Clinical trials have been changing the landscape of medicine for over 275 years. We celebrate Clinical Trials Day on May 20^th every year in recognition of the day in 1747 when Scottish surgeon James Lind began his pivotal study for the treatment of scurvy in members of the Royal Navy. While James Lind’s scurvy trial may be regarded as the first controlled clinical trial, the history of clinical trials and research dates back much further.

1025 AD
11^th-century Persian philosopher and physician Ibn Sina wrote the “Canon of Medicine”, an encyclopaedia describing the rules for assessing the effects of drugs and remedies. It was one of the most influential texts of its time and is considered the first description of a formal clinical trial, although there is no written record of these principles in practice. Many of the principles described in the Canon of Medicine still align with the contemporary approach to clinical trials.

1537
French surgeon Ambroise Pare accidentally conducted the first clinical trial of a novel therapy in 1537 when he treated wounded soldiers with a mixture of egg yolks, rose oil, and turpentine instead of the typical treatment of boiling oil for disinfecting and cauterising wounds.

After running out of oil, Pare created and applied the new mixture to the wounds, noting that the soldiers who received the new treatment showed much more rapid improvement than the soldiers who received the traditional treatment.

1747
James Lind’s pioneering controlled trial for the treatment of scurvy began on May 20^th, 1747. Lind selected 12 patients afflicted by scurvy aboard the ship the Salisbury. He paired the patients off and gave them one of six dietary supplements, such as seawater, vinegar, oranges and lemons.

Within a week, the sailors who received the citrus fruits were fully recovered and Lind’s pioneering contribution to the development of clinical trials has been celebrated ever since.

1800s
The 1800s brought the introduction of the placebo, first defined in Hooper’s Medical Dictionary in 1811 as “any medicine adapted more to please than benefit the patient”. Placebos have since been an important element of blinded studies ever since.

1900s
In 1937, Elixer Sulfanilamide, a treatment for strep throat, showed positive results in both tablet and powder forms. A liquid version was then released onto the market and due to a lack of proper studies, the consequences were grave. The drug was responsible for the deaths of over 100 people across the United States.

This event acted as a catalyst for the implementation of the 1938 Federal Food, Drug, and Cosmetics Act mandating that drugs be tested for safety before being marketed to the public. The 1900s also brought other achievements in the realm of clinical studies, such as the first double-blind clinical trial in 1943 and the first randomised curative trial in 1946.

Clinical research and trials have developed and evolved immensely since James Lind’s scurvy study and the work of researchers like Lind has benefitted millions of people over the past 277 years and will continue to transform the lives of patients in the future. That’s why every May 20^th we celebrate the hardworking clinical research professionals who help bring new medicines, technologies, and procedures to the public. Here’s to YOU and all you do for communities across the globe.

Allen, Owen. “The History of Clinical Trials: From James Lind to Nuremberg.” Vial, Vial, 19 May 2022, vial.com/blog/articles/history-of-clinical-trials/.