Throughout the greater part of his professional career Sydenham was a frequent sufferer from gout, some of the attacks being of a severe type and occasionally of long duration. During the winter of 1676, for example, he was seriously ill from renal calculus, haematuria being brought on by the slightest movements of his body. All through the year 1677 he continued to experience frequent attacks of pain, and on one occasion he was unable to leave the house for a period of three months.
Speaking of the epidemic of the Plague in 1665, during the progress of which he left London, Sydenham says: “When I saw that the danger was in my immediate neighborhood I listened to the advice of my friends and joined the crowd of those who were fleeing to the country. A little later, when the epidemic had further increased in severity, and before any of my neighbors had returned, I yielded to the calls of those who had need of my services, and went back to London.” It is worthy of remark, says Laboulbène, who fully appreciated the heroism which prompted this last decision, that we should never have known of Sydenham’s weakness in regard to facing his duty, if he himself had not stated the facts. This famous epidemic, as is well known, was accompanied by an appalling mortality.
Andrew Browne, a Scotch physician of good standing, entertained serious objections to some of the advice given by Sydenham in the treatise entitled “Schedula monitoria de novae febris ingressu,”[79] and, in order to learn more precisely what the author’s views on the subject really were, he decided to run down to London for a day or two. Sydenham gave him such a cordial reception and made his stay in the metropolis so pleasant that he remained there several months—instead of a day or two. “And when I returned to Scotland I felt contented and joyful as if I were carrying back with me a valuable treasure.”
As an instance of his thoughtful kindness, it is related that Sydenham had occasion to treat a poor man who lived in his neighborhood for an obstinate bilious colic, but his employment of narcotics did not effect very much in the way of relief. “I felt moved by pity for this poor man in his misery; and accordingly I loaned one of my horses to him in order that he might take long excursions on horseback.”
Sydenham had no eagerness for professional honors, although he appreciated highly those which came to him spontaneously. As already stated at the beginning of this sketch, the degree of Doctor of Medicine was not conferred upon him by Cambridge as a mere honorary affair, but was won by him after he had passed through the regular course of training required of all candidates for this degree. His case, however, was peculiar in one respect: he waited until after he had been in active practice several years before he decided to pass through the course of training required. He was not a member of the College of Physicians of London, and he held no official position at Court.
The following summary may serve to convey some idea of Sydenham’s views regarding pathology and treatment. He defines an acute disease as “a helpful effort made by Nature to drive out of the body or system, in every way possible, the morbific material.” As regards the latter he makes the following remarks:—
Certain diseases are caused by particles which are disseminated throughout the atmosphere, which possess qualities that are antagonistic to the humors of the body, and which—when once they gain an entrance into the system—become mingled with the blood and thus are distributed throughout the entire organism. Certain other diseases owe their origin to fermentations or putrefactions of the humors, which fermentations vary in their nature—in some cases the humors being excessive in quantity, while in others they are bad in quality; and in either event the body finds itself incapable of first assimilating them and then excreting them—a state of affairs which cannot continue beyond a certain length of time without producing further harmful effects.
According to Sydenham the fever, in the acute diseases, assists Nature by separating from the general (total) mass of the blood those particles which have undergone putrefaction or have been rendered unassimilable. Then they are driven out of the body by the route of the sweat-glands, by diarrhoea, by eruptions upon the skin, etc. On the other hand, in chronic diseases the morbific material is not of such a nature as to produce fever, which is a mechanism for securing complete purification. It is therefore deposited in one part or another of the body where no force exists which is capable of ejecting it; or its final transformation is not completed until after the lapse of a long period of time.
In some of Sydenham’s writings one is occasionally surprised to find teachings which seem to be strongly at variance with the advice which he was so fond of giving—namely, that physicians should be careful not to set up hypotheses which are not based upon observed facts. A conspicuous instance of such a disregard of his own rule may be found in his setting up of a pathological process to which he gives the name of “inflammation of the blood.” This process, he maintains, is the active cause of quite a large number of diseases, especially those of an epidemic nature—such, for example, as pleurisy, pneumonia, rheumatism, erysipelas, scarlet fever, etc. It is well-nigh impossible for us moderns to comprehend how so practical and clear-headed a man as Sydenham could have formulated such a purely hypothetical pathology, a doctrine so completely lacking in anything like a solid foundation of fact.
Sydenham excelled in the description of the clinical manifestations of certain diseases, as, for example, small-pox, hysterical affections, the encystment of a renal calculus, and the gout—a disease from which, as already stated, he was a very frequent sufferer throughout a large portion of his life. All his published works are in the Latin language, but translations have been made into English, French, German, Flemish and Italian. At All Souls College, Oxford, where Sydenham spent eight years of his life, it was a fixed rule that all its members should habitually converse and write in Latin.