Cold-water, Sulphur and 'the itch': James Henry's principles for conducting controlled trials (1843).

Abstract

Background: James Henry (1798-1876) was a Dublin physician and classical scholar best remembered for his translation of Virgil's Aeneid. Little is recorded about his medical practice.

Aim: To describe Henry's 1843 proposal for a controlled trial of treatment for 'the itch'.

Method: Qualitative examination of historical medical journals.

Results: Henry suggests taking twelve patients and treating six with cold-water treatment and six with standard treatment (sulphur). Henry's proposal sets out four general principles for selecting diseases to study the alleged benefits of cold-water treatment. First, the condition should be one upon which it is safe to experiment. Second, the disease should be 'visible and tangible, and… cannot be simulated or misrepresented, or misunderstood'. Third, it should have no spontaneous recovery. Finally, there should already be a 'certain [i.e. proven] remedy'. Henry had published in 1834 on sulphur as a laxative. By calling for twelve participants, it is possible that Henry's proposal was influenced by the writing of Francis Hauksbee the Younger (1743) and James Lind (1753).

Conclusion: Although there is no evidence that Henry's trial ever took place, his proposal and principles for selecting a disease to study reveal a critical and ethical mind. It also constitutes a notable landmark on the journey towards formal controlled trials.