Thomas Sydenham

Biography:

In the later half of the seventeenth century, internal medicine took an entirely new turn in the work of one of its greatest figures, Thomas Sydenham, who has been called the English Hippocrates, and the father of English medicine. He revived the Hippocratic methods of observations and experience. He was one of the principal founders of epidemiology, and his clinical reputation rests upon his first hand accounts of gout, malarial fever, scarlatina, measles, dysentery, hysteria, and numerous other diseases. He introduced Cinchona bark into England, and praised opium.

Like his great predecessor he emphasised accurate observations of the clinical picture. To him the foundation of medicine was not scientific examinations of anatomical and physiological conditions, but bedside experiences. He advocated no particular dogmatic system, but always tried to found his teaching on an independent reasoning. It was in London in the middle of the 1650’s he began his exacting studies of epidemics. This work formed the basis of his book on fevers (1666), which was dedicated to his friend, the Irish-born chemist and natural philosopher Robert Boyle (1627-1691). It was later expanded into Observationes Medicae (1676), a standard textbook for two centuries. He also presented the theory of an epidemic constitution, ie. conditions in the environment (air, season, etc.) which cause the occurrence of acute diseases. His treatise on gout (1683) is considered his masterpiece.

Sydenham himself suffered with renal stones and gout, and apart from his accurate descriptions of these disorders he described a number of other disorders accurately for the first time. He noted the link between fleas and typhus fever. Sydenham introduced opium into medical practice and was the first to use iron in treating iron-deficiency anaemia, and helped popularise quinine in treating malaria. His treatment of fevers with fresh air and cooling drinks was an improvement on the sweating methods previously employed.

Sydenham preached that a doctor must rely on his own observation and clinical experience and he appeared to have practised largely common sense medicine. Although he advocated bleeding, he did it in relative moderation compared with that of his contemporaries and followers. Derided by his colleagues, Sydenham benefited immensely from a consequent detachment from the speculative theories of his time.

Sydenham had ample opportunity to study epidemics. He saw the Great Plague of London, followed by severe epidemics of smallpox. Sydenham, however, wisely spent the plague years in the countryside. Life at the time must have been hard, also because the climate was much colder than now. During the last half of the 17th century, The Thames was frozen for months every winter.

It was particularly as a contributor to therapy that Sydenham acquired his reputation. It was his moderate treatment of smallpox, his use of cinchona, and his invention of liquid laudanum that came to symbolise his contributions to medicine. His renown came chiefly from the fact that he alleviated the suffering of the sick and made ill people well. Ironically, the only eponymous use of his name that still remains common, “Sydenham’s chorea,” refers to two paragraphs interjected in one of his treatises, more or less as an aside. Sydenham was characterized as an investigator free of prejudices.

His grave is next to a memorial renewed by the College of Physicians in 1810, with the inscription:
Propre hunc locum sepultus est Thomas Sydenham Medicus in omne aevum nobilis

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