Medical Journals and Medical Knowledge

Historical Essays

William F. Bynum, Stephen Lock, Roy Porter

• Publisher: Routledge
• Year: 2019
• Print ISBN:
  9780367075958
• eBook ISBN:
  9780429664526
• Topic: History
• Subtopic: World History
• Index: History

Originally published in 1992 Medical Journals and Medical Knowledge examines both broad developments in print and media and the practice of particular journals such as the British Medical Journal. The book is the first study to address these questions and to examine the impact of regular news on the making of the medical community. The book considers the rise of the medical press, and looks at how it recorded and described principal developments and so promoted medical science and enhanced medical consciousness. This book was a seminal work when first published and was one of the first to consider the importance of the roots of medical journalism, editorial practices and the ways in which the medical journalism altered the world of medicine.

1

The rise of medical journalism in Britain to 1800

Roy Porter

We seem to be drowning in print. ‘Like beach plums’, grumbles Gerald Weissmann, ‘new journals appear in crops overnight. . . . There are too many of them, they are published too often, they stare from the racks and reproach us for sloth’.¹

Were things different in the past? Instructing a young physician in his duties, the Revd Thomas Gisborne urged him to keep up. ‘The Medical Journal’s of eminence published in foreign countries, as well as those established in his own, will properly engage his attention. From the one and the other he will probably derive very important assistance in the discharge of his duty as a Physician’.² The youngster might even wish to contribute, though, here as elsewhere, the evangelical Gisborne warned of vainglory:³

He will not subject himself, by committing his thoughts to the press without sufficient previous enquiry, to the charge of purloining the discoveries of others; nor of being vain of communicating what is either unworthy of notice, or as yet but feebly and imperfectly developed, or hastily inferred from few and inadequate trials.

Gisborne fretted over the poisonous passions of print, warning the novice that ‘if, through any thing which he has done, or of any thing which he has published, he should find himself driven into a controversy’ he must ‘conduct the literary warfare with becoming temper’.⁴ The date? 1794. Clearly, the delights and dangers of the medical journal were well known by the close of the eighteenth century.

The centuries after Gutenberg naturally saw a proliferation of medical publishing: monographs, syllabuses, pamphlets, quacks’ handbills, textbooks and anatomy atlases, targeted at professionals, students and even the public.⁵ In the seventeenth century there were, in practice, no exclusively medical journals anywhere. Medical matters were, however, aired in the new scientific journals sprouting from mid-century: in Britain, in the Philosophical Transactions of the Royal Society; in France, in the Journal des Scavans of the Academie Royale des Sciences; in the Germanies, the Acta Eruditorum (1682).⁶ Historians often convey the impression that astronomy and physics were at the heart of the scientific revolution. Maybe, but quantitatively what filled the meetings of scientific societies and the pages of their publications were natural history, botany, zoology, anatomy, physiology and all aspects of medicine, theoretical, experimental, clinical and pathological. Open Phil. Trans. for 1667 and you immediately light upon a medical event of great significance: ‘An Account of More Tryals of Transfusion . . . The Method of Transfusing into the Veines of Men’.⁷ The prominence of medicine should come as no surprise: physicians like Martin Lister, Hans Sloane and James Jurin were amongst the Royal Society’s most active officers.⁸

The quantity of medical material in general scientific journals diminished during the eighteenth century. Doctors continued, of course, to avail themselves of traditional publishing outlets: handsome volumes, such as William Hunter’s The Human Gravid Uterus, went on sale alongside the vitriol of medical pamphlet wars in the golden age of Grub Street.⁹ And they exploited new publishing openings; to a small degree, the newspaper (mainly colonized by quacks),¹⁰ but mainly the superior monthly periodicals catering for polite and enlightened readerships. John Fothergill, John Coakley Lettsom, and many another elite practitioner sent their items to the Gentleman’s Magazine, a general-interest periodical with a circulation touching 10,000, which regularly carried essays on disease prevention, drugs, first aid, epidemics, and the new charity hospitals, as well as offering reviews of medical books, a battleground for professional altercations and a forum for what was termed a ‘medical correspondence’. Contributors to the Gent’s Mag. argued for closer communications between public and profession, urging jargon-free writing and easy information exchange.¹¹

But this was the time that also saw the specialist medical serial emerge.¹² ‘Hunt the first medical journal’ is a rather arid parlour game: scores of medical publications came out, promising a regular appearance, only to disappear before anyone even noticed them. Some of the earliest were ephemeral indeed. After the brief glory in 1682 of the Weekly Memorials for the Ingenious, which carried abstracts and reviews, many of them medical, Medicina Curiosa appeared on 17 June 1684, claiming to offer ‘a variety of new communications in physick, chirurgery and anatomy’, but never got beyond its second issue in October: about par for the course for early serials.¹³

The eighteenth century saw more durable productions. Here the pioneers were handsome collections of substantial papers, brought out occasionally under the direction of bodies of medical gentlemen: the Medical Essays and Observations, produced by a society in Edinburgh, which appeared in six volumes between 1733 and 1744; its successor, the Essays and Observations, published in Edinburgh in three volumes between 1754 and 1765; the Medical Observations and Inquiries, issued by a ‘Society of Physicians’ in London, which appeared erratically in six volumes between 1757 and 1784; the Medical Transactions, published in six tomes by the Royal College of Physicians of London from 1768 to 1820. The Memoirs of the Medical Society of London first appeared in 1787, continuing under than name, through six volumes, till 1805;¹⁴ and so forth. More specialized groups also pressed into print: the Royal Humane Society published its Reports from 1775 to 1795¹⁵ and, thanks to the energetic John Haygarth, the Chester Society for Promoting Inoculation its own Proceedings from 1778 to 1782.

