Pathology Spotlight – Simpson’s Forceps

Pathology Spotlight takes a look at obstetrical forceps used by Sir James Young Simpson.

These forceps are applied on the fetal head to aid difficult deliveries. They are shaped to accommodate the temporary elongation of the fetal head as it moves through the birth canal. Over the course of his career, Simpson designed various improved versions of such forceps.

forceps

Professor Sir James Young Simpson is  rightly famed for his association  with the use of chloroform for anaesthesia. The idea that major operations like the amputation of a leg or removal of a breast might be carried out while the patient is wide awake seems a terrifying and gruesome idea to us now. Indeed, whilst training as a medical student Simpson ran out of an operation to  remove a breast unanaesthetised,  unable to witness the agony and bloodiness of the scene and determined to give up medicine; thankfully he did not fulfil this resolution. The experience may well have set him on the course that led him eventually to discover chloroform and to champion its use for the alleviation of pain during surgical operations. However Simpson’s first interest lay in child-birth and it was as an obstetrician that he first found fame. When, against all the odds, he applied for the prestigious position of Professor of Midwifery at the University of  Edinburgh in 1840 the final votes of the various worthies who made the decision were 17 for Simpson and 16 for his rival Evory Kennedy. Thus at the early age of 29 years Simpson assumed the esteemed Chair of Midwifery, going on to make Edinburgh the centre for advancement in this area over the next 30 years. It was for the alleviation of the pain of childbirth that Simpson principally set out to discover an anaesthetic agent, experiencing as he did every day the the pain encountered by women during the labour of childbirth. However, keen as he was on the notion of painless childbirth, the obstetrician community as a whole was less eager and he faced resistance. For difficult births chloroform was acceptable to the ‘old school’  but for normal childbirth there was less enthusiasm. Various objections were made including ’not natural’,  ‘against scripture’ and ‘induces sexual excitement in the women’. Simpson fought against these arguments and in general overcame them to champion the use of chloroform. Queen Victoria had seven children in the first 10 years of her marriage and was traumatised by the process of giving birth, So when she was given  chloroform and reported that her birth  under its influence was ‘ soothing and delightful beyond measure’,  Simpson’s star rose even higher. He was soon given a knighthood and all manner of honours followed  and he became one of the best known and loved physicians in the UK, recognised all over the world for his scientific approach to clinical medicine.

smellie
Obstetrical forceps in use. Image from William Smellie (1697-1763): A Sett of Anatomical Tables with Explanations and an Abridgement of the Practice of Midwifery, 1754. Image courtesy of McLeod – Historical Medical Books at the Claude Moore Health Sciences Library, University of Virginia

Featured image- (C) Wellcome Collection 

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