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Sir James Young Simpson
Chapter IV. Early Practice and Professorship (1835-1840)

President of Royal Medical Society—Personal appearance—Practice among the poor—Corresponds with Miss Grindlay—Lecturer on obstetrics—Resignation of Professor Hamilton—Applies for vacancy —Active candidature—'Strong opposition—Marriage—Account of the midwifery Chair—The medical professors at the time— Their opposition—Cost of candidature—Triumphant election.

IN November, 1835, Simpson was elected one of the annual Presidents of the Royal Medical Society ; a position which has been occupied by many young Edinburgh graduates, who have subsequently risen to fame. He took pains to make his inaugural address worthy of the occasion, and chose a subject connected with the pathology of obstetrics. It was a great success, and contributed largely towards giving him a recognised position as an authority in that branch of study. After appearing in the Edinburgh Medical and Surgical Journal for January, 1836, it was translated into French, Italian, and German. It also obtained for him his first foreign honour—one of a long list that

was made up through his lifetime—that of corresponding member of the Ghent Medical Society ; indeed, his early works received more attention and appreciation abroad than at home. In 1836, in order to widen his experience in his chosen subject, he filled the post of house-surgeon to the Lying-in Hospital, and held it for twelve months. He was also elected a Fellow of the Edinburgh College of Physicians. From this time he became a profuse writer on professional subjects, and developed an easy and convincing style ; he carried on this work pari passu with practice amongst the poorer classes of the city and in addition to his work in connection with the Pathology Chair, always keeping in view his great object of becoming an obstetrician. It was not until 1838 that he became an independent lecturer on Midwifery. He had intended to do so earlier, but owing to Professor Thomson's ill-health, he had been called upon to act as Deputy-Professor of Pathology, a most valuable and useful employment.

Simpson's personal appearance at this time has been described by one who visited a meeting of the Royal Medical Society on an evening when he was in the chair :—" The chair was occupied," says the narrator, " by a young man whose appearance was striking and peculiar. As we entered the room his head was bent down, and little was seen but a mass of long tangled hair, partially concealing what appeared to be a head of very large size. He raised his head, and his countenance at once impressed us. A pale, rather flattish face, massive brent brows, from under which shone eyes now piercing as it were to your inmost soul, now melting into almost feminine tenderness; a coarsish nose with dilated nostrils, finely chiselled mouth which seemed the most expressive feature of the face. . . . Then his peculiar rounded soft body and limbs, as if he had retained the infantine form in adolescence, presented a tout ensemble, which even if we had never seen it again would have remained indelibly impressed on our memory."

In Simpson's youth physicians and surgeons made a habit of cultivating peculiarities of appearances and behaviour, but he was so shaped by nature as to attract attention without artificial aid. The growth of long hair seemed a natural accompaniment to his massive head and broad expressive countenance.

His practice at this time was scattered over the city, and he took long tramps in the course of the day. In one of his letters to his brothers, who were still loyally supporting him in his increasingly successful endeavours to establish himself after his heart's desire, he says :—"The patients are mostly poor it is true, but still they are patients ; ... if my health is spared me, I do hope I may get into practice sufficient to keep me respectable after the lapse of years ; but I know years must pass before that. At present I enjoy the best possible spirits and health, and with all my toils was never happier or healthier."

Tout vient a point a qui sait attendre. Simpson knew how to wait, he knew that waiting did not mean inactivity. Every opportunity that arose for advancement found him prepared to take full advantage of it.

That his lectures on pathology were acceptable was made manifest by the address presented to him by the students of the class at the end of his temporary term of office, testifying to his zeal, fidelity, and success, their admiration of his high talents, of the varied and extensive research which he displayed, and of his uniform and kind afiability which, while it exalted him in the eyes of all as a teacher, endeared him to each as a friend.

During this period he kept up a correspondence with the Miss Grindlay, of Liverpool, whose appearance he had been struck with when he visited the family, and towards the end of 1837 he found time to visit there again accompanied by Dr. John Reid.

The way for his appearance as an extra-academical lecturer on midwifery was made clear at the end of 1837 by the death of Dr. Macintosh, a successful teacher of that subject. He had been in negotiation, without success, with this Dr. Macintosh for the taking over of the part or whole of his lectures, and found it easy to step at once into his place at his death. He was firmly determined to succeed ultimately to the University Chair of Midwifery. On one occasion he pointed out to some friends the then holder of the Chair, Professor Hamilton, thus:—"Do you see that old gentleman? Well, that's my gown!"

The good luck which had been his during his boyhood did not desert him when he began his course of lectures; for not only did he speedily attain a reputation for teaching, science, and practical skill, wonderful for one so young, but he had not two years to wait after thus establishing himself before the chair of his ambition fell vacant owing to the resignation in 1839 of Professor Hamilton, who died soon afterwards at the age of seventy-two.

