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James Lind: a Tercentenary Note 135 History James Lind: a tercentenary note Mrs JVS Wickenden For the older and bolder among the Journal’s readership, Fleet was involved in extended patrol duties in the Bay of James Lind needs no introduction: however, it would be Biscay. It was during this period that Lind carried out what remiss in this, the tercentenary year of his birth, not to is now regarded as one of the earliest recorded controlled mark the event in these pages, some 101 years after he clinical trials, in a study of potential cures for scurvy. The first appeared in them.1 In September of this year, INM trial proper can be read in the book in which Lind described combined its regular September participation in Gosport’s it2, but may be condensed thus: Heritage Open Days with a Lind lecture, dinner and • With twelve patients sick with the same degree of exhibition on the preceding Friday. In addition, Royal scurvy, he grouped them into six pairs Naval Medical Service personnel and civilians participated • All had the same basic diet and drink in local commemorative events, culminating in a service • To each pair was given, daily, one of the following: in St Mary’s Church, Portchester, where James Lind was ➢ 1 quart (ca 900 ml) of cider buried. ➢ 25 drops of elixir of vitriol (sulphuric acid in alcohol, flavoured with ginger or cinnamon and James Lind was born on 4 October 1716 in Edinburgh, and given in thin barley-water)3 at the age of 14 was apprenticed to a local surgeon before, ➢ 6 spoonfuls of vinegar in 1739, entering the Royal Navy as a surgeon’s mate. His ➢ ½ pint (ca 230 ml) seawater most significant posting in sea service, to modern eyes, ➢ 2 oranges and 1 lemon was that as surgeon to HMS SALISBURY in 1747, when, ➢ 1 nutmeg-sized electuary (a paste of gum during the War of the Austrian Succession, the Channel tragacanth, garlic and spices) Figure 1: James Lind, by Sir George Chalmers, ca. 1720- Figure 2: The sealed pattern of the INM badge. 1791. Journal of the Royal Naval Medical Service 2016, Vol 102 No.2 136 NB: non-metric measurements are given according to the was appointed chief physician to Haslar, the second man to Winchester Standards (1588) used until imperial units were hold the post. He remained there until his retirement, when defined by the British Weights and Measures Act (1824). he handed over to his son John; he had married his cousin Isobel Dickie in 1748, and the couple had a daughter and At the end of six days the experiment had to be stopped two sons. James Lind died in July 1797 and was buried in when there were no more citrus fruit to be had, but by that Portchester Church. time the men who had been given oranges and lemons were in good enough health to nurse the remaining patients. James Lind has become known as the founding father Lind’s description of his experiment is told in around 450 of Naval medicine and hygiene; this is due chiefly to words in a book of as many pages. To modern eyes, aware his Treatise on scurvy, but also to his dedicated work at that vitamin C is not only a cure for but a prophylactic against Haslar and his care for the sailors who were his patients scurvy, it remains puzzling that he was not immediately there. Copies of his books may be seen in his portrait aware of the implications of his trial in appearing to prove (Figure 1), and other editions of most of his works are the antiscorbutic effectiveness of citrus fruit; but vitamin held in the Historic Collections Library at INM (Figure C was not isolated until 1928, and Lind did not believe 2). His influence is still seen today, not least in the lemon in making firm recommendations on limited proof. The tree which appears on the ship’s badge of INM. His name Admiralty finally ordered the issue of lemon juice in the was given to the James Lind Alliance and Library,5,6 an late 1790s. online resource for the study and application of fair tests of treatments in health care, and International Clinical Trials After his SALISBURY appointment Lind left the Navy, and Day is held annually around the day (21-22 May) when in 1748 qualified MD at the University of Edinburgh with Lind began his experiment aboard HMS SALISBURY. The a thesis on venereal diseases. His Treatise on the scurvy tercentenary year itself has generated a pleasing amount was published in 1753, and An essay on the most effectual of local and media interest7,8 which has helped to raise the means of preserving the health of seamen in the Royal profile not only of James Lind but also of the Institute of Navy in 17574. In 1758, perhaps on the strength of this Naval Medicine and the Royal Naval Medical Service. publication, or possibly through the patronage of Admiral Lord Anson, to whom he had dedicated the Treatise, Lind References 1. Rolleston, HD. James Lind, pioneer of naval hygiene. J Roy Nav Med Serv 1915:1(2);181-90. 2. Lind, J. A treatise of the scurvy. In three parts. Containing an inquiry into the nature, causes and cure, of that disease. Together with a critical and chronological view of what has been published on the subject. Edinburgh: Sands, Murray and Cochran for Kincaid and Donaldson;1753. 3. Commissioners appointed to take care of sick and wounded seamen. Order … to provide a sufficient quantity of elixir of vitriol; 23 January 1740-41. 4. Lind, J. An essay on the most effectual means of preserving the health of seamen in the Royal Navy [... etc]. London: Millar [... etc.]; 1757. 5. James Lind Initiative [Internet]. The James Lind Library: illustrating the development of fair tests of treatments in health care [cited 2016 Oct 14]. Available from: http://www.jameslindlibrary.org/ 6. James Lind Initiative [Internet]. The James Lind Library. Articles [cited 2016 Oct 14]. Available from: http://www.jameslindlibrary. org/articles/ 7. White, M. [Internet]. Lemons and limeys: the man who helped to cure scurvy. 2016 Oct 04 [cited 2016 Oct 13]. Available from: http://www.bbc.co.uk/news/uk-england-37320399 8. Jones, R. [Internet]. Five-a-day historically used to combat deadly disease. 2016 Sep 22 [cited 2016 Oct 14]. Available from: http:// www.itv.com/news/meridian/update/2016-09-22/five-a-day-historically-used-to-combat-deadly-disease/ Author Mrs Jane Wickenden, MA (Oxon), DipLib, Historic Collections Librarian Institute of Naval Medicine, Crescent Road, Alverstoke, Gosport PO12 2DL [email protected] Acknowledgements Thanks are due to Mr John Hepner, present owner of the original portrait of James Lind, for allowing its reproduction, and for bringing it for display at INM’s James Lind Dinner..
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