Hardly anything is known of Sydenham's personal history in London. He died in London on the 29th of December 1689, and was buried in the church of St James's, Piccadilly, where a mural slab was put up by the College of Physicians in 1810.
Although Sydenham was a highly successful practitioner and saw, besides foreign reprints, more than one new edition of his various tractates called for in his lifetime, his fame as the father of English medicine, or the English Hippocrates, was decidedly posthumous. For a long time he was held in vague esteem for the success of his cooling (or rather expectant) treatment of small-pox, for his laudanum (the first form of a tincture of opium), and for his advocacy of the use of Peruvian bark in quartan agues. There were, however, those among his contemporaries who understood something of Sydenham's importance in larger matters than details of_ treatment and pharmacy, chief among them being the talented Richard Morton. But the attitude of the academical medicine of the day is doubtless indicated in Martin Lister's use of the term " sectaries " for Sydenham and his admirers, at a time (1694) when the leader had been dead five years. If there were any doubt that the opposition to him was quite other than political, it would be set at rest by the testimony of Dr Andrew Brown,[1] who went from Scotland to inquire into Sydenham's practice and has incidentally revealed what was commonly thought of it at the time, in his Vindicatory Schedule concerning the New Cure of Fevers. In the series of Harveian orations at the College of Physicians, Syden- ham is first mentioned in the oration of Dr John Arbuthnot (1727), who styles him " aemulus Hippocratis." H. Boerhaave, the Leydcn professor, was wont to speak of him in his class (which had always some pupils from England and Scotland) as " Angliae lumen, artis Phoebum, veram Hippocratici viri speciem." A. von Haller also marked one of the epochs in his scheme of medical progress with the name of Sydenham. He is indeed famous because he inaugurated a new method and a better ethics of practice, the worth and diffusive influence of which did not become obvious (except to those who were on the same line with himself, such as Morton) until a good many years afterwards. It remains to consider briefly what his innovations were.
First and foremost he did the best he could for his patients, and made as little as possible of the mysteries and traditional dogmas of the craft. All the stories told of him are characteristic. Called to a gentleman who had been subjected to the lowering treatment, and finding him in a pitiful state of hysterical upset, he "conceived that this was occasioned partly by his long illness, partly by the previous evacuations, and partly by emptiness. I therefore ordered him a roast chicken and a pint of canary." A gentleman of fortune who was a victim to hypochondria was at length told by Sydenham that he could do no more for him, but that there was Jiving at Inverness a certain Dr Robertson who had great skill in cases like his; the patient journeyed to Inverness full of hope, and, finding no doctor of the name there, came back to London full of rage, but cured withal of his complaint. Of a piece with this is his famous advice to Sir Richard Blackmore. When Blackmore first engaged in the study of physic he inquired of Dr Sydenham what authors he should read, and was directed by that physician to Don Quixote, "which," said he, "is a very good book; I read it still." There were cases, he tells us, in his practice where " I have consulted my patient's safety and my own reputation most effectually by doing nothing at all." It was in the treatment of smallpox that his startling innovations in that direction made most stir. It would be a mistake, however, to suppose that Sydenham wrote no long prescriptions, after the fashion of the time, or was entirely free from theoretical bias. Doctrines of disease he had, as every practitioner must have ; but he was too much alive to the multi- plicity of new facts and to the infinite variety of individual con- stitutions to aim at symmetry in his theoretical views or at con- sistency between his practice and his doctrines; and his treatment was what he found to answer best, whether it were secundum artem or not. His fundamental idea was to take diseases as they pre- sented themselves in nature and to draw up a complete picture (" Krankheitsbild " of the Germans) of the objective characters of each. Most forms of ill-health, he insisted, had a definite type, comparable to the types of animal and vegetable species. The con- formity of type in the symptoms and course of a malady was due to the uniformity of the cause. The causes that he dwelt upon were the " evident and conjunct causes," or, in other words, the morbid phenomena ; the remote causes he thought it vain to seek after. Acute diseases, such as fevers and inflammations, he regarded as a wholesome conservative effort or reaction of the organism to meet the blow of some injurious influence operating from without; inthis he followed the Hippocratic teaching closely as well as the Hippocratic practice of watching and aiding the natural crises. Chronic diseases, on the other hand, were a depraved state of the humours, mostly due to errors of