'"^k'TOiwfiBKSHl llllllltlli a h !!!!! CORNELL UNIVERSITY. THE r*ostucll p. 3FXorocr Cibrarg THE GIFT OF ROSWELL P. FLOWER FOR THE USE OF THE N. Y. STATE VETERINARY COLLEGE. 1897 Cornell University Library R 489.S85P34 Thomas Sydenham 3 1924 000 274 633 Cornell University Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924000274633 MASTERS OF MEDICIS^E i "HOMINES AD DEOS NULLA IN UE ?L JPR.OPIUS "ACCEDUNT QUXM " ?SXLUTEM HOMINIBUS DXNDOV i CICERO. ■ Masters of Medicine Title. CJohn Hunter .... William Harvey . '-Sir James Young Simpson ^William Stokes -Sir Benjamin Brodie "Claude Bernard . - Hermann L. F. von Helmholtz u Thomas Sydenham Author. Stephen Paget UArcy Power H. Laing Gordon Sir William Stokes Timothy Holmes Sir Michael Foster J. G. M'Kendrick y. F. Payne In Preparation. Andreas Vesalius . . . C. Louis Taylor M ASTERS OF ED1C1NE THOMAS SYDENHAM t ///6--?/?_^z.j Csyw&eftAxz BY ph Frank Payne, m.d.oxon FELLOW AND HARVEIAN LIBRARIAN OF THE ROYAL COLLEGE OF PHYSICIANS Late Fellow of Magdalen College, Oxford •-vV Sir SAMUEL WILKS, Baronet, LATE PRESIDENT OF THE ROYAL COLLEGE OF PHYSICIANS, THIS RECORD OF A GREAT ENGLISH PHYSICIAJM IS DEDICATED WITH RESPECT AND AFFECTION. PREFACE *!g THE constant complaint of all biographers of Sydenham has been the paucity of their •^materials. It has been the custom to say that nothing certain was known about his life, and even the most important events in it have been involved in great obscurity. This complaint is no longer well founded. The publication in recent years of historical docu- ments from the Public Record Office, and other collections, has thrown a flood of light on the per- sonal history of the seventeenth century, and on the life of Sydenham among others. Many contemporary statements, especially as to his military services, which had been strangely discredited, have been shown to be perfectly correct. Again, a more careful search into the earlier printed records has brought to light many facts overlooked by previous writers. The first bio- ix PREFACE grapher to make use of the English historical docu- ments was a French physician, M. Frederic Picard, whose life of Sydenham, a most laborious and accurate study from original sources, is far superior to any of its predecessors. But there are other books and docu- ments which it was impossible that M. Picard, with all his thoroughness, should know. The following sketch is not based upon any previous biography, but compiled entirely from original authori- ties, whether previously quoted or not. Some sources have, I believe, never been drawn upon before except in the article on Sydenham which I contributed to the " Dictionary of National Biography," On this account it has seemed necessary to print in full some documents which are rather materials for history than history itself; and generally to give a good deal of detailed evidence which somewhat in- terferes with the writing of a continuous narrative. While regretting this, I hope that the stamp of authenticity thus given to the history may make up for other defects. In a work of this compass it would be impossible to give the authority for every statement ; but a general list of authorities is given at the end. For others, as well as for a bibliography of Sydenham's writings, I may refer to the " Dictionary of National Biography." PREFACE I should be glad if this sketch should induce some readers to study for themselves Sydenham's own works, of which good editions, both English and Latin, were published by the old Sydenham .Society, and are still accessible. The portrait placed as a frontispiece is from a direct photograph of the painting in the College of Physicians, which is, according to v the highest authorities, the work of Mary Beale. In conclusion, I desire to express my thanks to Dr. Nias, who very liberally placed his notes on the Sydenham -family at my disposal. CONTENTS PACE Introduction ....... i CHAPTER I. Early Life and Education . . . . .11 Birth — Parentage — Family history — Pedigree — Home life — First residence at Oxford. CHAPTER II. The Fighting "Sydenhams . . . . -25 Civil War in Dorset — Its peculiar features — Services and exploits of the Sydenhams — Death of Sydenham's mother — How avenged — Loss and recovery of Weymouth — Sydenham in the field — End of first Civil War — Sydenham returns to Oxford. CHAPTER III. Second Residence at Oxford . . . -5° A chance meeting determines Sydenham to become a physician — Second residence at Oxford — Created M.B. — Appointed Fellow of All Souls' — Oxford, under Puritan rule — Character of studies there — The scientific movement — Its connection with the London Society — Sydenham's studies — Revives his knowledge of Latin — Facilities for medical study — Teaching of medicine, anatomy, chemistry, botany. xiii A 1 CONTENTS CHAPTER IV. PAGE Sydenham's Second Military Service . . • 7 2 Sydenham's petition to Cromwell — John Sydenham, an . infantry captain, promoted to be major — Killed in Scotland — Thomas Sydenham, captain of horse — Narrow escape from a drunken soldier — Services in England and Scotland — Sydenham's marriage — Starts In practice in Westminster. CHAPTER V. Life in London ; Visit to Montpellier . -85 Sydenham's residence in Westminster — A malarious district — Becomes candidate for parliament — Appointed Comptroller of the Pipe — Visits Montpellier — Probable date of this journey — Probably a pupil of Barbeyrac — Restoration of Charles II. — Sydenham returns to London — Suffers severely from gout — Death of Colonel Sydenham, and of Sydenham's father — Obtains license of College of Physicians — Reasons why not a Fellow — Always mentioned with respect by the College. CHAPTER VI. Sydenham and the Plague . . . . .104 Previous history of the Plague in England — Cessation since 1647 — Recrudescence in 1664 — The Great Plague of 1665 — Flight of the richer citizens — Sydenham leaves London — Justification for this step — Returns in the autumn — His views on the Plague. CHAPTER VII. Sydenham's Writings on Fevers . . . . 115' His first work, " Method of Curing Fevers " — Dedication to Robert Boyle — Review in the "Philosophical Transactions" — rAttacked by Henry Stubbe-^Reprinted at Amsterdam — Second edition, with a poem by John Locke — The third edition, entitled, "Medical Observations on Acute Diseases" — His greatest work — "Theory of Epidemic Constitutions" — Description of scarlatina. xiv CONTENTS CHAPTER VIII. PAGE Sydenham's Shorter Writings . . . .138 Epistola Responsoria? dua — To whom the letters were ad- dressed — Materials on which they were based — Dissertatio Epistolaris addressed to Dr. Cole — Reference to Dr. Goodall — Sydenham's explanation of hysteria — Treatise on the Gout and Dropsy — Sydenham's personal experience of gout — His explanation, of dropsy — His estimate of anatomy — Schedula Monitoria — Description of a new fever — Remarks on other diseases, especially chorea, often called Sydenham's chorea — Close of Sydenham's literary activity. CHAPTER IX. Medical Practice in Sydenham's Time . .158 Change in medical practice after the Restoration — Rise of the chemical school — Influence of the Virtuosi — The King encourages quacks — Competition with surgeons and apothe- caries — Manners of physicians — A caricature portrait of Sydenham — His own methods of practice — His treatment of the small-pox— His use of bark and opium — " Sydenham's laudanum." CHAPTER X. Home Life and Last Days . . . 183 Sydenham's children and grandchildren — Professional success — His sufferings from gout — His habits of life— His pupils — Recommendation of Don Quixote to Blackmore — Failing health — Death and burial — Memorial and epitaph. CHAPTER XI. Sydenham's Will ; His Descendants . . .196 The will — Provision for children, grandchildren, and other relatives — Sydenham's eldest son — His professional career little known — Wrote a small medical work— Sydenham's grandchildren. XV CONTENTS CHAPTER XII. PAGE Sydenham's Posthumous Works . . . .201 Processus Integrl, written for the use of his son — The most popular of Sydenham's works — Large sale of early editions — The Oxford MS. — Anecdota Sydenhamiana — Written by' Locke — Theologia Rationalis, a MS. work on natural theology — Extant letters of Sydenham. CHAPTER XIII. In What Language did Sydenham Write? . .210 General use of Latin in Universities — Presumption that Sydenham knew Latin — Classical quotations in his writings — Positive statements that his works were Latinized by others — Evidence from Sydenham's English MSS. — Com- parison of those with the printed works — Conclusion. CHAPTER XIV. Sydenham and Hippocrates ..... 222 Sydenham's aims in studying diseases — Why he valued Hippocrates so highly — The dogmatic system of Hippocrates '., — The natural method of cure — Debt of Sydenham to Bacon — Sydenham's originality — Comparison of Harvey and Sydenham. CHAPTER XV. Sydenham's Friends : Boyle, Locke, and Others . 236 Robert Boyle — His scientific researches — Impartial interest in medicine — Sympathy with Sydenham — Letter from Sydenham to him — John Locke, a regular physician — Was much influenced by Sydenham — Their relations to each other — Letter of Sydenham to Locke — Locke's views about medicine — More revolutionary than Sydenham's — Other friends of Sydenham's — His contemporary and posthumous reputation. INTRODUCTION ONE of the most sympathetic critics who ever wrote about Sydenham, that delightful essayist, Dr. John Brown, speaks of him as " The Prince of practical physicians, " whose character is as beautiful and as genuinely English as his name." His name, indeed, has a thoroughly English sound. It calls up ' before our minds a little homely Somersetshire village which the fame of the great physician has made known throughout the world. And all the associations which cluster round his home life are equally English. He was born and bred in the heart of one of the most English parts of England, that old West Saxon king- dom which the modern Dorsetshire novelist has taught us again to know as Wessex. He was educated at the oldest English University, which has always drawn to itself, along with other elements of strength, the best intellectual promise of the western counties. He lived through a time when the English character was strung I B INTRODUCTION up to an unexampled height of intensity, and, being placed near the centre of affairs, had special opportu- nity of feeling the throb of the national heart, and sharing its emotions. Sydenham's character was certainly noble and beautiful. We will leave it to the genial Scottish physician to call it genuinely English. If there are strong elements in the English character, these Sydenham possessed, and if he had limitations, these also were national, and so not easily discernible by us. We might go further and recognise a thoroughly English type of intellect in the follower of Bacon and comrade of Locke ; linking his name with these two, perhaps the most representative of English thought, not only for his independence and originality, but for his love of the concrete, his prosaic, practical wisdom, his piety and benevolence. Locke left the subtleties of philosophy to show the reasonableness of Chris- tianity, or to discourse of the education of children ; and not their education only, but their diet and the thickness of their shoes. Bacon, if less practical, at all events gave such aims as these their most dignified expression, when he defined knowledge, not as matter for contemplation or discourse, but as " a rich Storehouse for the glory of the Creator and the relief of man's estate." No words could better consist with Sydenham's conception of knowledge. But we must not be too exclusively national, lest we 2 INTRODUCTION run the risk of being provincial. Sydenham's is a name not for England only but for the world. We do not ignore the foundation of Greek science on which Sydenham built, nor the breath of French medicine, which no doubt in some degree inspired him. Still in the main the object of the following sketch is to exhibit the life and character of Syden- ham not only in connection with medicine, but in its relation to English life, English history, and English science. We have now to try to give some picture of that little corner of England in which the great reformer of practical medicine first saw the light, and of the material and moral surroundings in the midst of which he grew up. First, it will be interesting to give some details concerning the little Dorsetshire village with which not our physician only, but his family were so closely associated. Wynford Eagle (according rp Hutchins's History of Dorset) is a hamlet and chapelry belonging to Little Toller or Toller Fratrum, lying about eight miles from Dorchester. In Domesday Book it is called Wynfort. Its curious additional name is derived from , the Honor de Aquila, or the Eagle, of which it was formerly held. This great " Honour " or Barony of Eagle had its seat in Sussex, but derived its name from a Norman family named Aquila, or Aigle, from a town in 3 INTRODUCTION Normandy, Aigle, whence they came, so that the village 'in England derived its second name from a village in France. The first holder was Gilbert de Aquila of Pevensey, who had other possessions in other counties. The " Honour " passed afterwards to the Crown, and was regranted by Edward II. to the family of Lovel. From the Lovels it passed through an heiress to the family of St. Maur, and from the St. Maurs, ,again through an heiress,, to William Zouch, whose son became Lord Zouch. His descendant, John Lord Zouch, sold it in the 36th year of Henry VIII. for ^40 to Thomas "$ Sydenham, who will be spoken of hereafter. After changing hands several times, the manor was bought by an eminent barrister, William Draper West, afterwards Puisne Judge of the Queen's Bench, and ultimately Chief Justice of the Common Pleas, who was raised to the Peerage in 1829, as Baron Wynford, of Wynford Eagle. It has thus ;' descended to its present possessor, Lord Wynford. 'si' ; Not now the manorial residence, it is occupied as a farmhouse. The picturesque, grey, ivy-grown old house is.still ..?<■ standing, little altered from its original state. It lies in a hollow, sheltered by the downs and upland pastures, ,;:| .1 and is a pleasing specimen of a small seventeenth- '. ; century manor-house. The front is composed, as usual, of three parts, each surmounted by a gable. The projecting central block contains a recessed 4 INTRODUCTION iorch with stone benches. The wings recede and .re pierced with old mullioned windows wrought in ery hard stone, and perfectly preserved. The whole milding is very solidly constructed of stone and [int. A thick growth of ivy covers the whole front, and aakes it difficult to decipher the date carved on the entral block, but it appears to be about 1630, so hat the house would have been built by Sydenham's ather. On the summit of the central gable an eagle carved n stone declares the ancient name of the house. This lird, however, is of modern workmanship ; the old eagle f the Sydenhams, headless and maimed, may be found ti a back yard. The old walled garden and a large rchard beyond appear to be quite in their original tate. The whole house appears small, having perhaps nee been larger ; and it stands in an awkward rela- ion to the road, which must formerly have taken a ifferent direction. The interior is almost entirely modernised, but one old oak room, beautifully panelled a the Jacobean style, remains to tell of its ancient ignity. The little church of Wynford Eagle is a chapelry elonging to the mother church of Toller Fratrum, ivo miles off. The original chapel must have been f great antiquitity, as it contained portions of sup- osed Saxon architecture. The Sydenhams, we are aid, erected a building on one side of it for a family 5 INTRODUCTION burial-place, "and there most members of our physician's family were laid. But the old chapel with the tombs of the Sydenhams has been entirely destroyed, not. a vestige of it remaining. The poor little modern structure, built in 1840, does not even stand on the same site, and has only a fragment or two of the old chapel built into its walls. Thus of the old family which interests us hardly a trace remains in their ancient and dignified home. Their name is preserved only in one field, which still goes by the name of " Sydenham's." The surrounding district, without being notably picturesque, presents a rich and pleasing English landscape. Its centre, of course, is Dorchester, a place of ancient fame, and having been — as its name implies, and some remarkable remains of antiquity testify — an important military station in Roman times. This importance was probably due to its proximity to the seaports of the Dorset coast, once busy and flour- ishing, though deserted by the course of modern trade. As, however, the history of epidemics is an important feature in the life of Sydenham, we may recall the fact that the greatest of all recorded epidemics, the Great Pestilence or Black Death of the fourteenth century, first reached our shores at a Dorsetshire seaport. The proximity of Wynford Eagle to Dorchester was also important in another way, since the fact had great influence in determining the political sympathies of the Sydenham family, and thus in affecting the 6 INTRODUCTION jurse of our physician's life. Dorchester was strongly uritan. Clarendon says "a place more entirely dis- Fected to the King England had not," and " it was le magazine whence the other places were supplied r ith principles of rebellion." This was doubtless true ot only of the town itself but of the surrounding istrict. Sydenham was thus brought up in an atmo- Dhere of Puritanism, or rebellion, as Clarendon calls it, nd it is worth while for a moment to consider what his meant. We can "gain from Mrs. Hutchinson's life of her usband, Colonel Hutchinson, a very clear notion f the reasons which determined conscientious men o side with the Parliament against the King. There vere political grounds and religious grounds. Politi- ally, such men protested against the assumption of hsolute power by the King, upholding the old English principle that the sovereignty of the State loes not reside in the Crown alone, but in Crown nd Parliament. On religious grounds, this party lesired to make the English Church approximate nore closely to the Reformed Churches of the Con- inent and of Scotland, regarding the changes which ( j lad been made at the English Reformation as incom- )lete or inadequate. But some who felt deeply on :he political question, Mrs. Hutchinson tells us, had ess sympathy with the religious aspect of the contro- rersy — that is, they were more Parliamentary than Puritan. 7 INTRODUCTION On the other hand the Royalists, or Cavaliers, v equal conscientiousness, took entirely opposite vi both political and religious. They considered t loyalty to the King to be paramount over all o( political considerations, and if the Parliament diffe from the King, that was flat rebellion. On , religious side they had no desire to see the Church England made more decidedly Protestant ; they cli to the Episcopacy, with the ceremonial and ot features of the old Church which the Reformatioi the preceding century had spared and which w strongly supported by the King. The views of the two parties were totally ii concilable, but it is clear that conscientious e might be found, and were found, on both sides. The Sydenham family were evidently both Par mentary and Puritan ; and it seems that an unus number of county families in Dorset were on ; si de; They were termed by their opponents " Rebel: the term " Roundhead," which originated in anot part of the country, being rarely, if ever, used in Dorsetshire pamphlets. In its literal sense, the lal jnickname would have been hardly applicable to hero, for Sydenham, like Cromwell, Milton, Hutch son, and most of the Puritan leaders of whom we h portraits, wore his hair long. It can hardly be thought an unimportant mal to which party Sydenham belonged. We can appreciate his whole character and career with INTRODUCTION """ remembering that he was imbued with the intense earnestness of the Puritans, and was quite prepared, in opposition to authority of any kind, to be called, if necessary, a rebel. THOMAS SYDENHAM Early Life and Education THOMAS Sydenham was born at Wynford Eagle, and baptized September 10, 1624. He /as the fifth son of William Sydenham of Wynford *agle, and Mary his wife, daughter of Sir John effery, Knt., of Catherston. Without necessarily upposing that genius is the result of external influences, r of hereditary transmission alone, the various factors irhich make up the antecedents and surroundings of man of genius are well worth studying. As regards antecedents the family history of Syden- am is very interesting. The family is first recognised t Sydenham, North Petherton, near Bridgwater, omerset, which manor was held by Robert de ydenham in the time of King John. From his ime onward a pedigree is traceable, which has been 11 THOMAS SYDENHAM carried on up to the present day and displayed in great detail by some living descendants of the Sydenham - - family. It forms a large printed sheet with some hundreds of names, which we have been allowed to inspect, and from which many interesting facts may be collected. In the Middle Ages we find that the family contri- buted some distinguished names to the national annals. ,; '^ One Richard Sydenham was judge of the Common j Pleas in the time of Richard II. ; Simon Sydenham was Bishop of Chichester in the reign of Henry V., and went on an embassy to the Emperor. - Numerous knights, members of parliament, sheriffs and other dignitaries issued from the family ; and amongst their alliances it is interesting to note that a daughter of Sir George Sydenham, ot Combe Sydenham, in Queen Elizabeth's time, married Sir ! Francis Drake. The main branch of the Sydenham family remained in Somersetshire, where they occupied seats at Brimpton, Aller, Chetworthy, Orchard Windham,'-":!! and Dulverton. A few words may be said about ■; their families before we pass to the branch from which our physician was descended. The Brimpton branch received a baronetcy, which became extinct in 1743. The Chetworthy branch was noted in the seventeenth century for its attachment to the Royal ; | family. Three of its members were knighted. The best known, Sir Edward Sydenham, fought with 12 EARLY LIFE AND EDUCATION es I. at Oxford, but afterwards compounded for tates and even became a member of the (Parlia- iry) Council of State ; but was removed in 165 1 spected complicity with the Stuarts, heiress of the Sydenhams of Orchard Windham, ed Sir John Windham of that place and of rigge, Norfolk, and was thus an ancestress of listinguished Windham family, one of whom, ^illiam Windham, was a Secretary of State under *e I. He left a son, Sir Charles Windham, also esman, who became Earl of Egremont ; but the >ecame extinct in 1845. te Dulverton branch has left the largest number lown descendants, among whom we find the Humphrey Sydenham, called the silver-tongued her, a noted Anglican divine of the seventeenth ry ; and a Colonel William Sydenham, who t in the civil wars on the opposite side to his sake, Colonel Sydenham, the brother of our cian. the eighteenth century we find Floyer Sydenham, :arned Platonist, who published the first English [ation of Plato, a version at one time much d. In later times we note among the Sydenham idants the late Professor Williamson, the naturalist, )wens College, Manchester, and Mrs. Mary :tt Green, the learned and indefatigable editor any volumes of the State Papers, to whom all ical students are so much indebted. To this J 3 THOMAS SYDENHAM lady's researches also is due a great part of what is known about the Sydenham pedigree. Other names more or less known in literature or in the public services might be mentioned, and many descendants of this family are still living. Those who have any belief in hereditary genius or talent will be interested in a record which shows so many members of one family distinguished in arms, statecraft, or letters. We now pass to the branch of the family to which our physician belonged. The Sydenhams first appear at Wynford Eagle in the person of Thomas, the third son of Richard Sydenham of Aller, Somerset, who, as already stated, ^ bought the manor of Lord Zouche.' Nothing is known of this William Sydenham but that his mother, when a widow, made her will, early in the fifteenth v century, intending to make a pilgrimage to the Holy ; Land, or at least to visit the tombs of St. Peter and St. Paul, but died before carrying out her design. This was not the last instance of strong religious feeling in the Sydenham family. Thomas Sydenham bought a farm and manor formerly belonging to the estate of the Abbey of Cerne, and is mentioned in the reign of Queen Elizabeth as the possessor of a park called Wynford or Sydenhams, to the extent of 160 acres, ■■',! beside considerable rights of sheep pasture. So that the property was an important one. His great-great- grandson William was the father of our Sydenham. EARLY LIFE AND EDUCATION le was born in 1593 and died in 1661. All we know .bout him is that he was of Puritan -leanings and trongly supported the cause of the Parliament, so that, vhen an elderly man, he fought in the Parliamentary rmy with the rank of Captain, and was for some time . prisoner to the Royalists. He married, November ., 161 1, Mary, the orphan daughter of Sir John efFrey of Catherston, deceased six months before. )f this lady nothing is known beyond the circum- tances of her death, to be afterwards mentioned ; but ire naturally try to learn something about her family. ler father must have been a gentleman of wealth and ;ood position in the county, though the mere fact of tis having received knighthood in the first year of ames I. does not perhaps prove very much, since t that time knighthood was regarded by many ountry gentlemen more as a burden than as an lonour. His tomb at Whitchurch Canonicorum is escribed as "a fine altar tomb with canopy." It is ecorded that his son George, Mrs. Sydenham's rother, died at the age of thirty, after a long illness, ; with firm faith in Christ." His epitaph expresses lore than a conventional amount of religious sentiment, nd the phraseology strikes one as somewhat Puritan, a as to imply that Sydenham's mother came of a ious family ; the more so as the monument was laced by the Sydenham family. George Jeffrey is escribed as "esquire," which at that time would idicate that he was the eldest or only son. The 15 THOMAS SYDENHAM j family of Jeffrey- does not further appear in Hutchins' History of Dorset, and it is possible that Mrs. Syden- ham was the last representative of the family, though it is not stated that she was an heiress. William and Mary Sydenham had born to them seven sons and three daughters, whom it may be desirable, for the sake of clearness, to enumerate. , (i) William, the well-known colonel and Crom- wellian, baptized 8th April, 1615, buried 1st August, 1661. (2) Francis, major in the Parliamentary army, born (or baptized) 24th April, 161 7 ; killed in the wars, 10th February, 1644-5. (3) John, born 26th April, 1621 ; died young. (4) George, died 5th September, 1629. (5) Thomas, baptized 10th September, 1624 ; died 29th December, 1689. (6) John, major in the Parliamentary army, born 3rd March, 1626 ; killed in the wars in Scotland, and buried 7th May, 165 1. (7) Richard, Civil Commissioner under the Com-' monwealth and Protectorate ; date of birth not recorded; buried 27th January, 1657. He is des- cribed in the Register as " Captayne," but his mili- tary service, if any, cannot be traced. The daughters were : — ( 1 ) Mary ; married Richard Lee. (2) Elizabeth, born in 1619 ; married Roger Sydenham, a distant cousin. 16 EARLY LIFE AND EDUCATION ) Martha, born in 1622 ; married William snce. is noticeable that the Sydenhams, at least the were a short-lived family. Only one beside nas, namely, William, lived to be over forty ; in 1 66 1 Thomas Sydenham, then thirty-seven old, was the sole male representative of the y. The dates of death of his sisters are not ded. may be convenient before going further to say thing about the character and career of Syden- s brothers, since they had a great influence upon life of the physician, and must have helped to Id his character. r illiam, the eldest, was educated at Trinity College, )rd, but does not appear to have taken a degree, vas not a literary man, but must have been a fair lar, for a letter of his dealing with military ers addressed to Sir Lewis Dives, which has preserved, is curiously full of Latin quotations, t he possessed great energy and also military ty is undoubted. During his military career he spoken of by the Earl of Essex, the Parliamen- commander, as " a gentleman of approved courage Industry ;" and he lived to be eulogised' by Milton le of the counsellors of Cromwell. Strongly dis- ci to the Parliamentary party by family ties, he me still more closely connected with the Puritans narrying the daughter of John Trenchard, 01 17 c THOMAS SYDENHAM Warmwell, an important Dorsetshire gentleman who was a staunch supporter of the Puritan party, being an original member of the Long Parliament for Wareham and named one of the King's judges, though not actually a regicide. The influence of this strong and masterful character on his brother Thomas, who was nine years younger, must have been considerable. Sydenham had before him another example of the Puritan soldier in his next brother Francis, who never went to the University, but afterwards became a daring and energetic officer, one of the most active leaders of the Parliamentary party in Dorset, though his par- ticular services are with difficulty separated from those of his brother William. The early death of Francis Sydenham at the taking of Weymouth, where Thomas Sydenham was also present, was one of the sad events which cast a shade over the Sydenham family. The further careers of these brothers will be noticed in the following pages. At the time we are now considering they were living the ordinary life of young country gentlemen, busy probably, for, the most part, with farming and field sports ; though, if we judge by their subsequent life, setting an example of manliness and sincerity. It was thus under the influence of a conscientious father, a pious mother, and manly elder brothers that Sydenham's boyhood was passed. We have already said something about the external 18 EARLY LIFE AND EDUCATION Lome of the Puritan gentleman's family; its con- lection with the Sydenhams did not last for many generations after our physician's time. To anticipate a little, we may here state that the amily estate passed on the death of the elder Syden- iam to his grandson, William, the eldest son of Colonel William Sydenham, whose line became ex- inct with his death, in 17 18. The estate passed ut of the family in a not very creditable manner, phich is thus related. " This William Sydenham put up the estate at a irivate lottery. It was generally supposed that there ras a trick designed, for it was contrived, or at least oped, that the fortunate ticket would fall to the share f a confidant of the family, who they imagined would ave been prevailed upon to return the estate for a nail consideration. That ticket happened to be hers ; ut, to their great disappointment, she immediately fterwards married Doily Mitchell, Esq., who sold : to George Richards, of Longbredy, Esquire. But being necessary that Mr. Sydenham and his two aughters (his sons having died during his lifetime) lould make a formal surrender of the estate to the endee, on their refusal they were committed to )orchester prison about 1709, where they ended leir days." In this dignified and beautiful home was Sydenham rought up. We know nothing of his early life, and ery little of the friends and connections of the family J 9 THOMAS SYDENHAM except that the other county families with whicl were most closely allied were evidently of a P way of thinking. It is equally impossible to discover anything di about his early education. He must of course received some , classical education to fit him fc University, but where this was received is unla Close at hand was the old Grammar Scho Dorchester, and further off the more celel school of Sherborne ; therefore he may have b pupil at one of these. On the other hand it 1 have been equally consistent with the customs c Country gentlemen that there should have been a living in the house, or that the Sydenham boys s have learned their Latin from some clergyman i neighbourhood. Then, as now, there were : learned clergymen in country parishes who bined high thinking with plain living. The of one such divine has been preserved, whom S' ham long afterwards spoke of as having been intimate friend and countryman " — Gilbert Ire the elder, Rector of Winterbourne Bassett, Wynford Eagle, and afterwards Bishop of Bi There is no other record of his connection wit] Sydenham family, but the existence of such mi the surrounding parishes shows that gentlemen's would have had no difficulty in obtaining the ments of a classical education. In his eighteenth year Sydenham was sen 20 EARLY LIFE AND EDUCATION brd. The selection of this University for a setshire man was almost inevitable, and his eldest her had already been a Fellow Commoner of lity College in that University. The college :ted for Thomas was Magdalen. Hall, where he riculated as a Fellow Commoner on May 20, 2. lagdalen Hall was originally closely connected 1, though not strictly speaking a part of Magdalen ege, being the "Grammar Hall" intended for elementary education of university scholars in nmar, but had gradually assumed an independent tion. It is now merged into Hertford College, finally a small society, it had rapidly increased in ibers during the early part .of the seventeenth :ury, so that about 1625 it had no less than three dred members. This increase seems to have been fly due to the high reputation of its Principal, 1 Wilkinson, Fellow and afterwards, under the iamentary rule, President of Magdalen College, kinson was one of the chief leaders of the Puritan y in the University, and under his guidance rdalen Hall became the great centre of Oxford itanism, which, notwithstanding the High Church tion initiated by Laud, had still a considerable iwing in the University. These reasons sufficiently ain why Sydenham should have been sent to this sing the popular Puritan college, presided over by 1 a man as Wilkinson. 21 THOMAS SYDENHAM But Sydenham was not destined to profit very long by the studies of the University, or to sit under the sermons of Wilkinson. His University career was cut short at its outset, not for any personal reasons, but by the course of political events. In the summer of 1642 the conflict between the King and the Parliament was rapidly proceeding to its final rupture. Even before the time that Sydenham went to Oxford preparations were being made for armed resistance to the King. In May the Parliament called out the militia in defiance of the King's prohibition ; and at the very moment when Sydenham was entering at Oxford the trained bands of London were being drilled in Finsbury Fields. As is well known, all attempts at reconcilia- tion were in vain ; and when on August 22nd the King raised his standard at Nottingham, the country was actually in a state of civil war. It is plain that this summer term was no time for quiet study ; and the crisis had now arrived when every Englishman had to ask himself on which side he meant to play his part. In Sydenham's case the answer could not be doubtful. His family connections and the state of political feeling in his native county placed him inevit- ably on the side of the Parliament. The University and city of Oxford being strongly in favour of the King, this was no place for his opponents, and Syden- ham must have left Oxford some time in the summer, though precisely when we do not know. It could hardly have been later than the King's declaration at 22 EARLY LIFE AND EDUCATION lottingham^ and may very probably have been earlier, nee even before that event Dorchester and Poole were sing fortified by the partisans of the Parliament. Anthony Wood, who does not display with regard ) Sydenham his customary omniscience, merely says lat he left Oxford without taking arms for the King, > the other scholars did. But Sydenham must have ft with a much more definite intention of the opposite ind, and as, after the battle of Edgehill, Oxford ecame the King's headquarters, he could not return lere till the first war was over. We see, then, that though it is quite correct to say iat Sydenham entered the University in his eighteenth ear, this step had little or no real influence on his ducation. His stay at Oxford cannot have exceeded ivo or three months, in a disturbed state of affairs, > that he must have learned little or nothing, and 5 regards University training this period was virtually blank. His real University education began much iter and under very different circumstances. We have now to follow him into one of the most ctive centres of civil war. We shall find him, still [most a boy, playing the part of a soldier in the most lemorable conflict of arms and opinions at once in rhich Englishmen have ever been engaged. In dis- ussing these great and stormy events, it is difficult for tiy Englishman, even at the present day, to avoid eing in some degree a partisan. The historian, it is Tie, professes to aim at being, and doubtless in a large *3 THOMAS SYDENHAM measure succeeds, in being impartial ; and this is no less the duty of one who assumes the humbler office of a biographer. But it must be admitted that in the case of the latter a stronger effort and more diligent., circumspection are necessary to preserve a rigidly impartial attitude. In one who undertakes to write the life of a great man, the object of his warm admira- tion, it would argue a certain want of human nature if he were not, generally speaking, on the side of his hero. If, therefore, in the following slight sketch of certain episodes in the Civil War things are looked at as they would have been looked at from the Syden- ham point of view, let not those whose views are different take offence. We all recognise that there were " heroic Puritans " and " heroic Cavaliers " ; but it will not appear strange if in the life of Sydenham more is said about the heroic Puritans than about their rivals. To the Sydenham family, as to many others on their side, the matter was a question of conscience. 24 II The Fighting Sydenhams WHEN Thomas Sydenham left Oxford in tl summer of 1642, his University career checkf at the outset, he found his native county in a state active preparation for war. Political feeling w strong there, and was mainly on the side of tl Parliament. Dorchester especially is spoken of 1 Clarendon as the most "malignant" (i.e., Puritaj place in England. Even before Charles I. had raisi his standard at Nottingham, men were drilled ar mustered in Dorsetshire to support the Parliamer In August Dorchester and Poole were fortified,' guard against a suspected design of the Marquis Hertford to seize them for the King, and short afterwards soldiers and ammunition were sent dov by the Parliament, which also contributed to tl expense of fortification. In these proceedings it probable the Sydenham family took part, but we fii no definite record of their being employed on tl Parliamentary side till April, 1643, when the eldc 25 THOMAS SYDENHAM brother, William Sydenham, received a commission as captain of a troop of horse, his position in the county, and probably the proof he had already given of energy and capacity, enabling him to dispense with passing through any inferior rank. His rise was rapid, for in December of the same year he became a colonel. The military service of Thomas Sydenham must have begun in the same year, but we do not find him mentioned till the next year, 1644, under circum- stances which will be spoken of later. It is curious to remark that the very fact ot Sydenham's having served in the Parliamentary army, though always established by direct contem- porary testimony, has been strangely obscured and even denied in later times. In the great biographical dictionary of the last century, the " Biographia Britannica," the direct testimony of Sir Richard Blackmore, who knew Sydenham well, is flatly con- tradicted, without any reason, and all succeeding bio- graphers have only touched the subject as if with the tips of their fingers. The motive in all this has been to clear Sydenham from the imputation of having been a soldier of the Parliament and Commonwealth. But that Sydenham did embrace the Puritan cause with earnest conviction, and when engaged in the quarrel, quitted himself like a man, is abundantly proved, not only by more diligent reading of the old books, but by official documents which have come to light and been edited of late years^ 26 THE FIGHTING SYDENHAMS efore speaking of the future physician's military :r, it will be well to get some general view of the imstances under which it was passed. In the war (a distinction to be carefully noted) Syden- 's activity was limited to his native county of set, where the Civil War had certain noticeable - ires. To begin with, it was remarkably local, ng no connection, or very little, with the great paigns by which the main issue of the war was led. The Dorsetshire forces do not appear to left their native county or its immediate neigh- hood. But an internal conflict was constantly itained there, and owing to a curious sequence events was never terminated by any decisive iry. The field of battle was too remote from the t theatre of war for either of the contending es to concentrate any great force there except in ; transitory emergency. he county was consequently divided. Each party :ssed some of the strong places ; there was a con- d succession of attacks and reprisals, and it was till the coming of Fairfax and Cromwell in 1646 the county was completely gained for the Parlia- t. t the outbreak of the war nearly the whole county on the side of the Parliament. The only strong ; held for the King appears to have been Corfe le, which sustained a memorable siege by the iamentary forces, in which one of the Sydenham 27 THOMAS SYDENHAM family held an important command. But in the summer of this year the taking of Bristol .by Prince Rupert, July 27, 1643, not only spread consternation through the western counties but set free the successful army for further conquests. Immediately after the surrender of Bristol a large Royalist force under the Earl of Carnarvon and Prince Maurice overran the county. Dorchester, " the great seat of disaffection," as Clarendon calls it, a town ill adapted for defence, notwithstanding its new fortifications, surrendered in a panic ; Weymouth and Portland soon followed its example. The siege of Corfe Castle was raised, and the whole county was reduced with the exception of two small towns, Poole at one end of the county, Lyme at the other, which, when summoned to sur- render, by Prince Maurice, "returned so peremptory an answer to the Prince's summons that he resolved not to attack them," and returned to press on the siege of Exeter (Clarendon). Poole is of interest to us, as subsequent events there are frequently associated with the names of William or Francis Sydenham. Lyme has no connection with our story. The Parliamentary party was, however, only checked, not destroyed. Vigorous efforts were made, and with partial success, to win back some of the towns and strong places from the Royalists. In the year 1643 the advantage was distinctly on the King's 28 THE FIGHTING SYDENHAMS , but the excesses of the Royalist soldiers stirred i strenuous opposition and brought into the subse- it struggle a bitterness of feeling which is recog- d and accounted for by Clarendon. The Royalist srian states that after the capture of Dorchester Weymouth the King's party, " taking advantage :he great malignity" of these places, used great lse. The Earl of Carnarvon, one of the King's ;rals, a high-minded Royalist who shortly after- ds fell with Falkland at the battle of Newbury, so indignant at the non-observance of the articles urrender by his own party that he quitted his imand and went off to join the King before ucester. "hese things must be borne in mind ir we find the equent fighting in Dorsetshire to show a some- ,t bitter spirit, the population generally being on side, the soldiery on the other. Later on the >rious Goring (to use the words of a Royalist srian), a man whose riotous excesses brought so :h discredit on the royal cause, carried " licence " higher pitch. ^he fighting which for the next two years harassed county was not exactly what is described by the yentional phrase, guerilla warfare. It rather mbled the state of things on the Scottish border 1 which Scott has made us familiar. Each of the parties possessed certain strongholds, from which leaders sallied forth, with small bodies of daring 29 THOMAS SYDENHAM horsemen, to intercept supplies, to cut off convoys of ammunition, to threaten or assault hostile castles and manor-houses, sometimes to lew contributions on contumacious towns or tradesmen ; or occasionally with larger forces to lay serious siege to one of the enemy's fortified towns. On neither side could the forces be regarded quite as regular soldiers ; they followed no doubt their natural leaders, the country gentlemen, whose raids and skirmishes resembled on a smaller scale the border forays of the Howards, the Percies, the Johnstones, and the Douglasses. Their deeds of daring were never sung ; only recorded, if at all, in the baldest of prose ; for the Cavaliers did not any more than the Puritans encourage the making of ballads. But for any one desirous of finding fresh material for that style of poetry, the keen fights and hazardous escapes recorded in the old pamphlets might offer many promising themes. So much it seems worth while to say in order to show what kind of military life it was in which these stormy years of Thomas Sydenham's youth were passed ; but of the actual events of this provincial campaign a few only can be mentioned. FORAYS OF THE SYDENHAMS. As might be expected, many of the daring deeds on the Puritan side are set down to the Sydenhams. Thus Vicars, the enthusiastic Parliamentary chronicler, relates how William Sydenham, setting out from 3° THE FIGHTING SYDENHAMS eham to attack Dorchester, apprehended the uty Governor and his lieutenant, who had been active against the Parliament, and breaking open jrison freed such honest men as had been corn- ad by " those cruel cormorants." There also he with a cart laden with muskets and gunpowder, id for Bristol. The gunpowder he threw into the , brake 200 muskets, and took away as many as nen were able to carry. He also borrowed there ne Mr. Cokar, a " malignant " goldsmith, Such as he had ; and all this he did in an hour and a and returned safe to his garrison at Wareham. :tle before this he went into the Isle of Purbeck carried away from thence 323 cattle of all sorts, apother occasion he had " a brave bickering " Sir Lewis Dives's forces, taking forty prisoners, 100 horses, &c. he Royalists on their side had, of course, the same to tell ; and the Royalist journals record successful tiishes and attacks, with similar results in the ire of prisoners, arms, and booty. For instance, November 21, 1644, Sir Lewis Dives set out from astle of Sherborne to dislodge a party of rebels ing from Poole, who had posted themselves at dford. Having succeeded in this, he marched to :hester, and hearing that a large body of the rebel 1 was in the neighbourhood, attacked them with ich smaller force, and put them to flight. Next he returned in triumph to Sherborne, having 3 1 THOMAS SYDENHAM increased his numbers by this march, besides horses, arms, and prisoners taken from the enemy. Cavalry raids and skirmishes of this kind were con- stantly going on ; and one sees that the flat, heathy country of eastern Dorset, not much enclosed in the seventeenth century, would have been very suitable for this kind of warfare. In these affairs the losses do not seem to have generally been severe, but there were some more sanguinary engagements like that now to be spoken of. We first hear of the activity of the Sydenham family in 1643, m connection with the obstinate defence of Poole. It was apparently William Sydenham who, when in the garrison there (though not governor), led the Royalists under the Earl ot Crawford into a disastrous ambuscade. Having been tampered with by Royalist emissaries, and offered heavy bribes if he would betray the town, Sydenham adapted the familiar device of pretending to entertain their proposals. Lord Crawford fell into the trap, and it was agreed that if he came on a certain night with his forces the town gate should be secretly opened. The Royalists came at the appointed time, and the gates being silently opened they entered, without suspicion. But when most of the force had passed in the gates were closed, and the Royalists found them- selves exposed to a terrible fire of musketry and artillery. Many were made prisoners, many were killed, while some fought their way out. The 32 THE FIGHTING SYDENHAMS > ilists were saved from total destruction only by the ' of the garrison of Poole in having closed the i a little too soon, and by the fact that the amentary artillery was found to be badly placed so the cannon balls passed over the heads of the ly. Lord Crawford had a severe lesson, while nham's combination of craft and fidelity gained great applause from his party, hough at the end of 1643 Dorset, except Poole Lyme, was almost entirely subject to the Royalists, face of affairs was completely changed in the next . The Earl of Essex, marching through on his arred expedition to the West, easily recovered Chester and Weymouth. The former town was ;ed incapable of defence. The latter, with Mel- be Regis, as the lower town was then called, was by Essex under the command of Colonel William :nham. Other names, one of them that of his her, Major Francis Sydenham, are mentioned in ariginal warrant, signed and sealed by the Captain- eral of the forces of the Parliament, June 22, j., which is still in the British Museum. At the : time Colonel Sydenham was put in command of e troops of dragoons, and a foot regiment of the anal strength of a thousand men. He built some I of fort in the upper town, and made Weymouth leadquarters. His occupation of this place must orne in mind, as it will be the central point in our t history of the Dorset campaigns. 