JAMES LIND
James Lind (4 October 1716 – 13 July 1794) was a Scottish doctor. He was a pioneer of naval hygiene in the Royal Navy. He is the first physician who has conducted a controlled clinical trial in the modern era. In 1731, he began his medical studies as an apprentice at the Royal College of Surgeons of Edinburgh.
In 1739,he entered the Navy as a surgeon's mate. By 1747, he had become a surgeon of HMS Salisbury and conducted his scurvy experiment while patrolling the Bay of Biscay. Just after that patrol he left the Navy, wrote his MD thesis on venereal diseases and earned his degree from the University of Edinburgh Medical School, and was granted a license to practice in Edinburgh.
He developed a theory of curing scurvy with citrus fruits. Lind argued for the health benefits of better ventilation aboard naval ships, improved cleanliness of sailor’s bodies, clothing, bedding, and below-deck fumigation. He also said that fresh water can be obtained by distilling sea water and the work was the advanced practice of preventive medicine and improved nutrition. After this experiment, Lind retired from the Navy and practiced privately as a physician. And in 1753, he published A Treatise of the Scurvy, which was mostly ignored. In 1758, he was appointed as chief physician of Royal Naval Hospital Haslar at Gasport.
Lind subsequently added to his first-hand experience in two ways: (1) he searched for, abstracted, and evaluated previous reports of the disease; and (2) he drew on accounts sent to him by members of the Society of Naval Surgeons. In other words, he conducted a systematic review of what had been written on the topic by others.
Prevention and cure of scurvy:
Scurvy was high on the list of dangers facing those 18th-century sailors who spent much time at sea. Lind thought that scurvy was due to putrefaction of the body that could be helped by acids, and then now he included an acidic dietary supplement in the experiment. And the experiment started after 2 months at sea when the ship was afflicted with scurvy. He divided twelve scorbutic sailors into six groups of two. All of them received the same diet, in addition, group one was given a quart of cider daily, group two was given 225 drops of the elixir of vitriol, group three with six spoonful of vinegar, group four half a pint of seawater, group five two oranges and one lemon and last group a spicy paste plus a drink of barley water. The treatment of group five was stopped as they ran out of fruit, but by that time one sailor was fit for duty while the other had almost recovered. Though he recognized the benefits of citrus fruit,he never advocated citrus juice as a single solution. He believed scurvy had multiple causes which require multiple remedies.
Figure 1: Lind giving Oranges and Lemons as a treatment to cure Scurvy
Preserving the health of seamen:
In 1762 Lind’s Essay on the most effective means of preserving seamen's health appeared. In this, he recommended growing salad i.e.,watercress. This was kept into practice and during winter in 1775, the British army in North America was supplied with mustard and cress seeds. However, Lind believed that scurvy came from ill-digested and putrefying food within the body, bad water excessive work, and living in a damp atmosphere that prevented healthful perspiration.
James Lind Alliance:
JLA method is designed to raise awareness of research questions that are of direct relevance and potential benefits to patients.
Table: James Lind Alliance Methodology
Recognition:
Lind's is one of twenty-three names on the Frieze of the London School of Hygiene and Tropical Medicine building in Keppel Street, London. Names were selected by a committee of the unknown constitutionsthat deemed them to be pioneers in public health and tropical medicine. At the University of Edinburgh Medical School there is, The James Lind Commemorative plaque unveiled in 1953, funded by citrus growers of California and Arizona.
The James Lind Alliance is named after him. It was during Lind's stay in Edinburgh that the book for which he is best known - A treatise of the scurvy – was published in 1753, and dedicated to Lord Anson. His Essay on the most effectual means of Preserving the Health of Seamen in the Royal Navywas dedicated to George Edgecombe (Lind 1757). ‘An essay on diseasesincidental to Europeans in hot climates. The plaque states that these works led to the conquest of scurvy, the development of modern naval hygiene, and the growth of tropical medicine.
Figure 2: Plaque of James Lind
Reference:
ncbi.nlm.nih.gov/pmc/articles/PMC3536506/
en.wikipedia.org/wiki/James_Lind
Collier R.Legumes,lemons and streptomycin: A short history of the clinical trial.CMAJ.2009;180:23- 24.[PMC free Article] [pubmed].
Student Name: Talari Neharika
Student ID: CLS_006/012023
Qualification: Pharm D
e-Mail ID: talarineharika.26@gmail.com
Comments