James Lind

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James Lind (1716 - 1794) was a Scottish doctor. He was a pioneer of naval hygiene and became an expert on the treatment of scurvy. His systematic attempts to establish the efficacy of treatments for scurvy make him an important figure in the history of medicine.[1]

James Lind was born in Edinburgh in 1716, the son of a merchant. He attended grammar school in Edinburgh, where he learned Latin and Greek. In 1731 he took an apprenticeship with George Langlands, a Fellow of the Royal College of Surgeons of Edinburgh. In 1739 he joined the navy as a surgeon's mate, and served in the Mediterranean, Guinea and the West Indies, as well as the English Channel.

Experiments on scurvy

"On the 20th May, 1747, I took twelve patients in the scurvy on board the Salisbury at sea. Their cases were as similar as I could have them. They all in general had putrid gums, the spots and lassitude, with weakness of their knees. They lay together in one place, being a proper apartment for the sick in the fore-hold; and had one diet in common to all, viz., water gruel sweetened with sugar in the morning; fresh mutton broth often times for dinner; at other times puddings, boiled biscuit with sugar etc.; and for supper barley, raisins, rice and currants, sago and wine, or the like. 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 spoonfuls 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 the mouth. Two of the worst patients, with the tendons in the ham rigid (a symptom none the rest had) 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 gentle physic. Two others had each two oranges and one lemon given them every day. These they eat with greediness at different times upon an empty stomach. They continued but six days under this course, having consumed the quantity that could be spared. The two remaining patients took the bigness of a nutmeg three times a day of an electuray recommended by an hospital surgeon made of garlic, mustard seed, rad. raphan., balsam of Peru and gum myrrh, using for common drink narley 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 consequence was that the most sudden and visible good effects were perceived from the use of the oranges and lemons; one of those who had taken them being at the end of six days fit four duty. The spots were not indeed at that time quite off his body, nor his gums sound; but without any other medicine than a gargarism or elixir of vitriol he became quite healthy before we came into Plymouth, which was on the 16th June. The other was the best recovered of any in his condition, and being now deemed pretty well was appointed nurse to the rest of the sick … "

From A Treatise of the Scurvy 1753[2]

In 1747, while serving as surgeon on HMS Salisbury in the Channel Fleet, he carried out experiments to discover the cause of scurvy, the symptoms of which included loose teeth, bleeding gums and haemorrhages.

He chose 12 men from the ship, all suffering from scurvy, and divided them into pairs, giving each pair different additions to their basic diet - cider; seawater; a mixture of garlic, mustard and horseradish; vinegar, and oranges and lemons. Those fed citrus fruits experienced a remarkable recovery. While the benefits of lime juice had been known for centuries, by this test Lind had, in a carefully controlled manner, established the superiority of citrus fruits above all other 'remedies'.

The importance of Lind's findings on scurvy were recognised at the time, but it was not until more than 40 years later that an official Admiralty order was issued on the supply of lemon juice to ships; this resulted in the almost complete disappearance of scurvy from the Royal Navy.

Later life

In 1748, Lind retired from the Navy and entered the Edinburgh University to take professional qualifications; he graduated MD and became licensed to practise in Edinburgh. In 1750 he was elected as a Fellow of the Royal College of Physicians of Edinburgh, and in 1753 he published A treatise of the scurvy, and in 1757 An Essay on the Most Effectual Means of Preserving the Health of Seamen in the Royal Navy, which threw light on the poor living conditions and diet of seamen.

In 1758, he was appointed physician to the Naval Hospital at Haslar in Gosport, where he investigated the distillation of fresh water from salt water for supply to ships, after noticing that when seawater was boiled, the steam was not salty.

He published Two papers on fevers and infection in 1763 (on typhus fever in ships) and An essay on diseases incidental to Europeans in hot climates in 1771.

In 1783, he was succeeded as Chief Physician at Haslar by his son John. He died in 1794 at Gosport, and is buried in Portchester Church

References

  1. The James Lind Library has been created to help people understand fair tests of treatments in health care. The principles of fair tests are explained in essays containing many examples.
  2. (1753).html James Lind: A Treatise of the Scurvy, 1753.