33 D THOMAS SYDENHAM In the meantime the stage was cleared by the departure of the two greater armies. Essex with his forces pursued their march towards the West and com- pelled Prince Maurice with the King's army to evacuate Dorset. A Royalist garrison was, however, left in Wareham, which had some bearing on our history. Whoever looks at the map of Dorset will see that Wareham is not far from Poole and lies on the way from that town to Dorchester. But in its political sentiments Wareham was totally opposed to Poole, being strongly Royalist, so that later on when it came, into the power of the Parliament, after an obstinate resistance of the townsmen, it was even proposed to raze the refractory town to the ground. The Royalist leader left in command at Wareham in July, 1644, Colonel O'Brien, an Irishman, brother of Lord Inchiquin, was not disposed to sit down quietly and await an attack. He assumed the offensive, and set out on his side to attack Dorchester in the month" of July, 1644. He was encountered by Colonel and Major (Francis) Sydenham with their garrison of Weymouth, and sustained a severe defeat. The Sydenhams pursued the Royalists almost to the gates of Wareham, and took 160 prisoners, among whom were eight Irishmen, of whom more hereafter. What most concerns us is that '■'■old Captain Sydenham (probably the father), who had been prisoner a long time to the Royalists in Exeter, behaved himself very bravely in 34 THE FIGHTING SYDENHAMS ction," serving with a lower military rank than ns ; and Thomas, though a young soldier, was bly also present. In the county history the " old " is omitted, and this at first led the it writer to believe that Thomas Sydenham was iptain referred to. :er this victory there is recorded an act of severity hich William Sydenham has been much blamed, ven by a recent biographer. The Irish prisoners idm mention has been made " had such quarter them as they gave the Protestants in Ireland " — s, they were promptly hung. The fate of these [rish and of others of their countrymen at this I of the Civil War was very sad. Brought over their native land to fight in a cause which was leir own, they found themselves deprived of the iry rights of war and treated as mere criminals, excuse was the state of national feeling. The r excited in England by the news of the terrible cres in the Irish rebellion, the feeling that the had been slack in punishing the rebels, and the :ion (which after all was not confirmed) that he ;oing to bring over the ruthless Irish savages (as inglish thought them) to fight against his own ious subjects, had worked up the national feeling )itch of wild excitement, only comparable to the se feeling which in our time was stirred by ales of the. Indian Mutiny. The Parliament a formal order that Irishmen taken in arms on 35 THOMAS SYDENHAM English soil should have no quarter. Sydenham's proceedings were, moreover, alleged to be a reprisal for the hanging of certain Parliamentary soldiers ; and thus led to further reprisals by Prince Rupert. Altogether it was an unfortunate business, but the national conscience and not the regimental com- mander should bear the blame. This is the only occasion on which the Sydenhams could be accused of undue severity. On another occasion they interfered on the side of clemency, with consequences which might have had a very untoward • influence on William Sydenham's career. In the month of August Colonel Sydenham is found finally reducing the Royalist stronghold of Wareham, and on this occasion in association with Sir Anthony Ashley Cooper, afterwards Lord Shaftesbury, who, from his wealth and position in the county, took the leading part, and was at this time an active rebel ; though, as he himself confesses, he was not physically well fitted for a soldier's life. For a time Ashley Cooper was the chief Parlia- mentary commander in Dorset, and on one occasion "I was in command of a force attacking the strong house of Abbotsbury, which was held by the Royalists. After once summoning the garrison, and on their refusing to surrender, he ordered that they should have no quarter, and even when the house caught fire, i and the unfortunate Royalist soldiers were trying to escape, ordered them to be driven back into the flames. 36 THE FIGHTING SYDENHAMS ; he states in the most definite manner in his siography. At the same time Colonel and Major nham rode up at the other side of the house, and ving or not knowing what was going on in front, tted the Royalists to quarter and saved their ; at the same time saving the Parliamentary party a serious disgrace. This interference of the nhams gave, however, great umbrage to Ashley >er and other officers, and was probably the occa- of the evident hostility to William Sydenham r n by certain gentlemen of Dorset. We find the irsetshire Committee," among . whom was Ashley jer, writing to the Council of State to recommend Colonel Sydenham's commission should be slled and his regiment disbanded. But Sir iam Waller, the chief Parliamentary general, spoke gly in favour of Sydenham. The Council rally followed his advice, and not only supported nham, but made him commander of all their s in Dorsetshire ; his brother Francis being about same time made commander of all the horse. active officer is soon afterwards found in London jlaining that he can get no pay for his men. this same summer there occurred a tragical and erious event in the Sydenham family. Their ler, Mrs. Sydenham, lost her life in the war, and, recorded by two contemporary authorities, was 1 by the Royalists : it is said by a certain Major iams. It is also shown by the parish register 37 THOMAS SYDENHAM that she actually died and was buried at Wynford Eagle about this time, in the month of July. The circumstances, under which a lady in her posi- tion was killed by the soldiers are quite unknown, and it is difficult to understand how such a thing can have happened. We can only conjecture that it may have been in an attack by the Royalists on Wynford Eagle, which in this war of raids and reprisals is not likely to have been unmolested ; and that she must have in some way incensed the soldiers. A plausible conjecture, and one which has the merit of impartiality, since the blame stands to the account of the other party, may be suggested by the death of a lady at the hands of the Parliamentary soldiers, namely, at Crom- well's storming of Basing House in the following year. Mr. Hugh Peters, who gave an account of the affair to the House of Commons, reports, as may be read in Carlyle's " Cromwell," to the following effect : " In the several rooms and about the house there were slain seventy-four (men) and only one woman, the daughter of Dr. Griffith, who, by her railing, provoked our soldiers then in heat into a further passion." Something like this may have been the fate of the Puritan gentlewoman. Of Mrs. Sydenham we know little but that she was the mother of four brave soldiers, two of whom gave their lives for the cause in which they fought. For a lady in her position to have thus exposed herself to the risks of war, she must have been either very courageous or very rash ; but it is 38 THE FIGHTING SYDENHAMS ot hard to suppose that the mother of four heroes ras herself heroic. In the great tragedy of a civil far one such casualty counts for little, but for her wn family it was a tragedy in itself, and had, as re shall see, further consequences of a tragic kind. The adventure now to be related is told by one ontemporary authority (Vicars) of Colonel William ydenham, by another (Rushworth) as explicitly of be Major, Francis. It is impossible to say certainly rhich version is the correct one ; we are inclined a think that Francis Sydenham was really concerned, nee at this time William Sydenham was Governor f Weymouth, but as Vicars's narrative is the fuller, re shall follow that authority. Sir Lewis Dives, the Loyalist leader who had been left in September of this ear, 1644, with a garrison in Sherborne Castle, and ras called Commander-in-Chief for the King in )orset, set out on November 30th with a force from )orchester to threaten Poole, where Colonel or Major ydenham was then in command. The Royalists made iccording to the Puritan chronicler) " a daring show nd bravado," but finding Sydenham prepared to eceive them, " drew off, and vanished like a vaporous loud," marching straight back to Dorchester, which fas then treated as an open town, and was at the lercy of whichever party might be superior in the eld. Sydenham determined to retaliate and "show ir Lewis Dives some action," drew out a party of fty or sixty horse " double pistolled," and marched 39 THOMAS SYDENHAM that night to Dorchester, where he fell upon the enemy in their quarters, and drove in their " out-guards " or pickets. Then calling on his men for a charge, he beat Sir Lewis's regiment quite through the town. The Royalists rallied, and a second charge followed with equal success to the Parliamentary force. Then happened an occurrence which, even as told in the rough words of the old chronicler, rises to the height of tragedy. When the Royalists rallied a third time Sydenham .; recognised in their leader a certain Major Williams, "who," it is said, "had basely and cruelly killed Sydenham's mother." For a soldier in the field to find himself confronted in arms by the slayer of his mother would be a crisis strange and startling enough to turn even a coward into a hero. It must have roused the Sydenham blood, which was not that of cowards, to an unexampled heat. What followed must be told in the words of the old narrative, since we can add nothing to them, nor have we the right to take anything away. "So soon as Colonel Sydenham saw Williams he spake to his men that were next to him, to stick close to him ; for said he, ' I will now avenge my mother's innocent blood ; ' and so he made his way to Major Williams, and slew him in the place, who fell dead under his horse's feet." This is the story such as we have it. It is of course the statement of a partisan, but there seems no reason 40 THE FIGHTING SYDENHAMS regard it as unhistorical ; and with it closes the lily tragedy of the Sydenhams. [f these tales of fighting and bloodshed should seem little moment in the life of a physician, we should nember that this rough school of warfare formed a t of Sydenham's education. It was essentially a ool of revolt, good or bad as we may choose to nk it, and must have had a share in forming the iracter of one who brought into matters of thought I science the courage of a soldier and the inde- ldence of a rebel. Only one more episode will be related, but it is one lich, though insignificant in the great field of tory, touched our family so nearly that it might nost be called the Sydenham epic. THE LOSS AND RECOVERY OF WEYMOUTH. Colonel Sydenham was now Governor of Wey- )uth and Melcombe Regis, and had two younger Jthers, Major Francis and Thomas, with him in the rrison, when an event occurred which shows us our ture physician actually in the field. In the beginning of February, 1644-5, the Parlia- sntary garrison was in undisturbed possession, having 1 foes nearer than Portland Castle, where there was Royalist garrison under Sir Walter Hastings, and erborne Castle, further to the north, held by Sir ;wis Dives. The place was well defended by two rts, one at least of which had been built by Colonel 4 1 '1'HUMAS SYU.fcJNJriAM Sydenham. But a plot was contrived by some of the townspeople to admit a force from Portland into Weymouth by treachery. Accordingly at midnight of February gth the " Portlanders " were admitted into the town by some secret ways, and secured the forts with scarcely any resistance. Some of Syden- ham's troops made a desperate attempt to recover them, but were repulsed with loss, and Major Francis Sydenham, who was doubtless in front of the fray, received a mortal wound, of which he died the next morning. Let us quote the words in which Peter Joice, the " minister of the garrison," speaks of the Governor's brother, " whose memory," he says, " may not be , buried with him. His death was no small joy to our enemies, to whom he was a perpetual vexation and terror, and no small grief to us who had our eyes too much upon him." The next day at noon arrived Sir Lewis Dives, with horse and foot from Sherborne ; and the Parliamentary garrison was compelled to evacuate Weymouth and retire to Melcombe, on the other side of the harbour, drawing up after them the bridge between the two towns. Here the Sydenhams and their men were in a position of temporary safety, but Melcombe was regarded as untenable, being imperfectly fortified, and the garrison were thought, in Clarendon's words, to be no better than "prisoners at mercy." Sydenham, 42 THE FIGHTING SYDENHAMS however, at once set to work to strengthen hii defences. The forts on the hill at Weymouth especially the " Chapel Fort," commanded the position and there was some cannonading and an attempt tc burn Melcombe by red-hot shot ; but, after a retalia- tion in kind by Sydenham, this method was discardec as being too dangerous to both towns. After a little while Melcombe seems to have been left pretty much alone by the Royalists, being regarded perhaps as harm- less, or as being too strong to be taken by a sudden attack. It was, however, closely besieged, anc apparently was not thought likely to be able to hole out long. Colonel Sydenham, however, with dauntless resolu- tion, held his ground and managed gradually to improve his position. He received supplies and reinforcements by sea from the Admiral (Lord Warwick) and others, and a troop of Parliamentary horse succeeded in finding their way in by land. Here occurred a little skirmish which we must mention, because it gives us the only glimpse we get of Thomas Sydenham in the field. The Governor. Colonel Sydenham, sallying out with all his horse, unexpectedly encountered a troop of the enemy's horse, and completely routed them, taking sixty prisoners and chasing the remnant up to the gates of Weymouth. This was done without the loss oi one man, only the Governor's brother being slightly wounded. Of course Francis Sydenham being now 43 THOMAS SYDENHAM in his grave, this brother could be no other than Thomas. Next we hear that at the end of the second week came Lord Goring from Salisbury with a large force of Cavaliers, horse and foot, and faced the walls or Melcombe all one Sabbath day, but did not venture to attack or even to summon the garrison, a neglect which greatly astonished the besieged, and for which Goring was severely blamed by his own party. He retired after leaving some reinforcements with the garrison of Weymouth. The end, however, was near at hand. Colonel Sydenham, with his restless energy, and favoured no doubt by the supineness of his adversaries, completely turned the tables upon them. The Royalists, being now stronger in the field, sent out some of their horse to bring in supplies. While thus engaged they were attacked by a Parliamentary force from Melcombe. The affair gradually became more important, and a force of infantry was sent out to support the Royalist cavalry. Colonel Sydenham, who was commanding in the field, saw that the garrison of the Chapel Fort must be seriously weakened, and seized his opportunity with the prompt decision of a born general. Riding back with a small force to Melcombe and throwing down the drawbridge, he hastened across and got on to the outworks of the Chapel Fort. Pressing his advantage, he entered the fort itself, and the garrison, surprised by an attack from an unexpected quarter, 44 THE FIGHTING' SYDENHAMS rendered in a panic, a large number being taken soners. This brilliant success, which was gained on February :h, practically secured for Sydenham the possession the town of Weymouth and the other fort. But ore the remaining positions were finally carried, ring tried to make up for his previous supineness a final effort to crush the Parliamentary garrison, irching from Dorchester with a large force, he de a determined night attack upon Weymouth. Ionel Sydenham, who had received a warning of approach, allowed the outworks to be easily carried, I received the attack in the streets with barricades ended by cannon. The Royalists charged gallantly, I got behind the main barricade, which was only ed f>y Sydenham in person rallying his men. At :, after two hours' fighting, in which they suffered at loss, the Cavaliers were compelled to retire, and : retreat became a flight. Sydenham, on the hteenth day after the loss of Weymouth, was again possession. Goring, after drawing out the Royalist rison, marched off" with all his force, to the great prise of his adversaries, and to the great chagrin, we are told, of the keen Sir Lewis Dives, and illy left Dorsetshire altogether. Thus Colonel lenham was again Governor ; and Weymouth, with Jcombe, remained in possession of the Parliament. The loss and recapture of Weymouth, though not .ch noticed in the great histories, excited great 45 THOMAS SYDENHAM attention at the time. It was a serious blow to the Royalists, and a cause of great exultation to the Puritan party. The thanks of Parliament and a grant of ^2,000 were given to the officers, soldiers, and seamen of Weymouth and Melcombe. Clarendon speaks with great severity of the conduct of the Royalist com- manders, especially Lord Goring, whose soldiers only distinguished themselves by "horrid outrages and barbarities " and " unheard of rapine," without applying " themselves to any enterprise upon the rebels." At this point the history of medicine must concern itself for a moment with a curious coincidence which political history would not stoop to notice — that is, an approximation quite unperceived on either side between two representatives of English medicine and English surgery respectively in this memorable siege. Richard Wiseman, the most eminent English surgeon of the seventeenth century, sometimes called the Father of English surgery, was engaged as a surgeon on the King's side in the Civil War. During this period he was not present at any of the great battles (though later on he was at the battle of Worcester), but was attached to the army in the West of England, under the nominal command of the Prince of Wales, afterwards Charles II., and in this capacity served in Somerset, Dorset, and other parts with the Royal forces. He was present, as he himself records, at the surprise of the Weymouth forts by the garrison from Portland, and remained in the place 46 THE FIGHTING SYDENHAMS rhile it belonged to his party. At the very time rhen Colonel Sydenham's troops surprised the Chapel ort, he had an adventure which may be recorded in is own words. " I was dressing a wounded man in the town almost nder the Chappell Fort, and hearing a woman cry, Fly ! fly ! the fort is taken ! ' I turned aside a little mazed towards the line, not knowing what had been one ; but getting up the works, I saw our people unning away and those of the fort shooting at them. slipt down this work into the ditch, and got out of he trench ; and as I began to run, hearing one call Chirurgeon ! ' I turned back, and seeing a man hold p a stumped arm, I thought it was an Irishman whom had absolutely dismembered, whereupon I returned, nd helped him up. We ran together, it being within alf a musket-shot of the enemy's fort ; but he outran ae quite." Evidently Wiseman had a very narrow escape. Now F Thomas Sydenham was, as is very probable, with his irother the Colonel on this occasion, they must have een within an ace of taking the Royalist surgeon risoner. The circumstance would have had no articular interest for Sydenham, and certainly Wise- lan could not have recognised in a young cavalry fficer of nineteen, at that time not dreaming of ecoming a doctor, the future reformer of medicine. !ut at this distance of time we can wonder at the urious irony of fate, bringing almost in presence of each 47 THOMAS SYDENHAM "' ?K other two men opposed in politics, but- both destined to adorn the same profession. In after years Wiseman practised surgery in London at the same time as Sydenham practised medicine there ; but the name does not occur among the numerous physicians mentioned . by Wiseman in his works, and for various reasons it is j not likely that they ever met. From this time the conflict in Dorset became much less active, all the important places being in the possession of the Parliament ; though the strong castle of Sherborne, impregnable by such means as the Parliamentary forces possessed, still held out under the "inexpugnable" Sir Lewis Dives. But while there was any fighting going on we may be sure that the Sydenhams were in the thick of it. Sherborne was reduced by Fairfax and Cromwell in August, 1645, and after this there was no more fighting in Dorset, but we are not told that the forces were disbanded. i In the next year, the 20th of June, 1646, Oxford J surrendered to Fairfax, and before the end of August, in Carlyle's words, " the First Civil War, to the last ember of it was extinct." It is well known that at the end of 1646 and in the following year a large part of the Parliamentary army was disbanded, and we cannot doubt that among those who surrendered his commission, if he had one, was Thomas Sydenham. But there is no positive proof that he held any military rank in the first war. If he 48 THE FIGHTING SYDENHAMS did hold any it was probably that of cornet, not capta The elder brother William was continued in l governorship of Weymouth for some time longer, a always retained the rank of colonel. He was n< made military governor of Bristol, the second city the kingdom, and colonel of the popular Gene Skippon's famous regiment ; but not for long, he soon became Governor of the Isle of Wig and held besides other civil dignities, which r a great influence on his younger brother's caree but with these we are not now concerned. Thon Sydenham had no part in them, and when he gave military service, which would have been probably in 1 latter part of the year 1646, if not earlier, his oi aim in life was to return to his University. On journey thither he had a chance meeting and conv sation with a physician, which altered the whole cou of his life. The story shall be told in his own woi 49 Ill Sydenham at Oxford. The Puritan Rule in the University IN the letter of Dedication to Dr. John Mapletoft prefixed to the third edition of his work called " Observationes Medicae," Sydenham makes a bio- graphical statement which has been often quoted, though not always accurately, and is here given in a translation. " It is now the thirtieth year since the time when, being on my way to London, in order to go from thence a second time to Oxford (from which the mis- fortunes of the first war had kept me away for some years), I had the good fortune to fall in with the most learned and honourable Dr. Thomas Coxe, who was at that time attending my brother during an illness ; and then, as he has been up to the present time, practising medicine with great distinction. He, with his well-known kindness and courtesy, asked me what profession I was preparing to enter, now that I was resuming my interrupted studies, and was come So SYDENHAM AT OXFORD o man's estate. I had at that time no fixed plans, nd was not even dreaming of the profession of ledicine ; but moved by the recommendation and ifluence of so great a man, and in some way, I uppose, by my own destiny, I applied myself sriously to that pursuit. And certainly, if my efforts ave turned out to be of the least public utility, the redit must be thankfully referred to him who was the atron and promoter of my early studies. After pending a few years in the University, I returned to London and entered on the practice of medicine." Now the work to which this letter is prefixed was inished December 30, 1675, and the dedication, being aturally composed when the book was completed, rauld have been written early in 1676, which is the ate of the published work. It would therefore have een in 1646 that he returned to Oxford, but from fie political circumstances it is clear that it could not ave been till the end of that year, and in conse- uence of the unsettled state of the University it is ot likely that many students returned even so early 5 that. It is possible, indeed, that there may have een a little vagueness of dates, and that he did not :tually go into residence till 1647, which would not e inconsistent with Sydenham's own statement. He :ems to have returned, in the first instance, to his old Dllege, Magdalen Hall. The next year, 1647, was a stirring period in the Tniversity. The Parliament, on May 1st, passed an 51 THOMAS SYDENHAM ordinance appointing Visitors, who were, of course, strong Puritans, to purge the University of all who refused to take the covenant, or opposed the ruling powers. The University made a vigorous and organised opposition, as they were clearly justified in doing, so that the whole of this year was occupied with disputes and conflicts, the result being that the work of subjecting the University to the Parliamentary rule was still very imperfectly accomplished. In March, 1648, however, the Earl of Pembroke, the Chancellor of the University, who had been dis- possessed by Charles I., was sent down to Oxford, with a strong guard, so that finally the opposition was broken and all the heads of Houses and Fellows who refused to submit either resigned or were deprived of",' their places. Some three or four hundred Royalist members of the University were driven out, but it was not till the month of August that the work was brought to completion. It does not seem likely that Sydenham had much time for quiet study during this distracted period, but his name appears on one or two occasions as a supporter of the Parliamentary Visitors, and on the 30th of September, 1647, he was appointed one of their delegates, as the representative of Wadham College.|| Sydenham was perhaps not satisfied with his old college. At all events, on the 14th of October, 1647, he entered as a Fellow Commoner of Wadham, as appears by the college registers. We may suppose 52 SYDENHAM AT OXFORD that his reason for selecting this college was that th celebrated Dr. Wilkins (a strong Presbyterian, thoug] afterwards Bishop of Chester) was already designate! for the headship of the College, in place of th. "Royalist Warden ejected by the Visitors. But a Wilkins did not come into office till April in the nex year there may have been no connection. Sydenhan himself referred in after life to his having been ; member of Wadham. He says in 1687, writing to ; Doctor Gould, a Fellow of Wadham, "I mysel was once a Fellow Commoner of your house ; but how long since I should be glad to know from you, as ] remember it was in the year that Oxford wai surrendered, though I had bin of Magdalen Hal sometime before." It is not,' however, quite cleai whether he speaks of the military surrender of Oxforc to Fairfax in 1646, or the- surrender of the University to the Commissioners in 1647. It is, however, singular that the name occurs agair in connection with Magdalen Hall. When the col- leges were summoned by the Visitors to submit tc their authority, each member of the college was askec individually whether he submitted. In the case oi Magdalen Hall we find among the Masters of Arts " Mr. Sidnam, M. A. " said, " I submit." There is nc reason why this should not have been our Sydenham, the variation in spelling being of no consequence ; and though there is no record of his taking the degree oi M.A. he was officially recognised as having this degree 53 THOMAS SYDENHAM when admitted, long afterwards, a Licentiate of the College of Physicians, and must then have exhibited some evidence of it. Moreover, it was probably possible then, as in later times, for a man to have his name on the books of two colleges at once. The story of Sydenham's medical degree, which is rather a curious one, has now to be told. When the Puritan party came into possession of the University, and had a number of vacant fellowships and other ' preferments to give away, there were a large number of students desirous of taking degrees who, from the disturbances of the times, had been unable to qualify _ t ^ themselves by the ordinary course of residence and of exercises in the schools (examinations in the modern sense being not then organised). To satisfy their aspi- rations and to provide a sufficient number of graduates :| for the vacant offices, a large number" of degrees were conferred by " actual creation," as it is called. That is to say, they were given by direct vote of Con- vocation, sometimes subject to the candidate perform- ing certain exercises, sometimes without any conditions at all. Often, or indeed generally, this was done in compliance with a recommendation (amounting to a command) from the Chancellor or even some other important person. When there was a king upon the throne he not unfrequently exercised this royal privi- lege of nomination. After the battle of Edgehill ; Charles I. ordered a number of degrees to be conferred 54 SYDENHAM AT OXFORD on his supporters — a transaction called by Wood " th Caroline creation." During the King's residence in Oxford the sam privilege was frequently exercised, and after the Res toration still more liberally. This right of conferrin degrees by creation, always possessed by the Universit) though sparingly used in ordinary times, was lavishl employed by the acting Chancellor, the Earl of Pem broke. The degrees given on April 12, 14, an 15, 1689, by his command are called by Anthon Wood " the Pembrokian creation." Though politic: ind personal interest had great influence in thes degrees they were not conferred on unworthy person; Dr. Wilkins, the Warden of Wadham above men rioned, was created Bachelor of Divinity the da sefore he was put into his Headship, and Dr. Wharton :he celebrated anatomist, owed his medical degree to th lomination of Sir Thomas Fairfax. Itwas generally con iidered decent to state the grounds of recommendation Sydenham, then, was actually created Bachelor c Vledicine on April 14, 1648, by command of th Earl of Pembroke. Wood notes that he had no >reviously taken any degree in Arts, nor did he do si it any time ; but we have seen there is a presumptioi hat he possessed the degree of M.A., which he couli lave received by creation as easily as that of M.B 'robably it was conferred at a time when the register vere not very accurately kept, as is confirmed b] vidence to be given later. 55 THOMAS SYDENHAM The modern reader may wonder a little that medical degrees, involving professional privileges, were conferred as readily as honorary titles in arts or law are given at the present day. But this was the custom. Sydenham could not at this time have made any serious study of medicine, having been barely a year resident in the University, and in a time of great confusion. He had thus the rare good fortune to obtain a degree at the beginning instead of at the end of his student's course. So much he owed to patronage. But if we consider the incalculable gain to the science of medicine involved in making Sydenham a doctor; we must admit that seldom has the blind Goddess of Patronage dispensed her favours with a happier hand. It is possible that this business of the degree may have been hurried on in order to qualify Sydenham for an important preferment which he obtained soon after. On October 3, 1648, he was appointed by the Visitors to a Fellowship of All Souls' College, doubt- less in place of an expelled Royalist. It is suggested that this place was obtained for him by the influence of his brother, the Colonel. Very likely this was so ; Sydenham was already persona grata, a favourite with the dispensers of patronage. In March of the next year he was appointed Senior Bursar of the College, and must thus have been in comfortable circum- stances. 56 SYDENHAM AT OXFORD OXFORD UNDER PURITAN RULE. Before continuing the story of Sydenham's life in Dxford, it will be well to consider for a moment the tate of the University in his time and how it had een affected by the recent changes. When Oxford surrendered to Fairfax at the close of he first war the University was completely dis- rganised, having been for nearly four years the seat of ;overnment, and occupied by a garrison-; so that the rdinary studies must have been suspended. The olleges had been occupied by courtiers and soldiers nore than by students, and the few scholars who emained had been in some sort of military service, ioth the University and the colleges were impoverished y their quasi-voluntary gifts to the King; some of heir buildings were in ruins, and there was, in Lnthony Wood's words, " scarce the face of a Uni- ersity left." It was necessary for the Parliament to deal with his state of affairs, and finding that the University uthorities refused to comply, they had to be compelled 1 the manner already described. The chief change t first was one of persons. It naturally followed that hose who refused to submit to the new rule were xpelled, and it is not easy to see how it could have een otherwise, considering the political importance of le Universities. No Government exercising its elementary duty of 57 THOMAS SYDENHAM self-preservation could tolerate its open enemies in academical seats any more than in ecclesiastic or civil offices ; and it should be remembered that during the Royal occupation the University had been thoroughly purged of all Puritan elements, only faithful Royalists being permitted to remain. The warden of Merton, Sir Nathaniel Brent (to take one instance), being absent and serving in the Parliamentary army, was very naturally, though not quite legally, deprived of his office by the King, who used his influence to procure the election of a more than worthy successor in the person of the great Harvey, destined to hold the Wardenship for one year only. The important point was the character of the new men thus forcibly introduced, and there can be no doubt as to the eminence of many of them. Anthony Wood has left an amusing picture of the new scholars, some of whom, coming from Cambridge, he calls " the dregs of the neighbour University," commonly called " Seekers." He ridicules their fond- ness for the sermons at St. Mary's ; their mortified countenances, puling voices and eyes lifted up ; their short hair, commonly called " the committee cut," and shabby attire, making them look rather like appren- tices or antiquated schoolboys than academicians or ministers. All this was fair game ; but it is not safe to take a humorist like Wood too seriously. Among the importations from Cambridge were Wallis, one of the greatest English mathematicians, and Seth Ward the 58 SYDENHAM AT OXFORD stronomer, appointed Savilian professors in place of wo unsubmitting Royalists. Among the " intruded " leads of houses was the " universally- curious " Dr. Vilkins, Warden of Wadham, a man of vast attain- tients and marvellous ingenuity, as versatile in science s he was fickle in politics ; destined in a short time become the leader of the scientific movement in )xford. At this time he was a Presbyterian minister, rid soon afterwards married Cromwell's sister ; but ieing what is called in modern times an "oppor- unist," managed to secure still higher patronage after he Restoration, when he was made Bishop of Chester. Another of the Puritan heads of houses was Dr. onathan Goddard, Cromwell's physician, and made by im Warden of Merton in succession to Sir Nicholas (rent. He was a distinguished physician, afterwards 'rofessor of Medicine in Gresham College, and who, ven before he came to Oxford, had occupied himself 1 London with philosophical experiments. He is tated to have constructed with his own hands the first slescope ever made in England. It was creditable Iso to the Parliamentary Commissioners that they llowed Pocock, the great Arabic scholar, to retain his rofessorship, though he refused to submit. A doctor by actual creation and an intruded fellow, ke Sydenham, was William Petty, an economist far [lead of his age, and accomplished in many sciences : ne of the most brilliant men of science ever born in 59 :m^W^_ THOMAS SYDENHAM ;■'""■ ''■":' •' England. It is not easy to estimate the merits of theologians, since of their eminence party spirit is the judge ; but the new school was never held to be defi- cient in learning. The actual state of things in Puritan Oxford may be learned better from Wood's private diaries, published by the Oxford Historical Society, than from the peevish complaints which the downfall of his party naturally enough drew from him. We gain an impression of keen intellectual activity and strict discipline, with by no means a complete absence of amusement, for though songs and ballads were frowned on by the Puritans, instrumental music was much cultivated. The ultimate result of the Puritan reforms in Oxford may be safely judged of by the unwilling testi- mony of Clarendon, who says : — " It might reasonably be concluded that this wild and barbarous depopulation would even extirpate all that learning, religion, and loyalty which had so eminently flourished there ; and that the succeeding ill husbandry and unskilful cultivation would have made it fruitful only in ignorance, profanation, atheism, and rebellion, but by God's wonderful blessing the goodness and richness of that soil could not be made barren by all that stupidity and negligence. . . . It yielded a harvest of extraordinary good and sound knowledge in all parts of learning ; and many who were wickedly introduced applied themselves to the study of good learning and the practice of virtue, and had inclination to that duty 60 SYDENHAM AT OXFORD and obedience that they had never been taught. Sc that when it pleased God to bring the King back to his throne, he found that University abounding in excelleni learning and devoted to duty and obedience, little in- ferior to what it had been before its desolation." It was indeed superior in most of these good quail ties, notwithstanding what is called its " desolation." The general impression derived is that the , nev rule in Oxford was far from being a " Puritan deso lation," or ruin, as. is sometimes said ; on the contrary the University was soon in a condition of prosperit] and remarkable intellectual activity. The Puritai discipline no doubt was strict, but in relation to th previous laxity and the immature age of scholars ii those days we have no right to say that it was toi strict. Sermons, no doubt, were more abundant thai modern taste would relish. In the University church in college chapels, on many week-days as well a Sundays, were sermons, which the scholars had no only to hear, but duly to transcribe, to an exten which would astonish a modern undergraduate. Th disputations in the schools on theology and philosoph were well maintained, not in Latin only but often i: Greek, which Wood observes was hardly or neve known in later times after the Restoration, and whic in these latest times seems almost incredible. We might suppose that theological and scholasti disputations were not much to Sydenham's taste, bt we find that he was deeply interested in divinity, an 61 THOMAS SYDENHAM even wrote a treatise on Rational Theology ; so that this side of Oxford studies seems to have left its mark. Another side of the intellectual life of the University would not have been thought much of by Anthony Wood, but has turned out to be the most important of all. In Wadham College or in the lodgings of Dr. William Petty met a remarkable group of scientific men. The universally curious Warden was generally the host ; around him would be Wallis and Seth Ward and Petty, and that. " miracle of a youth," Christopher Wren, whose budding genius was nursed in Wadham, but who became a colleague of Sydenham's as a Fellow of All Souls'. Dr. Thomas Willis, the anatomist, then practising in Oxford, though a Royalist and secretly an Anglican, would not stay away. Dr. Jonathan Goddard, Cromwell's physician, whom he had made Warden of Merton, was another member of the circle. Later, the great Robert Boyle, who came to live in Oxford in 1654, was added to the group which was the successor of his " Invisible College " in London. Robert Hooke, then Wallis's young assistant in chemical experiments ; Thomas Mil- ington, from All Souls', a friend or Sydenham's, afterwards President of the College of Physicians, and Richard Lower of a younger generation, who co- operated in Willis's anatomical researches, were also connected with the meetings. This scientific movement had indeed originated in 62 SYDENHAM AT OXFORD -ondon during the early years of the first civil war )rs. Goddard, Wilkins, and Wallis had been thi rincipal figures in a group or club of scientific lquirers — what the French call a cenack — whicl sed to meet sometimes at Goddard's lodgings, some !mes at Gresham College, or elsewhere, for mathe- latical and physical discussions. Two of these havi een spoken of already. The third, Wallis, was ii hose days clerk of the Westminster Assembly, an< ras specially obnoxious to the Royalists because he ha< sed his knowledge of cipher to give evidence agains vaud on his fatal trial — a piece of service for which hi iras never forgiven by staunch Cavaliers like Anthom Vood. Robert Boyle and Petty are mentioned as corre pondents of this club, which, under the name o : The Invisible College," was the real embryo of th loyal Society. Its centre was partly shifted ti Oxford about 1649, when Puritan patronage trans erred Wallis to be a Professor there, and Wilkins am joddard to be heads of houses. So that after thi here were two groups, in constant correspondenc yith one another — -the parent society in London, am he Oxford colony, called the Philosophical .Society \.s the movement has been strangely called " Anti 'uritan," it is necessary to draw attention to thi trongly Puritan cast of the original group, and o tiost of the Oxford Society. The scientific impuls nade itself felt in Oxford for another generation 63 THOMAS SYDENHAM amongst its most conspicuous" results being the anatomical and physiological researches of Willis, Lower, and Mayow. Then it somewhat unaccount- ably died away, but in London the corresponding movement gave rise to the formation of the Royal Society, founded after the Restoration. One would like to think that Sydenham joined the Philosophical Society, and took part in the meetings at Wadham or at Petty's lodgings. But there is no evidence that he did so ; the only link connecting him with the scientific circle being his friendship for Robert Boyle, and for Dr. Millington of All Souls'. There is even some presumption that he did not altogether sympathise with the philosophers, for when in London he never showed any interest in the advance of anatomy and physiology or the other objects of the Royal Society. We get a vivid picture of Oxford in the days of " Puritan desolation " in John Evelyn's record of his visit there in 1 654. He talks of the Acts performed at St. Mary's and in the schools, according to ancient custom : of a sermon from the famous Dr. Owen, " perstringing Episcopacy " ; of the disputations of the doctors ; the long speeches of the proctors and the Vice-Chancellor ; the creation of the doctors by the old ceremonies of the cap, ring, kiss, &c, not yet wholly abolished ; the excellent oration of Dr. Kendall, one of the Inceptors, abating his Presbyterian ani- mosities ; and even the " drolleries of the Prevari- 64 SYDENHAM AT OXFORD cators " J were not forgotten. In the Bodleian the visitors were shown the precious manuscripts, English and Oriental. The Physic or Anatomy School, adorned with some varieties of natural things, and the , Physic Garden, with its botanical curiosities, were also visited. The colleges were profuse in hospitality. At Evelyn's old college, Balliol, the staunch Royalist was made extraordinarily welcome. At All Souls' he heard music, of voices and theorboes, performed by some ingenious scholars. In New College and Magdalen the Chapels were still in their ancient garb, notwithstanding the scrupulosity of the times ; and in Magdalen was still standing the double organ (afterwards removed) on which Mr. Gibbon, the famous musician, gave a taste of his skill and talents. And above all he mentions the magnificent enter- tainment in Wadham given by his dear friend Dr. Wilkins, the Warden, who displayed his vast collection of curiosities and scientific instruments, belonging to himself and to that prodigious young scholar, Mr. Christopher Wren. Evelyn went away well satisfied with the hospitality of Oxford, and has left us a favourable impression of the activities and the amenities of the University, where academical studies, though not less exact than 1 Drollery of the Prevaricators. This was what Evelyn elsewhere call? an old facetious way of rallying upon the questions proposed in the disputations. It was replaced by the coarse buffoonery of " Terrae Filius," condemned by Evelyn on a later visit to Oxford in 1669. 