FURTHER STUDIES. 1830-1835
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 Grindlay--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 disappointment 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 proxima_." 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 L50 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 ~MATHESIS~ probably prevented his
uniting with the brotherhood to worship the ~EROS~ 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, Liege, 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 Liege 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 to-morrow 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 '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 well-doing; ... 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 fact; 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.