ABSTRACT
Clinical research in the sense of investigating the patient at the bedside with a view to recording findings of interest to other healers could be said to be as old as medical writings. The Enlightenment in particular witnessed the widespread reporting by doctors of clinical observations with a view to promoting medical knowledge. Clinical research, however, in the sense of a bedside experimental enterprise, often relying on laboratory work, undertaken by clinicians as a significant dimension of a medical career can be traced only to the mid-nineteenth century, notably to Germany. Here doctors could aspire to paid, university teaching positions and have hospital beds at their command and laboratory facilities at their disposal. This was the teaching and research model that reformers endeavored to introduce wherever orthodox medicine was practised. It is usefully called academic medicine. In the late twentieth century, in the West, clinical research is now overwhelmingly carried out by full-time or part-time funded clinicians in university hospitals usually in association with scientists and technicians and nearly always involving laboratory work. Funded clinical research was also taking place at the end of the nineteenth century in so far as pharmaceutical companies in Britain, America and Germany established their own laboratories and tested the drugs developed within them.