65 F THOMAS SYDENHAM • - ' • in former times, seem to have been more varied and more modern. Whatever positive knowledge Syden- ham may have gained in Oxford, he certainly had the advantage of living in a vivid centre of intellectual life. The unquestionable success of the Puritan rule in Oxford seems to have been due to several causes. First, the steady discipline to which the scholars were subject, however irksome, would undoubtedly make for industry. Then the Commissioners exercised great care in appointing men of eminence to fill the professorships and chief places in the University, as well as in the selection of young men of remarkable promise, such as Wren, Petty, Sydenham, and Millington, with others afterwards eminent, to occupy the vacant Fellowships. The candidates recommended for degrees by the Chancellors (including Cromwell himself) would also form a striking list. Indeed, one is tempted to suppose that all these appointments were made with considerable regard to conscience. Another very important factor was doubtless the intellectual stimulus arising from the shock and agitation of men's minds, and the spirit of originality fostered by the breaking down of traditional landmarks ; so that, as has often been noted in similar times of crisis, a- period of keen mental activity succeeded to the political and military intensity of the Civil Wars. At all events it is quite clear that the speculative and scientific Renascence, 66 SYDENHAM AT OXFORD imes put to the credit" of the Restoration, I, both in Oxford and London-, under the nonwealth and the Protectorate. tie is known from actual evidence of Sydenham's ts during his Oxford residence, but one interest- ory showing how he tried to make up for the tficies of his interrupted University course comes in a very indirect way. the diaries of Dr. Wm. Stukely (published by irtees Society) Stukely says he heard from Lord roke that he had heard from Dr. Thomas lgton that he was chamber fellow with Thomas ham at "Cambridge" (meaning Oxford) and he following story. That when Sydenham had led to the University after three years' absence id forgotten his Latin, but recovered it by ate reading of Cicero, translating him into 5h, and then retranslating into Latin, correcting the original. . Millington, afterwards Sir Thomas, Sedleian >sor of Natural Philosophy at Oxford, and lent of the College of Physicians, was actually iw of AH Souls' at the same time as Sydenham, also appointed by the Parliamentary Visitors, and erred to by Sydenham himself in one of his i as an intimate friend ; therefore the story seems titic enough. Sydenham was always an admirer cero, and according to Sir Hans Sloane kept a >f him in his library. 67 THOMAS SYDENHAM Oxford at that time offered but scanty facilities for medical study. There was a Regius Professor of Medicine, whose duties were to read a lecture twice weekly on the text of Hippocrates or Galen. The professor in Sydenham's time was Sir Thomas Clayton, appointed in 1647, the successor of his father, also Thomas Clayton. Sir Thomas Clayton was also Warden of Merton, where he was always quarrelling with his fellows, but not otherwise^ eminent. As Sydenham was always a great admirer and reader of Hippocrates, though of no other medical classic, it is possible that Sir Thomas Clayton may have introduced him to the study of the Father of Medicine. It is hardly necessary to say that there was no hospital for clinical instruction. There was some regular teaching in anatomy, though the anatomical school had not reached that eminence which it attained later, in the hands of Willis, Lower, and Mayow. A readership in anatomy had been founded by Richard Tomlyns in 1623, and was virtually annexed to the Regius Professorship of Physic, being first held by Thomas Clayton the elder, and in 1647 by his son. It is noteworthy that in 1633 a small anatomical work, a 7 reprint of the Institutions of Anatomy by Caspar Bartholinus, was printed in Oxford, probably as a text-book for the pupils of the Tomlyns reader. Sir Thomas Clayton,, \ who held the chair in Sydenham's time, is said to have SYDENHAM AT OXFORD ad a weakness which entirely disqualified him fo is office, namely, that he could not bear the sight o: lood without fainting. However, he provided ; iibstitute far better acquainted with anatomy than hi ras himself, Dr. William Petty. This remarkabli lan was accomplished in many sciences, though now nown chiefly for his " Political Arithmetic," am ther economical works, by which he is regarded a laving founded the science of vital statistics o demography. Evelyn said he had never known sue! nother genius. He had studied anatomy on the Continent, "probably at Leyden and Paris, since he i: :nown to have discussed Vesalius with Hobbes o /lalmesbury, when living in that city. The statute: rescribed only one dissection in the year, in Len erm, if a newly-executed criminal could be had ; bui /e know from Wood's diary that the medical student! ;ot news of persons hung in Abihgdon and othe: ilaces round, and made arrangements to obtain thi lodies for dissection. One celebrated case, of a poor woman hung a 5xford, who was found when brought to the anatomi chool to be not dead, and was recovered by the skil f Petty, made great noise at the time and was com nented on in a rather well-known pamphlet, " Newe rom the Dead, or the miraculous deliverance of Anni jreene, who being executed at Oxford, December 14 650, afterwards revived and by the care of certair hysiclans there is perfectly recovered." Severa 69 ■-J-5WRBSR. TH OMAS SYDENHAM gentlemen of the University, including Christophe Wren, Dr. Ralph Bathurst, and others, celebrated th event in Latin, English, and French copies of verses This occurrence brought Dr. Petty more celebrit; than his anatomical learning. Another similar even which is mentioned by Wood had a less favourabl issue, the executioners ruthlessly insisting on finishinj their work. It is clear that Sydenham had the opportunity o acquiring that moderate knowledge of anatonr with which he was content, as he never attach© much importance to this department of medica training. The accomplished Dr. Petty also gave lectures 01 chemistry, which Sydenham might have attendee After acting as deputy Petty was afterwards appoint© to the Tomlyn Readership in Anatomy ; Sir Thoma Clayton, with much good sense, resigning the offic to make room for him. Petty, however, did no occupy the chair long, obtaining two years' leave c absence from his college in March, 1651, to b physician to the Parliamentary army in Ireland, an did not return to teach in Oxford. Another branch of medical science, botany, wa represented only by the Physic Garden, which wa of considerable size and could show, in 1648, som six hundred species ; though, according to Evelyn, i contained, at the time of his visit, nothing very remark able. It was certainly at that time inferior to what i 70 SYDENHAM AT OXFORD ffW=',v e a few years later under its excellent German r, Bohart. e account now given exhibits the whole of the al education which Sydenham could have received iford — a very imperfect curriculum according to leas ; but he afterwards supplemented it by a practical kind of study in Montpellier, which )e spoken of presently. In the meantime his :rsity studies were interrupted by duties of a very :nt kind, as will be told in the next chapter. 1 may be observed that what is now to be related seems incon- with Sydenham's own statement in his dedication to Mapletoft o), that after spending some years in the University he returned !don. But, after the Restoration, all who had fought in the Rebellion were naturally reticent as to their exploits, and Syden- mld hardly have declared publicly that he had borne arms against gning monarch. He himself, it may be noted, never attributed jopularity of which he complained to this cause.- IV Sydenham's Second Military Service — Marriage — Start in Practice THE most authentic document bearing upon Sydenham's military services is a remarkable petition in his own handwriting, presented to Oliver Cromwell, then Protector, in March, 1653-4, which is still preserved in the Record Office (S.P. Interregnum, vol. lxvii. f. 37), and printed in Green's Calendar of State Papers (Domestic Series, 1654, p. 14). It is endorsed " Captain Sydenham's petition." It seems best to give this interesting memorial entire, and then to show what conclusion can be drawn from it. "CAPTAIN SYDENHAM'S PETITION. " To his Highness the Lord Protector of England, Scotland,, and Ireland. "The humble petition of Capt. Thomas Sydenham. " Sheweth : "That there was due to my brother Major John 72 SECOND MILITARY SERVICE ydenham, slayne in Scotland, a very considerable rrear for sundry and constant services in England and reland. " That your Highness Petitioner besides that he was :gally entitled to the sayd arrears did furnish his sayd rother with divers sums of money to inable him to uy horses and other necessaries for his going to cotland, for which your petitioner was never satisfied. " That the severall papers which should certifie the forementioned services, being all lost upon the death f the sayd Major Sydenham together with what else e had, your petitioner was made incapable in the rdinary way to recover what was due. "That your Highness petitioner after a two years ttendance on the Parliament for satisfaction, did pplie himselfe to a Committee newly constituted )r receiving petitions, who upon examination of his ase did order that Mr. Carie Rawligh should report heir sense to the Parliament, which was that satis- iction should be made him out of Irish lands, but our petitioner not being able to get on the Report 11 those Lands were passed away to Act, would not njoy the benefit of that order. "Your petitioner therefore most humbly prayesyour lighness that your Highness will please in considera- on of the faythfull and valiant services of your etitioners sayd brother, to order such satisfaction as 1 your Highness piety and wisdom shall be thought t to be made to your petitioner, who hath likewise 73 THOMAS SYDENHAM himselfe faithfully served the Parliament with the los of much bloud and therby much disabled his body for all which yet he never sued for any satisfaction Your petitioner would likewise insist on the man} services of another brother of his, one Major Franci Sydenham, slayne in the West, whose executors neve: received more than eighty pounds satisfaction of hi arrears ; but your petitioner shall cease to troubli your Highness. "And your petitioner shall pray etc. " Thomas Sydenham. "Friday March 3rd, 1653." The first point which strikes us as noteworthy ii this document is the endorsement, by which the write is officially recognised as " Captain Sydenham " and ii further documents connected with the affair is callet Captain Thomas Sydenham, so that he is clearl] identified. Now it seems unlikely or even out o the question that he would be called by this militan title in virtue of his service (in the first Civil War) a a young man in Dorset nearly ten years before, evei if he had a commission then — which is doubtful. I clearly points to some more recent military rank, am shows that he must also have taken part in the secom war — namely, that against Charles II. On consulting the Calendar of State Papers for th< years 1650-1, we find several references to Captaii Sydenham, all of which are referred in the inde: 74 SECOND MILITARY SERVICE Thomas Sydenham. But a closer examination )ws that there are clearly two Captain Sydenhams erred to. One was a captain of foot, the other a cavalry regiment. The infantry officer served the regiment of Colonel Stubber, which, on May , 1650, was ordered by the Council of State to irch from Kent to Chester for transportation to :land. A few days later the Council addressed a rere reprimand to Colonel Stubber about the haviour of his men. The Council had heard com- lints of the misconduct of his soldiers while in Kent, d also in many places where they passed ; more aerially at the house of Sir James Harrington, near xbridge, two sergeants of Captain Sydenham's com- ny had behaved in a very outrageous manner. This ptain was evidently Sydenham's next brother John, ho as we know from the petition did actually serve Ireland ; and this will be the best opportunity to 11 what more is known about this brother, who idently possessed the fighting -qualities of his family, e was too young to have served in the first war, id when he entered the army we do not know. He ust have gone with Stubber's regiment to Ireland id returned; and at the beginning of 1651 was •omoted to be major, being then barely twenty- ire years old. As a field officer he would have iquired an equipment of horses and so forth, for hich his brother Thomas, comparatively wealthy as Fellow of All Souls', advanced him money. He 75 THOMAS SYDENHAM went to Scotland with Cromwell's army which took the field against the younger Charles. In May it is recorded in Whitelock's journal that Major Sydenham was wounded in some one of the engagements near Stirling, and on May 25th letters from Scotland stated that he had died of his wounds. His fate was singularly like that of his brother Francis, both dis- playing the courage, and perhaps also the impetuosity, of the Sydenham character. The captain of horse mentioned in the State Papers was quite another person, employed at the same time in quite another part of the country, and there can be no doubt that it was Thomas Sydenham. How it happened that he was called from his Oxford retreat to active service in the field must now be explained. After the conclusion of the first Civil War (which to contemporaries seemed much more sharply cut off from subsequent campaigns than it appears to us), there was no more fighting in England. But the second Civil War began with the landing of Charles II. in Scotland in June, 1650. Cromwell was sent with an army to oppose the Scots who had embraced the Royal cause. After his well-known victories at Dunbar and elsewhere he was in the early part of 1 65 1 in the Highlands opposing the Scottish army under the King in person. During Cromwell's absence in Scotland there were great fears of a rising in England against the 76 SECOND MILITARY SERVICE arliament, and the greater part of the Parliamentary >rces being in Scotland and Ireland it was resolved ) call out a militia in various counties. Of these >rces there were to be 3,000 horse, and possibly there ras some difficulty in finding experienced officers 3 command so large a body. However this may have been, at all events a com- lission in the first regiment of militia cavalry was iven to Captain Sydenham. The original list of ommissions (dated April 21, 1651) is in the Record )ffice, and has been carefully examined ; but it is mtalising to find that no Christian name or initial > attached to the title. However, it could be no ther than Thomas Sydenham, since the only other rother, Richard, was engaged in important civil usiness in London as " Commissioner of Fee Farm Lents," and records of his activity in this position are till extant in the State Papers. We conclude, then, that Sydenham left Oxford rid obeyed the call of duty by again taking the field s a cavalry officer. His command must have been egarded as of some importance, since we find two xgent notices from the Council of State respecting is troop : one is to be the Army Committee, represen- ing that Captain Sydenham's troop, now appointed to aarch upon service, must have pay. Another is to he Militia Commissioners of Essex, ordering them complete his numbers by sending certain men to Captain Sydenham "that he being complete may 77 THOMAS SYDENHAM ' ": y attend the service of the Commonwealth to which he is commanded, and which cannot bear -delay." It is to this period that we must assign a remarkable anecdote of Sydenham, since it was the only time when he would have been in London with a captain's rank. It is related by a Dr. Andrew Broun, a Scottish admirer of Sydenham's to whom he confided in after years certain particulars of his military career, and who had this from his own mouth. " At the time of those Civil Wars, when he dis- charged the office of a captain, he being in his lodging at London, and going to bed at night with his clothes loosed, a mad drunk fellow, a soldier likewise in the same lodging, entering the room, with one hand griping him by the breast of his shirt, with the other discharged a loaded pistol in his bosom. Yet, oh strange ! without any hurt to him, most wonderfully indeed by such a narrow shield as the edge of the soldier's hand was his breast defended. For the admirable providence of God placed and fixed the ' tottering hand that gripped the shirt into that place and posture, that the edge thereof, and all the bones of the metacarpus that make up the breadth of the hand, were situate in a right line betwixt the mouth of the pistol and his breast ; and so the bullet discharged neither declined to the one side nor to the other, but keeping its way through all these bones, in crushing them lost its force, and fell at his feet. Oh ! wonder- ful situation of the hand, and more wonderful course 7 8 SECOND MILITARY SERVICE he bullet ! by any industry or art never again able ! and,. moreover, within a few days the soldier ig taken with a fever arising from so dangerous complicate a wound, died. Surely Providence < not bring forth so stupendous miracles, but for e great and equivalent "end." "hus moralises the worthy Dr. Broun ; and indeed marvellous escape shows that Sydenham's military ice had other dangers besides those of the field of le, on which, as he told Dr. Broun, he had several r narrow escapes. lie regiment of horse thus embodied was ordered oin Colonel Rich's force. The Council's orders lolonel Rich were, in order to securing the Midland s, to march to Leicester or Nottingham, and lie eabouts with his own troops, Captain Sydenham's others ; to disperse themselves to any emergency, keep up a constant correspondence with Major- leral Harrison in Scotland. Here the troops ained till July, when Cromwell, writing from :land, sent for them to " embody upon the lers " ready to serve in Scotland or England as ision should offer. Sydenham himself refers (in lecdota Sydenhamiana ") to his having been in land, where he seems to have physicked his men rell as led them to fight. Ve know what happened next ; Charles, slipping v from Cromwell's projected attack near Stirling, e a sudden dash southwards into England. Crom- 79 THOMAS SYDENHAM well started in rapid pursuit by a parallel line of march. He then ordered Harrison's cavalry, with Rich's force lying on the border, to hang upon the King's flank, and impede his progress. If Sydenham was, as we suppose, with Colonel Rich, he must have taken part in the encounters in Lancashire between the Parlia- mentary cavalry and the King's army. The fighting in some places, especially at the bridge of Warrington, was very severe. It hindered, but did not stop the King's progress. Whether the cavalry force came up in time to be present at the final battle of Worcester on September 3rd we have not been able to discover. The commanders under whom Sydenham served do not seem to be mentioned. At all events, after Worcester there was no more serious fighting, and Sydenham's second period of military service must have come to an end, having lasted about six months. It may have been in this campaign that he was, as he said once happened, " left on the field among the dead," but no positive record remains. We see that for at least two years afterwards he was still designated Captain Sydenham. We are now able to understand Sydenham's position when he presented this petition. His never failing sense of duty had led him to give up a position of ease and comfort for dangerous military service, which had seriously impaired his health. It is known, indeed, from his own statement in after years, that he had already suffered from gout. He was impoverished in 80 SECOND MILITARY SERVICE >rtune by his generous help to his brother ; and had Dnsumed nearly two years in vain attempts to obtain 'hat seems very reasonable compensation. Now, owever, the influence of his brother, Colonel ydenham, with the Protector, gave him a better hance of success. Colonel Sydenham had been a evoted adherent of Cromwell. He had been largely oncerned in the proceedings by which Oliver became 'rotector, and was one of his first Counsellors of State. le was now a wealthy man, receiving from his ppointments alone, according to a contemporary tatement, at least a thousand a year, a very large sum n those days. He does not seem to have assisted his irother in pecuniary matters, but his political influence rould doubtless be available, and probably it was partly wing to this that the Protector returned a favourable nswer to the petition. The result was the following document appended to he petition in the Record Office. " Friday, March 3, 1653-4. " His Highness being very sensible of the matters epresented in this petition, is pleased in an especial tanner to recommend it to the Council that they may give he petitioner due satisfaction and that with all convenient xpedition. "(Signed) J. Sadler." Accordingly, on April 23rd, six hundred pounds 81 G THOMAS SYDENHAM was ordered to be paid to Sydenham our of certain moneys belonging to the Commonwealth in the hands of the Commissioners for coal duties in the port of Newcastle-on-Tyne. In the minute of the Council of State ordering this payment we also find the entry that the Revenue Committee was directed to give Sydenham " such employment as he is most capable of." But it was not till five years later that he received any public appointment. It would appear from this fact that Sydenham had not even at this time definitely resolved to enter the medical profession, and he probably still had an eye on a political career ; but an event which happened in the next year, and which we may imagine was already much in his thoughts, seems to have finally decided him to engage in professional life. The archives of All Souls' College show that Sydenham resigned his fellowship in the year 1665 (though the precise date is not given), and in the same year the Parish Register of Wynford Eagle records that Thomas Sydenham was married to Mary Gee ; here again without giving the date. But these two events were of course closely connected, his marriage necessarily depriving him of his fellowship. One would naturally be anxious to know something about the lady Sydenham chose for his wife ; but there is no positive record of her parentage or family. There is, however, a little conjectural evidence, which, 82 SECOND MILITARY SERVICE n the absence of positive knowledge, may be worth ecording. As the marriage took place at Wynford Eagle, we hould suppose that the lady was of a Dorsetshire amily. The only person bearing this name who is nentioned in the county History is a certain Sir Drlando Gee, who bought an estate in Dorsetshire, hough he afterwards lived at Isleworth in Middlesex, nd died there in 1705. For various reasons he could tot have been the father of Sydenham's bride, but she nay have been connected with his family. Some ither members of the Gee family are traceable, but ve have not been able to find anything connecting hem with Sydenham's wife. Whoever his wife's mother may have been, ydenham certainly had a great regard for her. He irovided for her in his will, for she survived him ; and : seems probable that she had lived in his house. The sum which Sydenham received as compensa- ion, equivalent, according to the ordinary calculation, o nearly two thousand pounds at the present day, onstituted a small capital. Doubtless this enabled lim to marry, and also facilitated his entering into the nedical profession. We know nothing positive about the time at which ydenham began to practise, but two allusions* in his ublished works give a clue to the date. In the edication to Dr. Goodall, in September, 1686, of his rork entitled " Schedula Monitoria," he says he had 83 THOMAS SYDENHAM been engaged in investigating disease for the space of thirty years. And in his treatise on Dropsy, published in May, 1683, he says that the first case of Dropsy he ever treated was that of a Mrs. Saltmarsh, whom he attended in Westminster twenty-seven years before, or thereabouts. Both these allusions point to the same date, about 1656 ; and we may therefore con- clude that it was in the year after his marriage, or possibly in the same year, that he took a house in Westminster, and started in practice as a physician. V Life in London and Montpellier [ ~\ 7"E know nothing directly of Sydenham's life ii VV London. He certainly settled down in West linster, and it has been shown that he first lived ii ling Street, the little street running parallel to Parlia lent Street, which only last year, 1899, was demo shed to make room for new Government offices. I id not, however, of late years, contain any housi rhich Sydenham could have lived in, having beei nuch modernised. It is stated by Mackenzie Walcot ti his " Memorials of Westminster," that he lived in ;ouse upon the site of the Ram's Mews. But evei he "Ram" had disappeared in the latter days Cing Street. The reasons for Sydenham's choosing this part, ar vident enough. It was in the immediate neighbour lood of the Protector's Court at Whitehall, and th ifficial residences of his statesmen and generals. Poli icians, members of Parliament, while Parliament 85 THOMAS SYDENHAM there were, and army officers were all around ; and it was of course among this party that Sydenham's con- nection lay. His brother, Colonel Sydenham, must have been living near ; and somewhat later had lodgings in Whitehall itself. His brother Richard then or later was a little further off, at Worcester House in the Strand. And within a few minutes' walk, in Petty France, lived Mr. John Milton, Latin Secretary to the Council of State. One would like to think of the young Puritan physician being called in to tend the blind poet's growing infirmities, but of such a connection there Js no trace. It is not indeed possible to recover the names of any of Sydenham's patients in these days, except the worthy Mrs. Saltmarsh, formerly referred to, on whose dropsy he tried his 'prentice hand. This one case is, however, just enough to show that he practised among the citizens, and not solely, if at all in the official circles. Even the physical conditions of the neighbourhood had some bearing upon Sydenham's practice. He wrote very largely upon fevers and agues, and as has been remarked by Dr. Nias, the whole neighbourhood of Westminster was swampy and malarious, so that such diseases must have been rife there. The old Westminster was, as is well known, built upon a little creek, long since covered up. Behind King Street lay stagnant marshes, stretching out towards Pimlico, now collected into the ornamental waters of St. James's 86 AFE IN LONDON AND MONTPELLIER 'ark, which must have abounded in gnats or mos- uitoes, known in these days to be necessary to the ndemic prevalence of malarious diseases. Many well- nown persons suffered from these complaints ; indeed, Cromwell died of a malignant ague, the recurrence of n old enemy of his, which, though attributed to a chill aught at Hampton Court, might as well have been cquired in the neighbourhood of Whitehall. So we :e that external circumstances, even if they do not lould the characters of men, largely determine the Drm which their activity takes. It is not likely that Sydenham was at first very uccessful in practice, for there are two facts, to be resently mentioned, which show that he sat some- what loosely to his profession, and was even prepared o throw it up for political or'official life. Also it may e divined that he found his scanty stock of professional nowledge hardly sufficient for practising medicine with the thoroughness which his conscientious nature lust have felt to be necessary. It was not in him to arry off imperfect knowledge by plausible manner or ogmatic assumption. The unsettled state of his plans, perhaps, also affected y pecuniary needs, is shown by his becoming a candi- ate for Parliament as burgess for Weymouth in the TSt Parliament of the Protector, Richard Cromwell, which was summoned at the end of 1658, the writs eing actually issued on January 3rd of the next year, ydenham had then been probably less than three 87 THOMAS SYDENHAM years in practice. The immediate motive most likely was that his brother, Colonel Sydenham, was beating up recruits to assist the new Protector, whom he then, though not afterwards, supported. Sydenham was not elected, and had he been so, it would have been of little use to him, as the Parliament only lasted three months. However, he seems to have established some claim on the gratitude of his party, for he at length received the political patronage for which he was, as we have seen, recommended by the Council of State to the Committee of Revenue in 1654; being appointed on July 14, 1659, to the office of " Comptroller of the Pipe." The now obsolete Pipe Office was a department of the Court of Exchequer chiefly concerned with Crown Lands and other financial matters. It was abolished in the reign of William IV. The duty of the Comp- troller was, we are informed, to register leases granted by the Crown. Thus Patronage, with its customary blindness, having by mere good luck made Sydenham a physician, was now about committing a disastrous blunder in making him an official. It is melancholy even to imagine that the great Sydenham might have passed his life sitting in an office to register leases. But Providence, wiser than Patronage, determined otherwise ; for from the course of political events Sydenham could not possibly have held his place after the Restoration, which happened in the next year. E IN LONDON AND MONTPELLIER :ed, there is no evidence that he ever performed the es of the office, which may possibly have been a of sinecure, or capable of being discharged by a ity. However, there is reason to believe that his ial life, if it was ever really begun, was interrupted n important event in his career which may with h probability be referred to this time, namely, his g to study at Montpellier. SYDENHAM AT MONTPEIXIER. 'here is good evidence that Sydenham studied at itpellier, though there is considerable doubt about time at which he did so. The fact rests on the :ment of a M. Desault, a French surgeon of the teenth century, who says positively that a friend of a doctor named Emeric, who studied at Mont- er, knew Sydenham intimately there, and for a time carried on a correspondence with him by rs. M. Emeric was not a man of sufficient >rtance to be mentioned in medical biographies, we canot tell to what date this acquaintance is to eferred. Our only guide, then, in this matter is t we know of Sydenham's own history, rom what we know of Sydenham's occupations, it ;ry unlikely that he left England for any consi- ble time, or indeed at all, before he entered on tice. The suggestion that he visited Montpellier ring a long vacation " can hardly be entertained. question of vacation or term time would have 89 THOMAS SYDENHAM made little difference to him as a fellow of a college but absence from All Souls' would have meant losin the chief part of his income, since at that time th profit of a fellowship to a non-resident was very small We have also no reason for thinking that he had an; income independent of his fellowship. Between 165 and 1659, on the other hand, it is not impossible tha he may have saved some money, or the office conferrei upon him in 1659 may have been immediately profit table, or may have enabled him to raise some capital 01 its security. There is also another source from which some ligh may be thrown on a possible Continental journey During the Commonwealth and Protectorate (a indeed nominally under the Monarchy and even nov in many countries), no one was allowed to travel 01 the Continent without a direct permit from the Counci of State. For this there were political reasons, espe daily that any one proceeding to the Continent migh be suspected of keeping up communications with thi banished King- No doubt this rule was often evaded John Evelyn in his diary says that he counterfeited ; pass with success, " it being so difficult to procure on of the rebels without entering into oaths." But a mai of Sydenham's position and connections would havi incurred grave suspicion if he had gone abroad withou a pass. Now the minutes of the Council of State, a published in the Calendar of State Papers, contain thi names of many persons to whom permits wer 90 ^E IN LONDON AND MONTPELLIER ited, and the name of Sydenham occurs several :s, though in most cases with a Christian name ving it was not our physician. However, on the 1 July we find permission given to Mr. Sydenham Mr. Briggs to travel beyond seas. We,conjecture this meant Dr. Sydenham, though no Christian ie is given in the original entry. A further con- Lire may be hazarded as to who was his travelling panion. Among the professors at Gresham Col- , with some of whom, at all events, Sydenham intimate, was a certain Robert Briggs, Professor Law, son of Augustine Briggs of Norwich, a Ithy member of Parliament. Now we learn that ;gs had another son, who died abroad. Con- ire again suggests that this son may have been a iumptive young man, proceeding to the South of ice for his health, and that Sydenham accompanied as his physician, the wealth of the Briggs family ing this a not unremunerative task. All this, we t repeat, is conjectural, and the fact that Sydenham just been appointed to a lucrative office may be iidered as making it probable or improbable accord- to circumstances which we do not know. There Dwever,some slight corroborative evidence, founded he state of medical education at Montpellier. mong the French writers there is a strong tradi- that Sydenham was at Montpellier the pupil celebrated physician named Charles Barbeyrac. details referring to this supposed connection may 9i THOMAS SYDENHAM be found in the admirable life of Sydenham by Dr. FrWenc Picard, to which, and to Moreri's "Grand Dictionnaire " we are indebted for most of what follows. Barbeyrac, a native of Provence, took the degree of Doctor of Medicine at Montpellier in 1649, and settled in practice there, with great success. He was a Protestant, and as such incapable of holding an academical chair. Nevertheless, in 1658, he became a candidate for a professorship, with the object, it is hinted, of making himself known, though without any hope of obtaining the chair. The disputations which he held in support of his candidature procured him so high a reputation that though inevitably unsuccessful, he soon became the most popular physician in Montpellier. His reputation spread through the whole of France, and even to foreign countries. He was consulted in all difficult cases, and became the physician of many eminent persons, even of prelates, in spite, of his theological opinions. Being precluded from teaching in the University, he made use of his private practice for the instruction of students, following in this the example of Galen and other ancient physicians. Students crowded in large numbers to profit by his oral teaching. Some ten or twelve of them used to accompany him in his visits to his patients. " On the way he would give them a sort of clinical lecture on the cases and their treatment, answering the numerous questions of his 92 -IFE IN LONDON AND MONTPELLIER upils with excellent judgment and fluency. His leas about many diseases were entirely novel, but icid and well founded. His practice was admirable, eing at once simple and easy. He had discarded a irge number of the useless remedies employed before is time, which served only to embarrass the sick lan : making use of a few only ; but those well hosen and efficacious. These he employed so well lat no physician ever had more successful and striking ^sults from his treatment." It is also said that the blest European physicians who studied at Mont- ellier in Barbeyrac's time were his pupils. Now mch of this account is so like a portrait of Syden- am himself that it is easy to suppose it a portrait of is master. It is also notable that Sydenham's friend, Locke,, tudying at Montpellier some years after and knowing larbeyrac well, used to say, according to Moreri, that e never knew two men more alike in opinions and haracter than these two physicians. The mere fact bat Locke should have compared them is significant, t may also be observed that both were gentlemen by irth, and professed a form of religion unpopular in heir respective countries, but closely allied ; for Vench Protestantism and English Puritanism were mch alike. This may have been a bond of sympathy etween them, and in both may have contributed to aster independence of thought and originality. It must be admitted, therefore, that the tradition of 93 THOMAS SYDENHAM ;' the connection of Barbeyrac and Sydenham is : extremely probable one, even if not definitely esta lished ; and that the unacademical French teach may have had a large share in forming the profession character of his more illustrious pupil. Furthermor we may remember that Sydenham did not go i Montpellier to take a degree, and was under no obi gation to attend University lectures, so that he vei likely had little to do with the University, and fouri the instructions of an independent clinical teach< more to his taste. These circumstances may thnv some light on the entire absence of anything like a academical cast in his writings. It would be interesting to know whether Barbeyra taught any doctrines resembling those afterwan known as Sydenham's. A later French writer (M Bouteille, said (in 1776) that Sydenham had lean] his cooling method (in fevers) of Barbeyrac, whic seems somewhat hasty, since, according to M. Picarc the French teacher left no genuine works, those pre fessing to give an account of his doctrines bein without authority. Barbeyrac was a great personality though hardly a prominent figure in the history c Medicine ; but if he was the teacher of Sydenham, h has an additional title to fame. We have consulted little work called " Dissertations sur les Maladies," b M. Barbeyrac. It could hardly have been written b him ; but may perhaps be based on some unauthorise reports of his teaching. It professes to teach nei 94 S IN LONDON AND MONTPELLIER about diseases in opposition to the opinion of icients, and to some extent justifies this preten- Looking at the article on Small Pox we do find ■ords "cooling remedies" (chases rafraichissantes); n no other respect does the book remind one of iham. It is also important to remember that :pellier was regarded as the chief seat of Hippo- m, while Galenism reigned in the schools of regard to the chronological question raised above, clear that Barbeyrac did not become a popular er till 1658, so that Sydenham, if he was his i could not have visited Montpellier before that and he could not have been there later than , when he must have been in London, since he s of being laid up for two months with a severe t of gout in the summer of that year ; and his vations on the diseases of London begin in 1661. :e the date 1659, suggested by the permission e Council of State, fits in very well, may be asked why Sydenham selected Montpellier nprove his medical knowledge rather than the :r schools of Paris or Leyden ? It may have as has been suggested, because professional s called him to the South of France. It may been on account of the reputation of the school, *h at this time it does not seem to have been 1 visited by English physicians. A little later nham's friend, Locke, and a younger physician, 95 THOMAS SYDENHAM William Briggs, of the family above mentioned, who must have known Sydenham, studied there. But it is a curious fact that the excellence of Montpellier had some thirty years before been loudly praised in a little book published at Oxford in 1631 by Dr. James Primrose, a man of Scottish parentage, but born and educated in France, and a graduate of Montpellier. This little work was addressed to Dr. Thomas Clayton, Regius Professor of Medicine at Oxford, and main- tained that Montpellier occupied the first place among all schools of Medicine. Such a book, one of the few productions issuing at that time from the Oxford press, Sydenham could not have failed to come across in some Oxford library; and thus his curiosity to visit Montpellier may have been of long standing. It is impossible to say how long Sydenham remained in the South of France, but as such a journey was in those days a serious matter, it is very probable that he would have remained over the winter ; since, how- ever, he was in London in the following summer, his stay must have been less than a year, and may have been only six months. It is thus possible that he remained abroad long enough to be absent during the critical period of the Restoration of Charles II. in May, 1660. This event, however, brought no evil consequences to Sydenham, except the loss of his official position, for he enjoyed the benefit of the Act of Indemnity, which applied to all who had taken part in the rebellion, with certain exceptions. 