The First Recognized Clinical Trials

The First Recognized Clinical Trials

Clinical trials are essential for advancing medicine and ensuring that procedures and treatments are safe and effective for patients. However, these trials were not always at the current gold standard.

While the clinical trial process that we have today has evolved over the years, the same central idea of gaining information using a group of participants hasn't changed from the very first recognized clinical trials that happened a few centuries ago.


An Unexpected Trial

The first clinical trial in history was conducted by Ambroise Paré in 1537, but accidentally. Paré was a French military surgeon who unintentionally experimented with battle wound dressing.

The standard supplies for covering battle wounds at the time, which was boiling oil, ran out. This resulted in Paré applying a digestive mixture of egg yolk, turpentine, and rose oil for those that did not get the boiling oil. Paré was apprehensive about using this mixture to seal the soldier's wounds, though, because he thought it would not work and the soldiers would die from lack of cauterization.

However, Paré was surprised to find that, overall, the soldiers who received this mixture ended up in better condition than those who received boiling oil, with minimally swollen and irritated wounds.

This was not a planned clinical trial, but the innovation of Paré resulted in a new approach that was more effective than the standard treatment, which sets the foundation for all clinical trials. Paré's work also introduced the idea of advancing care by experimenting.


The First Planned Trial


While Paré conducted the first unofficial clinical trial, the first recorded and planned clinical trial was run by Dr. James Lind in 1747.

Lind was a Scottish naval surgeon studying scurvy, an illness characterized by low vitamin C that killed thousands of British soldiers each year. It was a significant hurdle for sailors on long voyages and played an integral part in naval success because a navy is only as strong as its sailors are healthy.

In the early 1700s, a few physicians hypothesized that citrus fruits might help with scurvy, and in 1747 Lind put this theory to the test.

Lind included 12 sailors with scurvy in his study. These soldiers were lodged together and separated from the rest of the crew while placed on a standard diet. Lind compared treatments for scurvy, such as an elixir of vitriol, cider, seawater, vinegar, nutmeg, and citrus. The results showed that the citrus diet, comprised of lemons and oranges, was far more effective than any of the other treatments. In fact, the two soldiers who followed the citrus diet were well enough to return to work in less than half the other groups' time, six days to their 14.

The publication of Lind's work led to an increase in comparative studies, which is currently a common component of clinical trials because it allows research to see how the new treatment compares to the standard.

Another component of clinical trials visible in Lind's is the controlled environment, which is essential to ensure no external components interfere with results.


Clinical Trials for Medical Advances


While clinical trails focus on the newest treatments in health and medicine, their practices stem from the past.

Clinical trials have continued to focus on precise and systematic approaches, as set by the standard of Lind. Additionally, they continue to be as essential in advancing medicine as when Paré found a new method of dressing battle wounds through experimentation.

Thanks to the work of these two men, we have the current clinical trial model to continue advancing medicine.

If you are interested in joining a study, you can use ClinicalConnection.com to search clinical trials near you and learn more about what is available.

You can also sign up now to receive alerts for when clinical trials begin recruiting near you.


References
  • Bhatt A. (2010). Evolution of Clinical Research: A History Before and Beyond James Lind. Perspectives in clinical research, 1(1), 6-10.
  • Gordis L. Epidemiology. 5th ed. Philadelphia, PA: Elsevier/Saunders; 2014.
  • Lind J. A treatise on the scurvy. 3d ed. London,: S. Crowder etc.; 1772. xiv, 2, 559, 1 p. p.