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The youngest son of Dr. David Ramsay (1749-1815), little historical documentation survives about James Ramsay. Born in Charleston in 1797, he followed in his father’s footsteps and attended the University of Pennsylvania to complete his medical education from 1816 to 1818. Upon his return to Charleston, he dove into a robust civic life. He joined the Medical Society on April 1, 1819, and, by the end of the year, was elected a trustee. From 1820 until at least 1828, he served as the Physician of the Poor House. Throughout the 1820s, Ramsay was also a member and officer of the Congregational Missionary Society, the Medical Society of South Carolina, the Seventy-Six Association, a lecturer for the South-Carolina Academy of Fine Arts, and a curator of the Literary and Philosophical Society of South-Carolina and the Museum of South-Carolina.

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He served as the first Professor of Surgery at the Medical College until his resignation in the summer of 1831, following the revocation of Dr. John Schmidt, Jr.’s medical license on the grounds of being mixed race. Ramsay was one of only two votes against revoking Schmidt’s medical license. Once a constant presence at Medical Society meetings, his attendance also diminished. Ramsay died at the age of thirty-five the following year. Despite his extensive involvement in Charleston’s medical and cultural circles, no obituaries appeared in the local newspapers following his death, only a brief funerary notice. Ramsay is buried with his siblings at the Circular Congregational Church in Charleston.