Thomas Wakley founded the medical journal The Lancet to expose corruption in the unregulated British medical profession, to advocate for reforms in metropolitan hospitals, and to share news of medical discoveries, treatments, and advances. In the twenty-first century, The Lancet remains one of the world’s leading medical journals.
Thomas Wakley, the youngest of eleven children, was born in Membury, Devon, on July 11, 1795. At the age of ten, his father allowed him to join the British East India Company as a midshipman, but he quickly found the naval life unstable and he returned to Taunton, where he studied pharmacology. In Taunton, Wakley encountered his first brush with discrimination in the medical profession as doctors routinely discounted the work of the pharmacists upon whom they relied for making medicines. At the age of twenty-two, Wakley was admitted to the Royal College of Surgeons in London, and he apprenticed at the United Hospitals of St. Thomas and St. Guys near London Bridge before opening his own practice in London.
During his medical education, Wakley was sensitive to forms of corruption in the medical profession, including doctors’ practice of nepotism, carelessness during surgeries, and doctors’ beliefs that they formed an exclusive group and were not servants of the people. Wakley’s outrage against these practices and attitudes would lead his drive to reform the entire medical profession, using The Lancet and his skill at public speaking as his principal tools.
Wakley was already a controversial figure; when he turned his attention to editing and writing The Lancet, his reputation as the “sailor doctor” preceded him. In May of 1820, he was rumored to have been the surgeon who had beheaded the members of the failed Cato Street Conspiracy, an attempt to overthrow the British parliament. Wakely was assaulted in his own home and left for dead when his house was set ablaze. It was not long after this incident, on October 5, 1823, that Wakley left private medical practice and began The Lancet with the financial support of his father-in-law, the merchant Joseph Goodchild. Wakely had married Elizabeth Goodchild on February 5, 1820.
Wakley probably was inspired to found The Lancet by the success of The New England Journal of Medicine and Surgery, founded in 1811 in Boston by Walter Channing, a leader in medical care for women. When the first issue of The Lancet appeared, there was one English medical journal with a good reputation, The Medico-Chirurgical Review, a monthly started in 1816. The Medical and Physical Journal—another monthly, started in 1799—would end publication in 1833. In 1827, just four years into The Lancet’s existence, a group of doctors who had sued Wakley for articles he had published about their malpractice started a third magazine, The Medical Gazette, which in 1839 became a part of The Medical Times.
The Lancet was a unique journal because Wakley, as editor, did not limit the journal’s contents to medical news. He also published his own editorials, which called for reform in the education of doctors and in the practice of medicine. He also attacked doctors for malpractice and fully reported how their patients died as a result of a given doctor’s poor care. Wakley also included, in the first two years of his weekly paper, chess games and theater reviews. Such content reflected his belief that chess offered good mental training for young medical students. In time, however, he decided to shift the focus of The Lancet to reporting on medical breakthroughs, effective treatments for diseases
The first issue of The Lancet included a detailed statement of purpose written by Wakley. The mission statement was not especially controversial, as it laid out the aims of the new periodical as being devoted to teaching and informing the public about the practice of medicine. Wakley had also published lectures by one of his teachers at the United Hospitals, Sir Astley Cooper. This type of editorial content was more controversial because students typically paid £15 for a professor’s medical lectures. When Wakley reprinted the lecture without permission—although he did not violate copyright law—he did take from Cooper the chance to make money from his own intellectual property. Instead of suing Wakley, however, Cooper met with him and gave him permission to publish some of his lectures as long as his name did not appear with the article; Cooper did not want to be associated with a weekly medical news journal.
To fill the pages of The Lancet, Wakley used copies of medical lectures he owned, his own rhetorical skills to write editorials, and a cadre of reporters to write about hospital news. Because he had many enemies, Wakley was sued for what was presumed to be infringement of copyright and for libel, as he exposed medical incompetence in graphic detail in the pages of his publication. Every lawsuit he won increased the reputation of the journal, and within two years of its founding, it came to focus solely on medical news (domestic and foreign) and had editorials that were focused on the profession.
Wakley’s reporters were frequently ejected from the hospitals they attempted to cover, and Wakley himself was assaulted several times because of his viewpoints. He also was a leading consumer advocate and had the most successful medical news organ of the nineteenth century, having driven three other medical periodicals out of print. He attracted journalists and doctors who could write well and who shared his views on political and social reform. From 1836 to 1839, for example, Wakley debated in Parliament and in the pages of The Lancet the cruelty of military floggings, and although reform was not achieved until 1881, Wakley raised public awareness of the practice from a medical standpoint, thus providing intellectual arguments that his readers could use to shape their opinions and influence their electoral choices. Although his attack on nepotism in the Royal College of Surgeons did not end the practice, he did provoke a series of reforms deemed beneficial that were outlined in numerous issues of The Lancet.
Within two years, The Lancet had four thousand subscribing readers and sold for the reasonable price of six pence per copy. It attracted readers from many fields, not just medicine, and as its reputation grew, it attracted a variety of contributors as well. The best-known contributor in Wakley’s day was William Cobbett
Wakley focused on a stable set of topics that would dominate the rest of his life and his careers as editor of The Lancet, as Middlesex coroner, and as a member of Parliament from Finsbury. He found that The Lancet alone could not be the sole reform tool, as he had envisioned. While he could use the journal to motivate the public (he actually was happy and eager to be sued by those whose malpractice he exposed, as such suits were signs that his message was being received), he still felt that he needed a better method of effecting changes in laws that affected the lives of all those needing medical help, particularly the poor.
In 1836, Wakley published a pamphlet in support of eliminating the Stamp Tax
In 1852, Wakley retired from Parliament. He died on May 16, 1862, while on a holiday in Madeira, Spain. He was buried in Membury.
The Lancet has been in continuous publication since 1823. The journal gave its founder, Thomas Wakley, a means to raise public awareness about medical malpractice, about the need to reform the Royal College of Surgeons, about poor medical practice, and about poor medical education. He also argued that coroners should be qualified as doctors. Wakley’s efforts, largely accomplished through the pages of The Lancet, effected major civil reforms. Under Wakley’s editorship, The Lancet lived up to its symbolic name, as Wakley used it to pierce the comfortable and corrupt lives of physicians and drain the wounds that for so long had plagued the medical profession.
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Digby, Anne. Making a Medical Living: Doctors and Patients in the English Market for Medicine, 1720-1911. New York: Cambridge University Press, 2002. Traces the commercialization of medicine in Great Britain from the mid-eighteenth century, beginning with the first volunteer hospital and ending in 1911 with the institution of national health insurance. Good general context for understanding Wakley and the medical profession of his times. -
Hostettler, John. Thomas Wakley: An Improbable Radical. Chichester, England: Barry Rose Law, 1993. This life of Wakley draws on the contemporary account by Sir Samuel Squire Sprigge and includes newer insights and explanations of Wakley’s political career. -
Sprigge, Sir Samuel Squire. The Life and Times of Thomas Wakley. 1897. Reprint. Introduction by Charles G. Ronald. Huntington, N.Y.: Robert E. Kreiger, 1974. The earliest biography of Wakley. Chapter 25 summarizes his achievements with The Lancet during its first decade.
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Elizabeth Blackwell; William Cobbett; Joseph Lister; Sir William Osler; Ignaz Philipp Semmelweis.