diet and general manner of life, for which we ourselves were directly accountable. Hence his famous dictum: "acutos dico, qui ut plurimum Deum habent authorem, sicut chronici ipsos nos." Sydenham's nosological method is essentially the modern one, except that it wanted the morbid anatomy part, which was first introduced into the "natural history of disease" by Morgagni nearly a century later. In both departments of nosology, the acute and the chronic, Sydenham contributed largely to the natural history by hisown accurate observation and philosophical comparison of case with case and type with type. The Observationes medicae and the first Epistola responsoria contain evidence of a close study of the various fevers, fluxes and other acute maladies of London over a series of years, their differences from year to year and from season to season, together with references to the prevailing weather—the whole body of observations being used to illustrate the doctrine of the "epidemic constitution" of the year or season, which he considered to depend often upon inscrutable telluric causes. The type of the acute disease varied, he found, according to the year and season, and the right treatment could not be adopted until the type was known. There had been nothing quite like this in medical literature since the Hippocratic treatise, Περί άέρων, ύδάτων, τόπων; and there are probably some germs of truth in it still undeveloped, although the modern science of epidemiology has introduced a whole new set of considerations. Among other things Sydenham is credited with the first diagnosis of scarlatina and with the modern definition of chorea (in Sched. monit.). After small-pox, the diseases to which he refers most are hysteria and gout, his description of the latter (from the symptoms in his own person) being one of the classical pieces of medical writing. While Sydenham s " natural history " method has doubtless been the chief ground of his great post- humous fame, there can be no question that another reason for the admiration of posterity was that which is indicated by R. G. Latham, when he says, " 1 believe that the moral element of a liberal and candid spirit went hand in hand with the intellectual qualifications of observation, analysis and comparison."
Among the lives of Sydenham are one (anonymous) by Samuel Johnson in John Swan's translation of his works (London, 1742), another by C. G. Kuhn in his edition of his works (Leipzig, 1827), and a third by Dr R. G. Latham in his translation of his works published in London by the Sydenham Society in 1848. See also Frdderic Picard, Sydenham, sa vie, ses œuvres (Paris, 1889), and J. F. Payne, T. Sydenham (London, 1900). Dr John Brown's " Locke and Sydenham," in Horae subsecivae (Edinburgh, 1858), is of the nature of eulogy. Many collected editions of his works have been published, as well as translations into English, German, French and Italian. Dr W. A. Greenhill's Latin text (London, 1844, Syd. Soc.) is a model of editing and indexing. The most interesting summary of doctrine and practice by the author himself is the introduction to the 3rd edition of Observationes medicae (1676).
SYDENHAM, a large residential district in the south of London, England, partly within the metropolitan borough of Lewisham (q.v.). The Crystal Palace (q.v.) is in this district.
SYDNEY, the capital of New South Wales, Australia, in Cumberland county, on the east coast of the continent, situated on the south shore of Port Jackson, in 33° 15' 44" S., 151° 12' 23" E. Few capitals in the world can rival Sydney in natural advantages and beauty of site. It stands on undulating and easily drained ground, upon a bed of sandstone rock, on a peninsula jutting into one of the deepest, safest and most beautiful harbours in the world; and in addition it lies in the centre of a great carboniferous area. The metropolitan area of Sydney consists of a peninsula, about 13 m. in length, lying between the Parramatta and George's rivers. The sea frontage of this area stretches for 12 m. from the South Head of Port Jackson to the North Head of Botany Bay; it consists of bold cliffs alternating with beautiful beaches, of which some are connected with the city by tramway, and form favourite places of resort. The city proper occupies two indented tongues of land, having a water frontage on Port Jackson, and extending from Rushcutter's Bay on the east to Blackwattle Bay on the west, a distance of 8 m., nearly two miles of which is occupied by the Domain and the botanical gardens. The business quarter is a limited area lying between Darling Harbour and the Domain. The streets are irregular in width, some of them narrow and close together, while those leading down to Darling Harbour have a steep incline. Sydney has in consequence more than usually the appearance of an old-world town.
The main street of the city, George Street, is 2 m. long, running from north to south; it contains the town-hall, the post office and the Anglican cathedral. The post office is a handsome sandstone building in Renaissance style; it is colonnaded on two sides with polished granite columns and surmounted by a clock tower, containing a peal of bells. The town-hall, a large
- ↑ See Dr John Brown's Horae subsecivae, art. "Dr Andrew Brown and Sydenham."
