The James Lind Library; a history of EBM

In Evidence-Based Medicine, Website reviews on April 4, 2008 by Alan Lovell Tagged: , ,

When you have a moment, take a look at the James Lind Library. To illustrate the evolution of testing in medicine (from 2000 BCE onwards!) the library takes passages from old manuscripts, books and journal, translates them where necessary, and for many of them gives a commentary, biography and other relevant detail. You can also access a free book, made available under Creative Commens, called ‘Testing Treatments’, which was originally published by the British Library in 2006.

An example piece of text from the library reads (emphasis added):

al-Razi (10th century AD). Kitab al-Hawi fi al-tibb [The comprehensive book of medicine].

‘When the dullness (thiqal) and the pain in the head and neck continue for three and four and five days or more, and the vision shuns light, and watering of the eyes is abundant, yawning and stretching are great, insomnia is severe, and extreme exhaustion occurs, then the patient after that will progress to meningitis (sirsâm) … If the dullness in the head is greater than the pain, and there is no insomnia, but rather sleep, then the fever will abate, but the throbbing will be immense but not frequent and he will progress into a stupor (lîthûrghas). So when you see these symptoms, then proceed with bloodletting. For I once saved one group [of patients] by it, while I intentionally neglected [to bleed] another group. By doing that, I wished to reach a conclusion (ra’y). And so all of these [latter] contracted meningitis.’

The harsh world of 10th Century EBM!


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