COLLEGE OF PHYSICIANS, WARWICK LANE. QUADRANGLE.
Of the London physicians of the seventeenth century none is better known than Thomas Sydenham. He was born in 1624, joined the Parliamentary army in 1643, and became M.B. Oxon. in 1648. In what his medical education consisted is not clear. It is very doubtful if he was ever at Montpellier or any foreign school. He was a great friend of John Locke. He came to London in 1660, and was a licentiate of the College of Physicians in 1663. Like the rest of the world, he ran away from the plague; but, as he lived in Westminster, he did not probably suffer from the fire. He died in 1689. His “Medical Observations concerning the History and Cure of Acute Diseases” was published in 1666, and was dedicated to Robert Boyle. In the preface of this work he strongly advocates an attempt at a scientific classification of disease by a careful comparison of the phenomena observed in different cases. Accurate diagnosis was the necessary preliminary to finding a reliable methodus medendi. His own descriptions of disease are excellent. Perhaps his account of the gout, from which he suffered, is more often quoted than any other. He was never a Fellow of the College of Physicians. There is no evidence that he ever applied to be made a Fellow. Expressions are frequent in his writings which seem to show that he was not on the best of terms with some of his contemporaries. Sydenham was undoubtedly a man who could think for himself, and perhaps his chief merit lies in the fact that he appreciated much of the medical writing of his time at its true value. It is recorded of him by Dr. Johnson that, “when Sir Richard Blackmore first engaged in the study of physic, he inquired of Dr. Sydenham what authors he should read, and was directed by Dr. Sydenham to “Don Quixote,” “which,” said he, “is a very good book; I read it still.” In this answer of Sydenham’s we perhaps get a clue to his attitude towards the profession. He was one of the first to use Peruvian bark in the treatment of ague, and this must have done much to advance his practice at a time when London was scourged by malarious fever. One of my objects is to bring before you personal facts with regard to some of our professional ancestors, and we get a good idea of Sydenham in that chapter of his “Schedula Monitoria” in which he details his own sufferings. It was in 1660 that he first suffered from the gout, and shortly afterwards symptoms of renal calculus developed, and in 1676 he began to suffer from hæmaturia. “This became,” he says, “afterwards habitual, as often as I either went along a way on foot, or drove in a carriage, no matter how slowly, over the paved streets. On an unpaved road, however, I might drive as far as I chose, and no such harm would occur.” He tried various remedies for this trouble without success. “I therefore made up my mind to try no further, and only guarded against the affection by avoiding as much as I could all motion of the body.” When his urine became bloody he was bled, and he took frequent doses of manna dissolved in whey as a laxative, and sixteen drops of laudanum in small beer at bedtime as a hypnotic. As to the regimen he observed, he says: “On getting out of bed I drink a dish or two of tea, and ride in my coach till noon, when I return home and moderately refresh myself (for moderation is well in all) with some sort of easily digestible meat that I like. Immediately after dinner, I drink rather more than a quarter of a pint of Canary wine to promote the concoction of the food in the stomach, and to drive away the gout from the bowels. After dinner I ride in my coach again, and (unless prevented by business) am driven out for two or three miles in the country for change of air. A draught of thin small beer serves for supper, and I repeat this even after I have gone to bed and am about to compose myself to sleep. I hope by this julep to cool and dilute the hot and acrid juices lodged in the kidneys, whereby the stone is occasioned.” He goes on to state that he prefers the “hopped small beer,” and “to prevent bloody urine I take care as often as I drive any distance over the stones to drink a free draught of this small beer upon getting into my coach, and also, if I am out long, before my return, a precaution which has always been sufficient.” Occasionally he suffered from what may be called a gastric crisis, and “in this case I drench myself with more than a gallon of posset, or else of this small beer: and, as soon as I have got rid of the whole by vomiting, take a small draught of canary wine with eighteen drops of the liquid laudanum, and, going to bed, compose myself to sleep. By this method I have escaped imminent death more than once.” In an attack of nephritic colic occurring in a patient of sanguine temperament, Sydenham took ten ounces of blood from the arm on the same side with the kidney affected. “After this a gallon of posset drink, wherein two ounces of marsh-mallow roots have been boiled, must be taken without loss of time, followed by the injection of the following enema: Marsh-mallow roots and lily-roots, of each one ounce; mallow-leaves, pellitory, bears’ breech, and chamomile flowers, of each a handful; linseed and fennugreek, of each half an ounce; water in sufficient quantity. Boil down to half a pint; strain; dissolve in the clear liquor two ounces each of kitchen sugar and syrup of marsh-mallow; mix and make into a clyster. After the patient has vomited and been purged, a full dose of twenty drops of liquid laudanum is to be given, or else fifteen or sixteen grains of Matthew’s pills.” Sydenham lived in Pall-Mall, and Cunningham in his Handbook of London has the following anecdote, which is of interest in connexion with his small beer and canary: “Mr. Fox told Mr. Rogers that Sydenham was sitting at his window looking on the Mall 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, says Fox, before he got among the bushes in Bond Street, and there they lost him.” Sydenham lived in Pall-Mall from 1664 to 1689, and was buried in St. James’s Church. A near neighbour of his was Madame Elinor Gwynne, over whose garden wall King Charles II. used often to look as he walked in the Mall in St. James’s Park. Sydenham, I have said, was a licentiate of the College of Physicians, and was never a Fellow. In Chamberlayne’s “Present State of England” for 1682 I find a list of the Fellows, candidates, honorary Fellows, and licentiates of the College of Physicians. The name of Thomas Sydenham does not occur in this list, although it contains the name of his son, Dr. William Sydenham. In 1684 Dr. Hans Sloane, a young physician afterwards to be very famous, took up his abode with Sydenham. It was not till after Sydenham’s death that his reputation reached the exalted position in which it has been held.
