I was alerted to this excellent page on the James Lind Library recently by Iain Chalmers. For those of you who don’t know what the James Lind Library is, you should take a look at www.jameslindlibrary.org/. Basically, it is a collection of essays and examples explaining the role of fair tests in treatments in health care. One item worth looking at is the book ‘Testing Treatments’ – published by the British Library in 2006 – which is available for free and is translated into a number of languages such as Arabic, Chinese and Spanish. From a good source, I’m assured this book has been downloaded 80,000 times (as of April 2009) since becoming available under a creative commons license. The page which Iain drew my attention to is about the 1925 book called ARROWSMITH, and the associated film which was released in 1931. Take a look at the video which is a stunning example about planning plague research using a controlled trial. What is unique about this video is it is such an early example of how to plan an epidemiological study to investigate the effects of an intervention, something that seems to be difficult to implement in the modern day health sector. In the key passages of the book there is a neat section illustrating Dr Martin and his rebellious nature. ‘But Martin was rebellious. He inquired, and publicly, “Dr. Davidson, how do they know ichthyol is good for erysipelas? Isn’t it just rotten fossil fish – isn’t it like the mummy-dust and puppy- ear stuff they used to give in the olden days?” How do they know? Why, my critical young friend, because thousands of physicians have used it for years and found their patients getting better, and that’s how they know!’ I’d consider this to be one of the earliest examples of evidence-based practice captured on film.

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1. http://www.jameslindlibrary.org/trial_records/20th_Century/1920s/lewis/lewis_tp.html