96 JFE IN LONDON AND MONTPELLIER His brother, Colonel Sydenham, was not so fortu- ate. He was one of the twenty persons, beside the jgicides, named by the House of Commons to be sempted from the benefits of the Act of Indemnity, i all particulars not extending to life, but his inclusion 1 the list was only carried by a small majority. In le end he was declared perpetually incapacitated from olding any office or public employment.- William ydenham retired to Clapham in Surrey, then a country illage. Later in the year he was informed againsl sr using seditious language, and compelled to give a ond of £ 1,000 to refrain from disturbing the quiet f the kingdom. This may be the best place to give what more > to be said of Colonel Sydenham. He returned tc Vynford Eagle, died, and was buried there on the isi f August, 1 66 1, being, as we imagine, crushed by th« lownfall of his party and cause. He left a son, William irho succeeded to the estate, but died without issue ir 718. His daughter, Mary, married Walter Thorn- lill, and became the mother of Sir James Thornhill th< lainter. Colonel Sydenham's will was made in haste inly a few days before his death, his brother Thomai leing both a witness and an executor. The amoun if the estate is not named, but it is stated from othe ources that Colonel Sydenham left a plentiful estati n money, jewels, &c. The year 1661 was a fatal one to the Sydenhan amily. Colonel Sydenham's widow survived he 97 H THOMAS SYDENHAM husband barely a week, The old father died November of the same year ; and as Richard Syde ham had died in January, 1657, Thomas was now t only survivor of that remarkable family of brothers. We do not know exactly how soon Sydenha recommenced practice after his return from Franc nor where he lived ; but he must have been practisii in London in 1661, since his observations, afterwai published, on weather and diseases in London beg with this year. The next important event in Sydenham's lite w his obtaining a license to practise from the Ro) College of Physicians. He passed the three obligato examinations on April 24th, May 8th, and June 51 being admitted a Licentiate on June 25, 1663. 1 the admission book he is recognised as being Mast of Arts and Bachelor of Medicine of Oxford, may seem strange that Sydenham had not obtain this license before, but had been practising witho legal permission. Strictly speaking, no doubt should have taken this step some years earlier, sin 1 Sydenham seems to have had some difficulty in bringing evidence his degrees. Probably he was asked at the first examination for diplor which he did not possess. He seems to have taken counsel with Rob Boyle, who wrote to his friend Dr. Richard Lower in Oxford. Lo\ obtained from " The Register " a certificate of Sydenham's M.B. degr but no record of the M.A. could be discovered. -Sydenham would i have claimed an M.A. degree unless he had actually taken it ; but t story confirms what was said above about the record of it being 1( The above story occurs in a letter from Lower to Boyle, dated April 1663 ; and though Sydenham's name is not mentioned, it must h referred to him. 98 IFE IN LONDON AND MONTPELLIER ie College of Physicians had the exclusive privilege : licensing all physicians in London and some miles • iund, so that no one could legally practise without s license. But during the troubled times of the livil Wars and the Commonwealth these regulations id not been strictly enforced, and a good many tiysicians were, like Sydenham, practising without a gal status. About this time, the President of the lollege of Physicians, Sir Edward Alston, took igorous steps to bring all physicians in London within ie collegiate fold. This object was partly effected y admitting many physicians of good standing, who assessed the requisite University degree, but from leir age and position were unwilling to undergo the :gular examination, as Honorary Fellows with full rivileges. In the year 1664 no less than seventy rere thus admitted, and by their fees greatly aug- lented the finances of the College, which had suffered :riously during the times of trouble. This privilege ould not have been offered to Sydenham, as he was nly a Bachelor of Medicine, but he had probably sceived a hint that he ought to apply for the uthorisation of the College. Sydenham never attained the higher rank of Fellow, nd since this fact has been interpreted as showing )me special animosity against him on the part of the College, it is right that the Question should be xamined. In the first place, no one could be ad- litted to the Fellowship unless he were a doctor of 99 THOMAS SYDENHAM ' medicine. Now Sydenham did not take his doctor degree till 1676, and then took it, not at his ow University, but at Cambridge. Why he allowe twenty-eight years to pass before he applied for th higher degree, and why he did not take it at Oxforc can never be precisely known. But it is easy to se that if he had applied for a degree at Oxford in th years immediately following the Restoration he woul have been in all probability not favourably receivec Indeed, a man of his antecedents and family connec tions might very likely, in those times of reactior have met with a non placet in Convocation. W know that Locke was refused a medical degree 2 Oxford when he tried to obtain one by special creatior even though he was supported by a very strong n commendation, almost equivalent to a command, fror Lord Clarendon, the Chancellor of the University and a second attempt was equally unsuccessful. Whil this was the temper of the University, Sydenham woul have had little chance. From all we know of Sydenham we should conclud that he cared little about academical distinctions, an doubtless he bore the privation with equanimity, an in later years, when the same difficulties might nc have stood in the way, he had ceased to care wh: letters he could write after his name. The mor surprising fact is that he did after all think it wort while to take a doctor's degree so late in life ; but < his motives in so doing we have no knowledge. 100 JFE IN LONDON AND MONTPELLIER The fact, however, is undoubted that up to the year 676 Sydenham was not eligible for the Fellowship ; ad the question could only be why, in the thirteen :maining years of his life, he did not attain this onour. Certainly he never applied for admission, 5 there is no record of any such application in the rchives of the College, and we can well believe that e would have been disinclined to present himself for n examination. Probably there was a party in the College opposed to him, and it is quite certain that ydenham thought there was. For this we have the estimony of Dr. Andrew Broun. This worthy and andid Scot relates that while in Edinburgh in the ear 1687 he came across Sydenham's "Schedula Moni- oria," and was so much impressed with his new method f curing fevers that he determined to seek further nowledge of it at the fountain head. Hastening herefore to London, he sought out Sydenham, and ound in the man and his practice " everything that ise to beget in wary and prudent people trust and :nowledge." After some months spent in his society, le returned home as much overjoyed' as if he had ;otten a treasure. Sydenham seems to have been very confidential with 3roun, and among other things complained to him hat by all his labours to advance medicine " he had inly gained the sad and unjust recompence of calumny nd ignominy, and that from the emulation of some if his collegiate brethren, and others, whose indig- 101 THOMAS SYDENHAM nation at length did culminate to that height, that they endeavoured to banish him, as guilty of medicinal heresies, out of that illustrious Society." If a certain clique ever had any such design, it is clear that it never came to any overt act. On the other hand, Sydenham enjoyed the friendship and admiration of several of the most eminent Fellows ; while the College in its official capacity, whenever there was occasion to mention Sydenham, spoke of him with the highest respect. When the College had to give its imprimatur to the second edition of the " Schedula Monitoria," the license to print was granted with the unusual and cordial expression, " Lubentis- sime." The presentation copies of some of Sydenham's works, still preserved in the library of the College, also bear curious testimony to the high estimation in which he was held. When he gave the "Epistolae Responsoriae," the inscription is " Ex dono CI. [clari or clarissimi] authoris. Mar. 30. 1680." The same words are used in the " Dissertatio Epistolaris," given in 1682 ; but the scale of admiration rises, for in the treatise on gout, given in 1683, the inscription is " Donatus ab autore prastantissimo." All this shows that Sydenham had warm friends su well as some enemies in the College. It is possible that the opposition of the latter deterred him fron applying for the Fellowship ; but, on the other hand considering that candidature would have implied ; 102 JFE IN LONDON AND MONTPELLIER >rmal examination, particularly distasteful to a man f his age and distinction, it is perhaps more likely hat this barrier, together with a constitutional in- ifference to honours and titles, may have induced lim to content himself with the title of Licentiate. 103 VI Sydenham and the Plague IT was a few years after Sydenham's return from MontpelKer, when he was still engaged in studying the epidemics of London, and preparing to write upon them, that the most formidable of all known epidemics visited the city. It was that terrible visitation known in history as the Great Plague of London, the last appearance of this dread malady in our country, and even to this day a name of fear. To explain the peculiar significance of this epidemic, a few words must be said about the previous appear- ances of the disease in our country. It had appeared from time to time since the greatest of all recorded pestilences, the world-wide (if we leave out the New World) epidemic of the fourteenth century, known in after times as the Black Death, which visited the shores of England in 1 349. It may have existed in Europe and in England during the Middle Ages, but on that point we have no accurate knowledge. 104 SYDENHAM AND THE PLAGUE What is certain however, is, that after the fourteenl century, though not constantly present, it renew* itself in destructive epidemics during the fifteenth, si: teenth, and seventeenth centuries. Some thought th: it was always introduced from abroad; some that sprung up afresh in our own soil from local condition a disputed question which need not be considered her It will be sufficient to say that there were sever; serious outbreaks in Tudor times, more especially ne; the beginning and near the end of Elizabeth's reigi but a much more alarming epidemic occurred in tl first year of King James I., in 1603. This was " great plague " causing over 33,000 deaths, and pn bably in proportion to the population of Londo: hardly less destructive than that of Sydenham's tim In the year of the accession of Charles L, viz., : 1625 another epidemic occurred still more fat. causing 41,000 deaths ; but whether this number w higher or lower in proportion to the population of tl city, would be difficult to say. Between these visit tions and up to 1647, the plague was never absei from London, causing in some years a large mortalit In 1647, 3,500 are said to have died of it ; but in tl next year the mortality fell to a few hundreds, and succeeding years almost to nothing. During the cii wars, and under the Commonwealth and Protectoral the disease was virtually absent from London, so fe deaths being ascribed to the disease that the figur may have no significance whatever. In other parts ios THOMAS SYDENHAM the country a few small epidemics were recorded, one of these being noticed, though not from personal knowledge by Sydenham himself; but they were insignificant. The exemption of London and England from its old and dreaded enemy for sixteen years, till it returned in 1664 is a very remarkable fact. Explanations might be hazarded, which it would be beyond our purpose to discuss. We need only consider how it appeared to the popular imagination. We are told it was a popular saying that the plague came in with a new king, referring, of course, to its appearance in the early years of James I. and Charles I. And as it almost vanished after the memorable year 1648, when the monarchy was overthrown by the execution of Charles I., it is not surprising that superstitious minds traced a connection between these pestilences and political events. The Puritans were not alone in recognising the hand of divine Providence in sending pestilence as a judgment for the sins of mankind, but they were especially prone to interpret these events in the light of Old Testament history, as a judgment on the people for the sins of their kings. Hence we find even John Milton when he wrote in 1660 his last despairing plea for " A free Commonwealth " in opposition to Monarchy, remarking on the plagues and pestilences that in the time of Monarchy wasted the City of London, such as through God's mercy, had not been known since. Probably when the 106 SYDENHAM AND THE PLAGUE pestilence recurred, only about four years after the Restoration, the Puritans may have thought their reading of History confirmed. Apart from political or religious prejudices these facts will help us to understand the feelings of the citizens of London about the Great Plague. It was nothing unprecedented or exceptional, as the popular histories of the event have led many to suppose. It was not a new and foreign disease like the Asiatic cholera of later times, but a familiar domestic foe. Old men might remember something even of the great plague of James the First's reign ; many would have lived through that of 1625 with its repeated recurrences, and even the younger generation would have heard their fathers tell of those terrible calamities. So in 1664 when news came of a destructive pestilence in Holland ; there was some feeling of alarm. Scholars would have muttered something about paries proximus- ardet ; the government proposed stringent rules of quarantine and exclusion, which the citizens and commercial classes, in the interests of trade, steadily opposed, so that nothing decisive was done. In the meantime indications of the coming storm became more numerous. In the autumn of 1664 a serious outbreak of plague occurred on the eastern coast at Yarmouth, a seaport having frequent intercourse with Northern Europe, and in London itself were premoni- tory symptoms, little heeded at the time, but as since brought to light, of great significance. During the 107 THOMAS SYDENHAM autumn and up to Christmas, 1664, ,there were many cases of a mild form of plague, such as in places where the disease has been carefully observed, have been found to be the forerunner of a severe epidemic. But the matter, says one of the sufferers who survived, was kept quiet, and as the deaths were few little evidence was furnished by the bills of mortality. Boghurst, an apothecary, who has left the best account of the great epidemic, affirms that plague had occurred for three or four years before in the parishes of St. Giles's, St. Clement Danes, St. Paul's, Covent Garden, and St. Martin's in the Fields ; that is, in all the western suburbs, parts of which were vaguely spoken of as Westminster. However, the cold of winter, as generally happens in Northern climates, checked the spread of the epidemic, and it remained dormant till the spring. In May the spread of the disease already caused alarm, though the number of deaths was not great. In June it steadily increased, and in July the epidemic burst out with explosive violence, and increased up till the fatal month of September, when the deaths were at the rate of something like 7,000 a week, after which it declined till the end of the year. What was notable, though paralleled in most epidemics of plague, was that towards the close a much larger proportion of those affected recovered. This fact is of some importance in considering Sydenham's relations to the plague. 108 SYDENHAM AND THE PLAGUE As the reader may like to have some notion of th actual mortality of this historical epidemic, we ma say that the number of deaths recorded in the bills < £" mortality is 68,596, but there can be no doubt thi this number is too low. The enumeration was mac from the reports furnished by certain ignorant 0. women called searchers to the parish clerks. F( obvious reasons the searchers would often be tempte i to give the disease another name ; moreover, lar£ suburbs were not included in these Bills, and r account would be taken of those who left the cii and died elsewhere. So that, taking the populatic of London then as about 400,000, it is probable th; about one-fifth may have died of the plague, while large though uncertain number sought safety in fligh This great mortality was confined to the year 166 for though the disease recurred in the next spring, ar caused a considerable number of deaths, they were rn so numerous as to amount to a great epidemic. ] succeeding years it steadily declined to a vanishir point ; and, as we know, has never recurred in tr country. The possible causes of its extraordina; violence in 1665 and of its final extinction a questions too large to be entered on here. We return, then, to the spring of 1665, and find th in the month of May there was already considerah alarm on the subject of plague. This . would ha been greater in the -West End, where Sydenham live than in other parts of London, since the group 109 THOMAS SYDENHAM parishes mentioned, especially St. Martin's and St. Giles's, were at first the chief focus of the disease. From these parts it travelled slowly eastward to the City, so that it did not reach the eastern parishes, as Boghurst tells us, till it had been six months in the western parts. Pepys, who lived in the City, says that on his journeys to Westminster he found the plague prevailing there, while he still hoped it had not affected the City, or at least only in a few houses, but he thought going home from Westminster to the City a very dangerous passage. Thus, when June came, there was great commotion in the West, and Pepys again records how on the 2ist of June he found "all the town almost going out of town." During the month of June nearly all the rich people and those who could afford to leave their business left the West End. The King and Queen went to Hampton Court ; afterwards to Salisbury and then to Oxford. So it happened that in the latter part of June Sydenham says the danger came to his own doors, and he was persuaded by his friends to add himself to the increasing number of fugitives. He and his family retired a few miles from London, afterwards, it would seem, to some more distant spot, possibly to Dorset. This is the one event in Sydenham's life which his biographers have always regretted. To a student of epidemics no more notable object of study could have no SYDENHAM AND THE PLAGUE been presented than the pestilence which was invadir London. To a physician it might seem that the dm was indicated of remaining to help sufferers who sto< in so great need of medical help. Had he remaini he might have added a memorable chapter to tl history of the plague, and done good service in r profession. On the other hand there are certain circumstanc apart from the mere fact that he had a wife ar young children, which put his conduct in a. somewh different light. To begin with, most of his patien must have left, or been on the point of leaving tow The regular or college physicians then practised chief among the rich, except so far as they were connecti with hospitals. Their regular fee was a high one f the times, viz., an angel, equal to ten shillings, wor three or four times as much in modern money. Ti name of this coin gave rise to numerous jests at tl expense of physicians. Boghurst, the worthy apoth cary, who stuck to his post during the epidemic, sa it was only the rich who were permitted to die " su rounded by angels." Culpepper, the herbalist ai quack, has a bitter gibe that " Physicians of tl present day are like Balaam's ass, they will not spe; until they see an Angel" All this meant th physicians attended chiefly wealthy patients. When it is said with some reproach that so mai London physicians left the city during the plagu this statement must be qualified by remembering tl in OMAS SYDENHAM peculiar class distinctions of the profession in thoi days, which exist indeed still to a large extent i England^ though they are not so clearly marked i other countries. The medical attendants of the po< were the surgeons and apothecaries ; and most of the seem to have remained ; and the latter at all even made a large harvest by selling medicines for prevei tion as well as for cure of the disease. Beside this, it was true of the plague of London, i it has been of most similar pestilences elsewhere, th; it affected the lower classes much more than th wealthy, even in proportion to their numbers, so th; it was known as " the poor's plague " ; and thus th regular patients of the physicians, even if they r< mained in town, were little affected. After th epidemic was over it was noticed how very fe 1 persons of wealth or distinction had died. However, a good many physicians did remain, sue as Hodges, who wrote a book on the plague ; Whartoi physician to St. Thomas's Hospital, who remained : his post to take charge of the sick soldiers at tr special request of the King, and who was promise a reward which he never received, and others. Bi all whose names we have been able to find lived i the City. Had the West End physicians remaine they would have found themselves almost in solitud among empty houses. These facts show what justification there was f Sydenham's leaving London. We cannot but wi! 112 SYDENHAM AND THE PLAGUE they had not appeared so strong, for if this gre; observer had remained to study the epidemic, medic literature might have been enriched by a master account of it, instead of the somewhat meagre ar unsatisfactory account of the disease, which was i that our physician's scanty opportunities enabled hi: to furnish. Probably he saw very little of the diseas Before he went away the epidemic was not wide spread, and the only case which he describes, sayir he did not know whether it was plague or not, ms be now, with our present knowledge, said pret certainly not to have been so. On his return he found the disease still lingerin and he says, modestly, that, in the absence of old physicians, he had a good deal of practice. But tl disease, if he saw true cases of it, had then, as is usu in epidemics, assumed a milder type, and thus Syde: ham was led to take an over-sanguine view of tl efficacy of treatment. His own method of treatment, founded partly < his own experience, partly on accounts which he h heard of successful practice in isolated cases whii occurred during the Civil Wars, was that of profu bleeding, which he admits was generally held horror. This method, however, has been condemned 1 most of the best physicians who had large experien of the disease, though it had been recommended 1 some. Boghurst, the apothecary, whose excelle 113 1 OMAS SYDENHAM account we have already referred to, condemns unreservedly. Sydenham's theory of the origin of plague was ] very different from that of most of his contemporar; ascribing it to atmospheric disturbances, and attached little importance to contagion. With nil candour, however, he admits that he had gr; suspicions whether the mere atmospheric constitute without some Fomes, or introduction from pestileni localities of an infected person, could in itself origin; plague. He instances the effect of strict prevent: 1 measures in keeping out plague, as was done in Ita when the precautions taken by the Grand Duke Tuscany in 1650 kept out of that country a plag which had ravaged nearly the whole of Italy. Medical opinion in that day was divided, as it 1 been to some extent ever since, between two oppos views on the subject — views which may be summar: defined as that of the Localists and that of Contagionis The former referred the outbreak of plague in a particular place to local conditions ; the latter importation from some other infected locality. V see that Sydenham was in the main a Localist ; I he admitted the possibility of some truth in the vie of the Contagionists. 114 VII Sydenham's Writings on Fevers SYDENHAM'S absence from London during t time of the plague had one advantage, tl it gave him some months of enforced leisure frc practice, and he employed the time well. For was then that he composed his first medical woi one of no small importance in the history of medicii It treated of fevers, and was founded on observatic which he had been collecting since 1661, when began to study the fevers of London as they present themselves to him in his own practice. This cl of diseases was always a favourite study of Sydenhan and, as already mentioned, had a local significar for him as being especially prevalent in the neighbo' /-hood where he practised. They also had a mi i-:l greater relative importance in his time than at 1 present day, since he estimated that they made two-thirds of medicine. In our own day the sai class of maladies, called in official returns zymo "5 DMAS SYDENHAM diseases, are credited with only one-tenth of the tot mortality from all causes. Sydenham, it is true, i: eluded some acute diseases not now reckoned fevers, such as Pneumonia, Erysipelas, and Rheumatisi But even supposing that he was led from speci circumstances to make too high an estimate, tl difference is enormous. This little book was entitled, " Thomae Sydenha Methodus Curandi Febres, propriis observationib superstructa " (" Thomas Sydenham's method of trea ing fevers, based upon his own observations "). It is small octavo of 156 pages containing . about 17,0c words ; that is, it would make about two longish articl in a medical journal. It was written, as were ; Sydenham's published works, in Latin, which gx it the great advantage of being intelligible to doctors < over Europe. Medical works in English were the very few, and looked upon with suspicion as if meaj to appeal to the public, not to the professio Surgeons and quacks might write in English, h for an orthodox physician to do so would have be< an act of bad taste, almost amounting to a crim The question whether the Latin was Sydenham's ov\ will be considered afterwards. The dedication is noteworthy, as it is to the Ho Robert Boyle, the eminent natural philosopher, ai the representative man of scientific research at th time. Boyle, who was so acute and diligent ; investigator in many departments of physical scienc 116 SYDENHAM'S WRITINGS ON FEVERS took great interest in medicine, but was not o that account popular with the medical professioi He was regarded as something of an interlope One contemporary physician names the "virtuosi (alluding to such men as Boyle) and "English books as among the crying evils which injured the in teres of medicine. Hence Boyle's was not a name 1 conjure with, and might not have been the be to choose for the patronage of a medical work. Bi Sydenham had a definite and very good reason fi his dedication. In the first place it was by Boyle advice and prompting that Sydenham undertook treat of this department of medicine, and he cal Boyle as a witness to the fidelity and usefulne of his observations, since the philosopher had, wii great kindness, accompanied him on his visits to r patients ; in which, says Sydenham, he showed benevolence and condescension contrary to the spii of the times. The treatise, moreover, would not ' less welcome to Boyle because it was small in bu and not swollen out with the spoils of other authc (whose ashes might rest in peace so far as Sydenha was concerned). There were other parts of medici; which he hoped to treat in the same manner, ai thus redeem a promise made to Boyle ; but for t present he thought it better to try the fate of tl little work before rashly attempting more, especial in an age when subtle speculations were more valu than honest practice. 117 )MAS SYDENHAM It is plain that Sydenham's respect and admiratii for Boyle were paid to his independence of thoug and habit of investigating nature at first hand f himself, not so much to the value of his spec researches, which lay for the most part outsit Sydenham's sphere of interest. The preface to the reader displays so well the nob and lofty spirit in which Sydenham regarded his woi as a physician, that the beginning of it is wor translating. " Whoever applies himself to medicine oug] seriously to weigh the following considerations. Fin that he will one day have to render an account the Supreme Judge of the lives of sick persoi committed to his care. Next, whatever skill < knowledge he may, by the Divine favour, becon possessed of, should be devoted above all things 1 the glory of God and the welfare of the huma race. Moreover, let him remember that it is n< any base or despicable creature of which he has unde taken the cure. For the only begotten Son of Go by becoming man, recognised the value ot the huma race, and ennobled by His own dignity the nature E assumed. Finally, the physician should bear in min that he himself is not exempt from the common lo but subject to the same laws of mortality and diseai as others ; and he will care for the sick with moi diligence and tenderness if he remembers that he hin self is their fellow-sufferer." 118 SYDENHAM'S WRITINGS ON FEVEI These sentences express Sydenham's deepest i victions ; they reveal his religio medici, and same high tone is maintained through all his writ on medical subjects. He goes on to say that e physician who desires to be held an honest man sh not only do his best to restore health to the sick, also to give greater certainty to the art which professes, so that it may hecome better and ric and some benefit may accrue to mankind even w he himself is in his grave. Sydenham does not omit, after the custom of time, to anticipate the criticisms which his work ; encounter. The carping critic or " Zoilus " i figure whose shadow darkens most prefaces in seventeenth century. Sydenham expects that su cilious persons will first pronounce his new me1 to be merely the outcome of a love of novelty paradox, and then, if they find that after all tl is some good in it, will assert that it was all ■ known before. He does not write for such cri but for serious and candid men who will put method to the proof. If they do so he has no d< that their experience will confirm his own, and t will cast another pebble on the heap which he begun. So much for the preface, which we have di upon especially because it- did not appear in the i edition of his work on Fevers, and, therefore, i sometimes have escaped observation. 119 S SYDENHAM The little book itself consists of four sections, (i) On Continued Fevers; (2) on Certain Symptoms which accompany Continued Fevers; (3) Intermit- tent Fevers ; (4) Small-pox, under which he includes Measles. It bears out on the whole the claim that it is founded on his own observations, no other author being quoted or even mentioned, and is mainly practical concerning the treatment of fevers, though not without some theoretical explanations, which, however, occupy a subordinate place. To try and give an account of such a work from a modern point of view would be a method liable to fallacy, since, on the one hand, we are apt to misunderstand views so different from our own ; while, on the other hand, we almost inevitably read into the text ideas very obvious to us, but which were not present to the author's mind. Therefore the best plan seems to be to try and show how the work appeared to contemporaries. Fortunately we are able to do this in a very satisfactory way ; for almost immediately after the publication of Sydenham's book, a notice of it appeared in the second volume of the " Philo- sophical Transactions " (afterwards called the " Trans- actions of the Royal Society"), dated May 6, 1666. It was probably written, as Dr. Latham remarks, by one of the two secretaries of the Royal Society, Hooke or Oldenburgh. The notice is headed, " An Account of Dr. Sydenham's book, entitled Methodus Curandi Febres, etc. ; " and, as will be seen, is purely 120 VDENHAM'S WRITINGS ON FEVERS asitory, not critical. We can give only a few acts. This book undertakes to deliver a more certain more genuine method of curing fevers and agues 1 has appeared hitherto. And it being premised st that a fever is Nature's engine which she brings i the field to remove her enemy ; or her handmaid er for evacuating the impurities of the blood, or reducing it into a new state : — Secondly, that the : and genuine cure of this sickness consists in such :mpering of the commotion of the blood, that it t neither exceed nor be too languid. This, I say, lg premised by the author, he informs the reader : — ; In the First Section, of the different methods to be Joyed in the cure of fevers, not only in respect of differing seasons of one and the same year, but of difference of one year from another. As to the ner, he shows in what sort of patients, and at what e of the fever phlebotomy, or vomiting, or both, to be used ; and when and where not ; in what :e of time the depuration, if Nature be not disturbed hindered in her work, will be performed ; when gatives ought to be administered, &c. ' As to the latter, he observes that one of the chief ses, rendering the cure of fevers so uncertain and uccessful is, that practitioners do accommodate ir observations, which they take from the successful e of some fevers in one season of the year, or of le one year, to that of all fevers in any season, or 121 )MAS SYDENHAM in any year whatsoever. And here he observes firs how vigorous the blood is in the spring, and how dispirited in autumn ; and thence regulates the letting of blood, &c. Next, how difficult it is to assign thi cause of the difference between the fevers of severa years, &c. " In the Second . Section he treats of the symptom! accompanying continued fevers, as phrensis, pleurisies coughs, hiccups fluxes, &c, showing whence they an caused, and how they are to be cured. . . . " To all which he subjoins a particular account o the iliac passion (or Ileus) esteemed by him to b< sometimes a symptom also of fevers, not only dis> coursing of its cause, but adding also a very plair way of curing the same, and that not by the use o: quicksilver or bullets (judged by him to be noxious) but only by mint-water, and the application of a living whelp to the patient's stomach to strengther the same, and to reduce it to its natural motion." [This curious prescription of applying a live puppj dog to the patient's stomach was maintained bj Sydenham in his last edition.] " In the Third Section, he treats of intermitteni fevers or agues. When he discourses of the cold anc hot fits, and of the separation of the subdued aguish matter, distinguishes ague into vernal and autumnal takes notice that as there are very few continuec fevers, so there are only quotidians and tertians in th< spring ; and only tertians and quartans in the autumn 122 SYDENHAM'S WRITINGS ON FEVERS e intersects, among other things, this note : — That e period of fermentation in fevers, both continued id intermittent, is (if left to Nature's own conduct, id well regulated, if need be, by art) performed in about 56 hours or fourteen days, subducting in intermittent les the hours of intermission, and counting five id a half hours for every paroxysm, and imputing e excursion beyond that time to the disturbance ven to nature by the error ot practitioners. "In the Fourth Section, the author in conformity ith the custom of those who write of fevers,, dis- mrses of the Small-pox ; and examining the cause of lis sickness, and its universality, delivers his peculiar )inion of the blood's endeavouring a renovation or a :w texture (once at least in a man's life), and is clined to prefer the same to the received doctrine of s malignity. . . . For the cure, he advises, in short, I permit Nature to do her own work, requiring Dthing of the physician, but to regulate her when le is exorbitant, and to fortify her when she is too eak. He concludes all with delivering a model of/ le method he would use for his only son, if he should) II into this sickness." On a few points in the above extract a little ex- anation may be useful. Sydenham's notion, which >pears so strange to us, that there was a natural period : fourteen days for the "fermentation " in fevers, seems > have been founded on the observation that the most ;finite and well-marked species among the continued 123 ^S SYDENHAM fevers known to him (which were not then dis- tinguished from one another), namely, Typhus, does usually come to an end in that time, so that it has been called the fourteen-days' fever. The other kinds, now known as Typhoid and relapsing Fever, would doubt- less have appeared to him less regular and typical, so that he ascribed their departure from the type to unskilful treatment. The arithmetical subtleties involved in calculating the duration of intermittent fevers we cannot attempt to follow. Sydenham's peculiar opinion as to Small-pox being a natural process which almost every one had to go through once, at least, in his lifetime, is undeniable evidence of the universality of«the disease in his day, but is of so highly speculative a character as to appear out of harmony with Sydenham's usual line of thought. It is omitted, however, in his final edition, and the probable reason for this omission is worth noting. We hear so much about the opposition to Syden- ham and his doctrines, that we might imagine a considerable controversial literature to have been directed against him. But a pretty careful scrutiny of the medical literature of his time has discovered only one writer who directly attacked Sydenham's views. This was a certain Henry Stubbe, a physician at Warwick, a violent pamphleteer, especially con- spicuous for his attacks on the Royal Society. He had been at Oxford at the same time as Sydenham, 124 iYDENHAM'S WRITINGS ON FEVERS 1 was there noted for his skill in carrying on lolastic disputations in Greek. He was doubtless a ster of formal logic, and a man of immense reading, t to say learning, so that his friend Anthony Wood >ught him one of the greatest lights of the age. It plain that he made himself the champion of book rning and the ancient methods against the innova- ns of the Scientific School, the Baconians, or the rtuosi ; and especially of the Royal Society. Stubbe 1 foul of Sydenham, probably because the dedication his book to Boyle identified him as one of the virtuosi," or at least a " semi-virtuoso," as his critic Is him. The pamphlet in which this passage occurs is called The Lord Bacon's relation of the sweating-sickness amined in a reply to George Thomson pretender Physick and Chymistry, together with a defence of llebotomy, in opposition to the same author . . . :. Whitaker and Dr. Sydenham, &c. London, 71." Stubbe refers to the passage mentioned in the /iew, which is still stronger in the original, where den ham speaks of Small-pox as due to a spontaneous brt of the blood to bring itself into a new state, and tting off its native state, by a process like moulting, put on, as it were, a new shape. He much prefers is view to that of a malignant substance received to the blood, which has to be expelled. But he fs, if any one prefers the latter view, he will not 1 25 IAS SYDENHAM greatly quarrel with him, for the indications for treat- ment remain the same. Quoting this, and also another something like it, in which Sydenham speaks of fevers in general, Stubbe criticises them in the following words : — " Whether Dr. Sydenham intend to ascribe sense, appetite, and judgment unto the blood I cannot well tell, but either he canteth in Metaphors, or explaineth himself in his general hypothesis about Feavers, as if his meaning were such. But it seems strange and irrational to attribute such an understanding to the blood, and to transmute a natural agent into one that is spontaneous ; and which is more, having represented it as such, to make it so capricious as not to know when it is well ; but to run phantastically upon such dangerous changes as occurs in putrid feavers and the Small-pox, for even this last ' ariseth from a desire the blood hath to change its state.'' " Also Stubbe asks, if this disease is Natural, why is it not more ancient and universal ? Whereas it is very doubtful whether it existed in ancient times, and it certainly was unknown in the West Indies till the Spaniards came there. Again, he finds it " most intollerable " in Dr. Sydenham that he seems to attribute all the evil con- sequences of the Small-pox to the indiscretion of those that attend them, be they nurses or physicians. Sydenham, we may add, spoke of certain bad symptoms of the Small-pox in a highly figurative 126 SYDENHAM'S WRITINGS ON FEVERS inner as due to the inability of the blood to :ry through the mutation and renovation which had begun. It cannot go back to its original te, and is not strong enough to go on to the new e which it is striving to induce. It can neither go ;kward nor forward, and the patient dies. Sydenham's theory of Small-pox ! was not worse than it of his contemporaries ; than that of Willis, for tance, who adopted the doctrine of the Arabian 100I ; but it was totally different. The objections to Sydenham's theory are just what >uld occur in any modern physician. They must ve come home to Sydenham, who prided himself abstaining from theories ; so without making any )ly to Stubbe he omitted the whole passage in his al edition. He did not, however, expunge the isage about the evil consequences of wrong treat- :nt of the disease. To the end of his life Sydenham ms to have thought that the Small-pox, if properly ated, ought to be a very mild disease, and cause [y a slight mortality. But his manner of dealing with the first point is •y characteristic of him. He was not averse from :orising, and sometimes indulged his fancy in giving iculative explanations of disease, but held theories be of little