The Lancet

“ In this capacity, and also as coroner for West Middlesex—an appointment he secured in 1839—he was indefatigable in upholding the interests of the working classes and advocating humanitarian reforms, as well as in pursuing his campaign against medical restrictions and abuses; and he made the Lancet not only a professional organ but a powerful engine of social reform. He died on the 16th of May 1862, leaving three sons, the proprietorship of the Lancet remaining in the family. ”

“ Sometimes we have to crawl out of our ivory towers for a minute or two—you know?"
Jenkins reddened again. He had never had any great love for physicians of the Black Service—who did?—but he found himself disliking this short, blunt-spoken man even more cordially than most. "Why implicate the Lancet?" he burst out. "You've landed the Mercy on plenty of planets before we brought the Lancet aboard her—"
"But we did not have it with us before the Lancet came aboard, and we do have it now. The implication is obvious. You have brought aboard a contaminant." ”

“ The moral aspect of the case is marked by every feature capable of exciting a sense of shame for our profession, and of sorrow for our kind. Can it be that a publication conducted in the spirit of the extracts produced at the late trial of Cooper against Wakley should be fostered and encouraged by a large proportion of the medical public? Is it indeed true that no feeling of loathing and disgust should have induced the purchasers of the Lancet to protest against its glaring injustice, its undisguised ferocity and malignity? ”

“ And of course I am forced to classify the Lancet as a plague ship until a bacteriological and virological examination has been completed on both ship and crew. The planet itself will be considered a galactic plague spot until proper measures have been taken to insure its decontamination. ”

“ Among the achievements of the medicine of the 19th century the growth of the medical press must not be forgotten. In England, by the boldness of the Lancet (founded in 1823) , the tyranny of prescription, inveterate custom, and privilege abused was defied and broken down; freedom of learning was regained, and promotion thrown open to the competent, independently of family, gild and professional status. For the record and diffusion of rapidly growing knowledge, learned societies, universities and laboratories, greatly increased in number and activity, issue their transactions in various fields ”

“ Jack said.
"We'll see," Dal said. "Tomorrow we'll know better."
But clearly the problem had been solved. The next day there was an excited conference between the spokesman and the doctors on the Lancet. The Bruckians had elected to maintain the same host body as before. They had gotten used to it; with the small pink creatures serving as a shelter to protect them against the deadly antibodies, they could live in peace and security. But they were eager, before the Lancet disembarked, to sign a full medical service contract with the doctors from Hospital Earth. ”

“ Once again the Lancet's calls fell into a pattern. Landings on the outpost planets became routine, bright spots in a lonely and wandering existence. The calls that came in represented few real problems. The ship stopped at one contract planet to organize a mass inoculation program against a parasitic infestation resembling malaria. They paused at another place to teach the native doctors the use of some new surgical instruments that had been developed in Hospital Earth laboratories just for them. ”

“ Wakley, as Editor of the Lancet, having given the first impulse to that cause, and having subsequently advocated it with undeviating firmness and fidelity, is entitled to the cordial thanks and support of this meeting."
Mr. Mills seconded the resolution.
Dr. Shiel said this was an important meeting, in his opinion; for, if this resolution were passed, it would identify the medical profession with the Editor of the Lancet. If the principle embodied in that resolution went forth to the world, it would be attended with consequences deeply injurious to the profession. He knew neither Mr. ”

“ From the publications of a number of physicians, who used the lancet and mercury in their greatest extent, it appears that they lost but one in ten of all they attended. It was said of several practitioners who were opposed to copious bleeding, that they lost a much smaller proportion of their patients with the prevailing fever. Upon inquiry, it appeared they had lost many more. To conceal their want of success, they said their patients had died of other diseases. This mode of deceiving the public began in 1793. ”

“ The Lancet gave it almost unqualified praise. In 1846 the Pathological Society of London was established, and Dr. Williams was chosen its first president. Its objects were the exhibition, description, and classification of morbid specimens, and the promotion of pathological research by systematic observation and experiments. In his opening address, Dr. Williams answered the sceptical question, “What is the use of opening bodies? We never find what we expected:” by describing a post mortem examination of a remarkable case of pulmonary [Pg 186] disease. ”

“ There are germs in clothes and customs—ah, the Lancet’s eye is keen,
It has even pierced the dustbin of the Browns of Walham Green!
There, it told them, germs in thousands lay in waiting night and day,
So they went and threw carbolic in a wildly lavish way.
Then it warned them in a leader that they’d better all look out
For a dreadful epidemic that came down the waterspout ”

“ The ship stopped at the specified contact points—some far out near the rim of the galactic constellation, others in closer to the densely star-populated center. At each outpost clinic the Lancet was welcomed with open arms. The outpost men were hungry for news from home, and happy to see fresh supplies; but they were also glad to review the current medical problems on their planets with the new doctors, exchanging opinions and arguing diagnosis and therapy into the small hours of the night. ”

“ Red Doctor Jenkins' face darkened. "The Green Doctor and I have maintained the Lancet in perfect conformity with the Sterility Code. We've taken every precaution on both landing and disembarking procedures. What's more, we've spent the last three months on a planet with no mutually compatible flora or fauna. From Hospital Earth viewpoint, Mauki IV is sterile. ”