In the lives of many of the early physicians are interesting facts which throw considerable light on the progress of medicine, both as a branch of knowledge and a profession; but the exigencies of time and space compel me to be brief.
Samuel Collins, who was president of the College in 1695, was one of the earliest comparative anatomists, and wrote a work entitled “A System of Anatomy treating of the Body of Man, Beasts, Birds, Fishes, Insects, and Plants.” I am not acquainted with the work, but the title seems to indicate that he had enlarged views on the question of biology. Nehemiah Grew, who was secretary to the Royal Society in 1677, and an honorary Fellow of the College in 1682 (and possibly earlier), is said to have been the first who saw the analogy between animals and plants, and to establish the fact of sex in plants. In medicine he introduced Epsom salts, which he obtained by evaporating Epsom water, so that we owe him a great debt, and undoubtedly he is one of the greatest men who has been connected with the College. Sir Edmund King was surgeon to Charles II., and was made an honorary F.R.C.P. by command of His Majesty. Charles II. being seized with apoplexy on Feb. 2nd, 1684, King promptly bled His Majesty without consultation. His act was subsequently approved by his colleagues, and he was ordered £1,000 by the Privy Council, which was never paid. Francis Bernard was apothecary to St. Bartholomew’s Hospital, and when the staff of that institution ran away from the plague, Bernard stopped at his post and ministered to the wants of the patients. For this he was rewarded by being made assistant physician to the hospital, and became honorary F.R.C.P. in 1680. He died in 1697, and is buried in St. Botolph’s, Aldersgate.
SECRET REMEDIES.
Two centuries ago, and even later than this, it was not thought unprofessional for a physician to have secret remedies. Thus Dr. Goddard, who was much trusted by Oliver Cromwell, who was one of the original members of the Royal Society, professor at Gresham College, the friend of Sydenham, and a Fellow of the College in 1646, was the inventor of “Goddard’s drops.” The most notable instance of “professional secrets,” however, is that of the midwifery forceps. This was the secret of the Chamberlen family, of whom I will mention two. Peter Chamberlen (M.D. Padua, F.R.C.P. 1628) was probably the first fashionable obstetrician, and is supposed to have been the inventor of the forceps. He made an attempt to organise the monthly nurses, was much employed about the English court, and had eighteen children by his two wives. Hugh Chamberlen, the son of Hugh Chamberlen and the nephew of Peter Chamberlen (F.R.C.P. 1694), was the most celebrated man-midwife of his day. He published a translation of Mauriceau’s Midwifery, and in the preface to that book he says: “I will now take leave to offer an apology for not publishing the secret I mention we have to extract children without hooks where other artists use them; viz., there being my father and two brothers living that practise this art, I cannot esteem it my own to dispose of nor publish it without injury to them, and I think I have not been unserviceable to my own country, although I do but inform them that the forementioned three persons of our family and myself can serve them in these extremities with greater safety than others.” This is a very pretty specimen of medical ethics on the part of one who was a censor of the College as late as 1721. What are probably the original forceps were accidentally discovered, in 1815, at Woodham Mortimer Hall, Essex, formerly the residence of Peter Chamberlen. “They were found under a trap-door in the floor of the uppermost of a series of closets, built over the entrance porch,” and may now be seen in the library of the Royal Medico-Chirurgical Society. Hugh Chamberlen is buried in Westminster Abbey, where a Latin epitaph of seventy-two lines, by Bishop Atterbury, adorns his tomb.
I feel tempted to mention two or three more of the early physicians who are deservedly famous, but in doing so I must limit myself to those who flourished mainly in the seventeenth century.
John Radcliffe, who became F.R.C.P. in 1687, appears to have been a blustering, kindly, and successful practitioner. He spoke his mind freely, even to monarchs, and seems to have made his way more by push than courtesy. His chief claim to be remembered is as a public benefactor. He accumulated a large fortune, and founded at Oxford the Radcliffe Library, Radcliffe Infirmary, Radcliffe Observatory, and Radcliffe Travelling Fellowship, and also left £500 a year to St. Bartholomew’s Hospital, London, for improving the diets of the patients. Radcliffe was only one of many London doctors who have been great public benefactors. I have already alluded to Linacre, Caius, Harvey, Baldwin Hamey, Caldwell, and Croon, and the list may be enlarged by mentioning Sir Hans Sloane (who founded the British Museum and gave the Chelsea Garden to the Apothecaries’ Society), William and John Hunter, Erasmus Wilson, and Richard Quain—the last and the most munificent benefactor of this (University) College.
Sir Hans Sloane was born in 1660, became F.R.C.P. in 1687, was president from 1719 to 1735, and died in 1753 in his ninety-fourth year. He was president of the Royal Society from 1727 (succeeding Sir Isaac Newton), and retired to Chelsea in 1740, where his name still lives in Sloane Street and Hans Place. In his youth he accompanied the Duke of Albemarle to Jamaica, and returned home with a valuable botanical collection. He was a great accumulator of archæological and natural curiosities, and his collection was by his will offered to the nation at a nominal sum, and thus was founded the British Museum. Sir Hans Sloane was born in the last days of the Commonwealth, only three years after the death of Harvey. In Evelyn’s Diary we read how, on April 16th, 1691, he (Evelyn) “went to see Dr. Sloane’s curiosities, being an universal collection of the natural productions of Jamaica,” &c. He lived in the reign of Charles II., James II., Anne, William III., George I., and George II., and died five years after the birth of Jeremy Bentham, who was so active in the foundation of University College.