Dark Beginnings for The Lancet

The Lancet is one of the oldest peer-reviewed medical journals in the world, published weekly by Elsevier, part of Reed Elsevier. It was founded in 1823 by Thomas Wakley, William Cobbett, William Lawrence and James Wardrop.

They named it after the surgical instrument called a lancet, as well as an arched window (“to let in light”).

The Lancet had a rather ignoble start, founded by William Cobbett, a racist, anti semite (In Rural Rides - he was most vindictive, giving way to an anti semitism that was unworthy of him) and ex prisoner; Thomas Wakley (the founding editor of The Lancet who was a friend of homeopath John Epps); William Lawrence whose book was immediately attacked by John Abernethy and others for materialism and for undermining the moral welfare of the people; and James Wardrop who wrote many witty and scurrilous lampoons in his column ‘Intercepted Letters’, under the pseudonym ‘Brutus’ - these letters were faked - the Lancet hasn’t changed much since that time! *see the Of Interest section below.

Thomas Wakley is also listed in James John Garth Wilkinson’s address book at ‘The Lancet Office, Strand, WC’ (Swedenborg Archive Address Book of James John Garth Wilkinson dated 1895).

The Lancet then was a campaigning journal, and began a series of attacks on the jobbery in vogue among the medical practitioners of the day.

In 1823 Thomas Wakley started the now well-known medical weekly, The Lancet, with William Cobbett, William Lawrence, James Wardrop and a libel lawyer as associates. It was extremely successful: by 1830 it had a circulation of about 4,000.

The libel lawyer was certainly needed, for the Lancet then was a campaigning journal, and began a series of attacks on the jobbery in vogue among the medical practitioners of the day. In opposition to the hospital surgeons and physicians he published reports of their lectures and exposed their malpractices.

James Wardrop had to fight a number of law-suits, which, however, only increased his influence.

Thomas Wakley attacked the whole constitution of the Royal College of Surgeons, and obtained so much support from among the general body of the profession, now roused to a sense of the abuses he exposed, that in 1827 a petition to Parliament resulted in a return being ordered of the public money granted to it.

Wakley’s campaigning was rough and outspoken:

[We deplore the] "state of society which allows various sets of mercenary, goose-brained monopolists and charlatans to usurp the highest privileges.... This is the canker-worm which eats into the heart of the medical body." Wakley, _The Lancet_ 1838-9, 1, p2-3.

"The Council of the College of Surgeons remains an irresponsible, unreformed monstrosity in the midst of English institutions – an antediluvian relic of all... that is most despotic and revolting, iniquitous and insulting, on the face of the Earth." Wakley, _The Lancet_ 1841-2, 2, p246. Thomas Wakley was especially severe on whomever he regarded as quacks. The English Homeopathic Association were "an audacious set of quacks" and its supporters "noodles and knaves, the noodles forming the majority, and the knaves using them as tools".

One of Wakley’s best ideas came in 1831, when a series of massive meetings were held to launch a rival to the Royal Colleges. Though in the end not successful, the LCM incorporated ideas which formed the basis of reforms in the charters of the main licensing bodies, the Apothecaries, the Royal Colleges of Surgeons and Physicians.

First, there was to be one Faculty: the LCM was to include physicians, surgeons and general practitioners; teachers at private medical schools and naval surgeons would also be included.

Second, the structure was to be democratic: there would be no restrictions by religion (eg the Anglican restrictions of Oxford and Cambridge universities) or by institution (eg membership of hospitals). Its officers and Senate would be decided by annual ballot.

The cost of diplomas would be set low; those already qualilfied would be eligible to become Fellows so, for instance, those qualified in Scotland would be received without reexamination. Appointments to official (public) positions were to be by merit, eliminating nepotism and the hand-placing of protégées. All Fellows would carry the prefix ‘Dr’, removing artificial divisions between members.

Perhaps not surprisingly, the LCM did not succeed against the united opposition of the established Colleges and other institutions. Nevertheless, the strong case for reform had been made in the most public manner. Subsequent legislation and reforms in governing charters were for many years influenced by this campaign.

All through his career Thomas Wakley proved to be a man of aggressive personality, and his experiences in this respect had a sensational beginning. In August 1820 a gang of men (reputedly, the Thistlewood gang) who had some imagined grievance against him burnt down his house and severely wounded him in a murderous assault.

The whole affair is obscure.

Thomas Wakley was unjustly accused, by the insurance company (which had contested his claim), of setting fire to his house himself. He won his case against the company.

