The world’s first clinical trial

The website called Common Ground has an article about the Canadian healthcare system, CAM, and the Body Heals Conference, which will take place later this month.

As an intro, author Alan Cassels tells about the first clinical trial.

It was 260 years ago in May that a British naval physician, James Lind, began what some have called the world’s first clinical trial. The subject was scurvy, a disease that left sailors weak, bleeding, and incapacitated — often killing them.

Dr. Lind hypothesized that foods high in acid content might be effective treatment. In addition to their regular meals, 6 pairs of sailors suffering from scurvy received garlic, seawater, cider, vinegar, oranges, or limes.

Within a few weeks it was obvious that while the sailors who received orange and lime treatment regained their strength and went back to work, the others worsened.

Preventing scurvy contributed to the strength and dominance of the British navy for the next 200 years.

The bottom line?
If this study were conducted today, Dr. Lind would have concluded that more clinical trials — double blind, in statistically appropriate sized groups — were needed.

It would have been important to first identify the active component of oranges and limes, and conduct dose-ranging trials.

Actually, I agree with all that, and have said so here. However, history supports the position that botanicals can make a significant impact on healthcare in the absence of initial detailed knowledge of the active component.

Both approaches can initiate the process through the development pipeline that leads to mainstream care. They are not mutually exclusive. Although as a general rule, the more we know, the more likely we are, I think, to be able to apply the treatment effectively in the largest number of patients.

5/2/07 22:31 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.