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
affability 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 fact 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 their 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 L200 already owing to his brother Sandy, and added:--"Again
he gave me a bill for L120 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 L200 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 L500, 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:--
"1, 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.