William Cobbett 1763 – 1835 was an English political pamphleter, farmer and prolific journalist.

William Cobbett had developed an animosity towards some corrupt officers, and gathered evidence against them while in New Brunswick, but his charges against them were sidetracked. Sensing that he was about to be indicted in retribution, he fled to France in March 1792 to avoid imprisonment. Intending to stay a year to learn the French language he found the French Revolution in full swing and the French Revolutionary Wars begun, so Cobbett sailed for the United States in September 1792.

Wiliam Cobbett was first at Wilmington and then Philadelphia by the Spring of 1793. Cobbett initially prospered by teaching English to Frenchmen and translating texts from French to English. He became a controversial political writer and pamphleteer writing with a pro-British stance under the pseudonym Peter Porcupine.

A disastrous lawsuit led to his financial ruin in 1799 and he returned to England in 1800 sailing from New York, via Halifax, Nova Scotia to Falmouth.

Cobbett was greeted warmly by the British Establishment on arrival but refused all offers of reward for his propagandising in the United States.

Three years later he started his newspaper, the Political Register. At first he supported the Tories but he gradually became a radical. By 1806 he was a strong advocate of parliamentary reform.

He began publishing the Parliamentary Debates in 1802. This unofficial record of Parliamentary proceedings later became officially known as Hansard.

William Cobbett stood for Parliament in Honiton in 1806, but was unsuccessful for he refused to bribe the voters by ‘buying’ votes; it also encouraged him in his opposition to rotten boroughs and the very urgent need for parliamentary reform.

William Cobbett was found guilty of treasonous libel on June 15, 1810 after objecting in ‘The Register’ to the flogging at Ely of local militiamen by Hanoverians. He was sentenced to two years imprisonment in infamous Newgate Prison.

While in prison he wrote the pamphlet Paper against Gold, warning of the dangers of paper money, as well as many Essays and Letters. On his release a dinner in London, attended by 600 people, was given in his honour, presided over by Francis Burdett who, like Cobbett, was a strong voice for parliamentary reform.

By 1815 the tax on newspapers had reached 4d. per copy. As few people could afford to pay 6d. or 7d. for a daily newspaper, the tax restricted the circulation of most of these journals to people with fairly high incomes. Cobbett was only able to sell just over a thousand copies a week.

The following year Cobbett began publishing the Political Register as a pamphlet. Cobbett now sold the Political Register for only 2d. and it soon had a circulation of 40,000.

Cobbett’s journal was the main newspaper read by the working class. This made Cobbett a dangerous man and in 1817 he learned that the government was planning to arrest him for sedition.

Following the passage of the Power of Imprisonment Bill in 1817, and fearing arrest for his arguably seditious writings, he fled to the United States. On Wednesday 27 March 1817 at Liverpool he embarked on board the ship IMPORTER, D. Ogden master, bound for New York, accompanied by his two eldest sons, William and John Cobbett.

For two years Cobbett lived on a farm in Long Island where he wrote Grammar of the English Language and with the help of William Benbow, a friend in London, continued to publish the Political Register. (*No doubt in Holywell Street - see below).

William Benbow was born in Manchester in 1784. As a young man he became a Nonconformist preacher with radical political opinions. A shoemaker, Benbow became one of the leaders of the reform movement in Manchester.

Benbow moved to London where he helped William Cobbett on the Political Register. In 1817 he heard that the government planned to have him arrested for sedition. Unwilling to spend another period in prison, Cobbett fled to the United States…

In an effort to stop the _Political Register_ from being published, the authorities arrested Benbow and he was tried and found guilty of seditious libel. When Benbow was released from Cold Bath Field Prison in London in 1820 he continued to work for William Cobbett. Benbow also wrote a series of pamphlets called Crimes of the Clergy. Benbow was once again arrested and imprisoned for seditious libel.

William Cobbett hatched a plan to return to England with Thomas Paine’s remains for a proper burial led to the ultimate loss of Thomas Paine’s remains. The plan was to give Thomas Paine a heroic reburial on his native soil, but the bones were still among Cobbett’s effects when he died over twenty years later. There is no confirmed story about what happened to them after that, although down the years various people have claimed to own parts of Thomas Paine’s remains such as his skull and right hand.

(Holywell Street behind the Strand was a well known street where pornography and politially radical pamphletes were published. These publishers ran the risk of imprisonment under the Obscene Publications Act. William Dugdale who was also ably assisted by one *William Benbow - was one such publisher who was imprisoned for publishing tracts by Thomas Paine and pornographic works).

