Quick Summary

James Lind’s 18th-century shipboard experiment is a landmark moment in the history of clinical research, demonstrating how controlled comparisons can reveal effective treatments. We reimagined his study with a modern protocol title and criteria, then connected his work to the professionals who advance research today.

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The Surprising Origin of Randomized Controlled Clinical Trials

Clinical trials reach back much further than many people expect. On May 20, 1747, a Scottish surgeon named James Lind began a monumental experiment aboard a British Royal Navy ship. Lind’s work is a key moment in the history of clinical research, and his experiment is widely considered the first controlled randomized clinical trial in modern times.

In the 18th century, scurvy was a serious health threat for sailors at sea. Lind divided 12 sailors suffering from scurvy into six pairs. He provided each pair with a different dietary supplement to observe which ones improved their symptoms.

Lind carefully controlled the conditions so that all participants remained in similar circumstances. He chose men with similar symptoms, kept them in the same place, and gave them a common diet. Lind observed that the pair who received oranges and lemons improved far more than the others.

Lind’s experiment demonstrated that citrus fruits were the most effective treatment among the options he tested for preventing scurvy. And while his experiment is significant in the history of clinical research and his conclusions proved correct, his findings were not implemented for more than 40 years. Once citrus became a required part of sailors’ diets, serious cases of scurvy largely disappeared.

It’s interesting to note that there were clues that citrus was the answer to scurvy long before Lind got involved. But it took Lind, his experiment, and another 40 years before the benefits were put to use.

History of Clinical Research Reimagined

Just for fun, I wrote a modern-day protocol title for Lind’s experiment:

A Prospective, Randomized, Controlled, Parallel Group Study Evaluating the Effect of Citrus and Other Dietary Interventions on Scurvy Symptoms in Royal Navy Sailors

 And I didn’t stop there. Here is a modern version of Lind’s inclusion-exclusion criteria:

Inclusion Criteria

• Active-duty Royal Navy sailor
• Current signs and symptoms consistent with scurvy
• Similar severity of illness at enrollment
• Residing aboard the same ship during the study period
• Willing and able to follow the assigned dietary intervention

 Exclusion Criteria

• No clear signs of scurvy
• Advanced illness requiring care outside the study conditions
• Inability to remain on the common shipboard diet
• Inability to complete the observation period
• Any condition that would make the response to the dietary intervention difficult to assess
• An immediate family member, such as a spouse, parent, sibling, or child of Dr. Lind or a member of Dr. Lind’s study team

Celebrating Clinical Trials Today

Lind’s trial helped lay the foundation for modern clinical research and evidence-based practice. International Clinical Trials Day was launched on May 20, 2005, to commemorate Lind’s pioneering contribution and to honor clinical research professionals each year.

Imperial sends a special thank you to our research partners and to research professionals everywhere. We celebrate your work in discovering safe and effective treatments and in developing better ways to detect, diagnose, and reduce the risk of disease.

Thank you!