Yet Some More History
We like to think that scientific reasoning and research design started with our generation or at least during the Age of Enlightenment. Yet again, though, the Bible beat us to the punch. Before Daniel had his famous encounter with the lions, he faced another challenge. King Nebuchadnezzar of Babylon ordered the Israelites to eat his food and wine “that they should be nourished.” But Daniel, obviously reacting to the lack of objective data supporting the King’s claim, made a suggestion that would endear him to vegetarians, teetotalers, and researchers alike. Daniel proposed that the King’s servants eat his food for 10 days, and his own men (obviously the experimental group) would eat pulse (a type of legume) and drink water. After 10 days, for the subjects in the experimental group, “their countenances appeared fairer, and they were fatter in the flesh, than all the youths that did eat the king’s food” (the significance level was not reported).
Yet again the world had to wait approximately 3000 years for the next experiment. Scurvy was a disorder that first came to people’s attention in the sixteenth century, once sailors were able to make long trips. Its symptoms were so varied, including swelling of the gums, loss of teeth, blotches on the skin, and lethargy, that no cause could be identified. After one disastrous voyage beginning in 1740 and ending in 1744, during which the majority of the crew died from the disease, James Lind conducted a trial aboard the HMS Salisbury:
I took twelve patients in the scurvey....Their cases were as similar as I could have them...and had one diet common to all....Two of these were ordered each a quart of cyder a day. Two others took 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 others took two spoonsful of vinegar three times a day, upon an empty stomach; having their gruels and their other food well acidulated with it, as also the gargle for their mouth. Two of the worst patients...were put under a course of sea water. Of this, they drank half a pint every day, and sometimes more or less as it operated by way of a gentle physic. Two others had each two oranges and one lemon given them every day.... The two remaining patients took the bigness of a nutmeg three times a day, of an electuary recommended by a 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.
The two men eating oranges and lemons recuperated completely after a week; the others barely survived their “treatment.” This story teaches us two lessons. The first is the power of a good research design (although today, no granting agency would approve a project where the sample size in each group is two). The second is the reaction of bureaucracies. The British Navy, hearing of a cure for a widespread and potentially fatal disorder, did nothing for 42 years. Then it substituted limes, which have far less antiscorbutic properties than lemons but were grown in British territories, whereas lemons had to be imported. The only positive feature of this debacle is that, had lemons been used, Britons would be called Lemonies by Americans rather than Limeys.
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| 5476. | Streiner DL, Norman GR. PDQ Epidemiology. 2nd ed. Hamilton, Ontario: BC Decker Inc.; 1996. |