William Cobbett arrived back at Liverpool by ship in November 1819 soon after the Peterloo Massacre. Cobbett joined with other Radicals in his attacks on the government and three times during the next couple of years was charged with libel.

In 1820 he stood for Parliament in Coventry but finished bottom of the poll.

Cobbett was not content to let the stories come to him, he went out like a modern reporter and dug them up, especially the story that he returned to time and time again in the course of his writings, the plight of the rural Englishman.

He took to riding around the country on horseback making observations of what was happening in the towns and villages. Rural Rides, a work for which Cobbett is still known for today, first appeared in serial form in the _Political Register_ running from 1822 to 1826. It was published in book form in 1830

In 1829, he published Advice to Young Men in which he heavily criticised the Principle of Population published by the Reverend Thomas Robert Malthus.

Cobbett continued to publish controversial material in the _Political Register_ and in July, 1831, was charged with seditious libel after writing a pamphlet entitled Rural War in support of the Captain Swing Riots, which applauded those who were smashing farm machinery and burning haystacks. Cobbett conducted his own defence and he was so successful that the jury failed to convict him.

Cobbett still had a strong desire to be elected to the House of Commons. He was defeated in Preston in 1826 and Manchester in 1832 but after the passing of the 1832 Reform Act Cobbett was able to win the parliamentary seat of Oldham.

In Parliament Cobbett concentrated his energies on attacking corruption in government and the 1834 Poor Law.

From 1831 until his death, he farmed at Normandy, a village in Surrey. In his later life, however Macaulay, a fellow MP, remarked that William Cobbett’s faculties were impaired by age; indeed that his paranoia had developed to the point of insanity.

He was a gifted writer, though later generations have taken offence at his some of his supposedly anti-Semitic and racist views. He is considered to have begun as an inherently conservative journalist who, angered by the corrupt British political establishment, became increasingly radical and sympathetic to anti-government ideals. He provides an alternative view of rural England in the age of an Industrial Revolution with which he was not in sympathy.

William Lawrence, 1st Baronet FRCS FRS 1783 – 1867 was an English surgeon who became President of the Royal College of Surgeons of London and Serjeant Surgeon to the Queen.

As a young man he published two books of his lectures which contained pre-Darwinian ideas on man’s nature and, effectively, on evolution. His second (1819) book was suppressed, after which his later surgical career was highly successful.

Lawrence was born in Cirencester, Gloucestershire, the son of a surgeon. He was apprenticed to, and lived with, John Abernethy (FRS 1796) for 5 years. He married Louisa (1803–1855), the daughter of a Mayfair haberdasher, who built up social fame through horticulture. Their son, Sir Trevor Lawrence, was for many years President of the Royal Horticultural Society.

Lawrence had a long and successful career as a surgeon. At his death he had reached the top of his profession, and the Queen rewarded him with a baronetcy. He was created a baronet (see Lawrence Baronets) on 30 April

1867. Lawrence suffered an attack of apoplexy whilst descending the stairs at the College of Surgeons and died later at his house, 18 Whitehall Place, London (5th July 1867).

Said to be a brilliant scholar, Lawrence was the translator of several anatomical works written in Latin, and was fully conversant with the latest research on the continent. He had good looks and a charming manner, and was a fine lecturer. His quality as a surgeon was never questioned.

Lawrence helped the radical campaigner Thomas Wakley found the Lancet journal, and was prominent at mass meetings for medical reform in 1826. Elected to the Council of the RCS in 1828, he became its President in 1846, and again in 1855.

During Lawrence’s surgical career he held the posts of Professor of Anatomy and Surgery, Royal College of Surgeons (1815-1922); Surgeon to the hospitals of Bridewell and Bethlem, and to the London Infirmary for Diseases of the Eye; Demonstrator of Anatomy, then Assistant Surgeon, later Surgeon, St Bartholomew’s Hospital (1824-1865).

Later in his career, he was appointed Surgeon Extraordinary, later Serjeant Surgeon, to the Queen. His specialty was ophthalmology, although he practised in and lectured and wrote on all branches of surgery. Percy Bysse Shelley, Pugin, and Queen Victoria were among his patients.

Despite reaching the height of his profession, with the outstanding quality of his surgical work, and his excellent textbooks, Lawrence is mostly remembered today for an extraordinary period in his early career which brought him fame and notoriety, and led him to the brink of ruin.

