Thomas Sydenham: The English Hippocrates, Laudanum and the Jesuits' Bark

In seventeenth-century London, most learned physicians reasoned about disease from ancient books and theories of the humours. Thomas Sydenham, a former Parliamentarian army officer who practised in Westminster from about 1660 until his death in 1689, did something that sounds obvious today and was unusual then: he watched his patients closely, wrote down what he saw year after year, and judged his medicines by what they actually did. Two of the medicines he became famous for came straight from plants — opium from the poppy, which he gave as his own liquid “laudanum”, and the powdered bark of the South American cinchona tree, the “Peruvian” or “Jesuits’ bark”, which he came to call his “sheet-anchor” against the intermittent fevers. Admirers called him “the English Hippocrates”.

This wing tells his story in four deep-dive articles: his life through the Civil War and the Restoration, his laudanum and his words on opium, the long road by which he came to trust the bark, and his bedside method with the diseases he described — scarlet fever, gout, and the childhood “Saint Vitus’s dance” now called Sydenham’s chorea. The overview below gives the whole story on one page. It is history and science for curious readers. Opium and the bark are reported as history and pharmacology; no preparation, quantity or dose is given anywhere in this wing, and nothing here is guidance on use.

Table of Contents

  1. Deep-Dive Articles
  2. 1. Who Thomas Sydenham Was
  3. 2. Two Plant Remedies on One Page
  4. 3. The Bedside Method and the Diseases He Described
  5. 4. Words Often Attributed to Him
  6. 5. Timeline at a Glance
  7. 6. Later Significance
  8. Key Research Papers
  9. Connections
  10. Featured Videos

Deep-Dive Articles

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Thomas Sydenham: Life and Times

A Dorset gentry family, Oxford interrupted by the Civil War, an irregular medical degree in 1648, a Westminster practice and friendship with John Locke, thirty-four years of gout, and death in Pall Mall in 1689.

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Sydenham's Laudanum: Opium as a Seventeenth-Century Remedy

The poppy in ancient medicine, his liquid laudanum and why he made it, his praise of opium in his own translated words, and what followed: morphine, opioid science, poisoned infants, addiction and regulation.

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The Jesuits' Bark: Sydenham, Cinchona and the Intermittent Fevers

How the bark of an Andean tree reached London, why Sydenham began cautiously in 1666, Robert Talbor’s Essex practice, the 1680 “sheet-anchor” letter, and the road from bark to quinine and artemisinin.

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Bedside Observation: Sydenham's Method, His Diseases and His Legacy

Diseases sorted into species like plants, London’s epidemic constitutions, scarlet fever, gout described from the inside, Saint Vitus’s dance, and what later research found behind them.

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1. Who Thomas Sydenham Was

Thomas Sydenham was born in September 1624 at Wynford Eagle in Dorset, into a family of country gentry. He went up to Magdalen Hall, Oxford, but the Civil War broke into his studies, and he served as an officer on the side of Parliament; his brother William became a Parliamentarian colonel. After the war he returned to Oxford, was elected a Fellow of All Souls in place of an expelled Royalist, and in April 1648 took the degree of Bachelor of Medicine — “irregularly”, as his Victorian biographer R. G. Latham put it, without first taking a degree in Arts. A tradition that he then studied at Montpellier rests only on one later French writer, and Latham himself doubted it.

In 1655 he resigned his fellowship and married Mary Gee, and by about 1660 he was in practice in Westminster. The College of Physicians licensed him in June 1663 after three examinations, but he never became a Fellow of the College; his doctorate of medicine came late, from Pembroke Hall, Cambridge, in 1676. The philosopher John Locke was his friend and went with him on visits to patients, and the chemist Robert Boyle encouraged him — Sydenham dedicated his first book, the Methodus curandi febres of 1666, to Boyle.

He was himself a patient for most of his career. Gout began around 1649, and in his 1683 treatise he described himself as “a man like myself, who has suffered from it thirty-four years”. In the same book he wrote that his “hand trembles too much to hold the pen”. He died at his house in Pall Mall on 29 December 1689, after long illness with gout and a kidney stone, and was buried in St James’s Church, Piccadilly, where the College of Physicians placed a memorial tablet in 1810. The full story is in Life and Times.

