Nov. 1S, r924] TERCENTENARY OF- THOMAS SYDENHAM IMCDICL JOUBNAl 919 Nov. _T9 practice and literary output, and eventually he died on December 29th, 1689, in his house in Pall Mall, where he THOMAS SYDENHAM: HIS WORK AND had lived since 1667, and was buried in St. James's Church, CHARACTER. Piccadilly, where a tablet, erected in 1810 by the College of BY Physicians, in the south wall aisle, eloquently describes him ARNOLD CHAPLIN, M.D., F.R.C.P., as " Medicus in omne aevum nobilis." HARVEIAN LIBRARIAN. To recall his works by name would be as uninecessary as it would be lengthy, for they are immortal, especially those IN the annals of medicine in this country three men may dealing with fevers, the distinction for the first time of be found who, by universal consent, are honouired above scarlet fever from measles and of rheumatism from gout, all others. They are William Harvey, John Huniter, .nad and the classical descriptions of chorea and of hysteria. Thomas Sydenham. Special measaries have been takeni to Scholarly criticism has been much concerned about the ques- prevent the glory belonging -to Harvey and Hunter from tion whether Sydenham originally wrote in English or in ever becoming dim, for a wise prevision has established Latin; the conclusion that appears to have most in its favouil societies and annual orations designed to perpetuate in is that he composed in the language he spoke, and that Dr. the minds of medical men the memory of those gireat John Mapletoft and Gilbert Havers, a scholar, did his text pioneers in medical and surgical scienice. But Thomas into Latin. But whatever medium he used he painted from Sydenham, although his labours have left an effect upon Nature, and, with the artistic instinct of a great clinician, medicine scarcely less than the work of the other two, hias emphasized the essential and kept the immaterial in due never been honoured by an annual oration for the purpose proportion. of keeping alive the memory of his great achievemenits. In his attitude of " back to Hippocrates," whom he called Indeed, apart from the society for medical publicationis ." the divine old man2" and the principle of observation bearing his name, the issue from time to time cf bis rather than the precepts of authority, Sydenham insisted collected writings, and attempts, sometimes inadequate, to on the importance of the accurate description of the natural portray his life and activities, but little has been dono to history of diseases, the constant and essential symptoms fix the public gaze upon the monumental work of thuis being distinguished from the accidental; he also advocated their separation into species, as in the classification of .. animals and plants, there being a common resemblance in their seasonal variations. Thus regarding diseases as specific, he urged that specific remedies should be sought for them. Sydenham has accordingly been regarded as the founder of scientific nosology. Further, he urged that a definite system of treatment should be established on rational grounds instead of on polypharmacy. As J. F. Payne, in comparing these two Masters of Medicine, wlho, as far as we know, never met, writes, Sydenham was the Master of Practice, while his contemporary William Harvey was the Master of Science. The importance of Sydenham's practical outlook cn medicine can hardly be over-emphasized, but this is l)ot his only claim on our remembrance; for in his attempts to obtain a cure for epidemic fevers he made observations on their incidence and variations which led to his famous hypothesis of " epidemic constitutions "-a somewhat nmysterious conception of a more elaborate character than Isaawc Bariow's certificate, slhowing the date of Sydenhlam's degree; those of Hippocrates and Ballonius (Guillaume Baillou) in the possession of the Royal College ot Ph3 sicians. in 1574. His view of acute, especially epidemic, diseases was to the effect that they were modified by the additionial most " English " of English physicians-this rugged geniu.s factor of a constitution or influence derived not only from wrho, unaided, laid the sure foundations of clinical medlicinle. the atmospheric and weather conditions, as Hippocrates Now, in this year 1924, three hundred years after his birth, believed, but from telluric and other sources; thus upon a tardy recognitionl of his merit is being laid at his shrinle a specific disease, in the modern bacteriological sense, are French medicine, ever ready to award a scientific crown superimposed features due to a common factor, which, wzherever it is deserved, irrespective of nationlality, has however, varies in the course of years and gives rise to already paid its tribute to one of England's greatest what he termed " stationary fevers." Thus