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ss nucleus - spring 1996,  Sydenham the Physician

Sydenham the Physician

Thomas Sydenham was born at Wynford Eagle, Dorset in 1624. He was an outstanding pioneer of clinical medicine, an ideal General Practitioner and has been called 'The Father of English Medicine'. He came from a Puritan family and was himself a man of deep Christian faith in the Puritan tradition.

He studied medicine at Oxford, befriending scientist, Robert Boyle and philosopher, John Locke. He graduated in 1648 and, after fighting alongside his father and four brothers in the Civil war on the Parliamentary (Cromwell's) side, resumed medical practice in Westminster. After further medical study in Montpelier, France, he returned to England and received the licentiate of the Royal College of Physicians in 1663, setting up practice in fashionable Pall Mall in 1667.

Seventeenth century medicine was a hotch potch of unscientific speculation, theory and dogma. Sydenham's astute mind discarded much of the received medical wisdom of the day. Like Hippocrates over 2,000 years previously, he stressed the importance of personal, scientific observation. His philosophy was typified by his advice to Sir Hans Sloan, later President of the Royal Society: 'You must go to the bedside. It is there alone that you can learn disease.'

He was a keen observer of the natural history of epidemics declaring, 'Cholera comes at the close of summer and the beginning of autumn, as swallows in the beginning of spring and cuckoos towards midsummer'. The Great Plague hit London in 1665. When the plague approached his house, he yielded at last to his friends' advice and joined vast numbers in leaving the city, removing his family to safety. He soon returned, however, at risk to his own life to give what help he could to those stricken by plague. He survived and continued to practise in London until his death in 1689.

He laid great emphasis on accurate diagnosis, relying on his case histories to build up an accurate pattern of disease which contributed greatly to medical education. His masterly description of scarlet fever has never been surpassed and his own suffering from gout contributed to a famous treatise on the condition - 'Tractus de Podagra' - in 1683. His classic descriptions of malaria, measles, bronchopneumonia, pleurisy, dysentery, hysteria, cholera and rheumatic chorea were published in his book 'Opera Universa' which became the most important medical text of the day in 1685.

He was a firm believer in natural remedies, avoiding many of the complicated prescriptions so popular at the time. He favoured plant extracts such as Peruvian bark (quinine) and opiates. He extolled the virtues of fresh air in sick rooms and recommended exercise, especially for nervous complaints. He warned against despising simple remedies.

Lessons we can learn from him are:

  1. The integration of his daily life. His lifestyle was 'holistic'. All awareness, activity, all enjoyment and development of personal powers and creativity, sacred and secular, were integrated in the single purpose of honouring God.
  2. The quality of his spiritual experience. Communion with God through Jesus Christ was central. God's Word, the Holy Scripture, was the light he sought to live by.
  3. His passion for effective action, not for self display but for God's praise, made him practical and down to earth.
  4. His personal ethics. Order, courtesy, family worship, goodwill, patience and fortitude under trial without grumbling or self pity were important virtues.
  5. His sense of human worth. Through believing in a great God, he gained a vivid awareness of the greatness of moral issues, of eternity and of the human soul.
  6. His ideal of spiritual renewal. He strove for a rich understanding of Christian truth, increase in love and devotion to God and more love, joy and firmness of Christian purpose in one's calling and personal life.
These ideals are apparent in his advice to medical students as published in 'Medical Observations concerning the History and Cure of Acute Diseases' in 1668:

'Whoever applies himself to medicine should seriously weigh the following considerations:

  • First, that he will one day have to render an account to the Supreme Judge of the lives of sick persons committed to his care.
  • Next, whatever skill or knowledge he may, by the divine favour, become possessed of, should be devoted above all things to the glory of God and the welfare of the human race.
  • Thirdly, he must remember that it is no mean or ignoble creature that he deals with. We may ascertain the worth of the human race since for its sake God's only begotten Son became man and thereby ennobled the nature that he took upon him.
  • Finally, the physician should bear in mind that he himself is not exempt from the common lot but is subject to the same laws of mortality and disease as his fellows and he will care for the sick with more diligence and tenderness if he remembers that he himself is their fellow sufferer.'

Bibliography

  • Rhodes P. An Outline History of Medicine. (1985) p67,68 Butterworths. London.
  • Cule J. A Doctor for the People - 2000 years of General Practice in Britain (1980) p56. Update Books. London.
  • Aitken JT, Fuller HWC, Johnson D. The Influence of Christians in Medicine (1984) p65,66. CMF. London.
  • Packer JI. Among God's Giants - The Puritan Vision of the Christian Life (1991) p26-31 Kingsway Publications. Eastbourne.
  • Legg J. Return to Ideals of Hippocrates - let Sydenham lead medicine back to bedside. Doctor (1984) 19 January.
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