We've all got used to the phrase 'clinical trial' in recent times, but who conducted the first ever trial and when?
In May 1747, after several weeks at sea, much of the crew aboard the Royal Navy ship Salisbury was laid low with scurvy. The disease was a common complaint at the time (and occasionally lethal) for the growing numbers of sailors who were exploring and trading across the world.
Rather than calamity, however, the ship’s physician, James Lind, spotted an opportunity. He chose 12 sickly sailors and divided them into pairs. “They all in general had putrid gums, the spots and lassitude, with weakness of knees,” Lind wrote in A Treatise on the Scurvy, published in 1753. These sailors were isolated from the rest of the crew and each pair was given a different potential treatment for scurvy: a daily quart of cider; spoonfuls of vinegar; a concoction made from horseradish, mustard and garlic; sea water; 25 drops of “elixir”; or oranges and lemons. Otherwise their diets were identical to those on the rest of the ship.
In just under a week, the two sailors who had been given oranges and lemons were back on duty and were nursing the others, all of whom remained ill.
Lind’s experiments showed that citrus fruits (which are high in vitamin C) could cure scurvy. He was not the first to suggest the benefits of oranges and lemons but he was the first to use a systematic experiment to test the hypothesis. In the annals of medical history, James Lind’s work on scurvy is considered to be the first ever clinical trial.
Today, improved versions of his trials have become the gold standard for modern medicine.