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2. Two Plant Remedies on One Page

Latham noted that the short biographies of his day remembered Sydenham for three things: his laudanum, his “cooling” treatment of smallpox, and his use of the Peruvian bark in agues. Two of the three came from plants.

Opium and his liquid laudanum

The opium poppy had been a medicine since antiquity — Theophrastus, Dioscorides, Pliny, Celsus, Galen and Avicenna all knew it — and the word “laudanum” was already linked with Paracelsus a century before Sydenham. What Sydenham added was his own liquid version: a tincture of opium in sherry wine with saffron, cinnamon and cloves, steeped and then strained. He did not claim it was stronger than solid opium. In the 1848 Sydenham Society translation of his works, he wrote: “Its merit consists in being of a more convenient form, and more uniform in the action of its doses.”

His praise of opium is among the most quoted passages in the history of medicine. In the same translation it reads: “And here I cannot but break out in praise of the great God, the Giver of all good things, who hath granted to the human race, as a comfort in their afflictions, no medicine of the value of opium, either in regard to the number of diseases that it can control, or its efficiency in extirpating them.” He added that “medicine would be a cripple without it”. The later history of opium includes the hazards he did not foresee: the historian Michael Obladen documents thousands of reported fatal poisonings of infants given opium “soothers” over the centuries, and nineteenth-century laudanum left a long record of addiction before early twentieth-century laws restricted it. The full story is in Sydenham’s Laudanum.

The Jesuits’ bark

The second plant was the bark of the cinchona tree from the Andes. According to the chronology Latham drew from Sir George Baker, it reached Spain in the 1630s, was promoted in Italy by the Spanish Jesuit cardinal Juan de Lugo, was distributed from Rome through the Jesuits from 1649, and appears to have reached England around 1655. A London newspaper advertised “Jesuites powder” in December 1658.

Sydenham did not trust it at first. In 1666 he wrote that, given just before a fit, “it has killed the patient”, though “in the decline of these fevers, Peruvian bark, cautiously given, has sometimes done good”. Meanwhile Robert Talbor, a contemporary without a medical degree, was treating agues with a secret bark remedy in the Essex marshes and was later knighted and rewarded by Louis XIV; whether Talbor’s success shaped Sydenham’s growing confidence is a question discussed by Baker, Latham and, more recently, T. W. Keeble. By 1680 Sydenham wrote that “the Peruvian bark became my sheet-anchor”, and that if he were as sure of the permanence of its effect as of its harmlessness, “I should look upon it as the prince of medicines.” He used the powdered bark itself: quinine, its main active alkaloid, was isolated only in 1820, by Pelletier and Caventou. The full story is in The Jesuits’ Bark.

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3. The Bedside Method and the Diseases He Described

Sydenham’s lasting idea was that diseases are distinct kinds, each with its own regular course, and can be described the way botanists describe plants. In the preface to his Observationes medicae of 1676 he wrote that “all diseases be reduced to definite and certain species”, with “the same care which we see exhibited by botanists in their phytologies”. The historian G. G. Meynell has examined John Locke’s part in that preface, and Mason and Hsin trace the botanical model of disease classification from Sydenham through Sauvages and Linnaeus into modern psychiatry. Sydenham himself put the method in one line: the physician’s task was the investigation of the history of diseases and of the effect of remedies, “as shown by the only true teacher — experience”.

He recorded London’s epidemics year by year from 1661 as a series of “epidemic constitutions”. He described scarlet fever as distinct from measles, with “small red maculae, thicker than those of measles” and peeling skin afterwards, and he described whooping cough. His 1683 account of a gout attack, written by a sufferer, is still quoted: the patient “is awakened by a severe pain in the great toe” that “cannot bear the weight of the bedclothes”. In 1686 he described the jerking movements of children with “Saint Vitus’s dance”, now named Sydenham’s chorea. His treatments were largely those of his century — bleeding and purging among them — and A. W. Sloan notes that his treatment was largely traditional, while his meticulous records paved the way for the clinical approach. The full story is in Bedside Observation.

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4. Words Often Attributed to Him

Several lines are widely credited to Sydenham that this wing does not quote as his words. A popular English version of his opium passage, beginning “Of all the remedies it has pleased almighty God to give man”, appears in many modern articles but was not found in the 1848 Sydenham Society translation used here, so the pages in this wing quote that translation instead. The saying “a man is as old as his arteries” is described even by the paper that uses it as a title as only “attributed” to him. Some modern accounts also write that he “advocated quinine”; that is an anachronism, since quinine was not isolated until 131 years after his death. And his Victorian biographer’s text gives his birth year as 1634, an error contradicted by the memorial tablet, which records that he was born in 1624 and lived 65 years.