In time, something more closely resembling a regular commercial medical press established itself. The Medical Museum, claiming on its title page to be ‘a repository of cases, experiments, researches and discoveries, collected at home and abroad’, came out monthly in two annual volumes, and reached a third volume before going under in 1764. The Foreign Medical Review appeared in four parts in two volumes between 1779 and 1780 before folding. The London Medical Journal was founded by Dr Samuel Foart Simmons in 1781; ten years later, it changed its name, presumably to gain a splash of novelty, to Medical Facts and Observations, and lasted till 1800. The Medical Spectator managed forty-eight ordinary and two extraordinary numbers between 1791 and 1796; the Medical and Chirurgical Review appeared in sixteen regular volumes between 1794 and 1808: the Annals of Medicine started in 1796, going on under that masthead till 1804, when it was born again as the Edinburgh Medical and Surgical Journal of distinguished reputation. Around 1800, there sprang up the London Medical Review and Magazine, and the Medical and Physical Journal

By now, we have gained familiar ground. A quite extensive medical press was operating by 1800 – over thirty titles had come and gone; and if few journals achieved any longevity before collapsing, or being renamed, new ones were always plugging the gaps. A formula was emerging – a core of cases and clinical materials, spiced with some news, copious book reviewing and a dash of correspondence, which makes them recognizable precursors of The Lancet or the BMJ. Not least, in 1799, a prospectus appeared for a monthly British Medical Journal itself. If it ever appeared, no copy seems to survive.¹⁶

Thus: the birth of British medical journals. There is no room here to examine their contents in any detail. But it is worth posing some broader questions: why did medical journalism emerge when it did? Why did it assume its particular form? What problems, what prospects, did it create for medical knowledge? Pre-modern medicine was beset by formidable difficulties regarding its public face, professional organization, ethical codes and scientific authority. However halting and uneven, the development of medical journalism in an Enlightenment age preoccupied with questions of knowledge, truth and power may be seen as a response to these challenges.¹⁷

Crucial was the question of information: its status, its proprietorship. Should medical knowledge be free and open? Or were there occasions for secrecy? Were some, but only some, chambers of the medical mansion fit for public viewing? Should knowledge have its private parts?¹⁸

If medicine was to be seen to be a progressive body of scientific knowledge, surely (many argued) it had to fulfil the Baconian criterion of being freely communicated and fairly criticized: ‘communications must run through all ye veines of ye Main worke’, John Beale had assured Henry Oldenburg, secretary to the Royal Society, in 1662.¹⁹ But there were carping voices claiming that, in actuality, medicine was the reverse, a closed shop, resting on hidebound authorities. Appalled at the stagnation of medical science, the late eighteenth-century reformer, Dr Thomas Beddoes, blamed the want of effective machinery for the storage and circulation of information. The protocols of private and medical practice discouraged data-pooling.²⁰

To all responsible opinion, barefaced secretiveness in a mortal matter such as clinical medicine (most notoriously, concealment of the composition of medicaments) was an abomination. ‘Secrecy, as you well know, and promises unrestrained by sense of shame’, Beddoes assured his colleague, Erasmus Darwin, ‘constitute the essential character of empiricism’.²¹ Little less harmful, however, Beddoes judged, was the near-universal oblivion which overtook clinical know-how. Mountains of valuable data were being daily registered in the brains, and even the notebooks, of doctors: what a scandal that most vanished without trace.²² Such ‘waste of facts’ was shocking, for ‘the grand expedient for rendering physiology popular and medicine certain, is to enlarge our stock of observations on animal nature’.²³

Beddoes proposed two solutions. First, systematic collection and indexing of medical facts.²⁴ ‘Why should not reports be transmitted at fixed periods from all the hospitals and medical charities in the kingdom to a central board?’²⁵ Other ‘charitable establishments for the relief of the indigent sick’ must also supply information, as should physicians at large.²⁶ Data should be processed by a paid clerical staff, and made freely available. Seminars should be held. The stimulus to comparison and criticisms would sift good practice from bad. ‘What would be the effect’, Beddoes mused, of ‘register offices, not exactly for receiving votive tablets, like certain ancient temples, but in which attestations, both of the good and of the evil, that appears to be done by practitioners of medicine, should be deposited?’²⁷ Without effective information storage, retrieval and dissemination, medicine would never take its place amongst the progressive sciences.²⁸ ‘To lose a single fact may be to lose many lives. Yet ten thousand, perhaps, are lost for one that is preserved; and all for want of a system among our theatres of disease, combined with the establishment of a national bank of medical wealth, where each individual practitioner may deposit his gains of knowledge, and draw out, in return, the stock, accumulated by all his brethren’.²⁹

Second, to complement his medical bank, Beddoes urged his fellows to publish more. He was h...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Contents
• List of figures and tables
• Acknowledgements
• Introduction
• 1. The rise of medical journalism in Britain to 1800
• 2. Periodical knowledge: medical journals and their editors in nineteenth-century Britain
• 3. Medicine, politics and the medical periodical 1800–50
• 4. Medicine and the Victorian scientific press
• 5. ‘Notorious abominations’: architecture and the public health in The Builder 1843–83
• 6. Social diseases? Crime and medicine in the Victorian press
• 7. The British Medical Journal: a retrospect
• 8. The American Medical Association and its journal
• 9. The British Medical Journal in America
• 10. Psychiatric journals and the evolution of psychological medicine
• 11. The medical journals and the politics of public health 1918–90
• 12. The British Medical Journal, general practitioners and the state 1840–1990
• 13. The British Medical Journal and the twentieth-century consultant
• Index