Thomas Sydenham

Biography

• Born 10 September 1624 in  Wynford Eagle, Dorset, England
• 1646 – Fought as a Cavalryman in the English civil war for the parliamentarians at the age of 22 against the Royalists. His interest in medicine developed from seeing the treatment of his wounded brother by Dr Thomas Coxe.
• 1648 – Graduated Bachelor of Medicine (BM) at Oxford, enrolled as a fellow in All Souls College, Oxford.
• 1651 – Medical studies interrupted by the start of the second civil war where he fought as captain in the cavalry. 
• 1663 – Certificate of the Royal College of Physicians. Sydenham was not elected to fellowship, potentially as he did not have a doctors degree and during his lifetime his fame was not recognised
• 1676 – Doctor of Medicine (MD) at Pembroke College, Cambridge University
• Died 29 December 1689 in London, England aged 65 of renal failure secondary to gouty nephropathy. Buried in St James’ Church Westminster

Medical Eponyms

Sydenham’s chorea: schedula monitoria (published 3 years before his death) – describes the involuntary spasmodic movements found following a streptococcal infection and in conjunction with rheumatic fever

Other Eponyms:

• The Sydenham Society (1844-1857
• The New Sydenham Society (1858-1911)

Key Medical Attributions

• scarlet fever – differentiating it from measles
• introduced laudanum (alcohol tincture of opium) into medical practice; proprietary opium tincture; “opium, 2 ounces; saffron, 1 ounce; bruised cinnamon and bruised cloves, each 1 drachm; sherry wine, 1 pint. Mix and macerate for 15 days and filter. Twenty drops are equal to one grain of opium.”
• quinine in malaria
• iron (chalybeate) in iron deficiency anaemia
• gout (1683)

Materia medica and preparations

• iron (chalybeate) in chlorosis (Green sickness; febris alba; iron deficiency anaemia) – (108) treatment with iron fillings with extract of wormwood (made up into pills) and taken twice daily for thirty days washed down with a draught of wormwood wine…increased the redness of the cheeks and gums and reduced the hysteria…
• quinine in malaria
• mercury inunction in syphilis
• Laudanum in the treatment of cholera and dysentery

Major Publications

• Sydenham T. Methodus curandi febres. 1666 [2e 1668 with chapter on plague]
• Sydenham T. Observationes medicae morborum acutorum historiam et curationem. 1676 [3e of Methodus curandi febres; including study on epidemiology and observations on epidemics in London 1661-1675; descriptions of dysentery, scarlet fever, scarlatina, and measles; Venereal diseases; and a treatise on gout and dropsy]
• Sydenham T. A Treatise on Gout and Dropsy. 1683
• Sydenham T. Opera universa. In quibus non solummodo morborum acutorum historiae et curationes nova & exquisita methodo diligentissime traduntur, verum etiam morborum fere omnium chronicorum curatio brevissima … exhibetur. 1685 [3e 1705]
• Sydenham T. Schedula monitoria de novae febris ingressu. 1688
• Sydenham T. Praxis medica experimentalis: sive Opuscula universa, quotquot hactenus ab autore ipso ultimùm revisa & aucta in lucem prodierunt. 1695
• Sydenham T. The works of Thomas Sydenham. 1809

Notable quotables

In an era of humoral medicine Sydenham insisted that specific diseases could be identified stressed the need for carefully observing patients and taking detailed case histories. Sydenham was interested in an empirical approach to medicine focussing on the physical signs of disease rather than narrative descriptions

Nature, in the production of disease, is uniform and consistent, so much so, that for the same disease in different persons the symptoms are for the most part the same

Sydenham 1676

On gout, himself a sufferer

The victim goes to bed and sleeps in good health. About 2 o’clock in the morning, he is awakened by a severe pain in the great toe; more rarely in the heel, ankle or instep. This pain is like that of a dislocation, and yet the parts feel as if cold water were poured over them. Then follows chills and shiver and a little fever. The pain which at first moderate becomes more intense. With its intensity the chills and shivers increase. After a time this comes to a full height, accommodating itself to the bones and ligaments of the tarsus and metatarsus. Now it is a violent stretching and tearing of the ligaments – now it is a gnawing pain and now a pressure and tightening. So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of bedclothes nor the jar of a person walking in the room.

Sydenham 1683

As to liquors, those are the best which neither sink to the weakness of water, nor rise to the generosity of wine…The old saw is that ” if you drink wine you have the gout, and if you do not drink wine the gout will have you.”

Sydenham 1683

Controversies

More controversial therapies include:

‘accubitus’

‘If you would but ride on horsebacke from Paris to Calis and from Dover to London upon that and drawing in this aer your symptoms will vanishe.’

References

Biography

• Thomas Sydenham. Medical Classics. 1939; 4: 287-319
• Dewhurst K. Thomas Sydenham (1624 – 1689) Reformer of clinical medicine. Med Hist. 1962; 6(2): 101–118.
• Bibliography. Sydenham, Thomas 1624-1689. WorldCat Identities

Eponymous terms

• Latham RG. The works of Thomas Sydenham, M.D. 1848 [Volume II]
• Comrie JD. Selected works of Thomas Sydenham, M.D. 1922
• Dewhurst K. Dr. Thomas Sydenham (1624–1689): his Life and Original Writings. 1966
• Brock WH. The two Sydenham Societies. A history and bibliography of the medical classics published by the Sydenham Society and the New Sydenham Society (1844–1911). 1985
• Anstey P. The Creation of the English Hippocrates. Med Hist. 2011; 55(4): 457–478.
• Pearce JMS. Sydenham on Hysteria. Eur Neurol. 2016; 76(3-4): 175‐181.