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Sir James Young Simpson
Chapter II. Student Days (1825-1830)

Visit to Edinburgh—Sent to the University—Takes the Arts classes— Gains a bursary—Influence of MacArthur and Reid—Robert Knox the anatomist—The Burke and Hare murders—Superiority of the extra-mural teachers of the day—Edinburgh an intellectual centre —University life—His mode of living as a student—Apprenticed to a chemist—Studies surgery under Liston—Regularly falls asleep in the obstetric class—Influence of his teachers—Verse writing— Description of the medical student of the day—Vacation work— Death of his father—Obtains qualification to practice at the age of eighteen.

Although Edinburgh was only eighteen miles from Bathgate, Simpson visited it only once as a schoolboy; probably he walked all the way, for railroads were as yet unknown and it was not a long walk for a country-bred vigorous youth. He exercised his already formed habit of noting objects of interest during this great event in his boyhood, and in his journal there are copies of old inscriptions from tombs in the famous Grey friars' Churchyard to which he made his pilgrimage.

The boy's nearest and dearest ambition was to become a student at "the College," as Edinburgh University was familiarly termed. It received encouragement in the periodical return to the village of elder boys who had gone up before him. He was specially struck, and afterwards stimulated, by the appearance of one John Reid, his senior by two years, and his former companion in many a country ramble, who came back for the vacations smartened up both physically and mentally by the new life.

Although the collegiate life characteristic of Oxford was unknown in Scots Universities, there was social intercourse amongst the boys very different from that of the village. The ancient Edinburgh University attracted students from all parts of the world, mostly for the medical curriculum, but many preceded the professional course with a year or two's attendance on the Arts classes; and it was usual for young Englishmen of good family to spend a session at Edinburgh before going to Oxford or Cambridge. Probably before he entered the medical classes, Simpson rubbed shoulders with lads of all ranks from home and abroad. Pillans was at this time the Professor of Humanity, Wallace held the chair of Mathematics, John Wilson—better known as Christopher North— that of Moral Philosophy, and Dunbar was Professor of Greek. Wallace had begun life as a bookbinder's apprentice, and Dunbar had risen from being a gardener ; the example of these men under whose influence he was brought encouraged the baker's son to go and do likewise.

The family had sent him off to the College with the mission to be famous, and he was beginning only in an orthodox fashion when he entered himself for the curriculum in Arts. It had been easy for him, with his magnificent brain power, to stand dux of the village school over the ordinary village youth; but here, in Edinburgh, he was brought into competition with the picked boys from other country schools, and intellectually eager youths from town schools where the course of instruction was such as more easily to lead to early University success than that of the Bathgate parish school. At first he found difficulty and desponded. The keen observer with senses all alert was dashed to find so much of the College life to which he had so eagerly looked forward only a magnified repetition of the dull school routine. But he was too intent on ultimate success to be repulsed by his initial disappointment, and soon brought his mind into adjustment with the circumstances he found himself in, reserving leisure time and vacations for the exercise of his faculties as he most loved to exercise them. He did not persevere in the Arts course after he found" his tastes led him to other studies; he did not trouble to obtain the Master of Arts degree, which was then conferred in a very lax manner; probably he saw its worthlessness, for it was not until the passing of the Scots Universities Act in 1858 that this degree became

really valuable. He recognised, however, the value of laying a good foundation of general knowledge; without straining after any distinction he acquitted himself creditably in all his classes. In the second year of the curriculum he won one of the numerous small bursaries of the value of 10 a year, for which logic was one of the chief subjects of examination; but as candidates were restricted to those who possessed either the name of the founder, Stewart, or that of his wife, Simpson, the competition was not particularly severe. His individuality and natural straightforwardness attracted the attention of some of his professors. The boldness of his original essays provided them with food for comment in a manner dear to the professorial heart.

The Arts curriculum served him usefully in helping to develop a literary style and in teaching him how best to express his vigorous thoughts, as well as in strengthening his knowledge of Latin and Greek. According to the record preserved on his class certificates he worked attentively and diligently; but the mere fact that he did not excel is sufficient proof that he did not make an attempt.

