Dr. Thomas Sydenham (1624-1689): his life and original writings / [edited by] Kenneth Dewhurst.

  • Thomas Sydenham
Date:
1966
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Dr. Thomas Sydenham (1624-1689): his life and original writings / [edited by] Kenneth Dewhurst. Source: Wellcome Collection.

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    Although humoral pathology was Sydenham's general working hypothesis, he discarded it whenever he found that his own clinical experience was at variance with its tenets. He had found by experience, for example, that a cooling regimen mitigated the symptoms of small pox, and when treating variolous patients he always put aside humoral doctrines. To his merit, Sydenham placed more reliance on empirical findings than upon humoral theory; and any doubts were settled by a final appeal to observable facts rather than to theory. Now if the present reasons be insufficient to prove absolutely that my view is the right one [he wrote], 1 1 shall be contented with the evidence of experience. This says that fevers like the present yield very slowly to the sweating treatment; which is enough—since it is not reason but experience which teaches us what fevers are cured by diaphoresis, and what by other evacuations. As to speculative reasons, no wise man, who knows the nature of either men or things, will fail to see that there is no certain experiment by which they can be tested. There is also some incompatibility in Sydenham's general acceptance of humoral pathology and his use of, and search for, other specific medicines, such as quinine, which had no heating, cooling, or purging action. As soon as he realized that cinchona bark was a specific remedy in intermittent fevers, Sydenham discarded humoral notions and strongly advocated its benefits to all his colleagues. According to Yost, 2 the success of his cooling regimen and his realization of the specific qualities of quinine caused Sydenham, towards the end of his life, to consider jettisoning humoral pathology as it gradually began to collapse under the weight of various ad hoc hypotheses thrust upon it by empirical facts. While Hippocratic writings revealed to Sydenham the importance of building clinical foundations upon accurate case-histories, it was the works of Bacon and his disciples that gave him the idea of compiling disease-histories from these clinical records. We have not to imagine, or to think out, but to find out what Nature does or produces 3 is one of several quotations from Bacon scattered throughout his works. And in studying the natural history of diseases, Sydenham closely followed Baconian methods similar to those adopted by his friends of the Royal Society in their classification of animals, vegetables, and minerals. But Sydenham included only morbid signs that were macroscopically observable such as the blotchy rash of measles and the puffy swellings of dropsy. He then concluded that these recurrent generic features of a disease would probably respond to the same treatment. In this manner 1 Thomas Sydenham, op. cit., vol. n, p. an. 2 R. M. Yost, op. cit., p. 104. 3 Quoted on title-page of Tractatus de Podagra et Hydrope (1683).