Thomas Sydenham

Thomas Sydenham, portrait gallery, 1835

Thomas Sydenham
(10th September, 1624 – 29th December 1689)
An English physician known as "Father of English medicine "

THE celebrated physician, Thomas Sydenham, in many respects the most eminent that England has produced, was born in the year 1624, at Wynford-Eagle, in Dorsetshire, where his father, William Sydenham, enjoyed a considerable estate. The mansion in which he was born is now converted into a farm-house, and stands on the property of Lord Wynford.

In the year 1642, when eighteen, he was admitted as a commoner at Magdalen-Hall, Oxford ; but quitted it in the same year, when that city became the head quarters of the royal army, after the battle of Edge-hill. He was probably induced to take this step by reasons of a political nature ; for we find that his family were active adherents of the opposite party. Indeed he is said, though on doubtful authority, to have held a commission himself under the Parliament during his absence from Oxford ; and his elder brother, William, is known to have attained considerable rank in the republican army, and held important commands under the Protectorate.

The political bias of his family is not without interest, as affording a probable explanation of some circumstances in his life which would otherwise be rather unaccountable,--such as the fact, that though he reached the first eminence as a practising physician, he was never employed at court, and was slighted by the college, who invested him with none of their honours, nor even advanced him to the fellowship, though a licentiate of their body, and qualified by the requisite University education.

When Oxford was surrendered to the Parliament, Sydenham determined to resume his academical studies ; and passing through London on his way, he met accidentally with Dr. Thomas Coxe, a physician of some repute at that time,, who was attending his brother. The choice of a profession became the subject of a conversation between them, which determined him in favour of medicine ; for in a letter addressed to doctor Mapletoft, thirty years after this time, which forms the preface to one of his writings, he refers with much warmth to this conversation as time origin of his professional zeal, and, consequently, of whatever useful advances he had made in medicine. Thus his success, both in the practice and reformation of his art, may show the advantage of waiting till the faculties are fully matured, before they are exercised in a study which requires independence as well as vigour in thinking : for the circumstances of his family being sufficiently affluent to place him above the necessity of choosing a profession early, he had not turned his attention to physic till an age at which the medical education is generally almost completed. We are not, however, to believe in the justice of an accusation brought against him, that he had never studied his profession till he began to practise it ; for though we do sot know what particular line of study he pursued on his return to Oxford, it is clear from many passages in his works that he had studied the writings of the ancient physicians with no common care ; and as his own show no defect of acquaintance with whatever real information had been collected before his time, we may reasonably conclude that this contemporary censure was mistaken or malicious. He certainly held the opinions of his modern predecessors in very little respect, for he does not often mention them, even for the purpose of confutation ; and in the letter to Dr. Mapletoft already referred to, be says that he had found the best, and, in fact, the only safe guide, through the various perplexities he had met with in his practice, to be the method of actual observation and experiment recommended by Lord Bacon. This sentiment is often repeated in his works ; but it surely does not countenance the idea that he had begun to practise without endeavouring to make what preparation he could, or would have had others follow such an example ; for the charge against him goes to this length. The notion might arise from a foolish anecdote related by his admirer, Sir Richard Blackmore, of his having recommended Don Quixote as the best introduction he knew to the practice of medicine, which Sydenham must have intended as a jest, or perhaps as a sarcasm on the narrator himself.

At Oxford he formed a close friendship with John Locke, better known afterwards as a philosopher than as a physician. Their intimacy, which lasted to the end of Sydenham's life, probably contributed not a little to give form to the disgust which he soon displayed at the unsatisfactory and fluctuating state of medical opinion, and to the zeal with which he sought to establish it on surer grounds ; for he appeals, as to the highest authority, in confirmation of some of his new views on the treatment of fever, to the approval of his illustrious friend, who even paid him the compliment of prefixing a eulogy in indifferent Latin verse to the treatise in which these views are developed.