During his Arts course Simpson lodged at No. 1, Adam Street, along with the John Reid already mentioned, who was now a medical student, and with a Mr. MacArthur, who had been a junior master at the Bathgate school, but had now also commenced to study medicine. MacArthur was a man of dogged determination 5 he urged Simpson to persist with his Arts course when his spirit seemed to rebel against it, and so long as they were together seems to have maintained some of the authority of the usher over both of the youths. The spirit of work was strong within him. Soon after Simpson joined him he related that he could then do with four hours' sleep, John Reid with six, but he had not been able to break in James yet. What MacArthur and the Arts course could not do, however, the attraction of medicine accomplished without effort, and Simpson soon formed the habit of early rising.

It seems remarkable that so much study should have been required when, compared with to-day, the science of the healing art was in but a rudimentary condition. The teachers of the day had, in spite of Sydenham, a great regard for authority, and burdened their students with much that is utterly unknown to the present generation, and, if known, would be regarded as worthless. A very large part of the curriculum consisted of practical and bedside work, so that book study was necessarily left to the evening or early morning. All three students, moreover, were1 fired with ambition, and thirsted for something more than mere professional knowledge. MacArthur constantly urged on his two young friends, and foretold great things for them if only they would work. When he afterwards heard of their successes he used to say, "Yes, but how they worked." Simpson became the greatest living obstetrician, and Reid rose to be Professor of Physiology in St. Andrew's University. MacArthur never became famous ; his name is known only because of the initial impetus which his influence gave to the professional careers of his two young friends.

In his close association with two such men as MacArthur and Reid, Simpson was again fortunate in his environment. The art of medicine was also fortunate inasmuch as at the right moment the right influences were at work to direct his mind towards it. While occupied in mastering the laws of hexameter and iambic or in assimilating the prescribed portion of Virgil and Tacitus, he happily now and then, living with two such enthusiastic medical students, got a taste of the more stimulating study of things scientific—food which was more agreeable to his mental palate, more suited to his mental digestion. By peeps into anatomical books, by little demonstrations of specimens in their lodgings, and by occasional visits to some of the lecture rooms or the wards of the Infirmary, his appetite was whetted for that great study of nature which his youthful training at Bathgate had prepared him for, and for which his mental constitution was specially adapted. One can picture the eagerness with which he would cast aside the finished Greek or Latin essay and urge the not unwilling embryo professor to demonstrate a bone or lecture on an anatomical preparation.

Sometimes as a special favour he was taken by Reid to hear one of the lectures of the notorious Robert Knox, the extra-academical teacher of anatomy, whose strong personality and unrivalled powers as a lecturer were at that time attracting to Surgeon's Square hundreds of students, while Munro (Tertius) was mechanically repeating his grandfather's lectures from the University chair.

It was towards the end of 1828, when Simpson was just about commencing his medical studies that Edinburgh, and in fact the whole of civilised Europe, was horrified by the revelation of the doings of Burke and Hare, when they were at last brought to justice for the long series of crimes perpetrated for the purpose of selling the bodies of their victims to the anatomical schools. Knox having a class of some four hundred students had special difficulty in meeting the demand for "subjects," and it was brought to light at the trial of Burke that the majority of the bodies were disposed of to Knox. As was only natural, a fierce indignation against Knox sprang up in the city. His residence was assailed and his effigy burnt. His life was in danger at the hands of the mob on more than one occasion.

Lord Cockburn in his "Memorials of His Time" says that all the Edinburgh anatomists incurred an unjust and very alarming though not an unnatural odium—Dr. Knox in particular, against whom not only the anger of the populace but the condemnation of more intelligent persons was directed. " But," he says, " tried in reference to the invariable and the necessary practice of the profession our anatomists were spotlessly correct and Knox the most correct of them all."

These were stirring times in Edinburgh medical circles. The strong, cool demeanour of Knox under the persecutions to which he was subjected, must have made an indelible impression on Simpson's mind, and the memory of it may have served to strengthen him in later years when himself subjected to the unjust accusations of thoughtless and ignorant people.

