Clinical Trials
Long before there were CROs, meta-analyses, or even stethoscopes, there was James Lind and the first controlled test in medicine.
Lind’s 1753 book Treatise of the Scurvy is an attempt to uncover the causes of the disease then striking down British sailors, and recounts both a randomised comparison of treatments and a systematic review of previous writings on the subject. (The Cochrane Collaboration would have been proud.)
A surgeon’s mate in the Royal Navy who rose to Fellowship of the Royal College of Physicians of Edinburgh, Lind tried out six therapies on twelve scurvy-stricken sailors on board the Salisbury in 1747.
By accommodating sailors in the same quarters and giving them identical diets, “his report thus illustrates his awareness of the need to guard against selection bias and shows how he tried to hold potential confounding factors constant – clinical condition, environment, and basic diet,” says Iain Milne, Sibbald Librarian at the Royal College of Physicians of Edinburgh.
While the patients receiving two oranges and one lemon a day fared well, the other treatments would be unlikely to pass today’s institutional review boards: cider, diluted sulphuric acid, vinegar, sea water, and a paste made from garlic, mustard seed, radish root and gum myrrh were given to the other sailors, says Milne.
