Simpson · 1847
Simpson and chloroform
On the late evening of the fourth of November 1847, in the dining-room of 52 Queen Street in central Edinburgh, James Young Simpson, thirty-six years old, the Bathgate-born Professor of Midwifery at the University of Edinburgh since 1839, and his colleagues Dr George Keith and Dr James Matthews Duncan, sat down after the family dinner with a box of experimental volatile-liquid samples that Simpson had been collecting from the chemists of Edinburgh over the previous fortnight, with the intention of testing them as anaesthetic candidates by the inhalation of small quantities. Ether had been used in surgery for about a year (since the Boston Massachusetts General Hospital demonstration of October 1846) but had the disadvantages of slow induction and pulmonary irritation. The third sample of the evening was a clear sweet-smelling liquid the chemists at Duncan and Flockhart on the South Bridge had provided to Simpson on the request three days earlier: trichloromethane, or *chloroform*. The three doctors inhaled small quantities. Within about a minute the three were, by Simpson's later account, *most happily under the influence and showing in our faces and in our conversation the effects we had been seeking*. Within ten minutes all three were unconscious on the dining-room floor. Simpson came round first (about half past eleven), woke the others, made notes of the experience, and wrote up the observations the following day. He presented the paper to the Edinburgh Medico-Chirurgical Society on the tenth of November 1847. Chloroform-assisted childbirth was administered for the first time on the eighth of November to a Mrs Carstairs of Edinburgh. Queen Victoria received chloroform from John Snow for the birth of her eighth child Prince Leopold in 1853, giving the royal imprimatur to the practice and effectively closing the church-of-Scotland resistance to obstetric anaesthesia.
It is twenty past nine on the evening of Thursday the fourth of November 1847, in the dining-room of 52 Queen Street, Edinburgh, in late autumn lamplight. He is thirty-six years old. He is James Young Simpson, born at Bathgate in West Lothian on the seventh of June 1811, the seventh and youngest child of a Bathgate baker, schooled at Edinburgh University (graduated MD at twenty-one, the youngest medical doctorate in Scottish university history), in his eighth year as Professor of Midwifery at the University of Edinburgh, husband of Jessie Grindlay (married 1839) and father of three children.
At the dining-table with him are George Keith, thirty-five, the junior partner in his private obstetric practice, and James Matthews Duncan, twenty-one, the brilliant young Aberdeen-medical-graduate who has been Simpson's residential assistant since the summer. On the table is a wooden box of about ten glass bottles, each holding about an ounce of a different volatile liquid, brought up over the fortnight from Duncan and Flockhart the chemists on the South Bridge. The samples have been tested by Simpson personally over the fortnight by the self-experimental method of cautious inhalation; the first two samples (a Dutch acetone preparation and a bromide of ethylene) have produced mild light-headedness and no anaesthetic effect.
He says, by the later account of Mrs Simpson (who came in from the parlour at about ten and found the three doctors on the floor): let us try the third bottle. The one from Mr Flockhart on Tuesday. The third bottle is a clear sweet-smelling liquid: trichloromethane, the English form chloroform coined by the French chemist Eugène Soubeiran in 1831, but not previously tested as a respiratory anaesthetic on a human subject.
The three doctors each poured a amount onto a folded handkerchief, raised the handkerchief to the face, and inhaled. Within about a minute, by Simpson's later paper of the tenth of November 1847, the three were most happily under the influence and shewing the effects we had been seeking. The conversation became, by Simpson's note, animated and full of laughter. Within ten minutes all three were unconscious on the dining-room floor.
Mrs Simpson came in at about ten. By her later report to the biographer John Duns (in The Memoir of Sir James Y. Simpson of 1873), I found Mr Simpson on the carpet, Dr Keith with his head in the fender, Dr Duncan under the chair. I thought for a moment they were dead. She called the housekeeper. The three were placed in the recovery position. Simpson, the largest of the three, came round first at about half past eleven.
He woke the others, made notes of the experience in the notebook he kept on the dining-room sideboard, and stayed up until about three in the morning writing up the observations. He presented the paper Account of a New Anaesthetic Agent as a Substitute for Sulphuric Ether in Surgery and Midwifery to the Edinburgh Medico-Chirurgical Society on the tenth of November 1847. Chloroform anaesthesia for childbirth was administered for the first time on the eighth of November by Simpson himself, on the patient Jane Carstairs at her Edinburgh home, for the delivery of her second child.
The church-of-Scotland resistance to obstetric anaesthesia (on the biblical-theological grounds that pain in childbirth was the divinely ordained consequence of the Fall, in pain thou shalt bring forth children, Genesis 3:16) was substantial through the first six years of the Simpson practice. The decisive moment for the public acceptance was the eighth of April 1853, when Queen Victoria received chloroform from the London anaesthetist John Snow for the birth of her eighth child Prince Leopold at Buckingham Palace. Victoria, by her later journal entry, found the experience soothing, quieting and delightful beyond measure. The royal imprimatur effectively closed the church resistance; chloroform-assisted childbirth was, by the 1860s, the standard practice of the British, American and continental-European obstetric profession.
Sir James Young Simpson was knighted in 1866 (the first knighthood awarded for medical services in Scotland), made a baronet by Queen Victoria in 1866, and died at 52 Queen Street on the sixth of May 1870, fifty-eight years old. He was offered burial in Westminster Abbey but declined in favour of the family plot at Warriston Cemetery in Edinburgh, where he was buried with the largest funeral procession of the nineteenth-century Edinburgh public record. The 52 Queen Street house is, since 1947, a private residence with a bronze plaque on the south wall: In this house on the fourth of November 1847 Sir James Young Simpson first discovered the anaesthetic properties of chloroform.