One night when Knox had attracted a large class to hear him on a favourite subject, the crowd in the street mustered in unusual force ; the yells and howls from outside were heard distinctly in the class-room. The students got alarmed, and kept looking to the doors of egress. Knox perceiving the restlessness and alarm of his audience paused, and then addressed to them reassuring words, expressing his contempt for the cowardly mob, and reminding them of the great men who at different times had suffered persecution for the cause of their science. His statement was received with such cheers as resounded beyond the class-room walls and actually cowed the uproarious mob, so loudly did the students applaud the words of the man who, they knew, daily placed his life in danger in order to lecture to them, and whose last hour seemed to have come, so great and threatening was the crowd on this particular evening.

If Simpson did not actually witness such a scene as the foregoing—he was not a member of Knox's class until the session 1830-31—he must at least have known full well about it at the time, and shared with the whole body of students the worship of the man as a hero. His fellow lodger, Reid, was not only a distinguished pupil in Knox's class, but became one of Knox's demonstrators in 1833, and was always a prominent Knoxite. We know also that Knox went down to Bathgate to visit Reid's relations there, so that it is justifiable to conclude that Simpson came closely in contact with this remarkable teacher. That the relationship between Reid and Simpson was most intimate we have the former's own words for. At a public dinner given to him when appointed to his professorship in 1841, he said, "In the croupier (Simpson) I recognise my earliest friend, a native of the same village. We were rivals at school and at college. We stood to each other from boyhood upwards in every possible relation, whether of an educational, warlike, delicate, or social character, which the warm and fitful feelings peculiar to boyhood and youth can produce."

In the end Knox and Reid quarrelled over a scientific matter. Knox never recovered from the effect of the Burke and Hare incident; in spite of the favourable report of an influential committee appointed to inquire into his share in the proceedings, and his own explicit statements, the public never acquitted him or at least a wilful shutting of his eyes to much that ought to have aroused his suspicions. His crowded class-room gradually became empty during the next few years, and the once brilliant, talented, and determined man became demoralised and left Edinburgh. Christison says that Knox finally died almost destitute in London, and that one of his last occupations was that of showman to a party of travelling Ojibbeway Indians.

However the strong personality and attractive lecturing of Knox may have influenced him, it is undoubted that to the personal influence of Mac-Arthur and Reid, acting upon his constant hunger to know nature and truth, stimulated as it was by what he saw of anatomy and physiology, we owe the fact that Simpson decided to enter the medical profession.

Although the number of medical students in Edinburgh University reached one of its highest points during the years that Simpson was a student, it is remarkable that with one, or perhaps two, exceptions, the University professors were men of no marked eminence in their various subjects. On the other hand, the extra-mural teachers included men of such wide refutation as Knox, Lizars, and Liston. Syme, who reacihed the height of his fame as a surgeon about the same time that Simpson became renowned, had just resi/gnd the teaching of anatomy to take up surgery; shut out at first from the wards of the Royal Infirmary by jealous colleagues, he was boldly establishing for himself the little Minto House Hospital, which became the successful nursery of his own unsurpassed system of clinical teaching, and remains in the recollection to this day as the principal scene of Dr. John Brown's pathetic story, "Rab and his Friends." It was chiefly these extra-academical teachers who at that time made the medical school famous, and were raising for it a reputation in surgery such as it had acquired in physic in the days of Cullen. In certain subjects the students would, according to the regulations for the degree, take out their tickets of attendance on the professor's course of lectures, but would put in only a sufficient number of appearances to entitle them to the necessary certificates ; the real study of the subject being made under the more accomplished teacher outside the University walls.

Edinburgh was at this period much more than the scene of the foremost medical and surgical teaching of the day in the world. It was a striking centre of intellectual activity. Sir Walter Scott, Cockburn, and Jeffrey were famous in literature and politics 5 Chalmers and MoncriefF in Church affairs; and Aytoun, John Wilson, Sir William Hamilton, and Sir David Brewster were names that attracted men from far and wide to the modern Athens. English and foreign advocates, scholars, artists, squires, and noblemen mingled together to hear or see some of these men. Lord John Russell, Henry Temple— subsequently Lord Palmerston—and Lord Melbourne were amongst the young Englishmen who attended university classes for a session or two; and H.R.H. the Prince of Wales, and his brother the Duke of Edinburgh, each matriculated in later days. When Simpson began his studies Knox was the great lion, without a visit to whose class-room no sojourn in Edinburgh was complete; just as in later years Simpson's house in Queen Street was the resort of all sorts and conditions of distinguished people.

