Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

The clinicial trial began and Lind waited to see which sailors, if any, would recover. Although the trial was supposed to last fourteen days, the ship’s supply of citrus fruits came to an end after just six days, so Lind had to evaluate the results at this early stage. Fortunately, the conclusion was already obvious, for the sailors who were consuming lemons and oranges had made a remarkable and almost complete recovery. All the other patients were still suffering from scurvy, except for the cider drinkers who showed slight signs of improvement. This is probably because cider can also contain small amounts of vitamin C, depending on how it is made.

By controlling variables such as environment and diet, Lind had demonstrated that oranges and lemons were the key to curing scurvy. Whilst the numbers of patients involved in the trial were extremely small, the results he obtained were so striking that he was convinced by the findings. He had no idea, of course, that oranges and lemons contain vitamin C, or that vitamin C is a key ingredient in the production of collagen, but none of this was important — the bottom line was that his treatment led to a cure. Demonstrating that a treatment is effective is the number-one priority in medicine; understanding the exact details of the underlying mechanism can be left as a problem for subsequent research.

Had Lind been researching in the twenty-first century, he would have reported his findings at a major conference and subsequently published them in a medical journal. Other scientists would have read his methodology and repeated his trial, and within a year or two there would have been an international consensus on the ability of oranges and lemons to cure scurvy. Unfortunately, the eighteenth-century medical community was comparatively splintered, so new breakthroughs were often overlooked.

Lind himself did not help matters because he was a diffident man, who failed to publicize and promote his research. Eventually, six years after the trial, he did write up his work in a book dedicated to Commander Anson, who had famously lost over 1,000 men to scurvy just a few years earlier. Treatise on the Scurvy was an intimidating tome consisting of 400 pages written in a plodding style, so not surprisingly it won him few supporters.

Worse still, Lind undermined the credibility of his cure with his development of a concentrated version of lemon juice that would be easier to transport, store, preserve and administer. This so-called rob was created by heating and evaporating lemon juice, but Lind did not realize that this process destroyed vitamin C, the active ingredient that cured scurvy. Therefore, anybody who followed Lind’s recommendation soon became disillusioned, because the lemon rob was almost totally ineffective. So, despite a successful trial, the simple lemon cure was ignored, scurvy continued unabated and many more sailors died. By the time that the Seven Years War with France had ended in 1763, the tallies showed that 1,512 British sailors had been killed in action and 100,000 had been killed by scurvy.

However, in 1780, thirty-three years after the original trial, Lind’s work caught the eye of the influential physician Gilbert Blane. Nicknamed ‘Chillblain’ because of his frosty demeanour, Blane had stumbled upon Lind’s treatise on scurvy while he was preparing for his first naval posting with the British fleet in the Caribbean. He was impressed by Lind’s declaration that he would ‘propose nothing dictated merely from theory; but shall confirm all by experience and facts, the surest and most unerring guides’. Inspired by Lind’s approach and interested in his conclusion, Blane decided that he would scrupulously monitor mortality rates throughout the British fleet in the West Indies in order to see what would happen if he introduced lemons to the diet of all sailors.

Although Blane’s study was less rigorously controlled than Lind’s research, it did involve a much larger number of sailors and its results were arguably even more striking. During his first year in the West Indies there were 12,019 sailors in the British fleet, of whom only sixty died in combat and a further 1,518 died of disease, with scurvy accounting for the overwhelming majority of these deaths. However, after Blane introduced lemons into the diet, the mortality rate was cut in half. Later, limes were often used instead of lemons, which led to limeys as a slang term for British sailors and later for Brits in general.