Thomas Sydenham, one of the most prominent physicians in 17th century England, was born 400 years ago, just ten miles from Dorchester
Known as the English Hippocrates, Thomas Sydenham was one of the most famous physicians of the 17th century. He was renowned for his observations on infectious diseases including smallpox and cholera, and some of his principles remain in medical practice to this day: most notably that teaching should be done at the patient’s bedside. He was born 400 years ago this month, on 10th September 1624, in the hamlet of Wynford Eagle just outside Maiden Newton. His parents, well-known Puritans William and Mary Sydenham, lived at Manor Farm.
A Civil War cavalryman
In 1642, at the age of 18, Thomas went to Magdalen Hall in Oxford, but just four months later his studies were interrupted by the outbreak of the English Civil War. Thomas returned to Dorset, joining his three brothers fighting for the Parliamentarians (or Roundheads) as a cavalryman, in line with his family’s beliefs. Thomas’ father William was taken prisoner in Exeter when it fell to the King. In 1644, after Dorchester was defended by the Parliamentarians – including the Sydenham brothers – a platoon of Royalists turned up in Wynford Eagle. Mary Sydenham was murdered on the doorstep at Manor Farm by Major Williams because she would not allow the Royalists to pillage the property. Thomas’ brother Francis later avenged her murder by shooting Williams. The Sydenhams were involved in several actions, including the Second Battle of Weymouth in February 1645, which was won by the Parliamentarians.
If the Royalist plot for the King’s army to take over Weymouth and Melcombe, known as the Crabchurch Conspiracy, had succeeded, it could have changed the course of the Civil War, as most other ports in the area were under Royalist control.
Col William Sydenham, another of Thomas’ brothers, was governor of the Weymouth garrison at the time and under his leadership 500 Royalist troops were killed in one night as they defended the town. William went on to serve as second-in-command in Cromwell’s new form of government, the Protectorate.
Thomas is thought to have been inspired to study medicine during the Civil War by Dr Thomas Coxe, a physician who treated William when he was injured in battle. Thomas Sydenham said: “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.”
Becoming a physician
In 1646, he returned to Oxford to take up his studies, becoming friends with fellow Dorset scientist Robert Boyle and physician and philosopher John Locke. Graduating two years later, he returned to fight in the second Civil War with his father and brothers, before moving to London to work as a doctor. He also studied at the famous medical school in Montpellier, France, before returning to London to work as a doctor. He received the licentiate of the Royal College of Physicians in 1663, and was officially confirmed as a doctor on 17th May 1676 – 28 years after graduating as a Bachelor of Medicine.
Thomas Sydenham’s legacy
Thomas lived at a time when many diseases were not understood – but it was also a time when rigorous scientific methods were being explored. He actively encouraged physicians to move away from the teachings of Hippocrates and Galen, which were aligned to religious beliefs and ‘humours’ and towards scientific methods of observation. He is perhaps best known for his work on infectious diseases, but also for believing in the fundamental principle of care and observation of patients taking place at the bedside – something that clinical teams still value and advocate today. In a letter to Sir Hans Sloan, the renowned Irish physician to the English aristocracy, Thomas said: “You must go to the bedside. It is there alone that you can learn disease.”
He had a few unusual recommendations too. He suggested that poet and royal physician Richard Blackmore should read Don Quixote to learn about the principles of medicine. In his defence, the book is full of medical knowledge, and Miguel de Cervantes’ father was a barber surgeon! When faced with a hypochondriac, Sydenham recommended he consult a Dr Robertson in Inverness. The man went off to Scotland … to find no such person there. He returned to London, enraged – but cured of his symptoms.
Thomas Sydenham is famous for the observations he made when treating the common infectious diseases of the time. He described cholera as: “[it] comes at the close of summer and the beginning of autumn, as swallows in the beginning of spring and cuckoos towards midsummer.”
Contrary to the theory of the four humours, Sydenham did not believe that a disease was different from person to person – he believed that each disease was different, and that doctors needed to observe the patient and identify the exact disease before recommending a cure.
When bubonic plague arrived in London in 1665, Thomas, along with many other physicians at the time, initially fled the city. However, he returned shortly afterwards, observing and treating the sick at a time when mortality rates were at 50 per cent. His first book, Methodus Curandi Febres or The Method of Curing Fevers, was published in 1666 and later updated to include a section on the plague in 1668. His best known work, Observationes Mediciae or The Observations of Medicine, was published in 1676, and it remained one of the most important medical textbooks for the next 200 years.
Thomas Sydenham was the first person to describe scarlet fever, and he used case histories to build up intelligence, contributing to medical knowledge. He named Whooping Cough pertussis, meaning a violent cough. His 1685 book ‘Opera Universa’ became the most important medical text of the day and included his classic descriptions of malaria, cholera, bronchopneumonia, pleurisy and measles. It is to Thomas Sydenham we attribute the famous saying: “A man is as old as his arteries.”
Another disease he identified was St Vitus’ Dance – also named Sydenham’s Chorea. At the time, rheumatic fever was common, and the condition is a complication of the disease. In Medical Observations, Sydenham used the word chorea to reflect the involuntary movement associated with the disease and its physiology.
Thomas Sydenham died in London in 1689, aged 65. He is buried in St James Church, Piccadilly, where there is a memorial stone with his name. However his legacy lives on in the importance of making sure practical experience, diligent observation and bedside teaching are prioritised in medicine and nursing.
