The Royal Brompton Hospital is well known for studies evaluating the use of streptomycin and other chemotherapy for tuberculosis (TB) in the 1940s to 1960s, but it is less widely known that the physicians at the hospital were already investigating treatments for TB 100 years earlier. This is a report of a study conducted in 1848.

• Objective: to investigate the use of cod liver oil in the treatment of consumption (also known as phthisis, and now called tuberculosis or TB) in 19th century London

• Hypothesis: that cod liver oil might arrest progression or reduce the death rate from consumption

• Protocol: the study was conducted in 1848 at the Hospital for Consumption and Diseases of the Chest, Brompton (fig 1⇓). The results were presented to the hospital’s Committee of Management in the First Medical Report of the Hospital for Consumption and Diseases of the Chest in 1849.1

In their report, the medical officers felt it their duty to bear testimony to the judgement evinced in the selection of the site for the hospital: The hospital is built on a dry gravelly soil, in a suburb of the metropolis long celebrated for its salubrity, sheltered on the north and east by the metropolis and open to the south and west; the wards are lofty and the corridors light and capacious.

542 inpatients with consumption were treated with cod liver oil, in a dose of 1 drachm (3.6 ml) three times a day, gradually increased, in some few cases up to 1.5 ozs (42 ml) per dose. The oil is straw coloured, transparent and free from offensive smell. Patients take it in general …