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James Lind

James Lind
1716-1794

Born and trained in Edinburgh, James Lind entered the British Navy as a surgeon's mate in 1739. During an extended trip in the English Channel in 1747 on the 50 gun, 960 ton H.M.S.Salisbury, Lind carried out a decisive experiment (the first planned, controlled clinical trial) that changed the course of naval medicine. He knew that scurvy (the great sea plague) often killed two-thirds of a ship's crew. Their diet included 1 lb. (0.45 kg) and 4 oz. (113.4 g) of cheese bisquits daily, 2 lb. 0.90 kg) salt beef twice weekly, 2 oz. (56.7 g) dried fish and butter thrice weekly, 8 oz. (226.8 g) peas four days a week, and one gallon (3.79 l) of beer daily. Deprived of vitamin C, sailors fell prey to scurvy. By adding fresh fruit to their diet, Lind fortified their immune systems so that British sailors no longer perished.

Quotes from Lind's Treatise on the Scurvy (1753)

On the 20th of May, 1747, I selected 12 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 common to all, viz, water-gruel sweetened with sugar in the morning; fresh mutton-broth oftentimes for dinner; at other times light puddings, boiled biscuit with sugar, etc., and for supper, barley and raisins, rice and currants, sago and wine, or the like. Two of these were ordered each a quart of cyder a day. Two other took 25 drops of elixer of vitriol 3 times a day, upon an empty stomach; using a gargle strongly acidulated with it for their mouths. Two others took 2 spoonfuls of vinegar 3 times a day, upon an empty stomach; having their gruels and their other food sharpened with vinegar, as also the gargle for their mouth. Two of the worst patients, with the tendons in the ham quite rigid (a symptom none of 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 ate with greediness, at different times, upon an empty stomach. They continued but six days under this course, having consumed the quantities that could be spared. The 2 remaining patients took the bigness of a nutmeg 3 times a day, or an electary recommended by an hospital-surgeon, made of garlic, mustard-seed, horse-radish, balsam of Peru, and gum myrh; using for common drink barley-water boiled with tamarinds; by which, with the addition of cream of tartar, they were gently purged 3 or 4 times during the course. The consequence was, that the most sudden and visible good effects were perceived from the use of oranges and lemons; one of those who had taken them, being at the end of 6 days fit for duty. The spots were not indeed at that time quite off his body, nor his gums sound; but without any other medicine than a gargle for his mouth he became quite healthy before we came into Plymouth which was on the 16th of June. The other was the best recovered in his condition; and being now pretty well, was appointed nurse to the rest of the sick. Next to oranges, I thought the cyder had the best effects. It was indeed not very sound. However, those who had taken it, were in a fairer way of recovery than the others at the end of the fortnight, which was the length of time all these different courses were continued, except the oranges. The putrification of their gums, but especially their lassitude and weakness, were somewhat abated, and their appetite increased by it.

Lind sailed on the HMS Salisbury in 1747. An early innovator in food technology, Lind obtained pure drinking water from the condensate in steam during cooking with sea water. He also described how to preserve citrus juice.

Let the squeezed juice of these fruits be well cleared from the pulp and depurated by standing for some time; then poured off from the gross sediment; or, to have it stay purer, it may be filtered. Let it them be put into any clean oven vessel of china or stoneware which should be wider at the top than at the bottom. so that there may be the largest surface above to favor the evaporation... Into this pour the purified juice: and put it into a pan of water come almost to a boil and continue nearly in the state of boiling ... until the juice is found to be the consistency of a thick syrup when cold... It is then when cold, to be corked up in a bottle for use. Two dozen of good oranges weighing 5 pounds 4 ounces, will yield 1 pound 9 ounces and a half of depurated juice; and when evaporated there will remain about 5 ounces of the rob or extract; which in bulk will be equal to less than 3 ounces of water. So that thus the acid, the virtues of 12 dozens of lemons or oranges, may be put into a quart bottle, and preserved for several years.

Lind published two books: An Essay on Preserving the Health of Seamen in the Royal Navy (1757); Essay on Diseases Incidental to Europeans in Hot Climates (1768). Easily available, his books were translated into German, French, and Dutch. Lind's landmark emphasis on the crucial importance of dietary supplements antedates modern practices. Lind's work defeated scurvy from the treatment regimen he discovered, but fifty years had to pass and many more lives lost before the British Admiralty required fresh citrus fruit on all ships. This was but another sad example of damage done when politics neglects science, and unqualified autocrats make final decisions on matters concerning health.

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