Sydenham's influence abroad.

A DOZEN of these Sydenham Memorial Lectures have already been given and several of them have made a substantial contribution to our knowledge of Sydenham and his times. It was in one of these lectures that Dr. Dewhurst first gave us in summary form the new biography of Sydenham, based on newly accessible sources in the Bodleian Library, which was later published in greatly expanded form in the Weilcome Historical Monograph series.1 It was in another that the late Dr. Richard Trail gave us a detailed study of Sydenham's influence on English medicine. Dr. Hugh Sinclair, an acknowledged authority on the work and writing of the great Dutch clinician, Herman Boerhaave, spoke to us of Sydenham's influence on his ideas, but unfortunately did not publish his lecture. Neither of the standard biographies of Sydenham, the first by J. F. Payne2 and the modern work by Dewhurst, says very much about Sydenham's influence outside England. This is an obvious gap in our historical knowledge which I shall try to fill, at least in outline, in this lecture. Clearly, it is not at all satisfying for a historian simply to declare, as many have, that Sydenham's influence spread rapidly throughout Europe and that his fame has persisted. It is our duty to probe rather more deeply and to inquire how and in what form this influence was spread and how the subsequent development of medicine was affected. In our search we shall follow three particular themes which were held to be the most important in his work among those whom he influenced. The first of these is exemplified by the title of 'The English Hippocrates'. This was certainly not accorded him by his compatriots, who are not given to the kind of adulation which it implies. Although some modern historians trace this title back to the early nineteenth century I have myselffound it in doctoral dissertations from continental universities published within a decade or two of Sydenham's death in 1689, and then not as something new, but as an honorific label already familiar in medical circles. It derives of course from the fact that Sydenham began his work at a time when medical practice was bedevilled by a number of conflicting theories and systems. Galenism was on the way out. Chemical medicine (not medical chemistry be it noted) was in the ascendant and few patients-unless they were Sydenham's-could expect better treatment than that accorded King Charles II in his last illness, of which Sir Raymond Crawfurd has left us a horrifying and detailed account.3 By taking Hippocrates as his sole guide and mentor Sydenham offered his bewildered contemporaries a new hope that there was a better way towards medical enlightenment. Many doctors today, after dipping into some of Sydenham's writings, have asked themselves-and some of them have asked me-why is Sydenham given such a high place in the history ofmedicine? The careful case-histories and descriptions of diseases,