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Nothing new under the sun
  1. Steven Reid, Editor

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When reading about evidence-based health care you might easily assume that it is a fairly recent development. How did we manage before the arrival of the Cochrane Collaboration and the mavens of McMaster? In fact, as the web-based resource The James Lindi Library ( shows, testing the effectiveness of medical interventions dates back as far as the Old Testament (with the first controlled trial recorded in the Book of Daniel). The library, established and edited by Iain Chalmers, aims to improve general understanding of fair tests of treatments and does so by showing how methods of evaluation have developed over time, from 2000 BCE to the present. An abundance of essays consider topics ranging from why fair tests are needed to the introduction of meta-analyses, and the collection also includes a selection of biographies and commentaries to provide context. To show that there really is nothing new under the sun we have reprinted below an extract from an essay by the nineteenth century physician and writer, Oliver Wendell Holmes, alerting readers to the dangers of chance, bias, and of course listening to experts. I would recommend this library to anyone with an interest in evidence-based practice—you will, of course, have to provide your own antique leather chair.


Oliver Wendell Holmes, 1861

The inveterate logical errors to which physicians have always been subject, are chiefly these:

The mode of inference per enumerationem simplicem, in scholastic phrase; that is, …

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  • Competing interests: None declared.

  • i James Lind was a British naval surgeon who in 1747 used a clinical trial to demonstrate that citrus fruit cured scurvy. Working on HMS Salisbury in the Channel fleet he selected 12 men, all suffering from scurvy, and divided them into six pairs, allocating different treatments to each group. Some were given cider, others seawater, others vinegar and one pair were given oranges and lemons. The benefits of lime juice had been noted before, but it was Lind who systematically established the superiority of citrus fruit above all other remedies.

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