It was a bold step for so young a man—for Simpson was only twenty-eight—to apply for the professorship. He was, however, not without his precedent. The second Monro obtained the Anatomy Chair at twenty-five, Alison filled that of Physic at thirty, and Thomas Hope and Alexander Christison were Professors of Chemistry and Medical Jurisprudence respectively each at the age of twenty-four. But this subject was one which was popularly thought to require a man of experience and especially a married man. Simpson had devoted his energies but partially to midwifery for only four or five years, and except for his short hospital appointment and recent experience as a lecturer on the subject had in the eyes of many no greater claim to the post than any other general practitioner, except in the feet that he had obtained a wide reputation in the science of the subject by his contribution to its literature and his researches. This last was the point on which he himself most relied ; for his age he had done more scientifically than any of his opponents. Those who had watched his career knew that he possessed in addition to zeal and ability, brilliant teaching and practical powers. The objection of his youth was less easily got over than that of his unmarried state. With characteristic promptness, as soon as he had determined to apply for the Chair and found that as a bachelor his chances would be small, he disappeared for a time from Edinburgh, and returned triumphantly with Miss Jessie Grindlay, of Liverpool, as his wife. It was a bold stroke which delighted his supporters, discomfited his opponents, who saw therein the removal of a barrier to his success and a weapon from their hands, and astonished the worthy town councillors in whose gift the appointment lay.

The Edinburgh Chair of Midwifery was established in 1726, and was indisputably the first Chair of its kind in the British Islands, and probably in the world. It was in that year that the Town Council first established the medical faculty, by appointing two Professors of the Theory and' Practice of Medicine and two of Medicine and Chemistry. A Chair of Anatomy had been instituted six years earlier through the instrumentality of the first Monro who became its first occupant. These five chairs were considered sufficient wherewith to teach all the medical knowledge of the day, and although appointed ad vitam aut culpam the professors received no remuneration out of the city revenues.. The Chair was not reckoned at first as a faculty Chair, but was termed a city professorship. The newly created medical faculty would have no midwifery within the precincts of the University ; and this is scarcely surprising when we remember that at first the only persons lectured to by the city professor were women of an inferior class in whose hands the practice of the art almost entirely lay.

Along with this appointment the Town Council established a system of regulation for midwifery practice within the city. It ordered that all midwives already in practice should at once be registered, and that no persons should thereafter enter on the practice within the city until they had presented to the magistrate a certificate under the hands of at least one doctor and one surgeon who were at the same time members of the College of Physicians or of the Incorporation of Chirurgeons, bearing that they had so much of the knowledge and principles of this art as warranted jtheir entering on the practice of it; whereupon a licence should be given them signed by four magistrates at least entitling them to practise. It was further enacted that certain pains and penalties were to be inflicted upon ignorant persons for practising without this licence whereby their "want of skill might be of such dangerous consequences to the lives of so many people". It is to be presumed that as qualified medical men granted them these certificates and that these women had extensive practices, they possessed also a fair amount of skill. But slowly and gradually they had to give way and retire to the rank of nurses before the rise and growing public tolerance of the qualified male practitioner of obstetrics.

The second occupant of the chair, appointed in 1739, was elevated to a place in the medical faculty, but Professor Thomas Young, who occupied it in 1756, was the first to teach the subject to medical students by means of lectures and clinical instruction. As already noted, it was left for James Hamilton to obtain the recognition of midwifery as a subject, a knowledge of which was necessary for the obtaining of the University medical degree.

At the time when Simpson was straining every nerve to gain the post he coveted, the medical faculty of the University comprised the following professors of the following subjects :—Botany, Robert Graham, who established the Edinburgh and Glasgow Botanical Gardens; Anatomy, Monro the third ; Chemistry, Hope, who discovered strontium in the lead mines of Argyleshire ; Institutes of Medicine, Alison, an eminent physician and philanthropist who first pointed out the connection between destitution and epidemics of disease, and secured improved Poor Laws for his country ; Practice of Physic, James Home; Materia Medica, Christison, the world-reputed toxicologist Natural History, Robert Jameson; Clinical Surgery, James Syme, the wonderful operator and teacher, and inventor of the "Macintosh" waterproof; Military Surgery, Ballingall; Medical Jurisprudence, Traill; Pathology, Thomson; and Surgery, Charles Bell, the discoverer of the double function of the nerves, who was ranked in his day on the Continent as greater than Harvey. It was thus not an undistinguished body that Simpson strove to enter; several of the best-known members were comparatively young men, recently appointed to their posts, and full of the rising scientific spirit. It is little to their credit that they were practically unanimous in opposing the candidature of this young and enthusiastic scientist, who afterwards shed such lustre on the University from the chair which they would have denied him for no reasons other than his youth and his humble origin.

Fortunately for Simpson and for the University, the appointment did not lie in the gift of the professors, but was entirely in the hands of the Town Council, comprising thirty-three citizens.

