The candid and philosophic temperament of the man is also well exemplified in the conclusion of the same preface. He foresees that “even where my practice has been tried, and its results been recognised, it will be asserted that my statements are anything but new, and that the world has long known them. I have, notwithstanding, never allowed myself to be deterred from communicating the following pages to those of my fellow-creatures who unite the love of truth with the love of their kind. It is my temper and disposition to be careless both of the sayings and the doings of the over-proud and the over-critical. To the wise, however, and the honest, I wish to say this much:—I have in no wise distorted either fact or experiment; I told the truth, the whole truth, and nothing but the truth.... In the meanwhile I ask the pardon, and submit to the arguments, of better judges than myself, for all errors of theory. Perhaps I may myself hereafter on many points change my mind of my own accord. As I have no lack of charity for the errors of others, I have no love of obstinately persisting in my own.”
At the outset of his treatise he asserts that a disease is an effort of nature which strives with might and main to restore the health of the patient by the elimination of the morbific matter. Yet he is so far in accord with modern discovery of bacterial germs, that he refers the specific differences between fevers to some unknown constitution of the atmosphere. His wisdom is conspicuous when he says he prefers nothing, on the outbreak of a new fever, to a little delay, and diligently observes the character and cause of the disease, and what kinds of treatment do good or harm. He discerns thoroughly that the scientific working out of the characteristics and phenomena of each disease must be accomplished before it can be asserted that any good work worthy of mention has been got through. It would be difficult to exhibit a more modest and a more truly philosophical spirit than that shown in the following lines at the close of his second chapter: “One thing most especially do I aim at. It is my wish to state how things have gone lately; how they have been in this the city which we live in. The observations of some years form my groundwork. It is thus that I would add my mite, such as it is, towards the foundation of a work that, in my humble judgment, shall be beneficial to the human race. Posterity will complete it, since to them it shall be given to take the full view of the whole cycle of epidemics in their mutual sequences for years yet to come.”
A signal instance of his philosophic moderation is given in the following extract: “For my own part, I am not ambitious of the name of a philosopher, and those who think themselves so, may perhaps consider me blameable on the score of my not having attempted to pierce into those penetralia. Now, writers like these I would just recommend, before they blame others, to try their hand upon some common phenomena of nature that meet us at every turn. For instance, I would fain know why a horse attains its prime at seven, and a man at one-and-twenty years? Why, in the vegetable kingdom, some plants blow in May and others in June? There are numberless questions of this sort. Hence, if many men of consummate wisdom are not ashamed to proclaim their ignorance in these matters, I cannot see why I am to be called in question for doing the same. Etiology is a difficult, and, perhaps, an inexplicable affair; and I choose to keep my hands clear of it. I am convinced, however, that Nature here, as elsewhere, moves in a regular and orderly manner.”
In how wise and firm a tone does Sydenham denounce and demolish the quacks and patent medicine vendors! He considers that any man who can, by any sure line of treatment, or by the application of any specific remedy, control the course of diseases or cut them short, is bound by every possible bond to reveal to the world in general so great a blessing to his race. If he withheld it, he pronounced him a bad citizen and an unwise man; for no good citizen would monopolise for himself a general benefit for his kind, and no wise man would divest himself of the blessing he might reasonably expect from his Maker in contributing to the welfare of the world.
Sydenham stands out as a great advocate and champion of Peruvian bark, which, in its modern form of quinine, has justified all that he claimed for it. He is also the founder of the “expectant” treatment. “My chief care,” he says, “in the midst of so much darkness and ignorance, is to wait a little, and proceed very slowly, especially in the use of powerful remedies, in the meantime observing its nature and procedure, and by what means the patient was relieved or injured.”
The new treatise at once attracted attention, and was reviewed in the Philosophical Transactions for 1666. In the same year there appeared a Dutch edition of the Method. The value and the effect of this treatise we can scarcely fully appreciate at the present time, but its pith is well given by Dr. John Brown, author of the “Horæ Subsecivæ.” “Besides their broad, accurate, vivid delineations of disease—portraits drawn to the life, and by a great master—and their wise, simple, rational rules for treatment, active and negative, general and specific—there are two great principles continually referred to as supreme in the art of medicine. The first is that nature cures diseases; that there is a recuperative and curative power, the vis medicatrix, in every living organism, implanted in it by the Almighty, and that it is by careful reverential scrutiny of this law of restoration that all our attempts at cure are to be guided; that we are its ministers and interpreters, and neither more nor less; and the second, that symptoms are the language of a suffering and disordered and endangered body, which it is the duty of the physician to listen to, and as far as he can to explain and satisfy, and that, like all other languages, it must be studied. This is what he calls the natural history of diseases.... What Locke did for the science of mind, what Harvey and Newton did for the sciences of organic and inorganic matter, Sydenham did for the art of healing and of keeping men whole: he made it in the main observational; he founded it upon what he himself calls downright matter of fact, and did this not by unfolding a system of doctrines or raising up a scaffolding of theory, but by pointing to a road, by exhibiting a method—and moreover teaching this by example, not less than by precept—walking in the road, not acting merely as a finger-post, and showing himself to be throughout a true artsman and master of his tools. The value he puts upon sheer, steady, honest observation, as the one initial act and process of all true science of nature, is most remarkable; and he gives himself, in his descriptions of disease in general and of particular cases, proofs quite exquisite of his own powers of persevering, minute, truthful scrutiny.”
In 1668 a second edition of the Method was published, with additions, especially a chapter on the Plague, and prefaced by a eulogistic address in Latin verse, extending to fifty-four lines, by the illustrious Locke. In 1676 appeared the third edition of the Method, so much enlarged that it is better regarded as the first edition of the “Medical Observations.” In the same year Sydenham proceeded to the degree of Doctor of Medicine, not at Oxford, but at Cambridge, this choice being probably due to the fact that his son had entered at Pembroke College, Cambridge, two years before.
From the preface to his treatise on gout and dropsy, published in 1683, we find that Sydenham was compelled to lay aside his project of a complete book on chronic diseases by the extreme attacks of gout which his labours brought on. “Whenever I returned to my studies,” he says, “my gout returned to me.” A few years before, in 1677, he had been prevented from practising by a severe attack of gout, and he was compelled to spend another three months in the country to restore his health. He continued his labours, however, it is to be believed, beyond his strength, and several editions of his works, with fresh observations, were issued in the later years of his life. He died at his house in Pall Mall on the 29th of December, 1689, aged sixty-five, being buried at St. James’s, Westminster. The truly appropriate description, “Medicus in omne ævum nobilis,” was given of him by the College of Physicians in 1810, when a mural tablet was raised to his memory near his place of burial.
Sydenham’s will shows that he had three sons—William, Henry, and James—the eldest of whom received entailed estates in Hertfordshire and Leicestershire. He bequeathed £30 for the professional education of his nephew James, afterwards Sir James Thornhill, Hogarth’s father-in-law. Sydenham’s executor was Mr. Malthus, an apothecary of Pall Mall (great-grandfather of Professor Malthus), whom he enjoins to bury him with a careful abstinence from all ostentatious funeral pomp.
It is perhaps not necessary to regret so acutely the lack of biographical details regarding Dr. Sydenham, as many have done, for we think that his character stands out clearly in his writings. In his letter to Dr. Mapletoft, already referred to, he says:—