in the years medical sons. And now a great journal, voicing th)e 1661-64 "the epidemic constitution " was malarial, in thougfhts of thousands of British medical practitioners, in 1665-66 plague-like, and in 1666-69 like small-pox. That tihe tongue that Sydenham spake, and in tile lanld that accomplished scholar-physician, the late Joseph Frank bared him, is placing on record its deep appreciation of tile Payne-sometime our Harveian Librarian-in his masterly work he accomplished. At the same time theB Royal College life of Sydenham expressed the hope that his " sketch of Physicians, of which body Sydenham was a distinguished should induce some readers to study for themselves member, has held a special evening session, and throughl Sydenham's own works." Since then several Fellows of the mouth of its President, Sir Hump)hry Rolleston, hiic- the College-Sir William Hamer, Dr. F. G. Crookshank, self a great clinical physician, has paid the debt it owes Dr. Major Greenwood-have devoted much thoughtful for the glory of having the name of Sydenham onl its roll. and to the epidemic constitutions, and Sydenham Thlis action of the College of Physicians is peculiarly fittinlg, hasconsiderationbeen rightly described by Dr. E. W. Goodall as " the for it is well known that, for reasons somewhat ob)scure Founder of the modern science of epidemiology." By a kind to us at the present time, Sydenham nevter applied for the :f prophetic sense he seems to have foreseen that bactelio- Feellowsllip of the College, nor was that honour ever offered [ogy might appear and be held to explain the whole question hlim, although for the last thirteen years of his life ho ' as Af the incidence of acute disease, and at any rate he in every way eligible. Bult thlis gatherinlg of the Fellows -rovided reservations to such a simple and exclusive of the Csollege in the twentieth century, for the purpose of ,onception. dloing honour to Sydenham's name, wvill surely be regardedl Thus the three-hundredth anniversary of the birth of as an adequate act of penance for its omission thlree ;ie Father of Clinical Medicine in Britain and the Prince centuries ago. Nor must we feel aggrieved that medicine )f Practical Physicians, of the Founder of the modern in a foreign land lhas peaid its tribute first to our Sydenlau!l ;cience of epidemiology, and of the originator of scientific in this year, the tercentenary of his birtil, for his influence mosology, " the incomparable Sydenham," should be kept upron medlicine w.as so great that it left its mark in a grateful and proud remembrance in his Country and XwllatsoeYer land it was p)ractised. It knew no national Jollege. boundaries. 'That vigorous intellect wrought for all timre r T Bitmsf 920 NoV. I5, I9241 TERCENTENARY OF THOMAS SYDEN-IAM. L MEDICAL Joiua2A. and for all countries, and we do not, therefore, grudge our forth to the stern business of fighting for the Puritans colleagues their first-offerings of homiage to the niame of against the Royalists. Thomas Svdehllam. Long before the actual struggle began, the Sydenilini It is not the purpose of this article to write a biography family had become deeply committed to the Puritan cause, of Sydenlisam, for that has been done with great ability and Thomas Sydenham was therefore brought up undler and discrimiination by the late Dr. Payne; but rather to strict Puritan influences. The adherence of the family to consider his character, his mental environment, and the this cause was no mere formal acceptance of its tenets) results for us to-day of his work. Some biographical for, when the civil war broke out, the father and his fix-e details will, however, be necessary in order to appreciate sons bore arms for the sake of their consciences on the side the true position occupied by Sydenham as a great medical of the Puritans, and two of them lost their lives in battle. reformer. Thomas Sydenham had only been at Oxford for a few Thomas Sydenham was born in 1624, at the Manor House months when the summons came. He at once threw aside of Wyynford Eagle, in the counity of Dorset. The exact the gown for the sword, anid took his place beside his valiant date of his birth is not recorded, and it can only be stated brothers, ready to risk all for the honour of his belief. that he was bap- So far as is tized on Septem- of A ohrmember ber 10tht:z.d{[LSUvA~~~~~~~~~~~~~~~~~~~~~m;-of that .......... year. He camie the College ofof f rom an old Phiysicians, Dr. So me rsetshli r Mairtin Llewellyni, family dating back actaly bore armis to the time of the p of Ihe Ro Vin the civil war. King John, wichic acahe Ilowing s l av ~t the conclusio ni multiplied exceed-at thIt is a wellkept .~of the first civil ingly. for no less o g s tn h e s t h an e ig h t J,.