At the age of 30, in 1813, Lawrence was elected a Fellow of the Royal Society. In 1815 he was appointed Professor of Anatomy and Surgery by the College of Surgeons. His lectures started in 1816, and the set was published the same year.

The book was immediately attacked by John Abernethy and others for materialism, and for undermining the moral welfare of the people. One of the issues between Lawrence and his critics concerned the origin of thoughts and consciousness. For Lawrence, as for ourselves, mental processes were a function of the brain. John Abernethy and others thought differently: they explained thoughts as the product of vital acts of an immaterial kind. John Abernethy also published his lectures, which contained his support for John Hunter’s vitalism, and his objections to Lawrence’s materialism.

In subsequent years Lawrence vigorously contradicted his critics until, in 1819, he published a second book, known by its short title of the Natural history of man. The book caused a storm of disapproval from conservative and clerical quarters for its supposed atheism, and within the medical profession because he advocated a materialist rather than vitalist approach to human life.

He was linked by his critics with such other ‘revolutionaries’ as Thomas Paine and Lord Byron.

Hostility from the established Church of England was guaranteed. “A vicious review in the Tory Quarterly Review execrated his materialist explanation of man and mind”; the Lord Chancellor, in the Court of Chancery (1822), ruled his lectures blasphemous, on the grounds that the book contradicted Holy Scripture (the Bible). This destroyed the book’s copyright.

Lawrence was also repudiated by his own teacher, John Abernethy, with whom he had already had a controversy about John Hunter’s teachings. Faced by persecution, perhaps prosecution, and certainly ruin through the loss of surgical patients, Lawrence withdrew the book. The time had not yet arrived when a science which dealt with man as a species could be conducted without interference from the religious authorities.

It is interesting that the Court of Chancery was acting, here, in its most ancient role, that of a court of conscience. This entailed the moral law applied to prevent peril to the soul of the wrongdoer through mortal sin. The remedy was given to the plaintiff (the Crown, in this case) to look after the wrongdoer’s soul; the benefit to the plaintiff was only incidental. This is also the explanation for specific performance, which compels the sinner to put matters right. The whole conception is mediæval in origin.

It is difficult to find a present-day parallel. The withholding of copyright, though only an indirect financial penalty, was both an official act and a hostile signal. We do not seem to have a word for this kind of indirect pressure, though Suppression of dissent comes closer than censorship. Perhaps the modern ‘naming and shaming’ comes closest. The importance of respectability, reputation and public standing were critical in this case, as so often in traditional societies.

After repudiating his book, Lawrence returned to repectability, but not without regrets. He wrote to William Hone, who was acquitted of libel in 1817, explaining his expediency and commending Hone’s “greater courage in such matters”.

He continued to espouse radical ideas and, led by the famous radical campaigner Thomas Wakley, Lawrence was part of the small group which launched The Lancet, and wrote material for it.

Lawrence wrote pungent editorials, and chaired the public meetings in 1826 at the Freemason’s Tavern. These meetings, for members of the College, were attended by about 1200 people, were called to protest against the way surgeons abused their privileges to set student fees and control appointments.

Also, Lawrence was co-owner of the Aldersgate Private Medical Academy (with Frederick Tyrrell). These private medical academies provided some of the best teaching of anatomy and physiology, but were constantly under threat from the Royal Colleges.

In his opening speech Lawrence criticised the by-laws of the College of Surgeons for preventing all but a few teachers in London, Dublin, Edinburgh, Glasgow and Aberdeen from issuing certificates of attendance at preparatory lectures. He pointed out that Aberdeen and Glasgow were bereft of cadavers for dissection, without which anatomy could not be preoperly taught.

A proposed change in regulations of the College of Surgeons would soon cut the ground from under the private summer schools, since diplomas taken in the summer were not to be recognised.

"It would appear from the new regulations that sound knowledge was the sort acquired in the winter, when the hospital lecturers delivered their courses, while unsound knowledge was imparted in the summer when only the private schools could provide the instruction" Lawrence in his opening speech, Freemason's Tavern, 1826. Lawrence concluded by protesting against the exclusion of the great provincial teachers from giving recognised certificates. However, gradually Lawrence conformed more to the style of the College of Surgeons, and was elected to their Council in 1828. This somewhat wounded [Thomas Wakley](http://en.wikipedia.org/wiki/Thomas_Wakley), who complained to Lawrence, and made some remarks in [_The_ _Lancet_](http://www.thelancet.com/).