importance, and would not allow them influence his practice ; or at least such was his ention, and to a very large extent he carried out. 127 AS SYDENHAM From these two notices we can see in what light Sydenham's book appeared to his contemporaries. The notice in the " Philosophical Transactions," while strictly impartial, showed that his little book was regarded as of some importance, and as tending in the direction of what we now call research, which was the especial object of the Royal Society ; though in his conception of what were the most important objects of research Sydenham differed widely from most of the Royal Society men. The acute, though ill-tempered, criticism of Stubbe did not touch his general method, but picked out what was undoubtedly a weak point, and one decidedly inconsistent with Sydenham's general line of thought. Stubbe criticised also some details in Sydenham's treatment of Small- pox which need not be here considered. On the Continent the " Method of Treating Fevers " was very well received. It was in the same year reprinted at Amsterdam. The Dutch printers of that time did good service to science by reprinting in a cheap form all valuable new publica- tions in medicine as in other sciences, and contributed largely to the diffusion of Sydenham's writings through Europe. His reputation grew more rapidly in foreign countries than at home, as is often seen in the case of innovators in all departments of science. To complete the literary history of the work on Fevers, we should say that a second edition, with some additions, especially that of a chapter on the 128 SYDENHAM'S WRITINGS ON FEVERS igue, appeared in 1668. To this was prefixed a lg Latin poem by John Locke, Sydenham's :imate friend, who deserves much credit for dis- cing the importance of Sydenham's little volume, e will quote the opening and concluding lines :■ — 'n tractatum de Febribus D.D. Sydenham, praxin mcdicam apud iditiexses mira Solertia aque ac felicitate exercentis. " Febriles aestus, victumque ardoribus orbem Flevit, non tantis par Medicina malis ; Nam post mille artes, medicse tentaraina curse, Ardet adhuc Febris, nee velit arte regi. # * * * Tu meliora paras, victrix Medicina ; tuusque, Pestis quae superat cuncta, triumphus erit. Vive, Liber, victis Febrilibus ignibus ; unus Te 8imul et mundumqui manet, ignis erit." The subjoined rough version may give the English ider some notion of the heroic vein in which Locke lised his friend's work : — " With Fever's heats, throughout the world that raged, Unequal war has mourning Medicine waged ; A thousand arts, a thousand cures she tries ; Still Fever burns, and all her skill denes, Till Sydenham's wisdom plays a double part, Quells the disease, and helps the failing Art. No dreams are his of Fever's mystic laws, He blames no fancied Humour as its cause ; Shunning the wordy combats of the Schools, Where an intenser heat than Fever rules. * * * * Thy arms, Victorious Medicine ! more intend, Triumphant, thou the unconquered Plague shalt end, Live, Book ! while Fever's vanquished flames expire, Thee and the world awaits one common fire." 129 K DMAS SYDENHAM Locke was so much interested in his friend's effort to reform medicine that he and Sydenham planne a joint treatise on the Small-pox, which was to b dedicated to Lord Ashley (afterwards Lord Shaftes bury), Locke's friend and patron. Locke, indeec wrote the dedication and the preface in Sydenham' name, which are still extant, in English, in th Shaftesbury papers. But the scheme was given ur. and the materials were doubtless used in the com position of the work now to be spoken of. Finally the work on Fevers was entirely recast and with very considerable additions, making it thre or four times as large, appeared in 1676 with a nev title as " Observationes Medicas circa morborun Acutorum Historiam et Curationem," which, not withstanding the great alterations, must be regardei as the third edition of the little book on Fevers. Thi fourth edition (so-called on the title-page) of 168^ was further revised, but contained no importan alterations. There were also at least two othe Continental editions, printed at Strasbourg and a Geneva. It was dedicated, not to Lord Ashley, bu to Dr. Mapletoft. In this, Sydenham's greatest work, are containei numerous observations on the epidemic diseases London, from 1661 to 1675. The leading principl in all his researches on this subject was to study fo himself the bewildering variety of diseases known a fevers, discarding all traditional explanations a'ni 130 SYDENHAM'S WRITINGS ON FEVERS :n the traditional names, to observe them in fact objects of natural history without being biassed a premature attempt to account for their phenomena accordance with the ancient dogmas or even :ording to the modern physical and chemical snce. The book contains also observations on ler diseases, such as pleurisy, pneumonia, and :umatism. [t would be impossible within the limits of this irk to give any analysis — even a short one — of i " Medical Observations." The accounts of the r eral diseases are not arranged, as they are in a )dern text-book, according to the diseases them- ves ; but according to the epidemics ' of particular irs. They were founded on Sydenham's own :ords of the diseases occurring in London from 6 1 to 1675. In those years he recognised five riods, viz. : (1) 1661-4 ; (2) 1665-6 ; (3) 1667-9 5 ) 1669-72 ; (5) 1673-5. Each of these periods is characterised by a particular Epidemic Constitution^ disposition of the atmosphere, and as many peculiar ximens of epidemics, viz., fevers. In the first, :ermittent fevers predominated, accompanied by a culiar species of continued fever. In the second, pestilential constitution, occurred the Plague, mg with pestilential fevers, analogous to but Fering from the true Plague. In the third, or riolous constitution, Small-pox predominated, but was :ompanied by a special kind of fever, produced by l 3 l .S SYDENHAM the same epidemic constitution of the atmosphere, which he calls the variolous fever. In the fourth, or Dysenteric Constitution, beside Dysentery and " Cholera," or Summer Diarrhoea, there was a peculiar fever resembling Dysentery and an anomalous kind of Small-pox. The fifth constitution was characterised by a peculiar Comatose Fever, and by peculiar characters in the other fevers, as well as by an epidemic cough, in which we may probably recognise Influenza. The general idea was that fevers change their characters according to the constitution of the year, and according to the prevailing epidemic. So that, for instance, any one knowing that a particular kind of Small-pox was prevalent, could pronounce what kind of fever would be prevalent at the same time, even without seeing a case ; or, knowing the nature of the prevalent fever, could predicate the kind of concomitant disease which also prevailed, such as Small-pox, Measles, Dysentery, &c. There is no doubt that this idea was founded on the histories of epidemics and their succession given by Hippocrates ; and Sydenham has been blamed for expecting that the course of epidemics in London in his day would be analogous to that of Greece in the time of Hippocrates. But it does not appear that he was entirely misled by this consideration ; for he expressly points out that Small-pox, and therefore the variolous constitution, with the disease dependent upon it, was unknown to Hippocrates. And he carefully 132 SYDENHAM'S WRITINGS ON FEVERS >udiates the belief that the succession of epidemics 11 in future years follow the same sequence as in the irs to which his observations refer. The conception, however, of a definite epidemic istitution in particular years was absolutely taken >m Hippocrates ; with the practical corollary that : diseases in particular constitutions required Ferent treatment. Sydenham attached the greatest portance to this idea, as will be seen from the lowing extract. " Just as an individual case of an epidemic has its sper periods, its stages of increase, crisis, and decline, also has the constitution in general, which deter- nes the epidemic ; that is, proportionally to the le of its predominance it has definite periods ; it :reases from day to day in its epidemic extension ; reaches its height ; it then decreases at the rate its increases ; and, lastly, it dies away altogether, iking room for a new constitution." The modern teaching would be that all this may be ite true of epidemics or outbreaks of particular eases ; but that it is not necessary to resort to the pothesis of a purely imaginary " constitution " to alain them. It was impossible for Sydenham to know, what :dicine has established by long and painful observa- n during two centuries, that the species of fevers : constant, and that their successive prevalence is t due to atmospheric or climatic conditions, but '33 S SYDENHAM to a variety of circumstances, such as importation of germs from other countries, contagion, the influence of particular species of animals, and so forth, many of which can be controlled by purely mechanical arrangements, while heat, cold, moisture, and so on, play only a subordinate part. Sydenham would have been quite prepared to learn, if he could have looked forward to these times, that the Plague never appeared again in England, that the intermittent fevers are practically extinct, and Small-pox reduced to very narrow limits. For he explicitly states his belief that some diseases would become extinct, and new ones, then unknown, would appear. But with the withdrawal of these formidable epidemics his whole system of epidemic constitutions crumbles to pieces. No one, however, was less dis- posed to believe than Sydenham himself in the finality of his own doctrines. The most disappointing feature in Sydenham's ac- count of fevers is that, notwithstanding their minute- ness, it is extremely difficult to be certain what species of fever, as now understood, he is describing in any particular year. This partly arises from his tendency to believe that the forms and symptoms of fevers were continually changing under the influence of the epidemic constitution, and partly from the fact that 4 he purposely abstained from giving in detail the histories of particular cases. In this he did not follow the example of Hippocrates, who has left 134 SYDENHAM'S WRITINGS ON FEVERS iny histories or patients with the precise dates of :ir being taken ill and the occurrence of prominent nptoms. Had Sydenham done this it would have :n much easier to identify his fevers. As it is, such identification is difficult, and in the end uncertain. In the sixth division of his work, where he speaks certain acute diseases not generally called fevers, he iy be said to have in some degree anticipated very idem views respecting these diseases. He refused to :ognise them as local diseases originating in the rans affected. With regard to Pleurisy and Pneu- >nia, for instance, he insists that they are due to a neral inflammation of the blood which causes the sction of the organs. So with Erysipelas, Rheu- tism, and Quinsy. He regarded them all as fevers hegin with, not as feverish diseases arising from the al condition. He expresses these views with even :ater confidence in his earlier editions. Now though this would not perhaps be accepted at : present day as a quite accurate statement of the ture of these diseases, still it recognises the truth w more and more generally accepted that these eases- are not affections of one part of the body Iy, but what are called general specific infections, oda, the eminent professor of Vienna, held very irly the same view about Pneumonia half a century >, though it was regarded when he first propounded is a startling innovation. Without unduly prolonging strictly medical dis- J 35. AS SYDENHAM cussions, we must say one word about Sydenham's description of Scarlatina. He has been generally credited, and even by great authorities, with first clearly distinguishing this disease. In the opinion of the present writer this praise is exaggerated, though" Sydenham certainly described this eruption more accurately than any one else. Sydenham could not have invented the word " Scarlatina," which, by its form and its traditional pronunciation, is evidently Italian in origin, and his description is strangely inadequate. He says nothing about the throat nor about contagion. He thinks the ailment (he calls it " the mere name of disease ") is merely " a moderate effervescence of the blood, arising from the heat of the preceding summer, or some other exciting cause." It is without danger unless (in his favourite formula) aggravated by injudicious treat- ment, in which case the patient might die of his doctor. Either Sydenham in his long practice never saw a bad case of Scarlatina or else, when he did see one, he called it by another name. We are inclined to think the latter explanation the correct one. His error, like the errors of all great men, was not without bad con- sequences, for it largely contributed, in our opinion, to the misunderstanding of Scarlatina and sore throats in the next century. But, with all deductions, this work will always remain one of the greatest of medical classics. The descriptions of many diseases and symptoms are so admirable and complete that they have never been 136 SYDENHAM'S WRITINGS ON FEVERS passed, nor are likely to be. Many flashes of ight and pregnant hints might be collected, which itemporaries did not understand, and to which later owledge is only able to do justice. Above all, the olute endeavour to study natural facts by pure >ervation, putting aside the theories, facts, and tions collected out of books "which, he says, "have much to do with treating sick men as the painting pictures has to do with the sailing of ships " — this ieavour, successful or not, will always be the best imple of method to all students of medicine. m VIII Sydenham's Shorter Writings " EpiSTOLiE RESP0NS0RI.3E " SYDENHAM was apparently not fond of writing, though he thought it a duty to publish his experience for the benefit of others, and probably want of health as well as want of leisure made composition difficult to him. His two next works were elicited from him by medical friends who urged him to give them his views on certain subjects, and who should be remembered with gratitude as having conferred a benefit on medical science by so doing. The first was Dr. Brady, the eminent Regius Pro- fessor of Medicine at Cambridge and master of Caius College, who in a very complimentary Latin letter begs Sydenham to continue his observations on the fevers of London up to the present year (1679) ; and also asks his advice on the use of the Peruvian bark in Agues, and on the treatment of Rheumatism. Brady, we may observe, anticipates that Sydenham will meet 138 SYDENHAM'S SHORTER WRITINGS th malicious opposition and calumny (" malevolorum gia, et invidorum stigmata atque calumnias "), pleasing though these will be to liberal and candid :n. The next to draw upon Sydenham's stores of :dical knowledge was also an important- man, Dr. man, Public Orator of the University of Cam- dge, and Professor of Medicine in Gresham illege, London. He reminds Sydenham in flatter- ; terms of his promise to supplement his great work Acute Diseases by a greater one, viz., on Chronic seases. He begs him therefore to write on a subject ;y had often discussed together, namely, the Vene- il Disease, which was commonly and very badly :ated by quacks, barbers, and the lowest mounte- iks. The answers to these letters were produced in a v weeks, and published together with the title Lpistolse Responsoriae duas " in 1680, being dated bruary 8 and March 10, 1679-80, respectively, le copy presented by Sydenham to the College of lysicians is dated March 30, 1680. These letters are really finished, though short :atises, and it may seem strange that they were com- sed in so short a time. No doubt, however, denham had the materials ready. The observations fevers must have been extracted from the notes lich he regularly kept on the diseases of London, tiere is evidence also that a part of the tract on the *39 \S SYDENHAM Venereal Disease was written as early as 1670, for the English MS. of the College of Physicians contains passages which agree word for word with the Latin tract. The final note in the MS. is, " And this is all that I know of this disease to the day whereon I write this, which is November 4, 1670." These facts illustrate Sydenham's method of composition, and show how thoroughly he founded all his writings upon his own carefully recorded observations. It is plain that he had accumulated a large store of similar observations. The Oxford MS., in the handwriting of Locke, called " Extracts from Dr. Sydenham's Physick Books," &c, must have been based upon materials of this kind. The first of the letters now published, that on Epidemic Diseases to Dr. Brady, contains a passage worth quoting. " I have always thought (and not without reason) that to have published for the benefit of afflicted mortals any certain method of subduing even the slightest disease was a matter of greater felicity than the riches of a Tantalus or a Crcesus. I have called it a matter of greater felicity ; I now call it a matter of greater goodness and of greater wisdom. For what more abundant instance of wisdom and goodness can any one display than (seeing his own share of our com- mon nature) to continually* refer such things as he has accomplished, not to his own glory but to the advantage of the world at large, of which he is so small and contemptible a particle ? I agree with that 140 'DENHAM'S SHORTER WRITINGS ous master of language and thought, my ite Cicero, the leading spirit of his age, if not of >rld at large, that ' as laws place the welfare of all bove the welfare of the individual, so a good and nan, obedient to the laws, and mindful of his 5 a citizen, will think more of being useful to 1 general than to any one or to himself.' srtainly it is clear that while to kill a man is the a criminal it will be the duty of a good man to. o save life, or teach others how to do so, when lself is in his grave. For it is an inhuman and :ble sentiment that it matters nothing to us happens when we are dead, even if the whole should be destroyed." " DISSERTATIO EPISTOLARIS." mham's next work was also called forth by the t of a learned friend, Dr. Cole, of Worcester, rrote to him in November, 1681, asking for ■ advice on the management of Small-pox, he had been treating with the greatest success, denham's methods. A common friend, Mr. :k, had told him that Sydenham had some ished observations on this disease ; and had also that there were some new observations on ical Diseases which also he hoped Sydenham publish for the benefit of the present age and Cole (who was not personally known to 141 HOMAS SYDENHAM , Sydenham) was a man of ability and learning, w though not holding any academical position, acquired a reputation by his writings on Apopl and other subjects. He afterwards wrote a work Fevers, of a very different kind to Sydenham's. • Sydenham's answer was completed by the r January, and though it is longer than the two fori letters taken together, Sydenham explains that hi obliged to be short, because his health was so shak especially at that time of the year, that if he were indulge in any deep train of thought, it would br on an attack of Gout. The letter appeared in 1682 with the t " Dissertatio Epistolaris ad Gulielmum Cole." ^ presentation copy in the College of Physicians dated March 21, 168 1-2. The first part of- the letter deals with the tre ment of confluent Small-pox. In it occurs the na of Dr. Goodall, who, as an intimate friend, s Sydenham the account of a case of Small-pox un his care. Sydenham's mention of him is remarkal " Dr. Goodall was the friend who, when m< men ventured to assert that I had done but little the investigation and cultivation of medicine, thi himself in the way of my maligners, and defem me with the zeal and affection of a son toward father." Now Goodall was something more than an emin Fellow of the College of Physicians. He was 142 )ENHAM'S SHORTER WRITINGS i of the college, and a warm defender of its he was indeed a typical College physician, his chivalrous defence of Sydenham is a fact lout importance in considering the attitude of ege towards the great innovator in medicine, second part of this letter, relating to Hysterical ;, is more important than the first, since the cognition of Hysteria as a special form of is rightly thought to be one of Sydenham's originality in Medical Science. a we look into, his treatise, we find, however, had a very different notion of the disease from modern physicians. He says that Hysteria is imonest of all chronic diseases. As Fevers p two-thirds of all diseases, and ~ chronic the other third, one-half of this third is con- by Hysteria. So that by this liberal estimate i is responsible for one-sixth of all human ;. Women, he says, except those who lead a id robust life, are rarely quite free from it ; nen, be it remembered, form one-half of adult 2 men who lead a sedentary or studious life, w pale over their books and papers, are subject same complaint. In their case it is indeed Hypochondria ; but this disease is as like i as one egg is like another. Men are less to it than women, not on account of the :e of their organs, but because of their more *43 OMAS SYDENHAM robust habit of body, as contrasted with the fine ar delicate organisation of women. But he clear recognises the occurrence of Hysteria in men, ar gives a very good case, which has been quoted wil high approbation by a modern French physician. Sydenham's pictures of the symptoms of Hyster in women, which have often been quoted, are viv: and true ; though he says the symptoms are i numerous and proteiform that it would be impossib to enumerate them all. Moreover, his general expl; nation of the affection, if translated into moder physiological language, is essentially what is now heli It all depends, he says, upon an ataxia or disturbanc of the " animal spirits," which, rushing down upo the various organs of the body, excite pain and spasm and in short " create the proper symptoms of thj part." Now the word " animal spirits," " psychice pneuma," or " breath of the soul," as carefully define by Galen, is almost precisely the equivalent c " nerve-force " or " nervous energy," as used ii modern books — phrases which, if more plausible oi the one hand, are on the other hand, equally vague So that, interpreted in modern language, Syden ham's explanation comes to this : that in Hysteri there is a " disturbance of nervous energy " or " dis ordered innervation" which affects different parts c the body, producing functional disturbances whicl simulate organic disease. 144 SYDENHAM'S SHORTER WRITINGS Even those who think that Hysteria defies defini- n must admit that this explanation is a very fair tement of the observed phenomena. And with s the whole traditional fabric of hypothesis indicated the etymology of the word Hysteria fell to the >und. With Sydenham's exaggerated notion of the im- rtance of Hysteria, it was natural that he should ■ry his doctrine into extremes. He thought this iection not only produced the symptoms of disease, t set up actual organic diseases. Chlorosis he yarded as a hysterical affection, arid attributed to the ne ataxia of the spirits, the production of ovarian apsy in women, which to modern experience seems :e putting the cart before the horse. In the treatment of Hysteria, as he understood it, denham again showed his good sense. Although lable to dispense with the traditional remedies, ceding and purging, he held the chief curative indi- tion to be " the restoration of the blood." For this irpose he gave chalybeates, and it is curious to iserve that he preferred steel in substance, i.e., steel ings, thinking them much more efficacious than iy chemical preparation of the metal. This actice, .at that time common, has, of course, ven rise to the customary medical phrase of " pre- ribing steel" when chalybeates are given. It may also be worth noting that Sydenham thought tichona bark very useful in Hysteria and Hypo- 145 L AS SYDENHAM chondria. Although he was certainly not the first to use bark for Agues, he does seem to have been the first who used it as what we now call a Tonic. When the doctor of to-day prescribes his salts of quinine and salts of iron as tonics, he often says he is giving bark and steel. But what is hardly more than a metaphor with us would have been a literal description of what Sydenham prescribed. " TRACT ATUS DE PODAGRA ET DE HYDROPE." In the following year, 1683, Sydenham brought out an independent work, not due to the prompting or solicitation of any of his friends. It was a short Latin treatise on two diseases, Gout and Dropsy ; the former part especially being j ustly regarded as of very great importance. -. The copy which he presented to the College of Physicians is not dated, but we may suppose that it came out about June, since the dedication is dated May 21, 1683. On the title-page is a motto from Sydenham's favourite author, Bacon, which he used also in a subsequent work, " Non fingendum, aut excogitandum, sed inveniendum, quid Natura faciat autferat." ( " We have not to imagine, or to think out, but to find out what Nature does or produces.") No words could more truly express Sydenham's method. As there is only one true method in science, we are not surprised at finding the same advice given a century later by SYDENHAM'S SHORTER WRITINGS inter to Jenner in the often-quoted words, " Do : think : try!" or more correctly, "Why think? y not try the experiment ? " The book was dedicated to Dr. Thomas Short, an inent Fellow of the College of Physicians. Syden- n says he presents this little tract in place of the ger volume which he had intended to write on ronic diseases in general. This longer work he had :n unable to complete, for so soon as ever he applied nself seriously to composition he was interrupted by severe attack of the Gout. Therefore he must ifine himself at present to treating of these two eases. He dedicated his work to Short for two isons. First, because Short had recognised the value, i publicly expressed his high opinion of Sydenham's mer writings when they had been slighted by lers ; and secondly because, in frequent consultations th his friend, he had learned to know his practical 11 in medicine ; and that, though versed in all binds learning, he preferred the niceties of practice to lpty speculations. If his labours commend them- ves to this friend, and those few other good and nourable men whom he counts his friends, he will re nothing for the hostility of those others who attack n because he thinks otherwise than they do of leases and their cures. " It is my nature," he says, " to think where others id ; to ask less whether the world agrees with me an whether I agree with the truth : and to hold HI OMAS SYDENHAM cheap the rumour and applause of the multitude. A what is it indeed ? Is it any great thing for a man do his duty as a good citizen, to serve the public to own private loss, and to take no glory for doing s If I take a right measure of the matter, I am now old that to study my own reputation will soon be a I studied the reputation of one who is not. For w. can it profit me after my death if the eight lett which compose the name Sydenham should pass fn mouth to mouth among men who can no more fo an idea of what I was, than I of what they will be ; men who will know none of those (then dead e gone) of the generation before them ; who will 1 other language and have other manners ; such the inconstancy and vicissitude of all thii human." Sydenham goes on to say that his health v prevent his troubling the world much longer w medical treatises. In writing this his hand shakes much that he can hardly hold the pen ; and he gra fully acknowledges the help given him in its compc tion by a good friend, Mr. John Drake, of Chris College, Cambridge. The treatise on Gout is the more important of t two, and has been generally regarded as Sydenhar masterpiece. He says that having himself sufFei from the disease for thirty-four years, he must be o slow and dull intelligence if his observations on disease peculiarly his own are so unsatisfactory as 148 SYDENHAM'S SHORTER WRITINGS rs after all that they are. But he will honestly put ,vn what he knows about it. ft would be out of place here to discuss the purely dical aspect of Sydenham's views on this disease. ; gives a full account of the causes and dispositions tich predispose to it, with a description of its attacks, vivid and accurate that it has never been surpassed, i remains to this day absolutely classical. Any .cher of medicine even now who may be tempted to ' and improve upon Sydenham's picture of a fit of : Gout will probably find that he had better stick to : actual words of the great Gouty Physician. It has often been said that Sydenham seems to have :n a little proud of his liability to this complaint, as ng the special appanage of distinguished men. If s observation be just, let the reader judge. ;c It may," he says, " be some consolation to those Ferers from this disease, who like myself and others : only moderately endowed with fortune and intel- tual gifts, that great kings, princes, generals, nirals, philosophers, and many more of like emi- tice have suffered from the same complaint, and imately died of it. In a word, Gout, unlike any ler disease, kills more rich men than poor, more wise in simple. Indeed, Nature, the mother and ruler of i shows in this that she is impartial and no respecter persons ; those who are deficient in one respect, ng more richly endowed in another ; her munificent wision for some men being tempered by an equitable 149 OMAS SYDENHAM proportion of evil. Hence that law universally reco] nised that no man is ex omni parte beatum, nor yet c the other hand in all respects miserable. And th mixture of good and evil, especially appropriate to 01 frail mortality, is perhaps the best thing for oi happiness." I At the end of the book on Gout, Sydenham sa; that if he should seem to have been niggardly in h list of medicines for this complaint, he will make i for the deficiency by giving a long catalogue collectf by Lucian in his TpayqSoiroSaypa, or " Gou Tragedy," a whimsical sort of comedy in whic Podagra appears as one of the characters, boasting hi invincibility, and ridiculing the pretensions of thoi who profess to have found a remedy for her torment Two unhappy doctors who made this empty boast ai brought in and tortured with the pangs which the pretended to relieve, till they cry for mercy. In concluding speeeh Podagra recounts the long list ( some fifty useless remedies which have been directe against her in vain, promising the sufferers that if the will do nothing to resist her, she will be much kindi to them. Finally, the Chorus of sufferers renounce all the pretended remedies, and promising to do nothing i resist the invincible Podagra, throw themselves on hi mercy. 1 Sydenham, perhaps, did not know the saying of the witty Fath Balde, who called Gout *' Dominus morborum et morbus Dominorum*" 150 SYDENHAM'S SHORTER WRITINGS The wisest sufferers from Gout, who know how :less all treatment is, will, Sydenham thinks, agree th the Chorus. The moral apparently is that the i you do against Gout the better ; not a very peful conclusion either for the sufferers or for the jrsician. The short tract on Dropsy which forms the second •t of this volume is much less important and valuable in that on Gout. This could hardly be otherwise, :ause Sydenham did not and could not understand : true nature of this complaint. We now know it it is not a disease in itself, but a condition arising im several different diseases or causes. Sydenham i no explanation for it but a watery state of the >od, entirely ignoring the alteration of the blood- eam and mechanical causes which are largely con- Tied in producing this condition. Now these causes re no doubt at that time imperfectly ascertained ; t Sydenham does not recognise what was actually own, nor what was being discovered by his contem- raries, the anatomists, who were engaged in carry- f on the work of Harvey. It is a notable fact that denham never once in his writings mentions the me of Harvey ; nor does he seem to have had any tion of the importance of Harvey's discovery, obably, had he been asked about it he would have d that no doubt all this was quite true, but that it ide no difference to practical medicine. If he had d any such thing, it would not have been without ; 151 .S SYDENHAM excuse. For in the class of diseases which Sydenham especially cultivated, namely Fevers and the like, Harvey's discovery had no great practical application ; and little or nothing would have had to be changed if Sydenham had more clearly taken into account the circulation of the blood. But in the case of Dropsy and some other diseases such as Apoplexy, disturbances of the circulation are of primary importance, and without considering these such diseases could not be accounted for. At this very time Lower, with Christopher Wren and other experimenters at Oxford, were making researches on Dropsy, founded on a knowledge of the circulation, which Sydenham entirely ignored. Lower did more to explain, and thus to suggest appropriate treatment for, Dropsy than Sydenham and other observers equally acute could have discovered by many years of pure observation ; more, in fact, than centuries of observation had done before. Sydenham, however, totally neglected the researches of the anatomists and physiologists, and even spoke of them with contempt. It would not be fair to say, however, that he thought a knowledge of anatomy quite useless. In this very treatise he discusses the question. He quotes the saying of Hippocrates (or a Hippocratic writer) in the work " On Ancient Medicine," con- troverting the doctrine of certain physicians and sophists that no one can understand the art of healing without knowing what man is, how he first came to 152 :u SYDENHAM'S SHORTER WRITINGS st, and so on, all which the writer says has less to do th the art of healing than with the art of painting. Probably the writer did not refer to the structure of ! body so much as to philosophical speculations on : origin of man. However, Sydenham, supposing it anatomy was meant, takes occasion to say that a psician ought to know the structure of the human iy. But he says this kind of knowledge is very ily obtained, by dissection of men or brutes, and :n by persons of little wit or judgment. Evidently thought a very general knowledge of the subject .s quite enough. Even then, he says, there is in ite diseases (that is in two-thirds of all diseases) omething divine," a specific property, which the ucture of the body will never explain. (Modern ence admits the specific factor in such diseases, but Is it a microbe instead of a divine element.) Syden- m goes on to use the very dangerous argument >m ignorance. " We may know," he says, " the ger organs of the body, but its minute structure will vays be hidden from us. No microscope will ever 3W us the minute passages by which the chyle leaves 5 intestine, or show by which the blood passes from 5 arteries to the veins." Now the fact was that the t - mentioned passages, or capillaries, had been monstrated under the microscope by Malpighi in 6 1, more than twenty years before; and the minute nphatic ducts, though demonstrated later, are now tin enough. 153 )MAS SYDENHAM Sydenham, we must admit, not only undervalued, but was ignorant of what had been done in anatomy, In another place he says, using the same argument from ignorance, that the human intellect will neve) be able to understand the use of the different parts oi the brain, forgetting that Galen, many centuries before, had shown by experiment much more about this matter than Sydenham recognised, and that his own contemporary, Willis, was extending that know- ledge in a remarkable degree. He lays down a still more dangerous principle when he says that " a little research teaches us how much knowledge is enough for the guidance of those who claim to be healers oi disease " ; which in the light of modern research we may say is just what no experience ever has taught, or is ever likely to teach us. So much it seems desirable to say in order to show that Sydenham, like many original investigators, was somewhat one-sided ; and, absorbed in the study of medicine by his own method of pure observation, ignored the results obtained by other methods, and by the anatomical and physiological schools, which was the school of Harvey. Sydenham's method was admirable in studying the class of diseases to which he especially devoted himself. But in others, namely, in organic diseases and most chronic maladies, it was insufficient. Perhaps this was one reason why his long-promised work on chronic diseases never appeared. He may have found 154 SYDENHAM'S SHORTER WRITINGS : task more difficult than he imagined. At all :nts, these considerations explain why the treatise on ■opsy was so inadequate. CHEDULA MONITORIA DE NOV-ffi FEBRIS INGRESSU. In September, 1686, Sydenham brought out the t medical work which was published during his :time, with the above title, which means "A :tch by way of warning of the approach of a new ver," that is, a new species of fever which he had served in the course of the year. The term " New ver " was used both by Sydenham and others for ■tain epidemics of Fever differing from what had mi observed before. Whether this particular demic really was one of a new disease it is difficult say. As before remarked, there is often great Sculty in determining to what species of Fever denham's descriptions, elaborate as they are, apply, lis disease seems to have presented some features e those of Enteric or Typhoid, but on the other nd, as it began in the spring we can hardly identify with that disease, and must leave the question determined. The little book contains also obser- :ions on other maladies, and on the whole must be isidered a sort of supplement to his larger works. It was dedicated to Dr. Charles Goodall with ex- :ssions of gratitude and friendship which we have oted before. There is a final chapter on Calculus, 155 lS SYDENHAM giving Sydenham's account of his own habits of life, which also is given elsewhere. Perhaps the most notable passage in the book is one where Sydenham incidentally gives a description of St. Vitus's Dance or Chorea. This has been greatly admired by some physicians as a masterpiece of description. One modern writer on the subject, the late Dr. Sturges, on the other hand, pronounced it to be so imperfect a description that the disease could hardly be recognised from it. To decide where doctors disagree is proverbially hard, but we must confess we lean to the opinion that it is not a very complete picture of the disease, though undoubtedly it seizes the most salient features. But the historical importance of this short account was very great. Here Sydenham first clearly separated this common disease of children from the rare epidemic hysterical disorder formerly called St. Vitus's Dance, or, " the dancing mania of the Middle Ages." Several historical records of the outbreaks of this extraordinary nervous malady remain, and have been collected in Hecker's well-known work on the epidemics of the Middle Ages. But this has in reality nothing what- ever to do with our modern disease called Chorea, and as it never occurred (so far as we know) in England there could be no confusion in the mind of an English physician. On the Continent, however, such a con- fusion was still possible. Hence the importance or Sydenham's description was at once recognised, and 156 SYDENHAM'S SHORTER WRITINGS : disease in question was often and for long after- :rds called "Sydenham's Chorea" (a name still :asionally met with), or " Chorea minor." This was the last product of Sydenham's literary :ivity. At the end of the book, dated September , 1686, he states that he has now delivered nearly that he knows respecting the cure of diseases. *57 IX Medical Practice in Sydenham's Time TO understand what there was novel or unusual in Sydenham's methods we must consider what kind of professional world it was into which he made his way when he settled in London. Never was there a period when the medical pro- fession underwent a more rapid change than it did in London after the Restoration. Before the Civil Wars physicians in London had been a very limited and, on the whole, a very uniform class. They were guided chiefly by the Galenical tradition which had at first only acquired new strength by the Revival of Medical Learning ; and in this revival Linacre and other early Fellows of the College of Physicians had played a distinguished part. The great discovery of Harvey, which seems to us now so signal a landmark in the History of Medicine, had introduced no change in its practice. The traditions of the classical school still bore almost undisputed sway, and the English physician 158 MEDICAL PRACTICE :he formal and learned scholar such as Linacre ided to make the type of a Fellow of his nly other school of Medicine which had any ame, or formed a distinct school in practice, Chemical, or Spagyrical, constituted by the of Paracelsus and Van Helmont. But in at least, the chemical physicians were at that nail and discredited class. Their exorbitant is to infallible skill and their trafficking in medies caused them to be ostracised by the of Physicians. The very name li $)uack" " §>uacksalber" invented for them, is an their position. For this meant originally mbre than ^uecksllber^ or Quicksilver, the name for mercury, a drug the use of which of their distinguishing marks. The long sy of the College of Physicians with a certain , a chemical physician, who had a secret :alled Aurum Potabile, or "Potable Gold," le essential antagonism between the quacks regular practitioners. iring the Civil Wars and under the Common- he upheaval of thought and disregard of d opinion put a sort of premium on unortho- ich gave the quacks a greater vogue ; and t of professional restrictions degenerated into died license vexing to the souls of the or- jhysicians. About this time and later a J 59 LS SYDENHAM number of books on chemical medicine appeared in London. After the Restoration the bonds of professional discipline were drawn tighter, and it might have been expected that a greater uniformity of practice would have resulted, but for several reasons this was not the case, while the strife of conflicting opinions and methods of practice became keener than ever.. One reason of this undoubtedly was the growth ot the scientific movement, of which the tangible expres- sion was the foundation of the Royal Society. The growth of physical science naturally tended to foster scepticism in regard to traditional doctrines of all kinds. Scientific men were not likely to be deterred by the censures of the orthodox physicians from extending a wide tolerance to novel theories and systems of medicine. Hence the "virtuosi," as the scientific men were named or nicknamed, incurred the odium of many of the old school of physicians by their supposed partiality for quacks and irregular practitioners. Robert Boyle, perhaps the most eminent of the " virtuosi," who took great interest in medicine, not only encouraged with intelligent sympathy the early labours of Sydenham, but dabbled in chemical remedies, and had a good word even for the most notorious arcanum of the quacks, the " Aurum Potabih." He is probably pointed at in the diatribes of the orthodox physicians against the "virtuosi" of which we shall presently give a specimen. 