 Lind’s experiments represent perhaps the first modern clinical trial because he attempted to address one of the primary challenges facing those who set out to evaluate medical treatments. How does one show that any differences in the outcomes of the treatments under study are a result of the treatments themselves, and not a result of the patients who received them, or other differences in the patients’ environment or diet? How could Lind be confident that the improvements in the two sailors were the result of the oranges and lemons, and not a result of the fact that he happened to give them to the two patients who occupied the most salutary rooms on the ship? Lind tried to address the challenge of confounding variables by beginning with patients who were as similar as possible. He carefully chose the 12 subjects for his experiment from a much larger pool of ailing sailors; he also tried to ensure that all 12 received the same rations each day, apart from the treatments provided as part of his study. It is also worth noting that Lind’s dramatic results were largely ignored for decades, leading to uncounted and unnecessary deaths, and highlighting the importance of combining clinical research with effective promulgation and implementation. The Royal Navy did not adopt citrus rations for another 50 years (Sutton 2003), at which point scurvy essentially disappeared from the Royal Navy.