On the 14th of April, 1648, he took the degree of bachelor of medicine, being then twenty-four years old ; and in the same year obtained a fellowship at All Souls College, by the interest of a relation. The degree of doctor he subsequently took at Cambridge, where, being among those who thought with him in politics, he probably found himself more at his ease. After a visit of some length at Montpellier, then considered the best practical school of medicine on the continent, he settled in Westminster, and soon after married,
His progress to eminence in his profession must have been unusually rapid, which might be owing, in some measure, to the call for men of good capacity to the more stirring scenes of civil strife ; for at thirty-six he had succeeded in establishing a first-rate reputation, which he continued to sustain in spite of much hostility and ill-health for upwards of twenty years.

He witnessed the breaking out of the plague in 1665, but when it reached the house adjoining his own, he was induced to remove with his family some miles out of town. Of this desertion of his post, however, he seems to have repented ; for he afterwards returned, and occupied himself diligently in visiting the victims of that devastating malady, and has left a short but interesting account of his opinions respecting it, and of the treatment he adopted ; for the comparative success of which, he appeals to the physicians who had witnessed or followed his practice.

At the age of 25, though a man of remarkably temperate and regular habits, he became afflicted with gout and stone, from which he suffered extreme torment. with great resignation and patience for the rest of his life. Of course he did not neglect.the opportunity of studying those diseases in his own person, and recording the result of his observations. His account of gout, especially, is considered to be a most accurate and able history of that disease.

He died, leaving a family, at his house in-Pall-Mall, on the 29th of December, 1689, in the 66th.year of his age, and was buried in the parish church of St. James, Westminster, where, in 1810, a tablet was erected to his memory by the College of Physicians, who became, as a body, tardily but fully convinced of his extraordinary merit and eminent claims to the gratitude and respect of his profession.

He is said to have been a man of the most retiring and unobtrusive disposition, and the utmost placidity of temper. In a biographical sketch by Dr. Samuel Johnson, prefixed to an English edition of his works by Swan, in 1742, it is remarked, that if he could not teach us in his writings how to cure the painful disorders from which he suffered, he has taught us by his example the nobler art to bear them with serenity. Nor was he less patient of mental than of bodily inflictions; for though he was the object of much asperity among the physicians of his time, he made no reprisals upon the reputations of those who slandered him : though he often speaks of their bitterness, he never even mentions their names,—a forbearance to which, as his biographer pungently remarks, they are indebted for their escape from a discreditable immortality. His writings breathe throughout a spirit of warm piety, candour, and benevolence : he is said to have been extremely generous in his dealings with his patients; for which, with other reasons, his practice though large was not very gainful, and he did not leave much wealth behind him. He never was sought after by the great, like his successor and disciple Radcliffe ; and had none of the talents by which that singular man was able to push his fortune and establish a kind of professional despotism. Yet, whatever medical skill the latter evinced seems to have been derived from Sydenham, whose doctrines and treatment he contrived to bring into a much more early and general repute in England than they would probably have otherwise obtained. Each had his reward : the one will be long remembered as the founder of a magnificent library ; the other can never be forgotten as the author of modern medicine.

The bent of Sydenham's mind was eminently practical; he thought that the business of a physician is to acquire an accurate knowledge of the causes and symptoms of diseases, and the effects of different remedies upon them, that if he cannot prevent them, he may at least recognise them with certainty, and apply with promptitude the means most likely to cure them: with Hippocrates and the ancient empirical physicians, whose tenets he professed to follow, he condemned all curious speculations upon the intimate nature -of disease, as incapable of proof, and therefore always useless, and often hurtful ; and maintained that the only trustworthy source of opinion in medicine is experience resulting from observations frequently repeated, and experiments cautiously varied ; and that no theories worth attention can be framed until the recorded experience of many observers, under many different circumstances, and even through successive ages, shall be embodied into one general system ; and he boldly declared his belief that every acute disease might then be cured. An instance, which unfortunately as yet stands alone in support of this rather sanguine expectation, may be taken from the history of small-pox. The observation of its contagious nature led to the general practice of inoculation, and this to the immortal discovery of Jenner, by which a disease but yesterday the scourge of the earth has been almost extinguished. It is remarkable that Sydenham, who first pointed out the important difference between its distinct and confluent forms,—who so materially improved the treatment by changing it from stifling to cooling,—and who studied and has described it with a laborious accuracy hardly paralleled in the history of medicine,—was not aware of this, to us, its most striking characteristic of contagion. A person conversant with such subjects will feel no surprise at this : to the general reader it may be a sufficient explanation, that it lies dormant for ten days ; and that as it can only be taken once, and was always prevalent in London, the number of persons susceptible at any given time, and in obvious communication with each other, were comparatively few : so that opportunities were not so likely to arise as might be imagined of tracing its progress in single families or neighbourhoods from one source of contagion.