160 MEDICAL PRACTICE Another factor of great weight in producing the >tley ' diversity of medical practice in Sydenham's le was undoubtedly the personal influence of larles the Second. It is true that on the one hand : King sanctioned, and, it is said, ordered a idical regulation of a most conservative kind, mely, the limitation of the Fellowship of the illege of Physicians to doctors of Oxford and mbridge. This singular restriction of the highest tiours of the profession to graduates of two univer- es which could not, from the nature of things, give cient medical teaching, and thus could produce [y a very limited number of physicians, was an lovation. In old times the College had welcomed iduates of Padua, Leyden, and other Continental looIs, without requiring them to pass through an iglish University. The wisdom of the new regula- n has been much questioned. On the one hand, it doubtedly maintained that standard of learning and ;nity by which the London College has, by general nission, always been distinguished. On the other id, it kept many of the most able and distinguished psicians of the succeeding century in a subordinate iition, and in the end had that fossilising tendency ich bigoted exclusiveness never fails to induce. But, whether right or wrong, no doubt it com- nded itself to Charles and his advisers, not as intaining the dignity of the College, but as a part the policy by which Roman Catholics, Presbyterians, 161 M \S SYDENHAM and Nonconformists were to be kept out of all im- portant public positions. On the other hand, Charles II,, partly through one of the most favourable points in his character, did more to lower the dignity of the profession in another way than he could have done by encouraging the restrictions just mentioned. No one can doubt that whatever Charles's faults as a king, he was a man of acute and lively intellect. He took a genuine, if somewhat languid, interest. in physical science ; he kept up a laboratory in his own palace, and his patronage of the Royal Society was not a mere affectation. Science in England has every reason to be grateful to him for the dignified and assured position which by this foundation he gave to it. But these very scientific proclivities led him, unfortunately, to give his countenance and patronage to quackery of every kind, reputable or disreputable. • Beside his regular physicians, he dignified certain persons of discreditable character with the same title. One John Archer, a writer of disreputable books and vendor of secret remedies for diseases not willingly named, who might in these days be prosecuted as an obscene quack, calls himself " Chymical Physician to his Majesty" (though his chemistry was certainly not that of the Royal Society), or " His Majesty's Physician in Ordinary," and boasts that the King recommended several noble persons to his care. Another of the King's physicians in Ordinary was 162 MEDICAL PRACTICE Jeon Harvey, afterwards Physician to the Tower, : a person of the stamp of Archer, for he was a duate and an educated man, but chiefly known as : author of scurrilous pamphlets, written with nty of vigour (and, it must be admitted, not without :), attacking other physicians under transparent guises, and especially the College, which for some son did not admit him as one of their body, lenham himself is evidently referred to in one place " a trooper turned physician," and probably as " a estern fiumh'n, that pretends to Limbo children in the lall-pox by a new method." Charles certainly read :se libels, at least "The Conclave of Physicians," i though he is reported to have censured a too Jent attack upon the eminent Dr. Willis, one can agine the merry monarch chuckling over Harvey's :es at the expense of the Institution of which he s supposed to be the official patron. Nor was the King more particular, as might be sposed, about the moral character of those whom he noured with his patronage. His favourite physician, Alexander Frazier, is mentioned in Pepy's Diary notorious for practices which in our times might ng him within the grasp of the criminal law. It is striking testimony to the loyalty of the College of ysician, that no word of complaint was ever heard the scandalous manner in which official patronage is dispensed by the founder of the Royal Society and tron of the Royal College. But it is easy to 163 THOMAS SYDENHAM imagine the difficulty which an honest and upright j physician must have had in steering his way among this crowd of quacks and sycophants. Another set of irregular practitioners were the astrologers, who about the middle of the century abounded in England. Not content with drawing horoscopes and ordinary fortune-telling, men like Culpepper, Lilly, and others trespassed on the province of the physician, and practised physic by the light of the stars — a method once indeed recognised in orthodox medicine, but by this time discredited. In addition to all these there was the great crowd of base empirics, herbalists, water-casters, and the like, who made no pretensions to chemistry or astrology, but with abundant effrontery offered to sell remedies for every complaint. Mountebanks from country fairs blowing their trumpets in the streets ; hawkers i of amulets, charms, nostrums ; charlatans and im- postors of every name and colour, plied their trade with little hindrance on the part of the law. All through the seventeenth century both physicians and surgeons complain bitterly of these ignorant pre- tenders. Laws were made against them, with powers given to the College of Physicians to enforce, X, but there seems to have been great difficulty in making them effectual, so that the quacks and empirics flourished abundantly. After the male quacks came a great crowd of females — midwives, nurses, and " wise women " — to 164 MEDICAL PRACTICE eep up the remaining crumbs of the medical St. Besides having to sustain competition of various ids of spurious physicians, the regular doctors had :ir practice much cut into by the surgeons and jthecaries. Surgeons were not allowed to prescribe internal maladies, nevertheless they did so. lothecaries were supposed to make up the prescrip- ns of the physicians for individual patients, but illy they made very lucrative use of the prescriptions lich passed through their hands by supplying them thout the orders of a physician to any patient lose case seemed similar. One apothecary is said to ve boasted that he made a hundred times as much t of a certain prescription as the physician got for iting it. Besides which, as was natural, they scribed for a multitude of patients without troubling : doctor at all, so that Gideon Harvey reckons the Dthecaries had fifty to one hundred patients to the ysician's one. " Hence," he says, " five-sixths of ; physicians go with their hands in their pockets all Y, the greatest part of business passing only through v men's hands (though some of them are much >re ignorant than the others), whereas there is scarce f little apothecary, but one time or another in the j there is life perceived in his mortar. Now this rceness of business being by Physicians imputed to i great a share one hath before another makes them >wl and snarl at one another, like so many barking 165 THOMAS SYDENHAM animals at a bone in the water they can't come at." Thus while one class of apothecaries worked for the physician, probably as much to their mutual advantage as in Chaucer's time, when, as he says of the Doctor and the Apothecary-v " Each of them made other for to winne Their friendship was not newe to beginne," there was another class who practised quite inde- pendently of the physicians, never calling them in, except occasionally to fortify their own position, or to renew their stock of prescriptions. Many attempts were made to check this abuse, about which numbers of polemical pamphlets were published ; but in vain. Dr. Goddard, the Gresham Professor,' proposed that physicians should compound their own medicines, and, himself did so, producing the celebrated Goddard's drops, which were highly approved of by Sydenham. It should be observed that physicians and surgeons were at this time absolutely distinct ; and physicians educated in England had no opportunity of learning any surgery ; while it was also often asserted that they had a very imperfect knowledge of the science of the apothecary. So what with "virtuosi," the chemical quacks, royal favourites, surgeons, prescribing apothe- caries, astrologers, base empirics, midwives, and old women, it was a motley rout of competitors that the honest physician had to contend with. No wonder 166 MEDICAL PRACTICE re was grumbling and bitterness. The profession 5 going to the dogs — this, at least, is what was lerally said in the profession. Dr. George Wharton, an eminent physician and Ltomist, summed up the matter in the following sons, which he gave to dissuade a young man from bracing Physic for a livelihood : — ' Because now there was more apparent cause of : ruine and destruction of Phisick than ever, by the armes of quackes, mountebanks, chymists, apothe- ies, surgeons, and especially this new upturned >od of 'virtuosi,' who are most likely by their .uitisme and policy, English books, experiments and :eipts in phisick, to fill all families of note in igland with their stuffy to overthrow all our old tied and approved practice of phisick, especially London : which is now miserably impoverished its burning and building and desertion of trade, it they have scarce money for their present sub- "ance, little for phisick and phisitians, and like to vc less hereafter. Soe that every one out of cessity and good husbandry must become theire me phisitians and make their owne phisick. For our ladies and gentlewomen keeps and stores up :eipt-books and closetts of medicines fitted for most casions. " Besides, Phisick is too much overstocked with idents graduated from the University. For I doe illy believe it will easily appear that now there 167 t THOMAS SYDENHAM is in England 400 for one phisitian that was formerly : so that it is impossible but that theire owne multitude must shortly ruine the profession without the plotts. and envy of theire enemies. He that begins the practice of phisick must resolve to be a perpetuall slave and servant to the meanest and basest all the dayes of his life, and if he neglect one instant and committ one error, or speak the least word amisse, his fame and name is lost for ever to him ; and if his patient dye, hath killed him for certain, by the view of the people. Upon the Phisitian is imposed taxes, polls, great charges for houses and servants and enter- tainments, more in this age than ever formerly ; — Coaches, Jacks (?) and charges expected, — feastings. He is never called to any but miserable patients, where the apothecary or surgeon or chymist have been tampering soe that commonly the phisitian is brought only to take away the scandall of killing him to himself. The phisitian is made that common jeare of the hunt, neglected, contemned, and reproached upon all occasions ; and, which is worst, they will one reproach and scandalise another for his ill practize, which is very certaine and evident tq all practizers." In the meantime we turn to the regular orthodox academical physicians and ask what were their methods ? Honourable and respectable men, no doubt, but with certain weaknesses which did not escape so hostile a critic as Gideon Harvey, who, 168 MEDICAL PRACTICE mgh drawing with the pencil of a caricaturist, -bably hit off some of their vulnerable points, some of the regular doctors, he makes out, had ire learning than practical knowledge, and veiled :ir ignorance of disease under pedantic language 1 a pompous manner. Harvey supposes "the Infant-physician so com- tely dressed up with School and Academic laments, and some new tinkling notions in :dicine, that you may hear the clapper of his igue echo from the East to the West-Gate of your vn. Introduce him to a Patient, and grant that by appuising or resting his velvet Body on his pan crutch, and fixing his intellect, by drawing the sad brimmed beaver over his eyes, seemeth to mick a decrepit gravity, and by that to weigh nself down to the bottom of your belly, to rummage • the disease : When he wakes (for he has only been s dumps) out of this brown study, he shall no more iow the Distemper or the cause of it (though he th read it in authors twenty times) than the skipper at never was tossed on the ocean before pretends to id out Bermudas by his Waggenaer. Nevertheless th he adventure to call for paper and ink, to figure wn a remedy he never saw before, being only quainted with the bare name of it." The basis of truth here was that most English ysicians had to gain their experience at the expense their earlier patients. The custom for young 169 THOMAS SYDENHAM doctors from the Universities to spend a short time at one of the London hospitals was only just beginning, and was by no means universal. Physicians of Sydenham's generation had probably never attended a hospital unless they had studied abroad. Other physicians, Harvey suggests, based their pre- tensions to medical knowledge on their researches in Anatomy. " They flay Dogs and Cats ; take livers, lungs, calves-brains, or other entrails, dry, roast, parboil them, steep them in vinegar, &c, and afterwards gaze on little particles of them through a microscope : — then obtrude to the world in print whatever false appearances gleamed into their eyes ; and all this to no other end, than to beget a belief in people that they who have so profoundly dived into the bottomless pores of the parts, must undeniably be skilled in curing their distempers." Really, our old physician becomes almost too modern ! So we will only say that by this class of doctors whom he nicknames the Anatomical Physicians, Dog Flayers, or Calves Head Dissectors, he intended to hit off such men as Wharton, Glisson, Lower, and the great Willis. When our doctor was started in practice it appears, according to Harvey, the main points were to have a good understanding with the apothecaries, and to be seen regularly at church. " The church door shall no sooner be opened but ecce Mr. Doctor, sitting in the most visible seat, Grave, 170 MEDICAL PRACTICE :af, Dumb, and immoveable as if an Apoplexy of ivotion had seized him, out of which his Apothecary :o raise him by knocking at half-sermon at his pew- )r to fetch him away post to a dying patient ; by ich means he draws the eyes of the whole congre- :ion after him ; but instead of going to the :tended House of Visitation they both drop into a >aret, there to pass the fatigue of a forenoon tiday. This knack of confederacy is to be repeated eral Dominical days, until it hath made an impres- n of the people, that he is a man of importance, and great Physick business." Here again, we can only say, how modern ! Did ib Sawyer — late Nockemorf, in the " Pickwick pers," descend straight from the seventeenth ltury ? or is it only that human nature, in like cumstances, acts in like manner ? Several well-known physicians of the time are need at in Gideon Harvey's scurrilous carica- es, such as the " Sieur de Tattle," who frequents : conventicles of all sects, making a vast inroad into ; good opinion of the Zealots, and thus hauls in >als of patients. The "Sieur Phlegmatique," lose constant attendance at church with a broad- mmed hat, the little band, an austere gravity and 11 countenance, soon gained him the title of an nest, conscientious, knowing physician. These ght have been identified by their contemporaries, >ugh not by us. But when we come across the 171 THOMAS SYDENHAM figure of a " ^uidam Doctor that cures most desperate 'diseases by methods and remedies contrary to the opinion of all others ' — of the * Doctor of Contraries ,' who with opium and Jesuits' Powder shall make more various sorts of passes at diseases than ever any Roman gladiator with his weapon ; and these shall be hits, and do execution" — we wonder whether Sydenham is meant. This same doctor, called the " Generalissimo" treats Small-pox with spirits of vitriol and opium. Apparently the same allows in that disease abundant draughts of small beer, throws off the bedclothes, opens the windows, cools the room, and so forth. All these particulars are so exactly what Sydenham recom- mends that we cannot doubt the " Doctor of Con- traries " is meant for Sydenham, and is the same with a " Western bumkin," who had been at the University. From Gideon Harvey's gross caricature we may get some notion of how Sydenham would strike a con- temporary, and some help in trying to reconstruct his outward appearance and personality. Sydenham's methods of practice. Thomas Sydenham, as we judge from his portraits, was of a large and robust frame, his complexion reddish, his eyes grey, his hair first brown, afterwards grey, worn long, in its natural state, without a wig. For his actual features we refer to the portrait. We suppose him to have been in his manner manly and simple, but perhaps somewhat rustic, rather than 172 yw.-^e. MEDICAL PRACTICE ished and conciliatory — more the manner of a >rsetshire squire and captain of horse than that of a irtly physician. He was essentially a man of action en most physicians were men of books. We can igine him taking command of the sick-room and ring his orders obeyed, with a rough word or two if rigs went wrong. He undoubtedly gained the most nplete confidence of his patients ; of this there is xndant evidence. But it would have been by his in honesty and benevolence and the ascendancy of trong nature rather than by pleasing and flattering. his treatment he was eminently straightforward, iving made out the nature of the disease he adopted latever means seemed best. Of drugs, bleeding, d other strong measures he was not sparing, but netimes would give no medicine at all — a proof of usual courage in those days. He was strict, though pedant, about diet, but did not disdain simple and mely measures, such as fresh air and open windows. s only rule was, " What is useful is good." Hence had recourse sometimes to very strange proceedings, :h as the application of a puppy dog to give warmth a patient, or even of a boy or a girl, as the case ght be. Routine and precedent had little weight th him ; and there was probably a grain of truth what was said of him seriously by Blackmore, affingly by Gideon Harvey, that he made it his prin- jle to go contrary to the practice of other physicians. It is plain that such manners and practices would *73 I THOMAS SYDENHAM not bring him popularity in his own proression,; especially if he expressed in conversation, as he probably did, those strong opinions about the faulty practice of others which so often occur in his writings. And his popularity with the public is not likely to have been of rapid growth, though in the end his triumph was complete. He is certainly not likely to have sought to bring himself into notice by the methods satirised by Gideon Harvey : such as by pretensions to a know- ledge of anatomy (which he despised), or by ingratia- ting himself with apothecaries, or by ostentatious regularity in attending public worship. It may be well here to enumerate those points in Sydenham's treatment which were specially his own, as applied to various diseases. First, in relation to Small-pox, his system of treat- ment, called " the Cooling Method," was certainly new in England, and acknowledged to be so, whether for praise or for blame, by his contemporaries. We cannot discover that it had been carried out in at all the same way by any Continental physician. Its merit can only be judged in relation to the treatment prevalent at the time ; and the matter will be best understood if we give it in Sydenham's own English, taken from his account of the Small-pox in the MS. of the College of Physicians, " ON THE TREATMENT OF THE SMALL-POX. "This I thought fitt to write both in regard that 174 MEDICAL PRACTICE what I formerly published concerning this disease in a booke of mine entituled Methodus curandi Febres etc. was less perfect for want of those opportunities of being thorowly informed, which since that time I have plentifully had, especially in the years 1667 and 1668, in both which the small pox raged more then scarce ever hath bin knowne ; and likewise for that I am abundantly sensible of the great mischiefes that are dayly done through mistakes about this disease but especially about its cure, wherein a great pudder is wont to be kept, and the Patient frightened into the enduring the torment of being kept wholl weekes sweltering in his bedd and of being burnt up with cordialls. And all to noe other effect oftentimes than the destruction of the Patient, or at best his cure's appearing to have bin better then it was by his having bin made worse than he needed, both in respect of those great and dangerose accidents to which he was unnecessarily exposed during his sickness, and likewise of the disfiguring impressions remaining oftentimes on his face after recovery that otherwise would certeynly have bin avoided. "Truly the j ust indignation I have both at the folly and cruelty of the received practise in this disease, provokes me to appeale to the less fallible because common reason of mankind whether the event were not to be suspected, if the stoutest Porter or some such person under the happiest circumstances of health and vigour, should be taken from his business and for 175 Wn^, >: THOMAS SYDENHAM experiment sake should be put to bed, where with the curtains close drawne and a large fire in the roome he should be kept in a sweat or (to use a softer name) in a gentle mador for some weekes, being in the meane while carefully assisted by a Nurse or two, who upon the least moving from his furme z or putting a finger out of bedd, should correct his error by heaping on more cloaths. And during all this time nether the use of small beer or anything else that is accustomary or gratefull to his palatt should be allowed him, but instead thereof he should be constrained to drinke possett drinke or some such mixture and likewise to take cordialls of sundry and severall forms 3a vel 4a quaque hora. For my owne part I should no less suspect his life to be in hassard under such discipline, '.& then his case to be very uneasy. But to be more serious, I doubt not but that by such meanes as these greater slaughters are committed and more havocke .; made of mankinde every yeare then hath bin made in any age by the sword of the fiercest and most bloody = Tyrant that the world ever produced ; and which makes it yet more sad, this destruction lights not upon any so much as the youth and more flourishing part of Mankind, amongst whom likewise the richest, as being the best able to be att the charges of dying according to art, suffer most under this calamity. " But now whether I have mended the matter both * Furme = form, the same word as is used when we speak of a hare's form ; that is, its bed or lair. 176 MEDICAL PRACTICE in exhibiting to the world the true if not the only history of this disease, which before lay entangled in the obscurity of notions taken up by bookmen and fitted to Hypotheses wherewith they had prepossessed themselves in their closetts ; as allso in delivering a cure that will render this heretofore so fatall a disease as safe as any other whatsoever, will be the Question till 'tis tried but noe longer. And till then I doe not begg but may reasonably challenge a beliefe. I know to write the history of a disease is common, but so to doe it as not to deserve the just contempt expressed by that great Genius of rationall nature, the Lord Bacon, agaynst some undertakers of the like kind is somewhat more difficult. Allso to write the cure of a disease is not less ordinary, but so to doe the same as to render men as potent in actions as words will be thought a greater task by those that shall consider that every Praxis abounds with the cures of those diseases which neither the Auther himself nor any man since could ever cure. " But lett me have don the one or the other ever so exactly, yet nevertheless I understand the Genius of this age and with what it is delighted, too well to expect any other reward from men save to be reproached for my paynes, which would have bin bestowed more advantageously to the accommodacion of my fame and interest, either in the starting some new supposition to administer matter of dispute in the schooles, or else in exhibiting to the world the I 77 N THOMAS SYDENHAM discovery of some minute part in the body which w; as much out of the ken of former ages, as it is beyon the skill of this to improve the discoveries of the lik nature which are allready made to the reall curing < diseases. However I shall not suffer my selfe to t discouraged by these considerations, but as long ; Allmighty God shall give me life, shall still prei forward to my avowed end of doing all the good I ca in my calling, and shall trust him with myselfe an my concerns, enterteyning in the meane time a perfec contempt and undervaluing, either for the scornes c any man upon this account, or for that share of loi which I myselfe (though otherwise noe prodigall c my fortunes) may susteyne in my practice by discovei ing what I know or shall find out, to every body. " Now if it shall be sayd that other men that hav seen as much as I, and that have bin furnished wit sufficient sagacity and parts to make observations, hav thought otherwise of the subject here handled, answere, that its not my business to excuse others, bu in my owne defence to attest matter of fact, wherei: I am not long able to impose upon the world ; bu 'twill quicklye be found out whether I have don benefitt to mankind in this and succeeding ages b what I have here written, or whether like a person c profligated life and manners have drawne upon m selfe the deaths of men, even when I shall be in m grave. But quid verba audio cum facta videam ? is no because Latine, a wiser saying and more expressive c 178 MEDICAL PRACTICE ,, the vanity of dwelling longer upon this subject, tnen the Proverb of our owne country. * The proof of the pudding is in the eating.' "Written in Juli 1669." In some fevers Sydenham followed to a certain extent a cooling treatment. In Agues or Inter- mi ttents he gave Peruvian bark very largely, and con- tributed to bring it into favour. He was not the first physician to use it even in England. It had been used by Brady, Prujean, and others some years before Sydenham wrote on Fevers ; and Sir Robert Talbor, an unlicensed practitioner supported by the Court, had made it very popular, though he kept his method of administration a secret. Sydenham in his first book on Fevers, in 1666, spoke of this remedy with caution as sometimes useful though dangerous ; but in 1676 had acquired greater confidence in it. In his later years he was no doubt specially distinguished for using this remedy, which he seems to have been the first to use as a tonic, in the manner shown by the following letter to a patient. It also gives Sydenham's opinion of the salutary effect, in some patients, of a fit of the i Gout — an opinion in which he has not been singular. "For the HONOURED MAJOR HALE at Kings Walden. " Leave this at ye Post house in Hitcham in Hartfordshire. " Sir, " Though I am perfectly satisfied that your case is 179 THOMAS SYDENHAM only that which in men we call Hyperchondriacall, in women Hystericall, proceeding from an Ataxy or Shatteredness of the Animall Spirits and accordingly that a course of Steele was a very proper means for you to have bin put under, yet in regard it hath missed of that success which with great reason must have bin expected, I thinke it will be to noe purpose to turn that stone any longer at least after you have taken out the Pills you have allready by you. But 'twill be more adviseable for you for two or three weekes totally to abstain from medicines of all kinds for these two reasons. First for that you have eyther from Dr. Eeles or myselfe charged your body allready with many medicines soe that a little rest from them may be very convenient for you. And then for that I have often observed that medicines have not liad theire due effect whilst they have bin takeing, but upon dis- continuance the benefit which they have done hath bin manifest. "But in case upon tryall for some little time you shall find your symptoms still pressing, I doe earnestly entreat you that you will use a remedy which I know you have a prejudice against, and which if you had not however you may think not at all indicated in your case, and that is the Peruvian Bark. I doe truely affirm to you that as it is as wholesome and innocent as the Bread that you dayly eat, for I have seen it succeed in such cases as yours where neither Antiscorbuticks or Steele have effected anything. Ii 1 80 MEDICAL PRACTICE you shall think fit to use this remedy be pieasea to give me notice thereat, and I shall give order to Mr. Malthus to furnish you with that which I can depend upon and shall likewise instruct you how to use it. "Be pleased to present my most humble service to your Lady, and for your selfe I could heartyly wish instead of a merry Christmas that you might have a smart fit of the Gout, which would quickly dissipate your other fears and those symptoms which if I mis- take not doe naturally desire and discharge upon the Articles, and therefore amongst all tamperings that you may be put upon at any time I doe advize you to beware of bleeding or Purging as diverting this bitter, but most effectual remedy, viz. the Gout. " I am, Sir, " Your most humble Servant, " Tho. Sydenham. "Pell Mell, December the 17th, '87." It may be observed that the use of Bark as a remedy not only modified Sydenham's practice, but must have somewhat changed his ideas about the action of remedies. It was impossible to explain its action on the old Hippocratic principles of concoction and elimination. He was obliged to call it a specific, and seeing its good effects, hoped that specifics might be discovered for other diseases, such as Gout. But he refused, for certain reasons, to allow that mercury was a specific in Syphilis. 181 THOMAS SYDENHAM . Opium was a favourite drug of Sydenham's, so that he was called, we are told, " Opiophilos." He in- vented or introduced a liquid form of Laudanum, called by his name, the Laudanum previously used having been a solid preparation. The name " Syden- ham's Laudanum " was in use a century or two after his death, especially on the Continent, and is still found in recent French and Austrian pharmacopeias. Old pharmacy jars, of French or Italian manufacture, sometimes bear the inscription " Laudanum Syden- hami." This preparation, closely resembling " Wine of Opium " in later pharmacopeias, has probably made Sydenham's name more widely known than any of his books. He used Opium in the form of his Laudanum for a variety of diseases in which it was not usually employed, such as Small-pox and Gout, and probably contributed to bring it into more general use. At the same time the famous old medicines containing Opium, such as Theriacum, were going out of fashion. 182 Sydenham's Home Life and Last Days IT seems now a convenient time to relate what little is known about the rest of Sydenham's life, which, like that of most doctors, was uneventful. As regards his family, we know that his eldest son, William, was born before 1666 from the allusion in the "Methodus Curandi Febres," published in that year, where Sydenham, describing his method of treating Small-pox, says that he would treat in the same way his only son, whose life and safety he held of more importance than all the wealth of the Indies. This son actually suffered from the Small-pox in 1670, and was successfully treated. In 1685 we find from a reference in the " Observa- tions Medicae " that he was the father of children. From his will we learn the names of the two other sons, Henry and James. There is no mention of any other children. Sydenham's wife must have died before him, as she is not mentioned in the will ; but THOMAS SYDENHAM the date of her death is unknown. Mrs. Sydenham's mother, Mrs. Gee, survived both her daughter and her son-in-law ; Sydenham's regard for her is shown by his making provision for her in his will. We also know that Sydenham was a grandfather, as three children of his son William, named Barbara, Henrietta Maria, and Thomas, were living at the time of his death. From these scanty notices we should conclude that Sydenham's domestic life, passed in a family circle which included four generations, was a happy one. While the affectionate language in which he speaks of his children, and his considerate care for the interests of others after his death, show that the great physician was a man of loving and generous nature ; doubtless as admirable in domestic life as in other private and public relations. His professional life also must have been prosperous. He had his grievances no doubt. We know that Sydenham complained frequently and bitterly of the opposition he met with from the profession, and thought that this interfered with his success. "By the whispering of some," he told Andrew Broun, " he was balked the employment of the Royal Family, though he was before that called among them one of the first physicians." He was also apparently warned by his friends, and himself believed, that he risked his reputation by promulgating new and strange doctrines, and even injured his prospects by too openly divulging 184 HOME LIFE AND LAST DAY! his methods of treatment to the world. Syaennam was above all such mean considerations, and frankly accepted the possible injury to himself resulting from this manly self-assertion and conscientious endeavours to do good to mankind ; but the odium left its mark. Nevertheless, after making all allowances, and admitting that by studying popularity he might have made more money, it is plain that he was on the whole very successful. His practice kept him constantly busy, and he numbered many persons of distinction among his patients. Indeed, his life might have been pronounced in all external respects perfectly prosperous but for the troublesome and painful inter- ruptions caused by his frequent illnesses, which to a man of less resolution might have been a sufficient excuse for undertaking no important work. He began to suffer from Gout before his thirtieth year ; and to this was afterwards added the still more painful disease, Calculus. The attacks were certainly frequent, for in the summer of 1660 (when thirty-seven years old) he was laid up for some months with a severer attack of Gout than he had ever suffered from before, and it was accompanied for the first time by Haematuria. In the early part of 1677 he had a very severe attack of Gout, and symptoms of stone, which made driving in a carriage extremely painful to him. These troubles lasted for three months, and compelled him to retire into the country till the autumn, so that during the whole of that year he was unable to visit 185 THOMAS SYDENHAM his patients. In 1681 his health was seriously He thought himself getting too old to go bey own house for company, and found literary com increasingly difficult through his mind being for serious thought from the effects of Gout. " Dissertatio Epistolaris " published at the begir 1682, he says he is obliged to be brief becau! were to indulge in any deep train of thought, i bring on an attack of Gout. These were o severer manifestations of maladies which mu almost constantly harassed him. It is no wonder, therefore, that Sydenha particular attention to these two diseases, an use of his own experience to try and help suffering in the same way. His treatise on Gout is elsewhere spoken of; only set down here the regimen which he was adopt as a defence against these complaints, h foes ; since it gives us some notion of his habits of life. " Concerning the regimen and mode of life seem suitable for those who labour under ei these diseases (Gout or Calculus), I add the fa remarks, being unwilling to pass by anything may be of use to such as are afflicted in the sar as I am myself. " On getting out of bed, I drink a dish or tea, and ride in my coach till noon ; when I home, and refresh myself moderately (for mod 186 HOME LIFE AND LAS- is the one thing to be always ai. u .,.«„.. ™.. } observed) with some sort of easily digestible food that I like. Immediately after dinner, I t.m accustomed every day to drink somewhat more than a quarter of a pint of Canary wine, to promote the concoction of food in the stomach, and to keep away the Gout from the bowels. After dinner I ride in my coach again, and (unless prevented by business) drive two or three miles into the country, to breathe a purer air. [One of his favourite drives was to Acton.] " A draught of small beer serves for my supper, and I repeat this when I am in bed and about to compose myself to sleep. My object in taking this draught is to cool and dilute the hot and acrid juices lodged in the kidney ; out of which the stone is formed. Both at this time and at dinner, I prefer the hopped small beer to that which is not hopped, however thin and mild. For even if that made without hops be better fitted by its greater softness and smoothness to remove a stone already formed in the kidneys ; still the hopped beer, on account of the slightly styptic quality which the hopps impart to it, is less likely to generate sandy or calculous matter, than that without hops, which is of a more slimy and muddy substance. On the days when I take a purge, I dine on poultry but drink my Canary as usual. I am careful to go to bed early, especially in the winter, nothing better than early hours, to accomplish a full and perfect concoction and to preserve that order and even course of life which 187 )MAS SYDENHAM we owe to natyre. Late hours on the other hand, diminish and cojrrupt the concoctions in old men who suffer from an$ r chronic disease. One precaution I always take tcj prevent haematuria whenever I drive any distance oyer the stones (for on the level" road I feel no discomfort) is to drink a full draught of small beer upon getting into my coach, and also, if I am out alone, before my return." In another { place Sydenham says that the best beverage for g outy persons is " one which neither rises to the ger erosity of wine, or sinks to the debility of water ; " sv ch as London small beer ; but water pure and uncot ked is dangerous. This opinion about; plain water was often expressed by physicians in his day, and probably originated in the fact that drinking-I water, in London and elsewhere, was often very- impure, and really dangerous. Evidently, Sydenham, did not, like Prince Hal, think meanly of " the poor creature small beer" ; it must be remembered that the small beer of his day was a weaker beer than any one can easily obtain nowadays. Another anecdote bearing on the same subject is told on the authority of Charles James Fox, though whence he obtained it is not recorded. It says that Sydenham was sitting at his open window looking on the Mall (the south side of the street being not then built) with his pipe in his mouth and a silver tankard before him, when a. fellow made a snatch at the tankard and ran off with it. Nor was he overtaken, said Fox, before he got 188 HOME LIFE AND LAST Dl among the bushes in Bond Street, and there tney lost him. This is the only reference to Sydenham's smoking tobacco. He never speaks of it himself ; but it is not improbable that, like 'his great contemporary, John Milton, he indulged in the solace of an evening pipe. He was at this time living in the newly built street Pall Mall, next door to the " Pestle and Mortar." It appears to have been in that part of the street near the bottom of the Haymarket, and thus very close to the present College of Physicians. The " Pestle and Mortar " was doubtless the shop of Sydenham's worthy friend, Mr. Malthus, the apothecary, whom he mentions in his works, and made the guardian of his heirs, ancestor of the Rev. T. Malthus, the political econo- mist. As the south side of Pall Mall and Cockspur Street were not then built, the house must have looked straight into the Mall in St. James's Park. Very few details of Sydenham's home life have been recovered, but the fragmentary anecdotes which follow are of some interest. Beside his family, Sydenham sometimes had. pupils living in his house, one of whom was the well-known Dr. Dovar, buccaneer and physician, first compounder of the immortal "Dovar's Powder," land author of " The Ancient Physician's Legacy to his Country." Dovar has left a curious account of how he was treated for the Small-pox by Sydenham while living with him. It appears that he was not allowed to stay in 189 THOMAS SYDENHAM bed during the first part of the illness. Dov« in another place to " honest Dr. Sydenham." Another young man who might be called a as, according to Pulteney, he lived for a Sydenham's house, was Hans Sloane, aft knighted, a very distinguished naturalist as physician, President of the Royal Society anc College of Physicians, and the virtual foundei British Museum. [May we be permitted, in a word of grateful tribute to Sir Hans for the able medical library which he collected ? ] The story about Sloane is that when he < to London (in 1684 ?) after studying on the nent, he brought a letter of introduction to Sy The letter commended him as " a ripe scholar, botanist, a skilful anatomist." Sydenham pen letter, looked hard at the young man, and said "This is all very fine, but it won't do — An; Botany. Nonsense ! Sir, I know an old wi Covent Garden who understands botany bette for anatomy, my butcher can dissect a join well ; no, young man, all this is stuff : y go to the bedside, it is there alone you c disease." Allowing for the exaggeration which is ini all anecdotes, the story is not improbable. Sj however, was afterwards very kind to the r. young physician, and frequently made him panion in his favourite drive to Acton. 190 HOME LIFE AND LAS- occasion Sloane took the opportuni v ~. ^v...— & Sydenham about his project of a voyage to Jamaica for the purpose of studying plants. Sydenham kept silence till the coach stopped in the Green Park, where Sloane alighted to walk home, and then burst out : " No, you must not go to Jamaica ; you had better drown yourself in Rosamund's pond, as you go home." [Rosamund's pond was a piece of water in St. James's Park, a favourite place for suicides.] Sloane, however, did go to Jamaica, and with what important results to the science of botany is well known, as he brought back more new species of plants than any one person was known to have collected before. Another well-known doctor who, though not an actual pupil of Sydenham's, was greatly influenced by him was Sir Richard Blackmore, a popular physician in the times of Queen Anne and George I., and author of " Prince Arthur " and other dull epic poems now forgotten, and the butt of all the " wits," Black- more tells us that when a young man he asked the advice of Sydenham as to his studies, more especially as to what books he should read to gain a knowledge of medicine. Sydenham's reply is well known, " Read ' Don Quixote.' It is a very good book ; I read it myself still." The obvious meaning of this retort was : " Read what you like ; reading books will never make a doctor." Though Dr. Johnson, who repeats the story, has some ponderous remarks about the harm which such a flippant observation might do, it is 191 THOMAS SYDENHAM pleasant to think that Sydenham, like his friend Loci was an admirer of the immortal romance which in 1 day was, in English, something of a new book, i least a new edition of Skelton's translation came o when Sydenham was at the University. But it li been, quite gratuitously, supposed that the saying w intended as a sarcasm on Blackmore, whom it is sa Sydenham must have despised as a pedant and a pri The historical fact, however, is that Sydenham nev knew Sir Richard, or the author of these epic poen which, though praised by Locke, Addison, and Johns< were the target for innumerable arrows of sarcasm ai invective, since Blackmore did not receive the hono of knighthood, or publish his poems till some yej after Sydenham's death. Our good physician cou hardly have snubbed a young man for crimes he h; not yet committed. Blackmore, to him, was merely a young Oxfoi doctor (or perhaps an undergraduate) who very nati rally sought guidance in his studies from the gre physician. It may be observed, in passing, that Blac more, though he had the unusual honour of beir satirized by both Dryden and Pope, as well as by tl whole army of wits and playwrights, owed this err nence, not so much to the dulness of his poems as his vigorous onslaught on the immorality of the stag and especially to his " Essay on Wit," in which 1 boldly threw down the gauntlet to the whole litera tribe. 