#78 1747 · James Lind, Royal Navy (HMS Salisbury) · Medicine / naval healthproxy-test
A ship's surgeon couldn't tell which of six competing scurvy cures worked, so he gave every pair of patients a different one at once
the problem
A killer with multiple competing folk remedies, none tested against the others, was bleeding a workforce for centuries
background
Scurvy killed more British sailors on long voyages than combat, storms and every other cause combined, and had done so for centuries by the time James Lind served as a naval surgeon aboard HMS Salisbury in 1747. Medical authorities disagreed on the cause and cure, and citrus fruit was just one of several remedies with anecdotal backers — cider, seawater, vinegar, diluted sulfuric acid and various tonics all had their own defenders, and no one had ever tested them against each other under matched conditions.
The standard practice was to pick a theory of the disease and treat accordingly, with no controlled comparison possible on land or at sea; a ship's surgeon simply had no way to isolate which of several confounded variables — diet, climate, treatment, individual constitution — was doing the work, so competing remedies persisted indefinitely on reputation rather than evidence.
the move
Lind selected twelve sailors with comparably severe scurvy, matched them into six pairs, and gave each pair one of six remedies then in use — cider, elixir of vitriol, vinegar, seawater, a garlic-and-mustard paste, or two oranges and a lemon daily — while holding their housing and base diet identical, isolating the treatment as close to the only varying factor.
the payoff
Within six days the citrus pair had one sailor fit for duty and the other markedly improved; the cider pair improved slightly; none of the other four pairs improved at all — a clear, reproducible result from a trial of just twelve men.
what came after
Lind's design is now taught as one of history's first controlled clinical trials, but his own 1753 treatise buried the citrus result among other theories and the Royal Navy did not mandate lemon juice rations until 1795, after Rear Admiral Alan Gardner ran a scurvy-free voyage to India on HMS Suffolk — nearly fifty years after the trial had already answered the question.
filed under
references
- [1]James Lind and scurvy: 1747 to 1795The James Lind Library, 2011jameslindlibrary.org
- [2]James LindWikipedia, 2026en.wikipedia.org