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A Misused Tool

John Marshall, MD

Arch Neurol. 1990;47(4):444-445.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Although there are examples of controlled clinical trials as far back as biblical times (Book of Daniel 1:12-15), the modern scientific approach began in 1834, when Louis¹ published his Essay on Clinical Instruction. In it, he laid down the principles that have remained largely unchanged, including the need for precise definition of the disease to be treated. Trials at the turn of the present century were largely in the preventive field of vaccination and immunization. It was after World War II, with the advent of antibiotics, that trials in the therapeutic field began to appear in large numbers.

The early therapeutic trials were simple in design: a therapeutic agent shown to be highly effective in vitro was tested in vivo against a known infective agent with sharp end points. The Medical Research Council² trial of streptomycin in primary pulmonary tuberculosis in 1948 provides the classic example.

The extension . . . [Full Text PDF of this Article]

Author Affiliations
From The National Hospitals for Nervous Diseases, London, England.

Footnotes
Accepted for publication September 27, 1989.

Reprint requests to The National Hospitals for Nervous Diseases, Queen Square, London WC1N 3BG, England (Dr Marshall).

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