192 HOME LIFE AND LAST E Moreover, as a physician, his leanings were enureiy the opposite of what would be implied by the epithet of pedant or book- worm. Perhaps the shaft of Syden- ham's wit went home, and determined the future bent of his mind. At all events there was never a more thoroughgoing asserter of the uselessness of learning in medicine than was Blackmore in after years. He threw over all the classics, medical or lay, and renounced even the divine old man whom Sydenham almost worshipped, protesting that the writings of Hippocrates were of no value to a modern physician ; and thus going much beyond his teacher. " Assiduous digging," he says, " in the works of the eldest physic cians, is like delving for silver in the mines of Corn- wall, which will not recompense the labour and expense." It is amusing also to find Blackmore more than once quoting " the ingenious author of ' Don Quixote.' " Such was the effect of an obiter dictum of Sydenham's. One other pupil of Sydenham's may be mentioned — Bartholomew Beale, son of Mrs. Mary Beale, who painted Sydenham's portrait. He afterwards practised at Coventry. Another glimpse into Sydenham's life is given by Dr. Andrew Broun, already mentioned, who travelled from Scotland to become acquainted with Sydenham's methods of treatment. The most important parti- culars which he has recorded are mentioned elsewhere. We will only here observe that his visit took place in 193 o THOMAS SYDENHAM ,? the last year of Sydenham's life. Even then, he says the old physician, though honoured by the admiratioi of most of the eminent men of his own profession still felt bitterly the neglect and opposition which an elsewhere spoken of. As years passed Sydenham became more and mor< afflicted with the two diseases already spoken of. Hi found composition increasingly difficult and laborious and, we may suppose, was less able to practise hi profession. Still he persevered in doing good t< others and striving to advance the science o medicine. The last work, which he himself published, thi " Schedula Monitoria," begins with these words :— "Although my advanced age and constitution broken by continual maladies, might have seemei rightly to demand release from the labour of though and intense meditation, yet I cannot refrain fron endeavouring to relieve the sufferings of others evei at the expense of my own health." Its closing words which follow directions for the treatment of th painful disease from which he himself suffered, are " And this is about the sum of all I know respecting the cure of diseases, up to the day on which I write- namely, the 29th September, 1686." So Sydenham laid down his pen, and all we can sa; about the remaining years of his life is that he wrot no more. He died on December 29, 1689, at his house in Pal 194 HOME LIFE AND LAST D, Mall, and was buried, December 31st, in St. James's Church, Westminster, now generally known as St. James's, Piccadilly. The original monument or inscription which marked his grave having disappeared, a tablet was placed at the expense of the College of Physicians, with the following epitaph. Who actually composed it is not recorded, but very probably it was Sir Henry Halford, who inserted the fine phrase adapted from a line in Horace — " medicus in omne eevum nobilis " (" a physician famous for all time"). PROPE HUNC LOCUM SEPULTUS EST THOMAS SYDENHAM MEDICUS IN OMNE «T1IM NOBILIS NATUS ERAT A.D. 1624 VIXIT ANNOS 65. DELETIS VETERIS SEPULCHRI VESTIGIIS. NE REI MEMORIA INTERIRET HOC MARMOR PONI JUSSIT COLLEGIUM REGALE MEDICORUM LONDINENSE A.D. l8lO OPTIME MERITO. 195 XI Sydenham's Will — His Children and Descendants AN inspection of Sydenham's will shows that it was executed November 27, 1688. He orders '. that his body shall be buried where his executors shall • direct, without any pomp or great solemnity. His real estate in the counties of Leicester and Hertford is left to three trustees — Richard Lee and William Lawrence, his brothers-in-law, and Daniel Malthus the apothecary — for the use of his eldest son William during his life, and ultimately to his three children in equal shares, providing for the jointure of William's wife. The two younger sons — Henry, then in Spain, ~'i and James — were to receive ^200 apiece ; and an annuity of £25 was to be paid to the testator's . mother-in-law, Katherine Gee, during her life. After William Sydenham's death the rents of the Leicestershire property, of the yearly value of £iy-> were to go to his widow for life, and afterwards in 196 SYDENHAM'S WILL equal shares to his three children, whose names are given as Thomas, Barbara, and Henrietta Maria. The Hertfordshire property was to go to the three children in equal shares directly. Daniel Malthus was to be the guardian of these children during their minority, and was to receive j£io a year for his trouble. A sum of ^20 to buy him a piece of plate, in memory of the testator, was also left to this faithful friend, with warm expressions of confidence and friendship. Another legacy of ^30 was left to James Thornhill, son of Mary Thornhill, the testator's niece, to bind him apprentice to some profession or trade. The whole personal estate was left to William Sydenham, who was made the sole executor. By a codicil, dated November 29, 1689, the yearly sum payable to Daniel Malthus was reduced to £5 instead of £10, in consideration that the larger sum might be too great a charge upon the estate. Also Henry Sydenham's portion was reduced by ^50, which . had been already given him for an " adven- ture." The general effect of the will was that Sydenham, according to the custom of the day, left nearly every- thing to his eldest son, the two younger receiving only small portions. But as there was no preference given to heirs male in the next generation, it is evident that Sydenham did not entertain the ambition of "founding a family." 197 THOMAS SYDENHAM The total value of the estate is not given, but as thi Leicestershire property alone was worth in moden money about ^400 a year, it is clear that Willian Sydenham was well provided for. At the same timi the whole estate probably did not represent a largi fortune for a successful physician. With respect to the persons mentioned in the will we may observe that Henry Sydenham was evidenth a merchant in Spain, , while James, the , younges brother, was possibly not of age when his father died as his portion was not to be paid for two years. James Thornhill, the great-nephew mentioned in th will, adopted the profession of painter, and was after wards well-known as Sir James Thornhill, an eminen artist in his day, who was employed in decorating th interior of St. Paul's Cathedral. His daughter marriei a greater artist, William Hogarth, and thus anothe eminent name is introduced into the Sydenhari pedigree. Daniel Malthus was an apothecary, Sydenham' neighbour in Pall Mall, and his intimate friend, wh probably owed his success 'in business largely to th patronage of the great physician. His son, christens Sydenham Malthus, was the ancestor of the Rev Thomas Malthus, rhe political economist, author c the celebrated "Essays on Population." Our knowledge of the family and descendants c Sydenham is very scanty. The only son whos fortunes can be traced further is William Sydenham 198 SYDENHAM'S WILL and but little is known about him. He must have been born about 1656 or 1657, anc * became in or about 1674 a pensioner of Pembroke College, Cam- bridge, the same college with which his father was incorporated in 1676 for the purpose of taking his doctor's degree. Dr. Munk, in his " Roll of the College of Physicians," states that William Sydenham seems to have left the University without taking a degree either in Arts or Medicine, but- obtained a doctor's degree from some foreign University and became Licentiate of the College of Physicians November 29, 1687. In 169 1 he presented a portrait of his father to the College. He certainly practised as a physician, whether in London or elsewhere we cannot say. He appears to have died about 1738, as in that year his name disappears from the College List. We find that a Mr. William Sydenham was buried at Toller Fratrum in 1740, which may have meant the doctor, but possibly it may have been a cousin. Sydenham took a great interest in his son's pro- fessional career, and compiled for his use his posthumous work, the " Processus Integri." William Sydenham published in 17 19 a little book entitled " Compendium Praxeos Sydenhami," containing a few emendations to the book just mentioned, and some additional formulas derived from his father's manuscripts. It is a mere collection of formulae in Latin, containing no original matter. An introduction was supplied by Dr. Walter Harris, an enthusiastic 199 THOMAS SYDENHAM ' -' admirer of the great Sydenham. Harris congratulates William on desiring to show himself worthy of so great a father, and also on this : that, beside being the inheritor of his father's talents, he had prolonged the paternal race by being the father of a numerous pro- geny. It would appear, therefore, that there were other grandchildren besides the three mentioned in Sydenham's will. Among the grandsons we hear of Theophilus Sydenham, who gave a portrait of his grandfather to the College of Physicians in 1748. In the Gentleman's Magazine for March, 1775, is a notice of the death of John Sydenham, Esq., the "only surviving grandchild of the celebrated Dr. Syden- ham." This is the latest notice of the family we have been able to find. Possibly there are descendants of Sydenham still living, but we have not succeeded in tracing any. 200 XII Sydenham's Posthumous Works IF we were asked which of Sydenham's works has been most popular and has had the most in- fluence, we should have to mention the small work published after his death, entitled, " Processus Integri in morbis fere omnibus curandis," London, 1693. (" Complete methods for treating almost all diseases.") The history of it is interesting. This little com- pendium (for it is a tiny volume) was written out by Sydenham for the use of this son, but delivered for safe keeping to a friend, Dr. Monfort, who edited and published it. Monfort first had about twenty copies printed for distribution among private friends. In some way a copy came into the hands of the publishers of a German erudite journal, the Miscellanea Curiosa of Nuremberg who reprinted it in their journal, but in an inconvenient form. Monfort thereupon, with the approbation of the College of Physicians, published a regular edition 201 x nwivi/\o o i un.iv n/vivj. in 1693, which was followed two years later second. The success was remarkable. Salmoi English translator, tells us that "many thous of these two Latin editions were sold. The E translation, called " Dr. Sydenham's Practii Physick," appeared in 1695, and probably ha a large sale. This was a remarkable success medical book in those days. Very numerous e< have since appeared, both here and on the Conti This little volume was the Vade Mecu English physicians for more than a century, present writer can even remember an Oxford rr student who, in his admiration for Sydenham, mitted large portions of the " Processus Integi memory. It is right to say that his example w generally followed. Certainly nothing could be more suited tc guide for practice, since it consists of an abrid: of all Sydenham's precepts on the treatment of d omitting explanations and discussions, so as reduced to the smallest possible compass, abridgments are generally the work of com] rarely has a great writer himself prepared s concentrated essence of his own works. In the second and subsequent editions are two short chapters, one on Phthisis, the otl Gout. The former must have been extractec translated) by Monfort from Sydenham's MS., it agrees very closely with an English chap 202 SYDENHAM'S POSTHUMOUS WORKS the Oxford MS. elsewhere spoken of. The chapter on Gout is essentially an abridgment of Sydenham's " Tractatus de Podagra." It mentions how Syden- ham (spoken of as " autor clarissimus ") treated himself for the Gout. This has been supposed by a modern writer to show that the " Processus Integri " was not Sydenham's own composition. But the explanation is obvious. " ANECDOTA SYDENHAMIANA." Some other medical observations of Sydenham's, not published till the year 1845, have a curious history. The late Dr. Greenhill, one of the most learned physicians and most exact medical scholars that this country ever produced, discovered among the Rawlinson MSS. in the Bodleian Library a small volume inscribed, " Extracts of Sydenham's Physick Books and some good letters on various subjects," which contains notes on various medical topics. The writer wasr evidently well acquainted with Sydenham, and states that he compiled these notes partly from Sydenham's dictation in the years 1682-3, anc * P art ly from certain MS. notes of Sydenham's to which he had access, written before 1670. On this evidence, together with remarkable coincidences between these notes and other passages in Sydenham's printed or imprinted writings, there could be no question of their authenticity. But Mr. Fox Bourne has since added a new interest to this MS. by showing that the 203 THOMAS SYDENHAM whole is in the handwriting of John Locke, with whic Dr. Greenhill was not acquainted. It was print< with the title, " Anecdota Sydenhamiana, Medic notes and Observations by Thomas Sydenham, M.E hitherto unpublished." Oxford, 1845 ; the edito Dr. Greenhill, modestly concealing his name. The book is partly in English, partly in Latii The English portions, which have only an occasion Latin sentence, are said to be copied from Sydenham own notes, and are evidently his own compositioj These portions agree in subject with parts of tl " Processus Integri," and partly with the Englis MS. of the College of Physicians elsewhere spoke of. The Latin portions are for the most part sa: to have been taken from Sydenham's own lips, an therefore, what the original language was may I uncertain. But as all the connecting words an sentences are in Locke's Latin, we must suppose thi he was responsible for the whole of the Latii Locke probably wrote ordinary Latin as fluently ; English, but Sydenham seems generally to have use English for recording his observations. As in evei other case known to us, all that Sydenham writes is i English. As an example of Sydenham's less usual methods 1 treatment, we may quote the "Methodus Meden morbos per accubitum junioris" ("Putting a chi or young person to bed with an invalid ") ; with tl idea apparently that the natural heat of the huma 204 SYDENHAM'S POSTHUMOUS WORKS body had some specific virtue. Several cases are recorded in Sydenham's own English. "One Mr. Little had a fever about seven weeks, and at the time was so far spent that his doctor judged him a Dead Man. He was ancient, and having been treated with violent medicaments, was as weak as ever I saw any that recovered. Other treatment having failed, I told his wife that nothing could preserve his life but the putting a boy to bed to him. So she procured a Link Boy to lie very close to him all night. The next morning I found his fever almost off, and his eye and countenance more lively, upon which I pronounced all danger to be over. Yet afterwards, upon the recess of the boy, he began to relapse, but the boy being got again, without any more treatment he" perfectly recovered." The same way he cured Bishop Monk's lady, an aged woman of a very feeble and thin habit of body, so weakened by an Ague that her physicians looked upon her as dead. Sydenham told the doctor nothing could save her life but a speedy transplantation of some young spirits upon her. Accordingly a girl of thirteen years was put in close to her breast, upon which she recovered very speedily. Unfortunately the girl fell sick, which was attributed to her lying with the lady ; but Sydenham was confident to the contrary, and the girl in the end got well. These cases may be regarded as among the curiosities of medical practice. 205 t THOMAS SYDENHAM One very remarkable statement is made ab( certain Tinctura Alexipharmaca D.D. Syder for which a very elaborate prescription is given, this Sydenham is made to say that when in Sec he used a gallon of it. No other allusion is kno^ Sydenham's having been in Scotland, but it may been when he was serving in the second War. One chapter on the Nephritic Paroxysm, said taken from a MS. of Sydenham's written in 16 literally the same as a passage in the MS. o College of Physicians, and must have been t by Locke from that — a coincidence which cor the authenticity of both documents. " THEOLOGIA RATIOKALIS." Among the writings of Sydenham unpub during his lifetime reference must be made manuscript treatise, entitled, " Theologia Ratioi by Dr. Thomas Sydenham. This was print Dr. Latham's English edition of Sydenham's from an MS. in tho Cambridge University Li Another copy, slightly more complete, is in the I Museum. Both are in a more modern handw than Sydenham's time, but the work must be sidered to belong to the author to whom it is attri unless any reason can be shown to the cor The work is a fragment of a Treatise on N Theology, designed to prove, on rational prin the existence of God and the immortality of the 206 SYDENHAM'S POSTHUMOUS WORKS and thence to deduce reasons for a virtuous life. The style and sentiments are perfectly consistent with what we know of Sydenham, and it seems reasonable to suppose that he was the author. But without discussing the matter, we will leave the reader to judge by copying the opening paragraphs. " The question is, how far the light of Nature, it closely adverted to, may be extended toward the making good men ? Toward the determining of which, this is all that shall be taken for granted by me, viz., that he is a wise and thinking man, whoever he may be, that sets upon this enquiry. " Such a man must needs think thus with himself. I see that there is a most perfect and exquisite order in the several natures of the world fully conducing to / ( i the preservation of their individual beings^ and to the ' propagation of their kinds. In all which they con^- ' / tribute nothing themselves by their own counsell or contrivance, as not knowing how they are made or how continued in their beings. And therefore I am enforced to think that something which is par- taker of admirable wisdom and power is the contriver and maker of them. But further, considering not only the artifice, by which these particular bodies which I see and converse with are made with respect of each of them to its self ; but likewise that artifice, by which each of them hath some subservience one to another for safeguard, food and other convenience, I am still led into greater certainty, that there was ., 207 lriUMAS SYJJ-fcJNriAM some Supreme Nature which (without and from all these) did as he made them so, put t this order in reference to one another. " But extending my thoughts yet further, sidering those innumerable and immense bodies which I can take in with my natural those yet as many more which I can take in help of glasses, and all these put and pre; motion so swift and regular, both for the cor of each of themselves, and for the convenieni whole, as cannot enter into the heart of tl man to conceive ; how can I less doubt the a nature infinitely wise and infinitely pow whose contrivance hath been performed am tinued the exquisite order of the stupendous the Universe, than I doubt my own being ? " . . . In a word, there being such orde particular bodies, whether sublunary or celes in reference to one another and to themselves being the least footsteps of counsel 1 or reas found in any of them, by which they can c any thing toward the production of this ; order which we call Nature ; the same mu contrivance of a wise powerful being, both them and in a condition above them, whicl God." Very few of Sydenham's letters have been j We are acquainted with four only beside the Boyle which is printed in Boyle's works. 208 SYDENHAM'S POSTHUMOUS WORKS in the British Museum ; one (to Locke) among the Shaftesbury Papers at the Record Office. One was in the possession of the late Dr. Munk, and a photo- graphic facsimile of it was published by the late Sir B. W. Richardson in his " Asclepiad." There is also a Consilium by Sydenham, on the case of Lord Shaftesbury, among the Shaftesbury Papers. 209 XIII In what Language did Sydenham Wi THE question in what language Sydenh wrote his books is a very curious one been much debated. They were all publi Latin, as we have seen ; the English version appeared later being direct translations fron Since nearly all books written by physicians t out Europe were in Latin, there was nothing ing in this, and it had the great advantage of his works at once available for the whole world. Only surgical books and popular trea health, with the little pamphlets of the quae] in English. Moreover, Latin was the current of Universities and learned bodies everywhere, proceedings, debates in convocation, dispi examinations, and many lectures were always the learned language. The Register and A the College of Physicians were kept in Lati the end of the seventeenth century, when Eng used on the recommendation of the legal adi 210 IN WHAT LANGUAGE DID HE WRITE ? the College, in order to avoid the uncertainty arising from the ambiguity of many Latin phrases. The annual Harveian oration was given in Latin up to the year 1865. Harvey's own notes for his lectures on anatomy are still extant, and are in Latin, though he now and then breaks into English under the exigency of some difficult point. At the hospitals physicians used to dictate Latin notes of their cases, for we hear that at the beginning of the nineteenth century Dr. Wells of St. Thomas's Hospital was noted for the elegance of his Latin as compared with that of his colleagues. In the Universities the custom was of course still more general and permanent, so that in Sydenham's time a sort of colloquial knowledge of Latin must have been essential for taking part in any University pro- ceedings. To this day a speaker in Convocation at Oxford is supposed to ask leave to speak in English. On the Continent the custom of lecturing in Latin has quite recently died out. Within the memory of living men, one of the formal lectures on medicine in a German University was always given in Latin. The present writer has heard a hospital physician in Vienna use Latin when speaking by the bedside if there was anything he did not wish the patient to understand ; and since such remarks were often of ominous meaning, it used to be said that when the patient heard the doctor talk Latin, he thought his case was hopeless. 211 THOMAS SYDENHAM Now from all this it is clear that a regular phj educated at a University was naturally expected able to express himself by speaking and writ; customary Latin ; and therefore the presur would be that Sydenham, an Oxford graduate wl also studied at Montpellier, was a sufficient schc these purposes. But in Sydenham's case there are certain diffi which must be considered. In the first pla< undergraduate education amounted, as we havi to almost nothing ; and even the story already about his reading Cicero after he had taken his i shows that he must have been conscious of h perfect scholarship. No doubt Sydenham was, the least, a vefy clever man, and would have better use of his opportunities than the average s but in his second Oxford career he could hardl had much time for purely linguistic studies. These facts, together with certain positive tions to be mentioned presently, must be alio' weigh strongly in the direction of proving that not a finished Latin scholar. There are, however, some important argum facts showing that he had a wide acquaintanc classical literature, as is seen from the allusions published works. He quotes not only the best- classical writers, but some comparatively obsci shows a range of reading which is more litera professional. Of the ancient medical authors hi 212 IN WHAT LANGUAGE DID HE WRITE ? two only, Hippocrates and Galen ; the former very frequently and often with some laudatory epithet, the latter only three times and on minor points. Aristotle is quoted once only. Aretaeus and Celsus are never once referred to. The allusions to and quotations from non-medical classics are more numerous. Cicero was Sydenham's favourite author ; he calls him ." the author I most admire, as the great teacher both in thought and language, the first genius of his own and perhaps of all ages." Besides him we find named or quoted Homer, Lucian, Theocritus, Virgil, Horace, Lucretius, Juvenal, Seneca, Persius, and Boethius. Among modern Latin writers the names of Politian, Scaliger, and Bacon occur. In addition we frequently come across current classical phrases, or in modern language " tags," some of which Sydenham's learned editor, Dr. Greenhill, has traced to the Adagia of Erasmus. Perhaps some of the minor classical quotations may have been derived from the same, or from similar sources. Now even allowing that some of the quotations were made at second hand, it is clear that this shows a wide range of classical reading, and if wide reading implied a corresponding ability in composition there could be no question of Sydenham's competence to write his own works in Latin. But we know that being able to read a language and being able to write it arc by no means the same thing. 213 THOMAS SYDENHAM On the other hand, there are several positive ments that Sydenham wrote originally in Englisl had his works put into Latin by others. Th< occurs in the pamphlet by Henry Stubbe, al mentioned. Quoting a sentence from Sydenha says, " Tis true he did not pen it in Latin, but ar (Mr. G. H.) for him ; and perhaps his skill ir tongue may not be such as to know when his the are rightly worded." This is, of course, rude meant to be disagreeable, but it is difficult to su that Stubbe merely invented the story. " M; H." evidently means Gilbert Havers, of T College, Cambridge, of whom we hear again. The second statement on the subject is a definite one. Dr. John Ward, in a well-known the " Lives of the Professors of Gresham Coll published in 1740, asserted that Dr. Sydenham's ' were written in English and translated into Lat Dr. Mapletoft, one of his medical friends, and Havers. This statement having been challe Ward replied in the Gentleman's Magazine, and supported his position by the evidence of the John Mapletoft, son of the doctor, who testifiec his father claimed to have translated all Syden works contained in the volume of 1683. This v( includes all the works published in the author's time, except the " Schedula Monitoria," whicl younger Mapletoft had heard on the authority o Montfort (editor of the " Processus Integri ") to 214 IN WHAT LANGUAGE DID HE WRITE? been translated by Mr. Havers. He excepted the first book on the Treatment of Fevers (1666), because at the date of its publication Dr. Mapletoft did not know Sydenham. But this is the very book to which Stubbe's rude innuendo above quoted refers ; so that these statements of Mapletoft and Stubbe, taken together, cover the whole of the works published in Sydenham's lifetime, and positively assert that they were not written in Latin by Sydenham himself. The posthumous " Processus Integri " is said to have been printed from Sydenham's own manuscript, but this is almost entirely taken from his previous works ; and so, though it is in Latin, it hardly raises the question of authorship. It is difficult to see what can be said against statements as positive as these. The only definite assertion of Sydenham's having written Latin is a report at second hand that a number of letters written by him in elegant Latin, addressed to Dr. Baldwin Harney, were still extant in the eighteenth century. But these letters can no longer be found, and though many letters addressed to Harney are preserved in the College of Physicians, there is none from Sydenham. It is curious also that every scrap of Sydenham's handwriting now known is in English. The most important manuscript in English bearing Sydenham's name is one in the library of the College of Physicians. As to the authorship there can be no doubt, though the identity of the handwriting is open 215 ' r "C THOMAS SYDENHAM to question. It is entitled, " Medical Observati Thomas Sydenham, London, Martii 26, 1669. has a characteristic Sydenhamian motto, " Wha thy hand findeth to doe, doe it with thy n (Eccles. ix. 10). It might be supposed " that we have he: original of the Latin " Observationes Medicas " o but it is not precisely this. Still less is any pan as Dr. Latham strangely suggests, a translatio the Latin. Evidently it is a rough first skel that work, containing observations written at times, which were afterwards used, with more alteration, in composing it. There are also p which first appeared in the " Epistolas Respon published in 1680, relating to the Venereal Disi We will venture to quote the preface, which partly the same as that afterwards prefixed to th " Observationes," but written in Sydenham's style, and so characteristic, that were it disc anywhere as a fragment, no one at all acquaint our physician's writings could doubt the aut for a moment. THE PREFACE. " Thus I think I have my being upon this triall orbe which is both situate and as it were out at vast distance from the glorious region < and life, and likewise in a continual flux and rt all and every of its parts. Nor doe I only live 1 216 IN WHAT LANGUAGE DID HE WRITE ? but weare also a body that is made up of the grosse and vile parts thereof, and is necessarily determined to that suddain change and dissolution whereunto the laws of its constitution have subjected the whole. " But nevertheless I have an intellectuall nature, which incessantly aspires after another and that a more happy state of being, and besides its know- ledge of a future happiness is furnished with faculties suited to the attainment thereof, if in compliance with the revealed will of God in Christ, and the innate laws of its owne originall purity it shall vanquish the irregular suggestions of my body, to which for a while it is coupled : and managing both its selfe, and that, under a due obedience to that will and those laws, shall employe the utmost faculties of both in adoring the supreme and ineffable being, in the practising of virtue, and in doing good to men. This being soe, I finde it highly imports me, as I am a Physician, not only with all my might to buckle to an industrious management of my calling for the present benefit of my patients, but likewise to the dayly improvement of the faculty its selfe, for the more universall benefit of mankinde when I shall be dead. In compliance, therefor, with the sense I have of what is my duty herein, I shall, God willing, set downe the most usefull observations which I have or shall make touching diseases or their cures. As to the faithfullnesse wherewith I shall doe the same I shall not need therein to beg the good opinion of any 217 THOMAS SYDENHAM man, by saying I should be afraid of anything '. write to entaile upon my selfe the deaths of men when I shall be in my grave ; but shall appeale i observations of others (provided they be not i ficiall), for the justifying my owne : as I can lik doe to my owne conscience, for the single aime ] at the benefit of maftkinde herein : being sensibli I have not been intrusted by God with these t or skill how meane soever they are which I received, to lay them out as I list either toward acquiring riches or applause but to doe good i world. But be my end what it will, sure I am do here in a little present even to the ingrateful supine the product of all my great and soare t both of minde and body, and perhaps in the mean* am so well acquainted with the customes of this world, that I looke for noe other reward here for I doe than their reproaching and vilyfying my lal But 'tis noe matter, I expect my reward in a 1 state of being, and in a world where I shall be ca of true felicity, in which neither the aire nor di this could have instated me." We will give also two or three sentences fror work itself, which are really the originals of pas in the " Observationes," and see how they bear o question of language. It seems clear that Syde] wrote a plain English style, which was rendered ambitious and rhetorical Latin with many u 218 IN WHAT LANGUAGE DID HE WRITE ? ornaments, for all of which the translator must have been responsible. For instance, Sydenham speaking of fevers, observes that they differ from each other in successive years, unlike other diseases, and unlike species of vegetables which are the same in any year whatsoever. He gives two reasons in support of this, and then says : — " Both which doe evince that they are of a quite different genius and nature." This plain sentence appears in the Latin as follows : — " Ex quibus constat morbos hosce utut quadantenus specie et symptomatis alienae admodum esse indolis et distare ut tsra lupinis." This last phrase, "as different as coins from Lupines " (flat seeds which were used on the Roman stage as substitutes for money), comes from Horace, and is just one of the traditional quotations, or " tags," with which a conventional Latin writer would swell out his phrase. It is not in the English, and was clearly added by the translator. So in speaking of Measles, the English MS. says quite simply : " This disease begins with a rigor and horror, and an inequality of heat and cold, which the first day several times succeed one another." In the Latin this passage appears as follows : — A rigore atque horrore, calorisque et frigoris, quse se mutuo primo die expellunt, insequalitate tragadiam ordltur. 219 THOMAS SYDENHAM i " It opens the tragedy with shivering and shs and interchange of heat and cold, which on thi day drive each other out in turns." It seems a very pedantic way of speaking of M to call it a tragedy, or tragic spectacle ; but this of pedantry is due to the translator, not to Syde Many other instances of the rhetorical expans a plain English phrase might be quoted. The natural inference would be that the Lati with its characteristic rhetorical style must hav« the work of Mapletoft and Havers. Dr. Latha compared the style of some public lectures c Mapletoft's with the Latin Sydenham, and f great resemblance between them ; a certain idiomatic Latinity " being, he thinks, characteri both. He also gives a curious coincidence i matter more than verbal, which it is needless to here. The style in the works of which the tran is attributed to Havers is, however, simpler. The conclusion of the. whole matter seems that even supposing Sydenham to have been ; write Latin of a sort, in private letters and so he was diffident of his own powers ; and. in imf works, intended for the learned world, he had re to the services of better Latinjsts than himse chose Dr. Mapletoft as being a friend, and also t he had a reputation for writing elegant Havers, not being a doctor, was doubtless em as a professional scholar., 220 IN WHAT LANGUAGE DID HE WRITE ? It is needless to inquire why Sydenham did not acknowledge his obligations to his Latin translators, but probably it would not have been thought by any one at that time a matter of great importance. It may be thought that this question of Sydenham's style is not now of much consequence. But it must [ always be a matter of interest to know whether we have before us the actual words of an author whom we admire or the words of some one else. To some readers it has appeared that the pretentious and artificial style of Sydenham's Latin works is both tiresome and unattractive in itself, and not what we should expect from the author's simple and manly character. It is a satisfaction to know that it was not our English physician's own language. The pedantry and rhetoric belonged to the translator. Of Sydenham's English we have no specimen which was actually prepared for the press, and it would be hardly fair to take the rough notes above referred to as what he would have finally approved. The sentences are sometimes terribly long, and the syntax involved, if not questionable ; but these blemishes might have been removed by the press-reader, if not by the author himself, before publication. When combined, as they unmistakably are, with rugged force, and occasional picturesqueness of expression, and with sudden outbursts of religious feeling, the style is characteristic of his age and of his party. 221 XIV Sydenham and Hippocrates SYDENHAM, as we have seen, prided hirr studying diseases without any preconceive thesis, and recording plain matter of fact. N< these were his aims, and he succeeded to a ver extent in attaining them. But had he su< completely he would have done more tha observer of Nature has ever achieved. The a to look at nature without prepossessions, and to only so-called " facts " without explanation, is a: No one has ever completely realised it. We avoid using the forms of thought bequeathed predecessors, looking at Nature, so to speak, t their spectacles. The very words Disease, Epidemic are the outcome of a long pro* observation and deduction. To say that a pati a fever is a complicated inference, far indee being plain statement of " fact." Sydenham in studying disease carefully j 222 SYDENHAM AND HIPPOCRATES , himself against being biassed by the hypothetical explanations current in his day. He would not accept the traditional classification of fevers derived from old Greek and Arabian medicine. He refused to regard Fever as a mere process of fermentation, like the chemical school, or as resulting from the collision of discordant particles like the mechanical school. But to avoid making any assumption as to the nature of disease generally, or of Fever specially, was beyond his power. He was obliged to take a great deal for granted. The "heir of all the ages," coming after a long series of investigators and thinkers, must do so. What Sydenham took for granted was the medical system of Hippocrates. He showed no respect for and hardly quoted any other ancient writer, and passed by the moderns in still more contemptuous silence. It is hardly too much to say that Sydenham regarded the "divine old man" as not only the earliest but the only physician before himself who had been quite on the right track. Later physicians had all erred more or less, though in the course of their wanderings they might have picked up some valuable truths. It seems worth while, then, to inquire for a moment what it was in Hippocrates that Sydenham valued so highly. The one feature in the Hippocratic writings (it is still difficult to say what Hippocrates actually wrote) which distinguishes them from many other ancient medical classics •■• is that they contain a large number 223 THOMAS SYDENHAM : ; of direct observations on s*ick persons, histo cases, or, in modern phrase, clinical observ These records are of great interest, because the) what actually happened to the sick man, not i what the doctors thought about him. The show the materials or data on which medical tl and methods of treatment were founded. The ancient medical writings contain fewer such vations, partly because they are chiefly expositor the nature of text-books. The inference whicl modern writers have drawn (and apparently Syd did the same) is that the writings of Hippocrate founded on clinical observation, and the writi the others were not, an inference which app< the present writer not warranted. But thi question far too large to discuss here. At all < what Sydenham valued in Hippocrates w; abundance of clinical observation. Another feature of the Hippocratic writings had a great interest for Sydenham and for a Ion determined the whole bent of his medical a< was the celebrated treatise on "Epidemics,' taining observations on the prevailing maladies < year and season. So far as we know Hipp originated such observations, which have developed into the science of epidemiology, medical classics had added little or nothing work of Hippocrates, so that Sydenham mighl regard himself as the direct successor in this sul 224 ■r> ■ ' ■■ ■ •• •■■ ' ■• pp; SYDENHAM AND HIPPOCRATES the Father of Medicine. The only previous obser- vations on the subject in modern times had been made by Baillou or Ballonius, from 1570 to 1579, but there is no evidence that Sydenham knew of them. If what has been here sketched out were the whole system of Hippocrates, and if our idea of him were to be founded on these features alone, he would appear as a pure clinical observer, collecting observations and drawing inductions after the manner of modern science. Some have thought that this is what he was and nothing else, but there was quite another side to Hippocrates which should not be forgotten, the dogmatic side, and with this also Sydenham was concerned. Hippocrates was regarded in antiquity as the founder and chief of the dogmatic school of Medicine. He taught an elaborate system of medical theory, certainly not derived from experience alone, but from speculation also. This system explained diseases as disturbances of four imaginary "humours" or elementary principles or the body : their concoction or digestion, the production of a determination or "crisis," the discharge of a morbid material, and so forth ; much too large a subject to discuss here. This, the so-called Humoral Pathology, has utterly passed away, and it is difficult for the modern man even to understand it. But it was accepted without question by Sydenham, who generally used the traditional terminology of this system in describing 225 Q THOMAS SYDENHAM any disease. Perhaps it would have been dii use any other expressions ; and Sydenham rr treated the system as a sort of " working hyp But it is notable that he never regards the Hi] dogma as a hypothesis like the modern hj and speculations against which he was so inveighing. One principle derived from Hippocrates oc important a place in Sydenham's method, that be separately spoken of. It is the famous that " Nature cures diseases," not found pre those words in Hippocrates, but deducible fi or three expressions somewhat like it. The i vis medicatrix naturte^ in some form or other, vailed all over the world. It merely expresses that most diseases come to an end, and rr people recover without the aid of art ; and : cause of recovery being apparent, we say that cures the disease. But what was meant by Hippocrates and S' was something more definite ; it was that th by which Nature effects her cures are certai processes constituting the disease, while other are the effect of the disease itself, and merely i How were the two kinds of processes to tinguished ? The salutary processes or natural methods were those by which something, presum matter causing the disease, was eliminated or 226 SYDENHAM AND HIPPOCRATES of the body through some of the natural channels, producing various morbid discharges. The Hippo- cratics thought they observed that such discharges often occurred at the turning-point or crisis of the disease. Hence they talked about critical evacuations, critical sweats, and so forth, and stated or implied that such processes were followed by recovery. By these considerations we can understand Syden- - ham's famous definition of a disease as "an effort of ■ Nature^ striving with all her might to restore the patient by the elimination of the morbific matter." This might seem to apply only to acute diseases which have a natural termination. But Sydenham applied it to chronic diseases also. He thought that Gout was the effort of nature to get rid of a dele- terious substance which it could not eliminate ; by removing it from the blood and storing it away in parts of the body where it could do less harm. To these natural instruments of cure, Sydenham, with extraordinary insight, added another, namely, Fever. He held that the production of excessive heat was a means by which Nature neutralised the injurious matter causing acute diseases, and doubted whether such a disease ever got well without Fever. This idea, almost unintelligible to his contemporaries, has re- curred in the most modern Pathology. This general idea of Nature's method of cure was of course not peculiar to Sydenham, but he stated it with remarkable clearness, and made it the foundation of all 227 THOMAS SYDENHAM * his treatment of disease. The aim of the p should be to recognise Nature's curative met support and strengthen them if they appea weak, to control them if they were violent physician had thus to be the critic as well servant of Nature. Whether these concep: disease and of treatment are true or adequati not propose to discuss. It is only necessary sider how they influenced Sydenham's practice (excepting specific remedies) was based on this { alone. First it was an essential preliminary that should be minutely studied. There should 1 plete histories of all diseases, and in writing tf author should carefully put aside every philo hypothesis whatever. Moreover, these desc should be as accurate and minute as possible ; painters in their portraits represent every m freckle, for some things which seemed slij trivial might have important bearings. Ah should not be histories of particular cases mere like the descriptions of botanists, comprise the u characters of each species. By a careful induction of all these particu physician was to arrive at a general methodus i or method of treatment for such diseases. This is a broad outline of Sydenham's me inquiry and system of treatment. We see himself professed to derive it from Hippocrates 228 SYDENHAM AND HIPPOCRATES were merely carrying on the work of the Father of Medicine. But Sydenham greatly extended the method of Hippocrates. He may be said to have been the first who explicitly laid down the principle that disease should be studied by the Natural History Method, like Natural objects, without trying to explain them. The method of most of his con- temporaries was to try to explain all morbid processes by some chemical or mechanical theory, and to guide their practice by these explanations. Sydenham - would have said, "Investigate first, explain afterwards if you like ; but remember that Nature is always something very much greater than all your ex- planations." He was never tired ot saying that human faculties are quite incompetent to know the primary causes of natural phenomena. We may know the secondary or "conjunct," that is, proximate causes ; in modern language, the immediate antecedents of any physical event, but the true causes are beyond our ken. It may be that Sydenham underrated the value of ex- planations or scientific theory in medicine. The science of Physiology which he undervalued is essentially an attempt to explain the processes of life and disease by wider generalisations, called physical laws. And physiology has had a far greater influence on the progress of medicine than Sydenham ever dreamed of. Still the lesson most needed by his con- temporaries was that the premature attempt to apply 229 THOMAS SYDENHAM chemical, mechanical, or physiological theoi medical practice was misleading and pernicious enforced this lesson not only by precept, t example, showing that the method of Hippc who knew nothing of the modern sciences, w fresh and living, and capable of leading to ne fruitful developments in medicine. Next to Hippocrates the name of another genius should be mentioned as having exen powerful influence on Sydenham, namely ] Bacon. Sydenham had a profound admirat: Bacon. He never quotes or mentions him v praise and respect. There is no doubt tr Sydenham, as by his contemporaries, the n science who founded the Royal Society, Bacc regarded as the great innovator who had introc new spirit into the investigation of Nature. C the poet of the Royal Society (who was hii Doctor of Medicine) has expressed this sen tin unmistakable terms. It is the more necess state this because the tendency of late years, esj in England, has been to depreciate Bacon, question his influence on the progress of scienc saying this we do not pretend to estimate the { of Bacon among philosophers, but only to em the historical fact that his writings had a p< effect in stimulating research, especially in the : tion following his own. As regards Sydenham 1 it might even be suggested that the germ 230 , SYDENHAM AND HIPPOCRATES Hippocratic and natural method is to be found in a passage in the "Advancement of Learning," where Bacon laments that modern physicians have discon- tinued "that profitable and accurate diligence of Hippocrates, whose custom was to set down a narrative of the special cases of his patients," &c. There is another passage from Bacon, quoted by Sydenham himself and bearing on the same subject. We do not know that Sydenham consciously followed the advice of Bacon, but the tie of intellectual filiation cannot be overlooked. Besides Hippocrates and Bacon we cannot trace the influence of any earlier thinker on Sydenham's scientific method, but no doubt he would himself have named Cicero as the third great teacher from whom he had learned. He calls him " that Great Master of Thought and Language," as he calls Bacon " that Great Genius of Rational Nature." Beyond these three we do not discern any one to whom Sydenham acknowledges any intellectual debt. Among his con- temporaries he has words of praise for many, but only Boyle and Locke seem to have made a deep impression upon him. The significance of frequent intercourse with two such active intellects can hardly be over- rated. Sydenham's originality. Though Sydenham prided himself on being the disciple of Hippocrates, and was, in a minor degree, 231 THOMAS SYDENHAM the follower of Bacon, he certainly possessed the of distinct originality. The independence of tr rebel was still there. He separated himself fro contemporary schools. The old traditional spi respect for antiquity, with a dislike of innovation evidently far from him. But it must be admittei .. there were few genuine medical conservatives i day. He was equally out of harmony with Chemical school, represented by Willis, the great his contemporaries ; thinking that they dealt speculative ideas, which degenerated into mere " ^ catching," or verbal disputes. For the same reas< could not accept the Mechanical school represent! other contemporaries. But it is more remarkabli he failed to perceive the importance of Anatomy Physiology. He spoke with great contempt of M Anatomy, that is, the investigation of changes ir body produced by disease, or themselves prodi disease. In a projected treatise on Medicine, the production of Locke and himself, still extant in in the Shaftesbury Papers, these words occu Sydenham's own handwriting : — " Others have more pompously and speciously p cuted the promoting of this art (Medicine) by se; ing into the bowels of dead and living creatures, as sound and diseased, to find out the seeds of di destroying them, but with how little success endeavours have been and are likely to be attendi shall in some measure make appear." 