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So careless of the single trial
Correspondence to:
Peter Tyrer, Professor of Community Psychiatry, Imperial College, London, UK; p.tyrer@imperial.ac.uk
| The first 150 words of the full text of this article appear below. |
Are God and Nature then at strifeThat Nature lends such evil dreams?
So careful of the type she seems
So careless of the single life.
Tennyson, In Memoriam, 1850
Tennyson was contemplating his own mortality when he wrote these words and rueing the changes in the established order of things that had been set in motion by Darwin in his principle of natural selection. In many ways In Memoriam is a narcissistic lament, the sad acknowledgment that even the most entitled and celebrated of humanity would eventually be "blown about the desert dust, or seal’d within the iron hills".
I paraphrase Tennyson because a similar phenomenon has developed with regard to that more prosaic form of creation, the randomised controlled trial. In the past, and even the recent past, the most celebrated trials, beginning with the famous James Lind trial of lime juice for scurvy in 1743, have
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