In 1866 his own country made an acknowledgment of his eminent attainments when the Queen offered him a baronetcy on the advice of Lord John Russell. Twice before he had refused a title, but this time he wrote to his brother that he feared he _must_ accept although it appeared so absurd to take a title. This honour was the first of its kind ever conferred upon a doctor, or even upon a professor, in Scotland. It was entirely unsought, and scarcely welcomed by its recipient for its own sake; he regarded it not merely as a personal honour but also as a tardy recognition of the services of the Edinburgh school in the cause of medicine. He enjoyed the congratulations which showered upon him, and felt glad when the citizens flocked to Queen Street to express their feelings, much to Lady Simpson's delight. The medical papers unanimously approved of the honour, the _Lancet_ remarking that apart from his connection with chloroform, Simpson was distinguished as an obstetric practitioner, as a physiologist, as an operator, and as a pathologist of great research and originality. Domestic bereavement quenched the rejoicings over the baronetcy, and condolences displaced congratulations. He fell ill for a time himself, and in a condition of unusual mental depression spoke of the baronetcy as appearing even more of a bauble in sickness than in health. In less than a fortnight after the offer of the title his eldest son David died after a short illness. He had been educated for the medical profession, and was a youth of considerable promise and of an earnest temperament; his death fell as a severe blow, and Simpson even contemplated abandoning the baronetcy which had not yet been formally conferred. The words of his friends, however, and the thought that his dead son had particularly insisted on its acceptance, persuaded him. A coat of arms had to be drafted for the new Baronet, and this was a pleasant interest for one of his tastes. The family history was searchingly entered into, and the arms of his father's family were differenced on the most correct lines with those of the Jervays from whom his mother had sprung. In the matter of a crest he was able to be boldly original, and adopted the rod of AEsculapius over the motto _Victo dolore_, and thus handed down to his family the memory of his great victory over pain. In June of the same year, 1866, the University of Oxford conferred upon him one of the few honours which reached him from England in awarding him the honorary degree of Doctor of Civil Law. The University of Dublin made him an honorary Doctor of Medicine, and he was created an honorary Fellow of the King's and Queen's College of Physicians of Ireland.