CodeDS/UK/5
Person NameSimpson; James Young (1811 - 1870); Sir; Professor; physician; obstetrician
Dates1811 - 1870
TitleSir; Professor
Epithetphysician; obstetrician
HistorySimpson was born on 7 June 1811 at Bathgate, Linlithgowshire, the seventh son and youngest of eight children of the village bakers, David Simpson and his wife.

He attended the local parish school, where he was soon identified as a promising scholar and his father and brothers committed themselves to providing him with the financial support necessary for a college education. Simpson enrolled as an arts student at Edinburgh University in 1825, aged fourteen, and began his medical studies two years later. He supplemented the official medical course by attending extramural classes, notably those in surgery offered by Robert Liston. Simpson, became a licentiate of the Royal College of Surgeons of Edinburgh in 1830 and graduated MD in 1832. The quality of his MD thesis (on inflammation) attracted the attention of John Thomson, professor of pathology, who appointed Simpson as his assistant. Simpson was elected senior president of the Royal Medical Society of Edinburgh in 1835. In 1836, while teaching pathology, Simpson secured an appointment to the City Lying-in Hospital in Edinburgh and began to practise midwifery on his own behalf. He undertook research into the diseases of the placenta, and in 1839 began to give extramural lectures on obstetrics. Later that same year he was appointed to Edinburgh University's chair of midwifery.

Since his days as a medical student Simpson had been greatly concerned with the problem of surgical pain. On 19 January 1847 he tried ether in a labour complicated by a deformation of the pelvis. He was using ether routinely within his obstetric practice by the end of 1847, employing an inhaler of his own design. Ether, however, had several disadvantages as an anaesthetic, particularly in domiciliary practice, and Simpson sought to find a substitute. David Waldie, chemist to the Liverpool Apothecaries' Company, suggested that the properties of chloroform might be worth investigating. On 4 November 1847 Simpson and his assistants, George Keith and James Matthews Duncan, tried inhaling a sample. In a very short time they collapsed, unconscious, dramatically displaying the substance's efficacy as an anaesthetic. Chloroform was first employed on an obstetric case on 8 November and its first public trial in surgery was successfully undertaken, by Professor James Miller, on 10 November in the Edinburgh Royal Infirmary. On 20 November 1847, a preliminary report was published in The Lancet. As the leading advocate of obstetric anaesthesia Simpson met with much opposition and prejudice. But Simpson's advocacy prevailed and anaesthesia, generally with chloroform, quickly became standard obstetric practice.

Simpson also made a considerable number of other major contributions, including several technical advances in the practice of obstetrics. He improved the technique of version-manual turning of the foetus in cases of deformed pelvis; he refined the design of the obstetric forceps; and he pioneered the development of the vacuum extractor. Despite his interest in technological aids Simpson's obstetric practice was significantly, and influentially, more patient and less interventionist than that of many of his colleagues. He was a vigorous champion of breastfeeding and understood the importance of what was later termed as 'bonding' between mother and baby.

Some of the most important work of the later part of Simpson's career concerned the complex problems of hospital infection and surgical sepsis. In 1850 Simpson argued that puerperal fever and surgical fever were identical and that both were contagious. He believed that victims of puerperal fever had been 'inoculated with a materia morbi … and this materia morbi is liable to be inoculated by the fingers of the attendant' (J. Y. Simpson, 414), in a manner analogous to smallpox inoculation. This was still an unpopular idea as late as the 1860s. Simpson advocated that the preventive methods which obstetricians had developed against puerperal fever, which principally entailed careful cleansing of hands and instruments, should be adopted by surgeons against wound sepsis. Simpson put forward a number of innovative ideas on hospital design, maintaining that alterations in layout and management, in particular the housing of patients in small isolated units, could improve the hospital environment to such an extent that the incidence of septic disorders would be greatly diminished. He first articulated this position in 1849 and his views were influential upon many later commentators on hospital conditions, including Florence Nightingale.

An inspiring and vigorous personality Simpson was a most successful lecturer and practitioner. He was always ready to attend the poor, often neglecting to collect a fee. Liberal in his social attitudes he advanced the cause of foreign students in Edinburgh and supported the medical education of women. He was also a supporter of the anti-slavery movement.

In 1847 Simpson was appointed one of the queen's physicians for Scotland; and he became a foreign associate of the Academy of Medicine, Paris, the members insisting on his election against the appointing commission which had omitted his name. In 1850, at the remarkably young age of thirty-nine, he was elected president of the Royal College of Physicians of Edinburgh. In 1856 he was awarded the Monthyon prize by the French Academy of Sciences, for 'most important benefits done to humanity'. He received the order of St Olaf from the king of Sweden, and was made an honorary member of nearly every major medical society in Europe and America. In 1866 he was awarded an honorary DCL degree by Oxford University, and in the same year he received a baronetcy, the first given to a doctor practising in Scotland. In 1868 he was awarded the freedom of the city of Edinburgh.

Simpson died on 6 May 1870 at his house, Strathavan, 52 Queen Street, Edinburgh. A statue was erected to him in Princes Street, but the Simpson Memorial Maternity Hospital, built at the expense of his friends, was his principal monument in Edinburgh. He was also honoured by the placing of a bust in Westminster Abbey, on which it is recorded that to Simpson's 'genius and benevolence the world owes the blessings derived from the use of chloroform for the relief of suffering'.

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