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A Bit of Edinburgh Medical History

The public’s appetite for crime is greater than its desire to hear about successes. Consequently, whilst we hear a great deal about Edinburgh’s Dr Knox and his criminal suppliers Burke and Hare, relatively little is said about the city’s more positive pioneering physicians.

From the Barber Surgeons of Surgeons’ Square, to the transplantation unit at Little France, medicine has been taught in Edinburgh since the sixteenth century. In that time, the University and the city were associated with many of modern medicine’s innovators. Three of the greatest are spirited Sir James Young Simpson, indomitable Sophia Jex-Blake and shrewd Sir John Crofton.

Simpson, born in 1811, is perhaps the most famous of the three medics in this selection, and the motto on his coat of arms boldly recalls his most significant achievement: ‘pain conquered.’

“Simpson was involved from an early age in inventing a variety of obstetric and gynaecological devices”, comments Tara Womersley, co-author of a new book about the history of medicine in Edinburgh. “As well as his widely-used forceps, he was inspired by the boys playing ‘suckers’ in Princes Street Gardens, and invented a vacuum-style device to extract a foetus.”

Although his devices helped with the safe delivery of countless children, Simpson felt something had to be done to relieve the pain of operations. “One of Simpson’s great adversaries claimed that he could amputate a leg in 90 seconds”, comments Tara. “Pre-anaesthetics, speed was of the essence.”

Having progressed rapidly from occasional lecturer to Professor of Midwifery at Edinburgh, Simpson had access to Lord Playfair, an eminent university chemist. “Simpson borrowed some substances from Playfair, and with a couple of friends set about trying them. He realised chloroform had worked when he woke to find his friend underneath a chair, and the other drowsily kicking the leg of the dining table.” Despite initial apprehension from the Church, within weeks of his discovery chloroform was widely adopted. It was used by the Archbishop of Canterbury’s daughter, and Simpson achieved Royal approval when Queen Victoria used the substance in the birth of her ninth child.

Whilst Simpson was still working in Edinburgh, a young woman named Sophia Jex-Blake, applied to Edinburgh’s medical school, when inspired by Elizabeth Blackwell, America’s first female physician. At that time no British medical school would accept women.

“To tackle this”, comments Tara, “Sophia headed a group of women called the ‘Edinburgh Seven’ who, in 1869, became the first females in Britain to be fully matriculated into a medical degree”. Despite the support of Simpson and influential public figures like the editor of the Scotsman newspaper, admitting women was largely an unpopular decision. Women were not thought to have ‘the right constitution’ for medical study and ‘could not cope with the coarseness of the men’.

Women were taught separately from the men, were charged more, and it was left entirely up to the male lecturers’ discretion whether he should repeat the lecture for the women.

“Before one of Sophia’s finals”, says Tara, “one of the lecturers organised a mob to prevent the women from attending the exam. The ‘Surgeons’ Hall Riot’ as it became known, apparently included a sheep being let loose in the exam room”.

In 1873 the women completed the course, but the University denied them their degrees. “Sophia left Edinburgh unqualified, and focussed her attention on changing the law”, comments Tara. “With the support of an MP, she managed to pass an enabling bill which forced medical examination boards to treat women equally”. Edinburgh finally allowed women to qualify in 1894, although the first women did not graduate until 1896. “Despite having been the first medical school to admit women, Edinburgh lost its way and ended up following everyone else.” Over a hundred years after the work of Jex-Blake, the medical school now has a plaque commemorating her campaign, and like other medical schools, consistently admits more women than men.

In the twentieth century, John Crofton triumphed over the international scourge of tuberculosis. “When Crofton came up to Edinburgh to take his new post as Professor of Respiratory diseases, Edinburgh was one of the few places in Europe where TB incidence was increasing”, comments Tara. “It was claiming a life every two hours in Scotland, and he was in charge of bringing it down.” Crofton was aware that the current treatments were ineffective and antibiotic resistance was developing.

“His great stroke of genius was to combine three antibiotics in a course of treatment” and the results were miraculous. “Between 1954 and 1957, the number of TB cases halved and within six years, TB had almost been eradicated”, says Tara. Crofton’s ‘Edinburgh Method’ was soon adopted worldwide. It is estimated that his team’s work has saved the lives of over 10 million people.

With the achievements of Simpson, Jex-Blake and Crofton we now benefit from pain-free surgery, a more balanced profession, and can manage the ancient curse of ‘consumption.’ Who knows what the future may hold for Edinburgh medicine.

Guy Rughani is a medical student at Edinburgh currently intercalating in Epidemiology

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