232 SYDENHAM AND HIPPOCRATES We do not know what arguments Sydenham meant to use, as this treatise was never completed, but subse- quent experience has shown that here Sydenham was • mistaken. Researches in morbid anatomy have had an immense influence on the progress of Medicine, and especially in the discrimination of diseases, which was one of Sydenham's main objects. The kinds of fevers which he so carefully investigated' have only been clearly distinguished by the study of anatomical changes in the dead body, quite apart from any theo- retical views. These prejudices show of course a certain limitation or narrowness of view, such as is so often seen in men of original genius, who, absorbed in studying Nature by their own methods, undervalue or even despise methods employed by another school. It is one of the privileges of genius to be in this sense one-sided ; the eclectic philosopher who carefully avoids this fault often shows other defects of a more serious kind. This blindness to the importance of the whole ana- tomical school, which, as we have said, meant in England the school of Harvey, is the only serious defect which can be found in the completeness of Sydenham's character as a Reformer of Medicine. But after all this fault had its compensations. The cor- rection which Sydenham applied to the anatomical school was probably needed. The anatomists and physiologists did little for practical medicine, and, what is more, seemed disinclined to study anything which 2 33 THOMAS SYDENHAM could not be put into a scientific shape. They ' to rationalise everything ; sometimes, as in the i Willis's Rational Therapeutics, they rationalised prematurely. Nothing could, on the other h; further from Sydenham's views than the attei reduce everything to a scientific system. He little for science in itself. Pure intellectual cu which after all is the mainspring of scientific re seemed to him, perhaps partly owing to the ] strain in his character, of little importance. He knowledge only either for its ethical value, as si torth the glory of the Creator, or for its p value, as promoting the welfare of man. The contrast which has been sketched out b the scientific school, of which Harvey was in E the founder, and the practical school of which ham is the acknowledged leader, might sug comparison between these two great glories of ] Medicine. The work of Harvey which has gone on up present day, producing new fruit, laid the fouj of that elucidation of the problems of' Life, w and always will be the basis of the scie Medicine. The great merit of Sydenham was to p the great truth that science was, is, and alwaj be incomplete ; and that danger lurks in the tendency to act upon it as if it were complete, practical man has to be guided not only by 234 ;C SYDENHAM AND HIPPOCRATES ': knowledge but by much that is imperfectly known. He must listen to the hints of Nature as well as to her clear utterances. To combine them may be difficult ; but the difficulty is solved in minor matters by the faculty called common sense ; in greater affairs by the synthetic power of Genius. These two currents of thought, the scientific and the practical, always have existed, and always will, in a practical science like Medicine. The daily work of every doctor has to do with both aspects of Medicine. We are happy in having before us two such great examples : Harvey the master of Science, and Sydenham the master of Practice. 235 XV Sydenham's Friends : Boyle, Locke, and o' WHILE Sydenham is so frequently compl; of the hostility which he encountered members of his own profession (though these : writings always remain anonymous) it is interest! record the warm and significant friendships i also fell to his lot. Of these the most important no doubt, the intimate relations which he estab with men so distinguished as Robert Boyle and Locke. The Hon. Robert Boyle was one of the most a perhaps the most so, of that remarkable groi scientific investigators who, in the- reign of Charle raised England to the foremost place among Eur nations in the pursuit of science, and gave their j a renown which has caused it to be often s] of, and very justly, as the classical age of Ei science. Boyle was about the same age as Sydenham, h 236 • SYDENHAM'S FRIENDS been born in 1626. We cannot say precisely when Sydenham first became acquainted with him, but in all probability it was during Sydenham's last year of residence in Oxford, where Boyle came to live in 1654, and joined himself to that scientific society of which we have already spoken. Boyle had been since ' 1646 engaged in chemical researches in London, being then connected with the earlier group of scientific inquirers in London known as the "Invisible College." While in Oxford Sydenham, as we have seen, was not specially connected with the scientific group, nor deeply interested in their pursuits. The mutual attraction between these two men would have depended upon a sympathy in general aims rather than on community of interest in special subjects. Both were investigators ; both were Baconians, and ready to defy the rule of authority in matters of knowledge. Boyle, too, we must observe, was above all things unprejudiced. He had leanings towards Alchemy and never quite repudiated a belief in the possibility of transmuting metals. In medical matters, which greatly interested him, he showed perfect tolerance towards those whom the profession called Quacks. In 1666 his name is found among those who attested the miraculous cures of one Valentine Greatrakes, a fantastic Irishman, who in a sense anticipated Mesmer and the Hypnotists ; curing various complaints by stroking and manipulations. And since,- according to 237 modern ideas, the " cures " of Greatrakes were by J means miraculous, herein Boyle showed only 1 scientific impartiality. This fact is not witho significance in regard to his attitude towat Sydenham. For when he appeared- -in the sar year as the patron (if we may say so) of Sydenhan Method of curing Fevers, his patronage of Greatrali may have diminished the value of his approval of tr work. We have already seen that in 1663, when Bo] was frequently, though not regularly, in London, did Sydenham a small service ; while his connectii with Sydenham's medical researches and with his fi] book have been already sufficiently discussed. Boyle continued to interest himself in Sydenhan practice, as will be seen by the following lett< written in the year in which Boyle eame to live London ; though it is evident that at this time he w still in Oxford. The book referred to was of com the second edition of the "Methodus Curandi Febre in which Locke's congratulatory Latin verses w« first published. The ironical references to " palmisl and chemistry " and the " Mountebank at Chari: Cross " are significant as bearing on what has be said about the medical charlatanry rife in Sydenhan time. The letter is printed in Boyle's works, and in I Latham's Life of Sydenham, but in the latter not qu correctly. 238 SYDENHAM'S FRIENDS We have not been able to trace any further correspondence between Boyle and Sydenham. " T>r. Sydenham to Mr. Robert Boyle. "Pall Mall, April 2, 1688. "Sir, — It had becomed me to have begged your • acceptance, when I took the boldness to tender to , you the. second edition of my book ; but partly business, and partly an unwillingness in me to give you two troubles at once, diverted me from writing. But now that you are pleased to give yourself the pains of a thanks, which I never thought myself capable of deserving from you, I hold myself obliged to return you my humble thanks, that you take in good part my weak endeavours, and are pleased to have a concern (as you have always done) for me. " I perceive my friend Mr. Locke hath troubled you with an account of my practice, as he hath done him- self in visiting with me very many of my variolous ;*> patients especially. It is a disease, wherein, as I have been more exercised this year than ever I thought I could have been, so I have discovered more of its days than ever I thought I should have done. It would be too large for a letter to give you an account of its history ; only in general I find no cause, from my best observation, to repent of anything said by me in my tract ' De Variolis,' but do greatly, that I did not .. say, that, considering the practices that obtain, both •v ; amongst learned and ignorant physicians, it had been 2 39 THOMAS SYDENHAM happy for mankind that either the art of phy never been exercised, or the notion of malignit stumbled upon. As it is palpable to all the woi fatal that disease proves to many of all ages, most clear to me, from all the observations tha possibly make, that jf no mischief be done, ei physician or nurse, it is the most slight and sai other diseases. If it shall be your hap to be se that disease (as probably you never may) I recommend to you, upon the word of a frie practice mentioned in the 155th page of my be " I confess, some accidents there are incident disease which I never was able to master, till 1 the end of last summer, and which, therefon not be mentioned by me, as a phrenitis coming eighth day, where the patient is in the vigour youth, hath not been blooded, and hath been 1 a dose from the first decumbiture ; as likewise is wont to be no less fatal) a great dosing, panied with a choaking respiration, coming o the tenth day (reckoning from the rigour and which is my way of accounting), and occasio the matter of a ptyalism in a flux-pox, baki: growing thick, as it declines and comes to a ( tion in those days. But, which is observab small-pox never fluxes or runs together, but been thrust out before the fourth day ; and wh see any eruption the first, second, or third da the decumbiture, you may safely pronounce it 240 1 ' SYDENHAM'S FRIENDS a flux-pox or a measle, for that sort, in its first appear- ance is like it. And, which is likewise observable in , the highest flux of all, as that which comes out the first or second day, it is in vain to endeavour the rais- ing them to an height, for it is both impossible and unsafe to attempt, but all the discharge there can be, must be either from a ptyalism, in a grown person, or a diarrhoea, in an infant, to whom the same is no more dangerous than the other to the former ; and, wherever they flux, their discharge must be made one of those two ways. But of these things I shall discourse to you more at large, when I shall have the happiness to see you, which I hope may be suddenly. " The town stands well in health, and at our end not anybody sick, that I hear, of the small-pox. I have much business about other things, and more than I can do, who yet am not idle. I have the happiness of curing my patients, at least of having it said of me, that tew miscarry under me ; but cannot brag of my correspondency with some other of the faculty, who, notwithstanding my profoundness in palmistry and chemistry, impeach me with great insufficiency, as I shall likewise do my taylor, when he makes my doublet like a hopsack, and not before,- let him adhere to what hypothesis he will. Though yet, in taking fire at my attempts to reduce practice to a greater easiness, plainness, and in the meantime letting the mounte- bank at Charing Cross pass unrailed at, they contra- dict themselves, and would make the world believe I 241 R THOMAS SYDENHAM may prove more considerable than they wou me. But, to let these men alone to their 1 have again taken breath, and am pursuing my of specifics, which, if but a delusion, so closely me, that I could not but indulge the spendi little money and time at it once more. I hav a great progress in the thing, and have reason not to be disappointed. My occasions will n< me give you more trouble and therefore be pl< accept of those very unfeigned thanks, which make you, for all the singular kindnesses and whereby you have obliged me to be very un mentary. " Sir, your most humble servant. "T. Sydenh The name of Locke in the foregoing lette duces us to the most important and interesting ship of Sydenham's life. John Locke was eight years younger than Sy< having been born in 1632, and in the same qi England — that is, in the adjacent county of Si He also was closely connected with the Purita his father having been a captain in the Parlia; army. He entered Christ Church, Oxford, i and was therefore an undergraduate while Sy was a Fellow of All Souls'. Their acquainta not begin at Oxford ; but its commence; referred by Mr. Fox Bourne, in his " Life of 242 SYDENHAM'S FRIENDS to 1668, when Locke came to live in London. Dr. Mapletoft, a common friend, is believed to have made Locke and Sydenham acquainted. Locke's great eminence in philosophy has made many people forget that he was a doctor. He was, however, a regular physician by education and by practice, having a medical degree. He first began the study of medicine in Oxford, though, for obscure reasons, he did not take his medical degree at the usual time ; and studied at Montpellier for a longer period than Sydenham did. He was turned aside from active practice as a physician partly by his delicate health, partly through obtaining the position or domestic physician to Lord Ashley (the first Earl of . Shaftesbury), which, together with a small patrimony, relieved him from the necessity of entering a pro- fession for a livelihood. His practice among the •family and friends of Lord Shaftesbury was, however, considerable. Numerous prescriptions and other records showing his professional activity are still extant in the Shaftesbury papers. Some have been recently published in the Journal of Historical Medicine, fanus, by Dr. Withington. He treated his patron for a dangerous Empyema with remarkable skill, saving a life which was- of importance to the State. Morever, Locke was very nearly obtaining a position which would have given him great weight in the medical world, and might perhaps have been of signal importance to the science of medicine. He was at 243 THOMAS SYDENHAM one time desirous of being appointed Profe Medicine in Gresham College on the e: resignation of his friend Dr. Mapletoft. never obtained the appointment. The chief facts relating to Locke's ass< with Sydenham in medical research — their p combined work, of which fragments remain Shaftesbury Papers, and his notes of Syde practice in the Oxford MS. " Anecdota ' : already been noticed. Their friendship re unbroken till Sydenham's death. It will be, however, interesting to inquire 1 each of the two friends influenced the oth which, if either, should be regarded as the dc spirit. Some Continental writers have spc Sydenham as a pupil of Locke in philosophy belonging to his school. But this was clearly case. There is no trace of this influence in ham's works, and Locke's celebrated " Essay Human Understanding " was not published ti Sydenham's death. On the other hand, in matters, it is clear that Locke was rather the Sydenham. In the rew Communications or of correspondence between them which ha^ preserved Locke always asks Sydenham's advii great deference. He consulted him about hi as well as about his own health. The only letter from Sydenham to Locke refers to th subject ; and so few of Sydenham's letters 244 SYDENHAM'S FRIENDS it may be interesting to give the greater part of it, copied from the original in the Shaftesbury Papers. We do not know enough about the nature of Locke's "malady to be able to judge of its medical value ; but the scrupulous and affectionate^ carefulness of his friend and physician are obvious. It is not dated, but Mr.' Fox Bourne thinks it was written in the autumn of 1674. Sydenham to John Locke. " For Mr. Locke, — Your age, ill habit of body, and approach of winter concurring, it comes to pass that the distemper you complaine of yields not so soone to remedies as it would doe under contrary : circumstances. However you may not in the least doubt but that a steady persisting in the use of the following directions (grounded not on opinion but uninterrupted experience) will at least effect your desired cure. First therefore in order to the diverting and subduing also the ichorose matter, it will be -, requisitt to take your pills twice a weeke as for example every Thursday and Sunday about 4 o'clocke in the morning, constantly till you are well. In the next place for as much as there is wanting in bodyes broken with business and dispirited upon the before mentioned accounts, that stock of naturall heat which should bring the matter quickly to digestion 'twill be highly necessary that you cherish yourselfe as much as possibly you can by .going to bed very early at night, even at 8 o'clocke, which next to keeping bed, 245 THOMAS SYDENHAM that is unpracticable, will contribute more to yc reliefe than can be imagined. As to diett, all me; of easy digestion and that nourish well may be allowi provided they be not salt, sweet or spiced, and a excepting fruits, roots and such like. For wine totall forbearance thereof if it could possibly be, a in its stead the use of very mild small beer such as o lesser houses doe afford, would as neare as I can gui be most expedient, for thereby your body would kept coole and consequently all accidents proceedi. from hott and sharpe humors grating upon the p; kept off. " This is all that I have to offer you and I ha thought of it, and all circumstances relating to yo case, with the same intention of mind as if my 1 and my son's were concerned therein. " T. S." Locke always wrote of Sydenham with the high( appreciation, as having introduced important refon in medicine. Some years after his death, he lamer that the physicians of the day had not followed Syde ham's natural method, but were still occupied wi verbal disputes about their theories of disease. Locke's practice was evidently founded upon Syde ham's, and we can see no great difference betwe them ; though we may assume that the older physici was a better practitioner. But with regard to their views of medicine as 246 SYDENHAM'S FRIENDS science, the scanty records which remain of Locke's opinions seem to show that they were not precisely the same as Sydenham's. To begin with, Locke was a far more thorough-going sceptic than Sydenham as to all medical dogma. Sydenham, in fact, like most men of action, could not fairly be regarded as a sceptic at all. He felt the need of some organised body of doctrine to direct his practice, and found this in the system of Hippocrates. Locke, on the other hand, had no more respect for the doctrines of the -ancients than for the speculations of the moderns. One sentence in a letter to Molyneux seems to show this : — " You cannot imagine how far a little observation, carefully made by a man not tied up to the four humours ; or sal, sulphur, and mercury ; or to acid and alcali, which has of late prevailed, will carry a man in the curing of diseases, though very stubborn and dangerous, and that with very little and common things, and almost no medicine at all." Of the words in italics, " the four humours " evidently means the " dogma " of Hippocrates and Galen ; " sal, sulphur and mercury " refer to Para- celsus and Van Helmont ; " acid and alcali " to the newer chemical system of Sylvius, as extended by Willis. The whole sentence is thoroughly in the spirit of Sydenham and expresses his practical method. But we see that Locke classes the doctrine of the humours with the modern speculations as all equally 247 THOMAS SYDENHAM unimportant, which Sydenham would prob have done. If Locke had had to teach med would evidently have thrown much more Hippocratic baggage overboard, and mig accelerated the progress of the medical ship Moreover, Locke possessed, as was natural, subtle and highly-trained intellect than Sy Hence he was more ready to see good in pure : research, which Sydenham thought of littl He was a Fellow of the Royal Society, a: sionally busied himself, on the instigation o with inquiries which Sydenham would proba condemned as unfruitful. In his earlier papers, as we have seen, he joined Sydej rejecting Anatomy and especially Morbid A as useless in the advancement of Medicine, after years he was wiser. There are le Locke's in the British Museum to Sir Han referring to cases of Morbid Anatomy. Lockt detects the cause, and recognises the valut observation ; and expresses the hope that sue vations will be multiplied, since they may thr on certain conditions which cannot alway plained by the peccant humours and the like i they were commonly ascribed. He would have extended Medicine on the side on whic ham saw no prospect of success. Locke's bic think it a fortunate circumstance that he diverted to the practice of Medicine. ] 248 SYDENHAM'S FRIENDS but the gain of Philosophy was the loss of Medi- cine. In any case the connection of Locke and Sydenham was perhaps the most remarkable partnership, in thought and work, of two great physicians, of which we have any record. There were other friends of Sydenham's of whom, did space permit, something might be said ; but all we can do is to give a bare^enumeration of the names of some of them. In All Souls' he became the friend of Dr. Milling- ton, afterwards President of the College of Physicians, a man as eminent by his character and manners as by professional knowledge. Dr. Mapletoft, Professor at Gresham College, an .intimate friend of Sydenham as of Locke, has been more than once referred to. Drs. Paman, Brady, and Cole, all eminent men, conferred a benefit on medical science, and also showed their respect for Sydenham by eliciting from him the treatises before mentioned. Dr. Goodall's chivalrous defence of Sydenham has been already spoken of. He refers with high praise to Sydenham in the preface to his " History of the College of Physicians." The dedication of the treatise on Gout to Dr. Short shows that he also had made himself one of Sydenham's defenders. Sydenham himself recognises the respect and friendship of Walter Needham, an eminent anatomist and physician. Dr. Walter Harris, author of a book on the diseases of 249 THOMAS SYDENHAM children, of which it is reported Sydenham sa: would have been proud to be the author, was o his warmest admirers, speaking of him with enthu in his lifetime and after his death. Andrew Broun tells us that a very impc person, Dr. Micklethwaite, President of the Co] tardily acknowledged the merits of Sydenl practice. " For when near death he did profess notwithstanding the attempts of several agains methods of Sydenham, yet these would yet prevai triumph over all other methods." Other inge and honest physicians, Broun says, made the acknowledgment ; though others, less honest, imi Sydenham's methods while they disavowed, and calumniated, the author. It thus appears that among Sydenham's friendi admirers were many of the most eminent physi of the time. His enemies and detractors, or other hand, cannot be traced. The pamphl Stubbe and the veiled insults of Gideon Ha already mentioned, are the only literary eviden controversy. Some ill-natured remarks of M Lister might be quoted, but they are quite important. Dr. Richard Morton is sometimes spoken c continental writers as the antagonist of Syden Nothing could be more misleading. Morton v younger physician than Sydenham, and should r be described as his follower, since his method 250 SYDENHAM'S FRIENDS • ' much the same. His first book, " Phthisiologia," a treatise on consumption, appeared in the last year of Sydenham's life. In the preface Morton enforces the importance of practical observations in medicine, and takes occasion to pronounce a warm eulogium on Sydenham, not inspired by the partiality of private . friendship, since Sydenham, we are told, hardly knew him by sight. Morton's well-known book on Fevers was not published till after Sydenham's death. In this he is led to differ from Sydenham on certain points, but does so in such a way that his deferential criticism and reluctant dissent are more flattering than uncritical agreement. While Sydenham was gradually conciliating pro- fessional opinion at home, he met with more striking and immediate recognition on the Continent. It has often been the lot of reformers, as of prophets, to be sooner and more highly honoured abroad than in their own country and city. Many important professors of medicine showered praises upon him. Schacht, an eminent professor of Leyden, as we are told by Christopher Morley, constantly recommended Syden- ham's works to his students. Ettmuller, of Leipzig, frequently mentioned Sydenham in his writings with praise. Spon (or Sponius), a physician at Lyons, also a medical writer, especially praised Sydenham's treat- ment of fevers, and says that he went in London by the name of " the Fever-curing Doctor." Dolaeus, an encyclopaedic writer on medicine, showed his 251 THOMAS SYDENHAM admiration in a more questionable manner. He ^ to Sydenham, asking him for an encomium to be fixed to a forthcoming book. Sydenham ansi that he was ready to give such as the book, af was perused by him, might deserve. The imp Dolseus, however, would not wait, but put ol book with a very honourable mention of Syden, and also a fictitious eulogium under his name, give this story on the authority of Andrew B It shows, at all events, that Sydenham's reputatio widely diffused on the Continent, where his i were frequently reprinted, even in his lifetime the next generation it stood even higher. Boerl the most eminent teacher of medicine in Ei never mentioned Sydenham, as the story goes, wi taking his hat off; probably a figurative w; saying that he never named him without a trib respect. In his own country Sydenham's fame was of s growth, though it was certainly rising at the tii his death. His books became increasingly popu is shown by the numerous editions which appea the Latin text, and of two English translations, of the eminent medical writers at the end c seventeenth and beginning of the eighteenth ce mention him with great respect. Blackmo: Queen Anne's time, notes that Sydenham's \ with their original observations, were still read ; Willis, with his Rational Therapeutics, was 252 SYDENHAM'S FRIENDS lected. And from the practical side, no doubt this was a fair judgment, though Willis's great services to anatomy and physiology can never be forgotten. Before the first quarter of the eighteenth century Sydenham was established in the estimation which he still holds, as the great reformer of practical medicine, the glory of the_ English school, and was named with . pride in Harveian orations as the " English Hippo- crates." His influence, no doubt, largely contributed to form that sober empiricism, resting on the accumu- lation of detailed observations,, which was the charac- teristic of English medicine in the eighteenth century, and -which it has never lost. A recent medical his- torian, M. Laboulbene, has observed that the modern clinical school of Vienna might trace its special characteristics to the same inspiration. In this inspiration we recognise Sydenham's chief contribution to the advancement of medicine. It was not his function to promote systematic science, some aspects of which he certainly undervalued. It was rather to hold up to over-confident Science its per- petual counterpart and corrective in the shape ot simple observation. If this was a necessary task in his own day, it has often been needed since, and some may think it not quite unneeded even in this age of progress. Not his contributions to the knowledge of special diseases, important as these were, nor his revival of the .study of epidemics, which fairly earns him the name of 2 53 THOMAS SYDENHAM the founder of modern Epidemiology, constitute Syden ham's chief titles to fame. It was that he first se the example of the true clinical method. His inde pendent and unprejudiced spirit, combined with grea powers of observation, made him the type of a clinics investigator. To become such, not only intellectua gifts, but moral qualities, were necessary — stronj character, perfect truthfulness, and an unfailing sens of duty, which in Sydenham were reinforced by hi intense religious convictions. More than all othe wise and good physicians of whom we know, he mad his profession a part of' his religion ; he prosecuted hi task of advancing knowledge and healing the sic) with the same ferverit zeal which other men hav shown in what are regarded as more sacred avocations It is only by considering his life as a whole, from hi youth upwards, that we can understand the comple: influences, intellectual, political, and religious, whicl helped to mould the character of the great Puritai physician, Thomas Sydenham. 254 REFERENCES AND AUTHORITIES. ■ 1. Clarendon. "History of the Rebellion.'' 2. Rushworth. "Historical Collections." 1692. 3. Whitelocke. "Memorials." 1732. 4. Anthony Wood. " Athenae Oxonienses and Fasti." Also his Diaries, published by the Oxford Historical Society. 5. Green. " Calendar of State Papers.'' Domestic Series. 6. Vicars. Parliamentary Chronicle (" Magnalia Dei Anglicana"). 7. " Mercurius Civicus." 1644. 8. "A Brief Relation of the Surprise of the Forts of Weymouth, the Siege of Melcombe," &c. By P. I. (Peter Ince), Minister to the Garrison. London, 1644. 9. Register of the Visitors of the University of Oxford, 1647-1658. Ed. Prof. Montagu Burrows. Camden Society, 1881. 10. Carlyle's " Letters and Speeches of Oliver Cromwell." 11. Hutchins's " History of Dorset." 3rd edition, 1864. 1 2. Andrew Broun. " A Vindicatory Schedule con- cerning the New Cure of Fevers, first invented by the sagacious Dr. Thomas Sydenham." Edinburgh, 1 691. 255 <;;■"'-' W? : -._ APPENDIX ■'.-.-'.;' 13. Gideon Harvey. "The Conclave of Physicians." 2nd edition, 1686. 14. Dr. F. Picard. " Sydenham, Sa Vie, ses CEuvres." Paris, 1889. 15. Dr. Nias. " Some Facts about Sydenham." St. Bar- tholomew's Hospital Reports, 1890. 1 6. Dr. John Brown. " Horae Subsecivae." 2nd edition, 1859. 17. W. D. Christie. "Life of A. A. Cooper, first Lord Shaftesbury." 18. Sir T. Longmore. "Life of Richard Wiseman." 1891. 19. Fox Bourne. "Life of John Locke." Two vols. 1876. With other Pamphlets and MSS. in the British Museum and State Paper Office. The editions of Sydenham's works referred to are : "Opera Sydenhami." Edited by W. G. Greenhill. Sydenham Society, 1844. " Sydenham's Works, translated into English, with a Life of Sydenham," &c. By Dr. R. G. Latham. Two vols. Sydenham Society, 1848. 256 INDEX Abbotsbury House, taking of, 36 Agues in Westminster, 86 Anatomical Physicians, 170 Anatomy, how taught, at Oxford, 68 Anatomy, Sydenham's views on, 152 Anecdota Sydenhamiana, MS., 203 ; written by Locke, 204 Animal spirits, 144 Anthony, a chemical physi- cian, 159 Apothecaries, 165 ; men- tioned by Chaucer, 166 Archer, John, a quack, 162 Ashley Cooper (Lord Shaftesbury), 36 Astrologers, 1 64 B Bacon, motto from, 146 ; referred to, 177 : his influence on Sydenham, 230 Baillou, or Ballonius, 225 Barbeyrac, Sydenham's sup- posed teacher, 91 ; men- tioned by Locke, 93 Beale, Bartholomew, pupil of Sydenham's, 193 Blackmore, Sir Richard, 173 ; his anecdotes of Sydenham, 191 ; views on medical classics, 193 Black Death, 104 Boerhaave, Professor, 252 Boghurst, Apothecary, on the Plague, 108, no, 113 Botany at Oxford, 70- Bourne, Fox, 203, 242 257 INDEX Boyle, Robert, 62, 63, 64 ; encourages Sydenham's first book, 116; 125, 160; friend of Sydenham, 236 ; letter from Sydenham, 239 Brady, Dr., 138, 179 Briggs, Sydenham's travel- ling companion, 91 Broun, Dr. Andrew, an admirer of Sydenham, , visits him, 101, 184, 193 Brown, Dr. John, his appre- ciationof Sydenham, 1 Carnarvon, Earl of, 29 Charles II., his relations to Medicine, 161 ; founder of Royal Society, 162 Chemical School of Medi- cine, 159 Chorea, 156 Cicero, read and admired by Sydenham, 67 ; his favourite author, 213, 231 Cinchona Bark, Sydenham's use of, 145, 181 Civil War, first, end of, 48 Clayton, Sir Thomas, 68 Cole, Dr., 141 Cooling Method in Small Pox, 174 I 258 Conclave of Physicians, Gideon Harvey, 163 Corfe Castle, 27 Cromwell, Oliver, Syd' ham's petition to, 72 ; Scotland, 76, 79 ; ans^ to the petition, 81 . Crawford, Lord, Roya commander, 32 D Degrees conferred by Cr tion, 54 " Dissertatio Epistolari Dives, Sir Lewis, 31, 39, i 45, 48 Dolaeus, Professor, 251 Don Quixote, book reco mended by Sydenha 191 Dorchester, 6, 25, 28, 29 Dorsetshire, Civil War 27, 32 Dorsetshire Committee, « Dovar, Dr., pupil of Syd* ham, 189 E Empirics, 164 English Hippocrates, 253 English character of Syde ham, 1 English School of Medicii 253 INDEX Epidemic Constitutions, 131 Epidemics, history of, 224 ; Fellowship of the College of Physicians, its limitation, 161 Fevers, Sydenham's writings ;; On, H5 SjlFrazier, Sir Alexander, 163 Galen, 144, 154 Goddard, Dr. Jonathan, 59, 62, 63, 166 Goodall, Dr. 142, 155 Goring, Lord, Royalist General, 29, 44, 45 Gout, Sydenham's treatise on, 148 ; suffered from, 185; salutary effects of a fit of, 181 ; regimen in, 186 " Gout Tragedy," Lucian's, 150 Greenhill, Dr., editor of Sydenham, 203', 213 H Hale, Major, Sydenham's letter to, 179 Hamey, Dr. Baldwin, letters ,,,. ..addressed to him, 2 1 5 •p'. "' 259 Harris, Walter, admirer of Sydenham, 199 Harvey, Gideon, 163, 168, Harvey, William, Warden of Merton, 58 ; never men- tioned by Sydenham, 1 51 ; his school, 233 ; compared with Sydenham, 234 Havers, Gilbert, 214 Hippocrates, Sydenham's debt to him : features of his writings, 223 ; his dogma, 225 Humoral Pathology, 225 Hutchinson, Mrs., life of her husband, 7 Hypochondria, 143 Hysteria, Sydenham's views on, 143 Irish prisoners, execution of, 35 Ironside, Gilbert, 20 Invisible College, 62 J Janus, Journal of Historical Medicine, 243 Jeffrey, Sir John, 11, 15 King Street, Westminster, INDEX Sydenham's first residence in London, 8 5 Language in which Syden- ham wrote, 210 Latin, its general use in Universities and learned bodies, 210 Latin poem by Locke, 129 Latham, Dr., on style of Sydenham's works, 220 Laudanum, Sydenhafn's, 182 Locke, John, Latin poem, 129 ; joint treatise on the Small ''Pox, 130; wrote out Sydenham's observa- tions, 204 ; friend of Sydenham, 242 ; medical practice, 243 ; letter from Sydenham, 246 ; views on Medicine, 247 Lucian,his "Gout Tragedy," 150 M Magdalen Hall, 21 Malthus, Apothecary, 189, 197, 198 Mapletoft, Dr., 50 ; trans- lated Sydenham's works, 214 ; friendship with Sydenham, 249 Medical Practice in Syden- ham's time, 158 Medicine, how taught Oxford, 68 Micklethwaite, Dr., 25c Microscope, used in 1 century, 170 Millington, Dr., friend Sydenham, 67, 249 Monfort, Dr., editor " Processus Integri," : Montpellier, Sydenr studies at, 89 ; the i of Hippocratism, < Primrose's book abc 96 Morton, Richard, his ad ration for Sydenham, : Munk, Dr., quoted, 19 N Natural History method studying disease, 229 Nature's method of ci 226 Needham, Dr., ,249 New Fever, 155 O " Observationes Medic 130 O'Brien, Colonel, encour with the Sydenhams; 1 Oxford, - surrendered Fairfax, 48 260 INDEX Oxford University, Parlia- mentary visitation, 52 ; the Pembrokian creation, 55 ; under Puritan rule, 57 ; testimony of Claren- don, 60 ; disputations in Greek, 61 ; the scientific J .. movement, 62 ; Evelyn's *' .'^ visit, 64 P .'■. Paman, Dr., 139 Pepys, on the Plague, no Petition to Cromwell, & „ ^Sydenham's, 72 ; answer, 81 Petty, William, 59, 62,' 63 ; teacher of Anatomy, 69 Philosophical Society, 63 Physic Garden at Oxford, 70 Physicians in the seven- teenth century, their difficulties, 167 ; their ? z it.. manners, 168 ; means of V/ ■ gaining practice, 170 ; anatomical physicians, 170 .Plague, history of, in Eng- ... land, 104; the Great £■■* Plague, 107; prevalence in West End of London, 109 ; Sydenham saw little of it, no; his views r..'""' about, 114 Poole, siege of, 32 Prevaricators, 65 Prujean, Dr., 179 Puritans, their principles, 7 Q Quack, origin of the name, "59 R Roundheads, 8 Royal Society, 160 Royalists, their principles, 8 St. Vitus's dance, 156 Saltmarsh, Mrs., Sydenham's first recorded patient, 84 Schacht, Professor, 251 " Schedula Monitoria," 1 5 5 Scotland, Sydenham's ser- vice in, 79, 206 Shaftesbury, Earl of, 243 ; see Ashley Cooper Sherborne Castle, 39, 41, 42 Short, Dr., dedication to him, 147 Sloane, Sir Hans, pupil of Sydenham's, 190 Stubbe, Henry, attacks Sydenham's book on Fevers, 124, 214 261 INDEX Sydenham family, their pedigree, 12 - r military exploits, 30 Sydenham, Francis (Major), 16, 18 Sydenham, John (Major), 16, 72, 75 Sydenham, John (last sur- viving grandchild), 200 Sydenham's mother, 11, 15; killed, 37 Sydenham, Richard, 16 Sydenham, Theophilus (grandson), 200 Sydenham, Thomas : birth, 11 ; pedigree, 12 ; brothers and sisters, 16 ; early education, 20 ; goes to Oxford, 21 ; military service, 26 ; in the field, 43 ; left military service, 4.8 ; second residence at Oxford, 50 ; meeting with Mapletoft, 50 ; enters at Wadham, 52 ; at Magdalen Hall, 53 ; medical degree, 54 ; Fellow of All Souls, 56 ; studies at Oxford, 71 ; petition to Cromwell, 72 ; , commission as Captain, 77 ; narrow escape from being killed, 78 ; services in England and Scotland, 79, 80 ; recommended for Sydenham,Thomas {cont.\ public employment, 8 resigned his fellowship, ! married, 82 ; commeni practice, 83 ; candid for Parliament, 87 ; pointed Comptroller the Pipe, 88 ; at Mo pellier, 89 ; return, 9 obtains license of Colli of Physicians, 98 ; ne' made' a Fellow, 99, r sons, 1 01 ; takes deg of M.D., 1 00 ; praised the College, 102 ; first book, 115; review in " Philosophical Tn sactions," 120; attacli by Stubbe, 124 ; views on Small Pi 123 ; on Epidemics, 13 on Scarlatina, 1 3 on Hysteria, 143 ; Gout, 148 ; on Drop 1 5 1 ; views on Anaton 152 ; close of liter* activity, 157 ; caricatui by Gideon Harvey, it 172 ; his methods practice, 172 ; manne 173 ; treatment, 173; small pox, 174 ; of agu 179 ; letter to Hale, 17 his laudanum, 182 ; hoi life", 183 ; children,- 18 262 INDEX Sydenham,Thomas (eont.) — his grandchildren, 1 84 ; ' , ' professional life, 1 84 ; success, 1&5 ; illnesses, 185 : regimen of life, 186 ; use of small beer, 188 ; his pupils, 189 ; failure of health, 194 ; epitaph, 195 ; his will, 196 ; value of landed '.' estate, 198; eldest son, 198 ; posthumous works, 201 ; unusual methods of treatment, 204 ; allusion to Scotland, 206 ; letters, 208 ; in what language he wrote, 210 ; know- ledge of Latin, 212 ; * favourite authors, 213 ; MS. medical observa- tions, 215; English style, 218, 221 ; relations to Hippocrates, 222 ; to Bacon, 230 ; estimate of Morbid Anatomy, 232 ; compared with Harvey, 234; his friends, 236; letter to Boyle, 239 ; friendship with Locke, 242 ; his detractors, 250 ; reputation on the Conti- nent, 2 5 1 ; at home, 2 5 2 ; general value of his work, 252 Sydenham, William (junior), Colonel, 16, 17; made Colonel, 26 ; recovers Weymouth, 4 1 ; in danger at the Restoration, 97 ; his death, 97 Sydenham, William (senior), 11, 15 Sydenham, William (son 01 the physician), 183, 198 ; his medical work, 199 ; his family, 200 Sydenham's wife, her family, 83 T Talbor, Sir Richard, 179 " Theologia Rationalis," 206 Thornhill, Sir James, 198 Toller Fratrum 3, 5 " Tractatus de Podagra," &c, 146 V Virtuosi, 160 i i 7 W Wadham College, 52 >■ , Wallis, the mathematician, 58, 62, 63 Ward, Seth, 58, 62 Ward, Dr. John, 214 Wareham, 34, 36 Weymouth and Melcombe Regis, 33 ; loss and re- 1 covery of, 41 263 INDEX Wharton, Dr. George, 167 Willis, Dr.,. 6z ; his Rational Therapeutics, 154, 252 Wilkinson, John, of Mag- dalen Hall, 21 Wilkins, Warden of Wad- ham, 53, ss, 59, 62, 63, 65 Williams, Major, 37 Wiseman, Richard, 4 Wood, Anthony, quot 58, 60, 63 Wren, Christopher, t Wynford Eagle, 3 ; d tion of, 4, 19 Wynford, Lord, 4 UNWIN BROTHERS, THE GRESHAM PRESS, WOKING AND LOND< 264 llilll 1