Page:Encyclopædia Britannica, Ninth Edition, v. 22.djvu/842

 806 S Y D S Y D what was commonly thought of it at the time, in his ftndvatory Schedule concerning the New Cure of Fevers. In the series of Harveian orations at the College of Physicians, Sydenham is first mentioned in the oration of Arbuthnot (1727), who styles him "aemulus Hippocratis. " Boerhaave, the Leyclen professor, was wont to speak of him in his class (which had always some pupils from England and Scotland) as "Angliae lumen, artis Phcebum, veram Hippocratici viri speciem." Haller also marked one of the epochs in his scheme of medical progress with the name of Syden- ham. 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 after- wards. 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 living 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 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 effectu- ally by doing nothing at all." It was in the treatment of small- pox 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 sccundum 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 ; in this 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 Deiim 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 his own accurate ob- servation and philosophical comparison of case with case and type with type. The Observationes Mcdicse and the first Epistola Respon- soria 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 ob- servations 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, Iltpl dtpuv, vddruv, rbirwv ; 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 smallpox, 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, "I believe that the moral element of a liberal and candid spirit went hand in hand with the intellectual qualifications of observation, analysis, and comparison." The most critical biography is that by Dr R. G. Latham prefixed to his translation of Sydenham's Works (2 vols., London, 1848, Syd. Soc.). Dr John Brown's " Locke and Sydenham," in Horse Subsecivse, Edinburgh, 1858, is more of the nature of eulogy. Many collected editions of his works have been pub- lished, as well as three English translations. Dr W. A. Greenhill's Latin text (London, 1844, Syd. Soc.) is a model of editing and indexing. There have been foreign monographs on Sydenham by Goeden (Berlin, 1827), Rovers (Dort, 183S), F. Jahn (Eisenach, 1840), and Hvasser (Upsala, 1846). The most inter- esting summary of doctrine and practice by the author himself is the introduc- tion to the 3d ed. of Observationes Medicae (1676). (0. C.) SYDNEY, the capital of New South Wales, and the oldest city in Australia, is situated on the east coast of that island-continent in 33 51' 41" S. lat. and 151 12' 23"-25 (lOh. 4m. 49'55s.) E. long. It lies on the southern shore of the magnificent harbour of Port Jackson, which in 1770 was named, though not discovered, by Captain Cook. He anchored and landed in Botany Bay, about 6 miles to the south, and on afterwards coasting to the north noted what looked like an inlet, to which he gave the name of Port Jackson, after Sir George Jackson, one of the secretaries to the admiralty. It may seem strange that so careful an observer as Cook should have passed close to one of the finest harbours in the world without recog- nizing its capacity ; but the cliffs which guard the entrance are 300 feet in height, and no view of the landlocked basin can be seen from the masthead. Middle Head, which is posted right opposite the entrance, closes it in, and it is necessary to enter, turn to the south, and then to the west before the best part of the harbour discloses itself. This topographical peculiarity gives to the port its great shelter. When in 1788 Captain Phillip arrived at Botany Bay with the first convict fleet, he found its shallow waters and flat shores unsuited for the purposes of a settlement. Strangely enough he was also deterred by the want of water ; yet it is on that very shore that the pumping-engine is situated by which Sydney has been supplied for many years. Going northwards, he turned in to examine Port Jackson inlet. Thither the fleet was instantly removed ; and Sydney was founded, and Australian colonization started, on 26th January 1788. Captain Phillip's choice of a site was de- termined by the existence of fresh water in a small stream running into Sydney Cove. FIG. 1. Harbour and environs of Sydney. The port is flanked on both sides by a number of pro- montories its characteristic feature so that in addition to a broad central channel with deep water there is both on the north and the south side a series of sheltered bays with good anchorage. The entrance is a mile wide, with a minimum depth of 15 fathoms. Some little distance inside is a rock awash, known as the Sow and Pigs, between which and the nearest headlands on either side is an inner bar, with 20 feet of water at low tide ; through this bar on the southern side a ship channel has been dredged giving 27 feet of water at neap tide. On the southern side there occur in succession Watson's Bay, Rose