is to gladden as well as to
prolong the course of human life by warding off disease as the greatest of
mortal evils ; and restoring health, and even at times reason itself, as the
greatest of mortal blessings. ... 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 the brightness and beauty that will ever cheer you onwards and keep
your steps from being weary in welldoing; . . . while if you practise 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 grovelling love that dictates it."
Simpson's method of study was simple, at the same time that
it involved immense labour. In entering upon a new work his first proceeding
was to ascertain conscientiously all that had already been said or written
by others upon the subject. He traced knowledge from its earliest sources
and was able, as he followed the mental workings of those who had preceded
him, to estimate the value of every vaunted addition to the sum of knowledge
; and to weigh the theories and new opinions of men which had been evolved
with the progress of time, and which had sometimes obscured, instead of
casting greater light upon the truth. His antiquarian tastes added to his
knowledge of Latin helped him in this work and turned a tedious task into a
real pleasure. This preliminary accomplished, he plunged into the work of
adding to the knowledge of the subject by thought, research, experiment, or
invention.
In writing upon an abstract subject he would disentangle the
confused thoughts of his predecessors and restate their opinions in direct
and simplified language. But matters of opinion never had such an attraction
for him as matters of feet; in dealing with these latter he would test by
experiment the statements of authorities and correct or add to them by his
own researches. Most of his professional writings, as well as his
archaeological works, are valuable for the historical resume of
the knowledge on the subject as well as for his additions. His later
writings show as careful an attention to the inductive method with which he
started, as those produced in the days of his more youthful enthusiasm; when
fame was attained and fortune secured, when excessive work was sapping his
physical strength, he never sank into lazy or slovenly methods in scientific
work, but ever threw his whole vigour into the self-imposed task.
When studying Nature directly he was constantly asking her
"why?"—just as in his notes of his teacher's lectures the query was ever
recurring. He never felt himself beaten by an initial failure, but returned
again and again with his questions with renewed energy each time. He was not
to be denied, and in this manner he wrested from Nature some of those
precious secrets the knowledge of which has relieved suffering and prolonged
human life in every corner of the globe. "He never kept anything secret,"
says his nephew and successor, Professor A. R. Simpson, "that he thought
could help his fellows, and it is hard to say whether his delight was
greater in finding some new means to cure disease, or in demonstrating to
others his methods of treatment."
He was indeed clothed in well-nigh impenetrable armour, and
provided with powerful weapons, when in the autumn of 1835 he returned from
his foreign tour to commence the serious fight in which his avowed object
was not only to obtain professional eminence, but to stand forth a proud
benefactor of the human race. Although he appealed always directly to Nature
and used his own well-trained eyes and ears in preference to those of
others, he did not completely brush aside authority as Sydenham had done; he
hesitated neither to extract all that was valuable, nor to discard what
appeared worthless from the writings of past masters. |
