Registration of clinical trials--a regional perspective.

The birth of the scientific clinical trial is often cited as an experiment by James Lind. On 20 May 1743, Lind compared the effect of a few supposed nutritional remedies against scurvy. The research subjects, 12 sailors suffering from scurvy on board the ship HMS Salisbury, were divided into 6 groups. In one group, each patient was given 2 oranges and 1 lemon every day, to eat upon an empty stomach. This was the group that showed marked improvement. Lind’s experiment has sometimes been described as “the first deliberately planned therapeutic trial” [1]. However, centuries before Lind’s experiment, a simple clinical trial was used by Abu Bakr Muhammad ibn Zakariyya al-Razi (865-925 CE), known to the Latin world as Rhazes in the 10th century AD, to assess the value of bloodletting in cases of suspected meningitis [1]. The largest and most important of al-Razi’s medical works is Kitab al-hawi fi al-tibb (The comprehensive book of medicine), which was translated into Latin in the 13th century and repeatedly printed in Europe during the 15th and 16th centuries under the title Liber continens. Al-Razi’s writings had a major influence on the development of medical practice in Europe [2]. In his writings, al-Razi’s makes clear that he could not simply accept what he read, but had to investigate the effects of medicine himself before making a judgment. Al-Razi’s approach to refining his treatment reflects a way of thinking about one of the principles of drawing inferences about the effects of treatments, namely, the need for comparison.