History for Clinical Research Courses: The First Clinical TrialOctober 15, 2019
James Lind is thought to be the first person to conduct a clinical research trial. His focus was on scurvy and how it could be treated. Interestingly enough, Lind’s theories and conclusions differ from what we know to be true today. So, although his trials didn’t necessarily lead to the entire answer, they were the beginning of a primary research method used today in the world of medicine.
If you’re curious about how a doctor used first-hand experience, previous reports of scurvy, and observations on 12 sick subjects to conduct the first clinical trial, read on! You may learn a thing or two about persistence and curiosity while you’re at it.
Why Students in Clinical Research Training Should Know About James Lind
James Lind was a Scottish physician who lived from 1716-1794 and served as a naval surgeon. During his time at sea, he witnessed many cases of scurvy, at a time when more sailors were being killed by the sickness than in combat. Scurvy was thought to be caused by poor diet and the living conditions at sea, but people were unsure of how to treat it.
Lind decided to try applying a hypothesis he had developed. He theorized that acid could treat the illness, and gave various sources of acid to afflicted patients.
Supplements used by Lind:
- Sea water
- Lemons and oranges
- Diluted sulfuric acid
Why You Should Know the Term “Fair Test” for Clinical Research Training
James Lind’s use of citrus fruits to treat scurvy patients wasn’t the first case of the remedy being identified. Citrus had already been used by the Dutch to keep sailors healthy on long trips. However, when Lind set about testing the efficacy of citrus against other remedies, he did so using a method that has influenced clinical research training today called fair testing. In this method:
- Like must be compared with like
- Patients were at a similar stage of scurvy
- The group had been eating the same basic diet prior to the test
- All men were being taken care of in the same area on the ship
In this way, Lind noted that many factors need to be kept similar or the same in order for a study to give accurate results. Though citrus as a treatment for scurvy had been identified before, Lind was the first person to systematically show its effects.
These fundamentals carry forward into today’s clinical trials, where factors are kept constant to isolate the effects of medications or treatments. If you’re in clinical research courses, you likely already know the importance of this for a study to be worthwhile.
What We Know now that James Lind Didn’t
In conducting his study, Lind didn’t think that citrus fruits provided the vitamin C that the sick patients’ bodies needed. He viewed scurvy as a disease caused by faulty digestion, and was testing different treatments that could help with this. In fact, although those who took citrus improved, James Lind continued to believe his original hypothesis.
Over time, we’ve come to a different conclusion. Today, we know that scurvy is caused by a nutritional deficiency that oranges and lemons are able to remedy. This is an example of the value in reassessment and critical thinking, which are key in clinical research.
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