Such an election was always a matter of keen interest to the inhabitants of Edinburgh, and each candidate brought all the direct and indirect influence within his power to bear on every councillor whom he could reach. The Professors in the various faculties had no doubt great influence ; they openly canvassed for the candidate they favoured, and did not hesitate to decry those they did not approve of. Shortsighted as this professorial opposition was, it proved no small difficulty in Simpson's way. Foremost amongst his opponents was Syme, who commenced a long feud with him by supporting his chief rival, Dr. Kennedy;"I feel no hesitation in stating," he wrote purposely for publication, "that of all the candidates in the field, he (Kennedy) is out of all question, according to my judgment, the one that ought to be elected." Sir Charles Bell was equally emphatic, and characterised Simpson's testimonials, in a note which Kennedy circulated, as given by "good-natured people merely to do a civil thing to a friend"—which was his mode of describing the declarations of some of the most eminent men of the day.

Each candidate also brought political influence to bear, and Whig and Tory grew agitated as the contest became keener. Simpson seems to have thought that both political parties were in opposition to him, but he certainly had the strong support of Ritchie of Scotsman fame, and the no less important influence of Mr. Duncan Maclaren.

When writing to ask Mr. Grindlay for his daughter's hand, Simpson candidly confessed his pecuniary position at the time. He referred to a debt of 100 already owing to his brother Sandy, and added :—" Again he gave me a bill for 120 to assist me in furnishing my house. This has been renewed and becomes due in January. He hopes to be able to pay it, and I fondly imagined I would have paid the half, but this canvass has involved me in new difficulties, and besides, I have endeavoured to assist my sister to go out to Van Diemen's Land. As it is now I am self-sufficient enough to think that I am as well off as regards station in my profession as any who started here in the race of life with me. They have all, I believe, been aided by friends or by private wealth. They have almost all been fortunate enough to have the protection of a father's roof during the first years of practice. I have had no such advantages, but have worked and stood alone. I have accumulated for myself a library and museum, worth 200 at least, amidst these difficulties. These I have won by my pen and my lancet, and these are my only fortune. And now could you trust her future happiness to me under such circumstances ? I did not intend to ask her hand at present. I fondly hoped I might have first cleared myself of my debts."

Grindlay did not hesitate, but willingly gave his daughter, as she was willingly given, for better or worse.

The expenses of the canvass amounted to about 500, an amazingly large sum ; he spared no expense in printing and posting his testimonials and letters to every one who had any influence with the Council, however small; but taking into consideration the cost of printing and postage in 1839, it is difficult to realise how the money was expended. His aim was to make known his scientific attainments, powers as a teacher, and personal qualifications which he felt, if duly realised, would outweigh the disadvantages of his youth and comparative inexperience. His testimonials spoke in strong terms of his abilities and characteristics they were a good deal more numerous and elaborate than is customary to-day, but Kennedy's also made a fat volume of 150 octavo pages.

As the day of election drew near the excitement amongst citizens, professors, and students grew intense. Of the five candidates in the field, three, including his former teacher Thatcher, speedily fell out of the running. Dr. Evory Kennedy, of Dublin, and Simpson stood face to face as rivals. Kennedy was no mean opponent, and his supporters honestly considered him the better man of the two; his attainments certainly merited warm support. The prophets foretold a close struggle, and the event proved them correct. So keen was public interest that when a report was circulated that Kennedy was a bad lecturer, his friends brought him over from Dublin a few days before the election, hired a public room, and made him lecture to a crowded and enthusiastic audience to dispel that illusion. In spite of this the popular vote was decidedly in Simpson's favour; if the citizens had had votes Simpson would have been returned at the head of the poll by a large majority.

On Tuesday, February 4, 1840, at a Council meeting, at which all thirty-three members were present, the Provost himself proposed Kennedy, while Baillie Ramsay proposed Simpson. The result was awaited with breathless suspense, the chamber being crowded by anxious spectators. Simpson's enthusiasm had infected his supporters ; he had kindled the first sparks of that enthusiastic affection with which the citizens of Edinburgh ever after regarded him ; when his triumph, by the narrowest majority, was announced, the cheers resounded loud and long.

The same evening he was able to write to Liverpool :—

"i, Dean Terrace.

"I 'was this day elected Professor. My opponent had sixteen and I had seventeen votes. All the political influence of both the leading Whigs and Tories here was employed against me ; but never mind, I have got the chair in despite of them, Professors and all. Jessie's honeymoon and mine is to commence to-morrow."

It was the man's strong individuality which carried the day. The town councillors threw aside the political and academic bias of those who endeavoured to lead them, and elected the man who had boldly said, "Did I not feel I am the best man for the Chair I would not go in for it"; and had more boldly gone on showing them how thoroughly he felt what he said until they themselves came to believe it.

The gift of this Chair, as of many others in the University, has now passed from the hands of the Town Council into those of a body of curators, seven in number, three nominated by the University Court and four by the Town Council such a body might have made a more cautious choice, but never a more fortunate one both for the city and the University than this of their long-headed and far-sighted predecessors.

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