Sir James Young Simpson and Chloroform (1811-1870): Masters of MedicineGordon, H. Laing (Henry Laing)
History
Sir James Young Simpson and Chloroform (1811-1870): Masters of Medicine
Gordon, H. Laing (Henry Laing)
Anesthetics; Chloroform; Simpson, James Young, 1811-1870
Simpson left his mark in other departments besides those of the
subject of his professorial chair and of anaesthesia. About ten
years after the introduction of chloroform he turned his attention
to the process of wound-healing--the repair of necessary wounds
inflicted by surgeons in the course of their work--and although he
was promptly told to go back to his midwifery, he worked persistently
at the subject. In those days the subject was the most burning one in
surgery and the methods employed to bring about successful results
varied in different schools. The object of all methods was the
same, viz., to obtain a healthy, clean, and sightly result after
an operation; to leave the part which had been of necessity cut in a
condition as nearly as possible approaching that in which it had
been found, without the incidence of any of the too frequent grave
complications. Surgeons did not recognise at first the power of
nature to effect for them what they strove after; they thought to
attain their object by compelling the tissues to heal as they
desired by complicated applications, and many were the layers of
ointments and masses of dressings heaped on wounds for this
purpose. For a long time all efforts were directed to the discovery
of some specific substance, the application of which would give the
necessary impulse towards healing in the desired manner. Before
Simpson's day it had been generally recognised that the cause--but
its nature was quite undreamt of--of the trouble lay in the air
surrounding the wound, and more dressings were piled on to keep
out the air. But at the same time bleeding was arrested by tying the
cut arteries with ligatures--chiefly silken--and these were left
with long ends hanging out of the wound to work their way out by a
process of ulceration, or irritation of the tissues until liberty was
obtained. This process was practically incompatible with the ideal
form of healing, known as healing by _first intention_, _i.e._,
union without appreciable loss of substance or the formation of
_pus_ or matter. So-called "surgical fever," secondary haemorrhage,
and blood-poisoning were the frequent fatal results of operation
wounds treated in this manner. Simpson and others thought to prevent
these alarming diseases by devising other means of closing the
arteries; thinking that if some method or material were used,
which nature resented less, the wound would more readily close by
first intention. In 1858 Simpson stated that he had for some time
past been experimenting with substitutes for the ordinary silk and
thread ligatures, and in the course of his experiments had made use
of iron, silver, and platinum wires. In his usual way he hunted up
old authorities, and found a record of both silver and gold threads
having been experimentally used by bygone practitioners. He seems to
have been pleased with his results, stating that he found the
tissues much more tolerant of these metallic ligatures than they were
Public-domain text, read in full here on John Shaqi.
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