The University had little control over her students once they were outside the gates of the quadrangle. There were no residential colleges; each youth found lodgings for himself suitable to his means, and led a perfectly independent life. So long as he conducted himself with propriety within her walls his Alma Mater cared little how he conducted himself or how he fared outside. Before 1858, when the Town Council controlled University aflairs, there were sometimes attempts to order the comings and goings of students. It is recorded that in 1635 the Town Council discovered that the scholars of the College were much withdrawn from their studies by "invitations to burials," which "prejudiced their advancement in learning," and they enacted that no student was to be permitted to attend burials except those of University or city worthies. This was at a time when some of the students were provided with residences inside the University, but by the beginning of the eighteenth century College residence had ceased. From time to time attempts have been made to render the students conspicuous in the city by the wearing of red gowns, but without success; and those of all faculties continue to be their own masters, in marked contrast to the mode of government in force at Oxford and Cambridge. Recently, in the eighties, a batch of students who had figured in the police-court after a riot in the gallery of a theatre were surprised to find themselves summoned before the Senatus Academicus and rusticated for varying periods; this, however, was but a spasmodic exercise of power. The chief advantage claimed for this custom of leaving the student to his own devices is that it encourages independence and develops each man's individuality better than a system of discipline and control. In men of Simpson's calibre it certainly has had a good effect.

Although the family in Bathgate strained every nerve to keep James well supplied with the necessary funds as a student, they were not able to place him in such a pecuniary position as to make it unnecessary for him to exercise economy. He appears to have been very careful indeed of the money which he had ; much more careful than when he reckoned his income by thousands. He kept methodical accounts of his expenses down to the most trivial items, and regularly submitted them to his family. His cash-book opened with the following quotation from a small book called the "Economy of Life," which figures at a cost of ninepence:—"Let not thy recreations be expensive lest the pain of purchasing them exceed the pleasure thou hast in their enjoyment"; and to this he added :—

"No trivial gain nor trivial loss despise;
Mole-hills, if often heaped, to mountains rise.
Weigh every small expense and nothing waste;
Farthings long saved amount to pounds at last."

It is easy to see here the imprint of a well-known national characteristic, from which, however, he completely shook himself free when prosperity came to him.

His share of the rent of the Adam Street lodging amounted to only three shillings a week. The entries in the cash-book show how frugally he lived and how every spare sum was devoted to the purchase of books. His library, the foundation of much of his encyclopaedic knowledge, was a curious mixture. Adam's "Antiquities," Milton's Poems, Byron's "Giaour" and "Childe Harold," a Church Bible, Paley's "Natural Theology," Fife's "Anatomy," and "The Fortunes of Nigel," were amongst those entered as purchased. The daily entries were such as the following:—"Subject (anatomical), 2; spoon, 6d ; bread and tart, 1s. 8d. Duncan's Therapeutics, 9d.; snuff, 1 1d.; Early Rising, 9d."

He followed out the usual student's custom of the day of learning dispensing by serving for a time in a chemist's shop. The late Dr. Keiller, of Edinburgh, used to relate how, while he himself was so employed in a chemist's shop in Dundas Street, one day " a little fellow with a big head" was brought in and entered as a pupil by a relative. The little fellow was Simpson, and no sooner was he left in the shop than he sat down with a book upon drugs, and turning to the shelves took down drug after drug to read up. The prompt industry of the big-headed fellow deeply impressed Keiller.

