Thomas Sydenham

The English physician Thomas Sydenham (1624-1689) emphasized, in practicing medicine, careful observation and experience and earned the title "English Hippocrates."

Born in Winford Eagle, Dorset, the fifth son of a wealthy country gentleman, Thomas Sydenham entered Magdalen College, Oxford, in 1642. His studies were interrupted by the outbreak of the civil war, during which the Sydenhams fought for the parliamentarians. He returned to Oxford in 1647, receiving his bachelor degree the following year. In 1651 he rejoined the army, after which he stayed at Oxford until 1663, when he was married and opened his London practice.

With only 18 months of formal medical education, consisting of a mixture of classics, anatomical dissections, and formal disputations, Sydenham found little use in theoretical learning, and experimental science seemed just as useless to him. He was convinced that only the careful observation of diseases at the bedside could lead to medical progress, and he spent all his efforts on detailed clinical observations. Despite his objection to theory and his insistence on a purely empirical medicine, he accepted the traditional concept that diseases resulted from disturbances of the bodily humors. He revived the Hippocratic notion that the seasons and atmospheric conditions played an equally important role, but he differed from Hippocrates in the emphasis he placed on the recognition of specific diseases. He believed that the detailed study of the natural history of any disease would eventually indicate what specific medication should be used for its treatment. Recognizing that Peruvian bark (crude quinine) was the only specific he knew, he prescribed it for malaria, which was the most prevalent fever in the London of his time.

At a time when most physicians were deeply concerned with theoretical questions, with systematization and attempts to relate medicine to experimental physics or chemistry, Sydenham's empiricism and emphasis on clinical description did not make him popular among his medical colleagues.

Some of Sydenham's writings became classics, like his description of gout (1683), which he suffered from for years and which ultimately led to his death. He differentiated scarlet fever from measles. His description of hysteria, which is frequently mentioned for its accuracy, included other conditions as well. The prevalence of smallpox led him to the conclusion that it was a physiological process which everyone had to go through. Because of his accurate portrayal of St. Vitus's dance, this disease became known as Sydenham's chorea. In therapy he insisted on simple prescriptions and measures, a fact which may have contributed to his great success as a practitioner.

His personal friend and fellow physician John Locke applied Sydenham's empiric medical ideas to philosophy. Succeeding generations of physicians found Sydenham's emphasis on bedside observation most useful and proclaimed him the "English Hippocrates." His emphasis on the study of the natural history of diseases and of all the factors surrounding their occurrence gave great impetus to the subsequent development of epidemiology.

Further Reading on Thomas Sydenham

A detailed biography, which also contains some of Sydenham's works in translation, is Kenneth Dewhurst, Dr. Thomas Sydenham, 1624-1689 (1966). Other studies are Joseph F. Payne, Thomas Sydenham (1900), and David Riesman, Thomas Sydenham, Clinician (1926). For background see Fielding H. Garrison, An Introduction to the History of Medicine (4th ed. repr. 1967).