Sydenham is justly celebrated for the happiness of his descriptions, and his skilful application of simple methods of cure, which are as effectual as they were novel in that age when a medical prescription sometimes contained a hundred different substances; but he has merit of a higher kind, as a discoverer of general laws. Among others, he was the first to notice that there is a uniformity in the fevers prevailing at any one time, which is subject to periodical changes ; and that other acute diseases often partake largely of the same general character, and sometimes even merge in it altogether, as the plague is said to have swallowed up all other diseases. This, which he ascribed to some peculiar state of the atmosphere, he called its epidemic constitution ; and to be aware of its vicissitudes must of course be very important to the physician as a guide to practice. The value of these laws, which Sydenham deduced from a multitude of observations, has been attested by almost every medical writer since his time.

His works have been repeatedly printed in the original Latin, as well as in English and the continental languages. The first was published after he had been sixteen years in practice; the last he edited himself, is dated three years before his death ; and an elegant compendium of his experience was published posthumously by his son. They all appear to have been extorted by the importunity of his friends or the misrepresentations of his enemies. It is said that they were composed in English, and translated into Latin by his friends Mapletoft and Havers : there is, however, little reason for attaching credit to this report, as we are assured, on the authority of Sir Hans Sloane, who knew him well, that Sydenham was an excellent classical scholar, and perfectly capable of expressing himself elegantly in Latin. They are most carefully written and clearly expressed, and bear marks of the utmost truth and impartiality in the narration of facts, and judgment in arranging them. They are not voluminous, as he studiously refrained from overloading them with trivial matter, and from entering into the detail of a greater number of cases than might be sufficient to illustrate his method of practice. His object was to confine himself to the results of his own observation : to this he pretty strictly adhered, so that little space is occupied in his writings by quotations or criticism.

It must be admitted that he occasionally lapses into theoretical discussion, in violation of his own principles ; but as lie seldom or never permitted his fancy to divert him from what was practically useful, he may be pardoned, if in that age of speculation he could not entirely resist the seduction. A graver charge against him is, that he overlooked or undervalued the immense body of information to be obtained from examining the effects of diseased actions after death, and devoted himself too exclusively to the study of the symptoms during life, and the effect of remedies upon them. It is hardly a sufficient justification of a man of so much independence of spirit to reply, that such examinations were opposed by the prejudices of the age in which he lived. Others have overcome the same obstacles, and with them many of those difficulties which perplexed and misled even the mind of Sydenham. He had equal or greater difficulties to contend against in the deep-rooted absurdities of the chemical and mechanical schools, which in the early part of his life held an almost equally divided sway in medicine : the former originated with Paracelsus and his disciples, and had the advantage of a longer prescription ; and the latter had received a fresh accession of strength from the recent discoveries of Harvey : both, however, gave way before his energetic appeal to fact and experience. Scarcely less credit is due to him for his successful opposition to the popular superstition in favour of a host of futile remedies, which are now happily consigned to oblivion with the family receipt books and herbals in which their virtues were paraded, than for his victory over false principles and dangerous rules of practice.

On the whole, it may be safely advanced that medicine, as a practical science, owes more to the closely-printed octavo, in which the results of his toilsome exertions are comprised, than to any other single source of information.