Excerpts from the Lind (1753), with help on the ye olde English from others who have quoted him (Hughes, 1975; Bartholomew, 2002; Weber & De Vreese, 2005).
Lind’s study is sometimes presented as an RCT, but it’s not clear how his patients were assigned to groups, just that the cases “were as similar as I could have them” (see discusison in Weber & De Vreese, 2005). Bartholomew (2002) argues that Lind was convinced scurvy was a disease of the digestive system and warns against quoting the positive outcomes for oranges and lemons (and cider) out of the broader context of Lind’s other work.
Here’s what Lind said he did:
“On the 20th May, 1747, I took twelve patients in the scurvy on board the Salisbury at sea. Their cases were as similar as I could have them. They all in general had putrid gums, the spots and lassitude, with weakness of their knees. They lay together in one place, being a proper apartment for the sick in the fore-hold; and had one diet in common to all, viz., water gruel sweetened with sugar in the morning; fresh mutton broth often times for dinner; at other times puddings, boiled biscuit with sugar etc.; and for supper barley, raisins, rice and currants, sago and wine, or the like.”
Groups (n = 2 in each):
- “ordered each a quart of cyder a day”
- “twenty five gutts of elixir vitriol three times a day upon an empty stomach, using a gargle strongly acidulated with it for their mouths.”
- “two spoonfuls of vinegar three times a day upon an empty stomach”
- “a course of sea water”
- “two oranges and one lemon given them every day. These they eat with greediness”
- “The two remaining patients took the bigness of a nutmeg three times a day of an electuray recommended by an hospital surgeon made of garlic, mustard seed, rad. raphan., balsam of Peru and gum myrrh, using for common drink barley water well acidulated with tamarinds, by a decoction of which, with the addition of cremor tartar, they were gently purged three or four times during the course”
Excerpt from the study outcomes:
- “The consequence was that the most sudden and visible good effects were perceived from the use of the oranges and lemons; one of those who had taken them, being at the end of six days fit for duty”
- “Next to the oranges, I thought the cyder had the best effects”
References
Bartholomew, M. (2002). James Lind’s Treatise of the Scurvy (1753). Postgraduate Medical Journal, 78, 695–696.
Hughes, R. E. (1975). James Lind and the cure of Scurvy: An experimental approach. Medical History, 19(4), 342–351.
Weber, E., & De Vreese, L. (2005). The causes and cures of scurvy. How modern was James Lind’s methodology? Logic and Logical Philosophy, 14(1), 55–67.