Thomas Sydenham
1624-1689
English Physician
Thomas Sydenham put British medical practice on a firm empirical foundation. He eschewed medical theorizing, discounted medieval medical traditions and Renaissance science, trusted no medical author except Hippocrates (460?-377? B.C.), and based his therapeutics on his own direct observation of each patient.
Sydenham was born the son of a country squire in Dorset. In 1642 he matriculated at Magdalen Hall, Oxford University, but the English Civil War interrupted his studies. He fought on the side of Parliament and achieved the rank of captain. He returned to Oxford in 1647 and received his bachelor of medicine there in 1648. This was not an earned degree, but a reward for his services to Cromwell. Much later, in 1676, he received an honorary M.D. from Pembroke College, Cambridge University. He became a licentiate of the Royal College of Physicians in 1663, but never was admitted as a fellow, probably because after the Restoration of Charles II in 1660, the British political climate was against those who had opposed the monarchy.
Although he remained at Oxford until 1655, he distrusted academic medicine and was skeptical of anything he was taught. He was more interested in curing diseases than in speculating about their causes. Nevertheless, he developed his own theories of the origins and transmissions of diseases and held to the humoral theory of Hippocrates that the healthy body is in balance with nature. He claimed that each disease must run its natural course, but that the physician, using nature, could ease the suffering of the patient along this course. His belief that each disease was a separate entity made him a godfather of the nosological movement in the eighteenth century.
In 1655 Sydenham opened the medical practice in Westminster, London, that occupied him for the rest of his life. The same year he married Mary Gee. They had three sons, one of whom, William, became a physician.
Sydenham's observations contributed much to the knowledge of dysentery, malaria, pneumonia, and several nervous conditions. He popularized using cinchona or Peruvian bark, the source of quinine, to treat malaria. He used opiates to treat nearly everything else and he invented laudanum. He was among the first toprescribe fresh air for convalescence, exercise for tuberculosis, and iron tonics for anemia. He formed close friendships with the chemist Robert Boyle (1627-1691) and the philosopher John Locke (1632-1704). The three mutually influenced each other's work for decades.
Sydenham's most important work was his 1683 Tractatus de podagra et hydrope (Treatise on gout and dropsy), in which he distinguished between gout and rheumatism. The first edition of his Observationes medicae (Medical observations), published in 1676, contained the best descriptions of measles and scarlet fever up to that time, and the first clear distinction between these two diseases. The fourth edition (1685) reported significant progress in smallpox research. His Schedula monitoria de novae febris ingressu (A warning essay on the emergence of a new fever), published in 1686, included his description of chorea minor or St. Vitus's dance, now called Sydenham's chorea or rheumatic chorea. Among his other books are: Methodus curandi febres (Method of curing fevers), 1666; Epistolae responsoriae duae (Two responsive letters), 1680; and Dissertatio epistolaris ad . . . Guilielmum Cole (Dissertation in the form of a letter to William Cole), 1682.
Sydenham had many followers, especially posthumously, and his positive influence lasted at least two centuries. His clinical reputation is based primarily on the fact that he made his patients feel better. He relied chiefly upon vegetable materia medica and noninvasive methods. He bled patients as often as did most other physicians of his time, but did not take such great quantities of blood. Even if he did not cure his patients, they were satisfied with his fatherly concern and gentle therapeutics.
The Sydenham Society, dedicated to the preservation of medical knowledge, was founded in London in 1844 and succeeded by the New Sydenham Society in 1858.
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