James attended most of the University classes, but studied surgery under the great Robert Liston, the foremost extra-mural surgeon, daring and skilful as an operator and of great repute as a lecturer, who afterwards filled the post of Professor of Clinical Surgery in University College Hospital, London. Liston was an abrupt-mannered but sincere man, and a keen lover of truth. He was a warm advocate of hospital reform, and was successful in introducing several needed improvements into the Royal Infirmary after a fierce fight. Here again Simpson was brought under the influence of a strong, self-reliant man with a distinct tendency towards controversy, to whom he was also attracted by the fact that Liston was a native of Linlithgowshire. Liston and Syme, after being close colleagues, quarrelled most fiercely, and were bitter rivals until Liston removed to London in 1835. Simpson attended Liston's lectures during three sessions.

There is no record of his having obtained great distinction in any of the medical classes, but his certificates show that he worked with pre-eminent diligence in them all, and obtained a characteristic mastery of each subject. If any exception occurred it was in the very subject in which he afterwards earned his greatest scientific fame—that of obstetrics. He attended Professor James Hamilton's course of lectures on that subject early in his career, and apparently felt so little interest—the subject only became a compulsory one for examination for qualification in 1830 —that he regularly went to sleep during the lecture. The excuse urged was that the lecture being a late one, three to four in the afternoon, it found him tired out after a long morning of study, lectures, and practical work. But had he been keenly interested he would have been wide awake, for Hamilton was a forcible, if plain, lecturer.

Hamilton was another of Simpson's teachers who exhibited the same uncompromising fighting characteristics—eager and strenuous in his efforts to obtain some object—which Simpson himself afterwards displayed. He fought hard for fifteen years to gain recognition for the subject which he taught, and to have it included in those necessary for qualification. He succeeded in the end, but in the course of the struggle had to bring two actions at law against professional brethren. In one the defendant was Dr. Gregory, whose teaching was mainly responsible for the British system of medical practice in the early part of this century, viz., free purging, free bleeding, and frequent blistering, and who was the inventor of that well known household remedy, Gregory's powder. Gregory was also a pugnacious man and could not abide the pretensions of the representative of the despised art of midwifery; he administered a public caning to him, and had to pay 100 in damages which, it is said, he offered to pay over again for another opportunity of thrashing the little obstetrician. This encounter occurred before Simpson became a student, but the memory of it was frequently revived in the subsequent disputes which Hamilton carried on.

The notes which Simpson took of the curriculum lectures were concisely made and full of comments, criticisms, and queries. He by no means bowed down to authority; he allowed nothing to pass which he did not understand at the time, and specially noted points which it seemed to him his teachers themselves did not understand.

Like most young men of his abilities and temperament, Simpson took pleasure in rhyming, and some of his verses are preserved. They indicate something of the rollicking spirit of the medical student's life seventy years ago. The medical student at that date has been described in a recent interesting sketch of Edinburgh student life as wearing a white great-coat and talking loud; his hat was inclined knowingly to one side of his head, and the bright hues of an Oriental handkerchief decorated his neck. There was a great deal of acting in his motions. He was first at the door of the theatre on a Saturday night, and regardless of the damages sustained by the skirts of his coat, secured the very middle seat of the fifth row of benches in the pit. Simpson, however, hardly conformed to this description. He enjoyed recreation as much as any man, and had a keen sense of humour which made him popular among his fellow students, but he was saturated with the love of study and was not led into extravagances of the Bob Sawyer type, or the harmless inanities of Albert Smith's immortal Medical Student.

During the long summer vacation he noted carefully his observations on the botany, zoology, geology, and even the meteorology of the Bathgate district. Dr. Duns, in his memoir, points out that he was much more at home with the phenomena of organic than with those of inorganic forms. His highest powers came into play when he had to do with the presence of life and its varied manifestations. Even his antiquarian notes illustrated this. He passed at once from the things to the thoughts and feelings of the men associated with them.

In the holidays he also assisted the village doctor in visiting and dispensing, and lent a willing hand in his father's shop when he was wanted, often enough driving the baker's cart on the daily round of bread delivery.

In January of the year 1830 his father was taken seriously ill, and James hastily left Edinburgh and tended him till his death. On his return he presented himself for the final examination at the College of Surgeons. This he passed with ease and credit in April, and found himself a fully qualified medical practitioner at the age of eighteen.

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