But, true to form, Thomas Wakley soon saw Lawrence’s rise in the College as providing him with an inside track into the working of the institution he was hoping to reform. For some years Lawrence hunted with The Lancet and ran with the College. From the inside, Lawrence was able to help forward several of the much-needed reforms espoused by Thomas Wakley. The College of Surgeons was finally reformed by a new charter in 1843.

This episode marks Lawrence’s return to repectability; in fact, Lawrence succeeded John Abernethy as the ‘dictator’ of Bart’s. From then, Lawrence’s career went ever forward. He never looked back: he became President of the Royal College of Surgeons, and Serjeant-Surgeon to Queen Victoria. Before he died she made him a baronet.

“Never again [did] he venture to express his views on the processes of evolution, on the past or the future of man.” He did, however, warn the young Thomas Henry Huxley – in vain, it must be said – not to broach the dangerous topic of the evolution of man…

Lawrence’s Natural history of man contained some remarkable anticipations of later thought, but was ruthlessly, and successfully, suppressed. The suppression was so effective that to this day Lawrence does not seem to get the recognition he deserves. He is omitted, for example, from many of the Charles Darwin biographies, and from some evolution textbooks.

Lawrence was one of three British medical men who wrote on evolution-related topics between 1813 and 1819. They would all have been familiar with Erasmus Darwin and Lamark at least; probably also Malthus. Two (Prichard and Lawrence) dedicated their works to Blumenbach, the founder of physical anthropology. “The men who took up the challenge of Lamark were three English physicians, Wells, Lawrence and Prichard”… “All three men denied soft heredity (Lamarkism)”

Not too accurate in biographical terms, as Lawrence was actually a surgeon, Wells was born in Carolina to a Scottish family, and Prichard was a Scot! However, correct in principle on the main issue. Each grasped aspects of Charles Darwin’s theory, yet none saw the whole picture, and none developed the ideas any further.

The later publication of Robert Chambers’ The Vestiges of the Natural History of Creation and Patrick Matthew’s Naval timber was more explicit; the existence of the whole group suggests there was something real (though intangible) about the intellectual atmosphere in Britain which is captured by the phrase ‘evolution was in the air.’

The years 1815-1835 saw much political and social turmoil in Britain, not least in the medical profession. There were radical medical students and campaigners in both Edinburgh and London, the two main training centres for the profession at the time.

Many of these were materialists who held views favouring evolution, but of a Lamarkian or Geoffroyan kind.[28] It is the allegiance to hard inheritance or to natural selection which distinguishes Lawrence, Prichard and Wells, because those ideas have survived, and are part of the present-day account of evolution…

James WardropMDFRCSEdFRCS (1782–1869), Scottish surgeon. Born in Torbane Hill, Lanark, Wardrop trained in Edinburgh 1797, London 1801 and Vienna 1803. Ophthalmic surgeon in Edinburgh 1804–08; London 1808–69; gained MD St Andrews 1834.

Wardrop was associated with Thomas Wakley in the founding of The Lancet in 1823, for which he wrote many witty and scurrilous lampoons in his column ‘Intercepted Letters’, under the pseudonym ‘Brutus’.

The letters were faked.

Wardrop taught surgery from 1826 at the Aldersgate Street medical academy with William Lawrence and Frederick Tyrrell, and published surgical treatises.

Wardrop, an excellent surgeon, was early appointed surgeon-extraordinary by the Prince Regent, the future George IV. This infuriated his rivals in London, and he found the doors of the large hospitals closed to him.

In retaliation he founded the West London Hospital for Surgery near the Edgware Road, and invited general practitioners to watch him operate. Further royal honours came, but he declined a baronetcy (in lieu of royal fees) and moved out of royal circles.

His social gifts, a knowledge of horseflesh and marriage to a wife with aristocratic connections brought him popularity.

He was later rehabilitated with the College of Surgeons, becoming a Fellow in 1843.

Of interest:

*From http://www.collective-evolution.com/2015/05/16/editor-in-chief-of-worlds-best-known-medical-journal-half-of-all-the-literature-is-false/ ‘… In the past few years more professionals have come forward to share a truth that, for many people, proves difficult to swallow. One such authority is Dr. Richard Horton, the current editor-in-chief of the Lancet – considered to be one of the most well respected peer-reviewed medical journals in the world. Dr. Horton recently published a statement declaring that a lot of published research is in fact unreliable at best, if not completely false. *\*“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.” **(source http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2960696-1.pdf)…’