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5. Timeline at a Glance

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6. Later Significance

Both of Sydenham’s plant remedies became the starting points of modern drugs. Opium led, through Sertürner’s isolation of morphine, to alkaloid chemistry and eventually to the study of opioid receptors; Norn and colleagues note that a non-addictive opiate is still elusive. The cinchona bark led to quinine, and a 2011 review by Achan and colleagues describes quinine as still in use almost 400 years after its effectiveness was first documented — an alternative to artesunate for severe malaria and still important in the first trimester of pregnancy. Artesunate itself descends from another plant medicine, sweet wormwood, the story of Tu Youyou.

The diseases he described also found their causes. The chorea he observed in children is now understood as the neurological form of acute rheumatic fever after a group A streptococcal throat infection; Cardoso’s review describes antibodies raised against the bacterium that cross-react with the basal ganglia of the brain. The gout attack he lived through was traced in 1961 to urate crystals in the joint fluid, the finding of McCarty and Hollander. And his idea that diseases are distinct species, each to be described from the bedside, runs through later classifications of disease, which is why historians such as Kenneth Dewhurst called him a “reformer of clinical medicine” and others “the father of clinical observation”.

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Key Research Papers

  1. Dewhurst K. Thomas Sydenham (1624-1689) reformer of clinical medicine. Med Hist. 1962;6(2):101-18. PubMed PMID: 16562238
  2. Sloan AW. Thomas Sydenham, 1624-1689. S Afr Med J. 1987;72(4):275-8. PubMed PMID: 3303370
  3. Pearce JM. Thomas Sydenham "The British Hippocrates". J Neurol Neurosurg Psychiatry. 1995;58(3):292. PubMed PMID: 7897408
  4. Low G. Thomas Sydenham: The English Hippocrates. Aust N Z J Surg. 1999;69(4):258-62. PubMed PMID: 10327115
  5. Bloch H. Thomas Sydenham, MD (1624-1689): the father of clinical observation. J Fam Pract. 1994;38(1):80-1. PubMed PMID: 8289057
  6. Meynell GG. John Locke and the preface to Thomas Sydenham's Observationes medicae. Med Hist. 2006;50(1):93-110. PubMed PMID: 16502873
  7. Mason D, Hsin H. 'A more perfect arrangement of plants': the botanical model in psychiatric nosology, 1676 to the present day. Hist Psychiatry. 2018;29(2):131-146. PubMed PMID: 29480060
  8. Norn S, Kruse PR, Kruse E. [History of opium poppy and morphine]. Dan Medicinhist Arbog. 2005;33:171-84. PubMed PMID: 17152761
  9. Obladen M. Lethal Lullabies: A History of Opium Use in Infants. J Hum Lact. 2016;32(1):75-85. PubMed PMID: 26163533
  10. Permin H, Norn S, Kruse E, Kruse PR. On the history of Cinchona bark in the treatment of Malaria. Dan Medicinhist Arbog. 2016;44:9-30. PubMed PMID: 29737660
  11. Keeble TW. A cure for the ague: the contribution of Robert Talbor (1642-81). J R Soc Med. 1997;90(5):285-90. PubMed PMID: 9204030
  12. Achan J, Talisuna AO, Erhart A, Yeka A, Tibenderana JK, Baliraine FN, Rosenthal PJ, D'Alessandro U. Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria. Malar J. 2011;10:144. PubMed PMID: 21609473
  13. Cardoso F. Sydenham's chorea. Handb Clin Neurol. 2011;100:221-9. PubMed PMID: 21496581
  14. McCarty DJ, Hollander JL. Identification of urate crystals in gouty synovial fluid. Ann Intern Med. 1961;54:452-60. PubMed PMID: 13773775

PubMed Topic Searches

  1. PubMed: Thomas Sydenham history
  2. PubMed: Sydenham chorea and rheumatic fever
  3. PubMed: cinchona bark, history and malaria
  4. PubMed: opium in the history of medicine
  5. PubMed: gout, history and urate

Further Reading

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Connections

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