Excerpt from The New York Medical Journal, Vol. 46: A Weekly Review of Medicine; July to December, 1887, Inclusive

Young Simpson. It is not, says Sydney Smith, the man who first says a thing who deserves the credit, but he who says it so loud and so long that at last he persuades the world it is true.

Having thus been able to do something more than snatch an occasional victory by sleight of hand, like Lis ton's, the art of the surgeon made rapid progress, and about 1862 Simpson began to insist that we should know some thing about surgical results, that we should know indeed not only whether we were doing as much as we could do for the welfare of patients upon whom we had to operate, but whether the results obtained were at all in proportion to the labor, expense, and suffering involved. Curiously enough, the research was at first not made on the main line, but on a side issue - that of inquiry as to the best method of closing bleeding points. Simpson collected a mass of statistics which excited amazement at the terrible mortality of such simple operations as amputation of the leg and forearm. He blamed the old method of ligature, and he led us astray about acupressure. But even that mis taken divergence was of infinite use, for it led us to discon tinne the long ligature - an advance which has never been acknowledged and never accredited to Simpson's work, as it ought to have been long ago. It was an advance as great as Ambroise Par�'s introduction of the thread itself.

In my youth every stump was left with a number of threads hanging out of it, and after a week they were pulled by the house surgeon or dresser day by day till they came away; sometimes they never came. Simpson's attack led to a reconsideration of the whole question; in fact, we owe to him an enormous debt for the whole advance of modern surgery in the three directions which I have indicated anaesthetics, statistical research, and the arrest of bleeding. For all of these rich fields were lying ready. Baker Brown showed that we had no need to fear that for which we had all such a mortal dread - a little piece of dead stump inside the abdomen. The rivalry between Baker Brown and Speu cer Wells induced the latter to adopt a method of record: ing his cases which has been followed ever since, and the, method of proper statistical research was begun. finally the battle of torsion and ligature was decided in favor of short ligatures of animal tissue, and our present perfect methods were established.

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