Medical treatments that alleviate or cure disease have always required trials to prove its efficacy. This has been the case since time immemorial, as there is evidence of it in the descriptions in the Bible from 500 BC. C.
The evolution of clinical research
In a recently published study by James Lind and Dr. Arun Bhatt, called “The Evolution of Clinical Research: A History Before and Beyond,” the authors outline the long journey of clinical research, through historical evidence and records of the evolution of clinical trials.
The first registered clinical trial
According to this study, the first registered clinical trial is found in the Bible, in the “Book of Daniel.” It was not done by a doctor, but by the king of Babylon, Nebuchadnezzar, who ordered his subjects to follow a diet of meat and wine, which he believed was the healthiest.
But some young men of royal blood objected, and the king allowed them to follow a diet based on legumes and water, although for only 10 days. After this time had passed, the king observed that the vegetarians seemed better nourished than the carnivores, therefore, he allowed them to continue with their diet.
The history of clinical trials
The oldest text describing clinical trials, the researchers note, corresponds to Ibn Sina (1025 AD), Latinized Avicenna, an eminent physician of the Middle Ages. In his encyclopedia “Canon of Medicine”, the sage describes some rules to follow for a drug test.
Avicenna suggests that it be used a remedy in its natural state, in uncomplicated disease and he also advises studying two cases of opposite types, studying the time of action and the reproducibility of the effects. During the investigation, no evidence was found of the application of these rules in practice.
In 1537, the first controlled clinical trial for a new therapy was conducted. It was carried out by surgeon Ambroise Pare, the person in charge of treating wounded soldiers on a battlefield.
The first physician to conduct a planned controlled trial was Dr. James Lind, in 1747, when he worked on a ship as a surgeon. Lind conducted a comparative trial of a scurvy drug and provided a full description of the procedure.
In 1943, the MRC (Medical Research Council) UK, conducted the first double-blind controlled trial to investigate patulin treatment for the common cold, and in, 1946, the first randomized curative trial was conducted to test the drug streptomycin.
At the beginning of the 19th century, the term placebo began to be used, although it was not until 1863 that it was described in a clinical study. It was the American physician Austin Flint, who in his report compared the efficacy of the fictitious drug with the existing drug.
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