One of medicine's first controlled trials cured scurvy, then was ignored.
In 1747 a Royal Navy surgeon, James Lind, split twelve sailors with scurvy into pairs and gave each pair a different remedy: cider, vinegar, seawater, oranges and lemons. The pair eating citrus recovered fastest. It took the Navy nearly fifty years to act on the result.
Scurvy, which we now know is caused by a lack of vitamin C, was the curse of long voyages. On George Anson's voyage around the world in the 1740s, about 1,400 of some 1,900 men died, most of them reportedly from scurvy. Lind claimed the disease killed more British sailors than French and Spanish weapons did. Citrus had been recommended before, by the surgeon John Woodall among others, but nobody had tested it systematically.
In May 1747, aboard HMS Salisbury in the Bay of Biscay, Lind took twelve sailors with scurvy and put them all on the same basic diet. Then he split them into six pairs. One pair got a quart of cider a day; others got drops of dilute sulphuric acid, vinegar, seawater, or a spicy paste with barley water. The fifth pair got two oranges and a lemon daily. The fruit ran out after six days, but by then one of those sailors was fit for duty and the other nearly recovered. Only the cider showed any other effect. Because it compared groups treated differently, it counts as one of the first reported controlled clinical trials.
Yet Lind did not draw the conclusion we might expect. Like most doctors of his time, he believed scurvy came from putrefaction inside the body and had many causes, so he never promoted citrus as the single answer. He even recommended a boiled-down juice concentrate, and boiling destroys vitamin C. His 1753 Treatise of the Scurvy was mostly ignored.
Naval officers and surgeons such as Gilbert Blane pushed the practical lesson. In 1794 a ship sailed non-stop to India for 23 weeks with a daily lemon juice ration and had no serious outbreak. The next year the Admiralty agreed to issue lemon juice across the fleet, though supplies stayed short until after 1800. Lind's lasting gift is the method: test treatments side by side and let the results decide. The James Lind Library, an open resource on testing treatments, carries his name.
Source: Wikipedia — James Lind · Text summarised from Wikipedia (CC BY-SA 4.0)