“ Hall became prominently known; for the dropping of the lancet was an evident change of procedure which the public as well as the profession could lay hold of. In 1825 the young enemy of the lancet was elected Physician to the Nottingham Hospital by a large majority of votes, and the best practice of the neighbouring counties was his. He was unremittingly employed: in his walks and rides almost heedless of external occurrences, absorbed in contemplation; at home ever busy in his library or his laboratory, making chemical experiments from which numerous valuable memoirs arose ”

“ Thus Wilson became a specialist of great merit as well as profitable practice, and, says the Lancet (August 16, 1884) , “knew more about skin diseases than any man of his time. He cured when others had failed to cure; and his works on dermatology, though they met with pretty searching criticism at the time of their appearance, have nearly all maintained their position as text-books. The horrible cases of scrofula, anæmia, and blood-poisoning which he witnessed among [Pg 245] the poor of London—they are happily rarer now than they were half a century ago—enlisted his warm sympathies. ”

“ You young men who are following the hospitals hardly know how much you are indebted to Louis. I say nothing of his Researches on Phthisis or his great work on Typhoid Fever. But I consider his modest and brief Essay on Bleeding in some Inflammatory Diseases, based on cases carefully observed and numerically analyzed, one of the most important written contributions to practical medicine, to the treatment of internal disease, of this century, if not since the days of Sydenham. The lancet was the magician's wand of the dark ages of medicine. ”

“ Conversations during a forty-four years’ practice with men who began their professional calling sixty years ago, when the lancet was in often call, is to the import that there has been such a change in diseases as renders the frequent resort to blood-letting less important than formerly ”

“ But now a flareup had occurred. The Lancet brought in supplies of the antibiotic, and Tiger Martin spent two days showing Singallese physicians how to control further outbreaks with modern methods of immunization and antisepsis. ”

“ Did you advertise your lecture in the Lancet? I expect you will have a lot of blackguardly doctors there in consequence. Don’t have any libel cases, and don’t be hard on the students. They’re very bad, but they’re not so bad as the Professors. ”

“ In a word, it is not industry, but worry, that kills, and in this respect he certainly takes his own prescription, and adds the example to precept, for his hours of recreation spent outside his laboratory or his library are very few indeed. He finds the greatest pleasure in keeping abreast of medical thought and development in all parts of the world, and is a contributor to the Lancet and other leading organs of the profession. ”

“ Of this book the Lancet of August 15, 1857, remarked: “Comprehensive, lucid, exact, and reliable, this work has, in the main, stood the test of forty years’ trial. A better has not been produced.” When Dr. Baillie, nephew of John Hunter and President of the College of Physicians, first saw Marshall Hall, he complimented him on being the son of the author of so extraordinary a work as that on Diagnosis. Being modestly told that he himself was the author, Baillie exclaimed: “Impossible! it would have done credit to the greyest-headed philosopher in our profession.” ”

“ At one time I thought the Editor of the Lancet would kindly publish a letter from me on the subject, but further reflection led me to doubt whether an insignificant individual would be noticed without some special introduction. ”

“ It is probable that greater certainty and success in the treatment of this disease will not easily be attained, for idiosyncracy, and habits of intemperance which resist or divert the operation of the most proper remedies, a dread of the lancet, or the delay of an hour in the use of it, the partial application of that or any other remedy, the unexpected recurrence of a paroxysm of fever in the middle of the night, or the clandestine exhibition of wine or laudanum by friends or neighbours, often defeat the best concerted plans of cure by a physician. ”

“ In saying that there should be a thousand investigators of disease where there is now one, I believe that Professor Lankester would be the first to admit that this statement was that of an ideal to be aimed at, rather than of an end to be practically reached. Every careful thinker will agree that to gather a body of men, young or old, supply them with laboratories and microscopes, and tell them to investigate disease, would be much like sending out an army without trained leaders to invade an enemy's country. ”

“ Indeed, few, if any, trade or business organizations can compare with the medical profession in this respect, and this medical power is further greatly increased beyond that of any other profession, trade or business in being in practical control of our most important Departments of Public Health and Vital Statistics all over the country, so that in advocating and practising the dangerous barbarism of compulsory medicine this medical power can easily deny and conceal the actual effects of this dangerous medication on human health and life in our vital statistics. ”

“ Whilst it is true that little or nothing has been done by the State in acquiring or making use of knowledge as to the first and second of these factors, with a view to controlling the spread of disease, it is the fact that much has been done both in the way of investigation and administration in relation to the third factor. The great public-health enquiries and consequent legislation in this country, in which scientific men of the highest qualifications, such as Simon, Farr, Chadwick, and Parkes, took part during the Victorian period, have had excellent results ”

“ His great notebook of observations lay unopened on the library table, and his little gold syringe of anti-fever serum—a clever device of his own, with a self-contained reservoir, attached to a broad gold finger ring, and single-pressure action peculiar to itself—rested idly in a small leather case beside it. Vigor, ambition, and the desire for study and observation seemed to have died within him; and he made no inquiries about his clinic, where hundreds of germ cultures stood in their orderly phials awaiting his attention. ”

“ The trend of modern medical research and practice in our great colleges and endowed research institutes is almost entirely along combative lines, while the individual, progressive physician learns to work more and more along preventive lines. The slogan of modern medical science is, "Kill the germ and cure the disease." The usual procedure is to wait until acute or chronic diseases have fully developed, and then, if possible, to subdue them by means of drugs, surgical operations, and by means of the morbid products of disease, in the form of serums, antitoxins, vaccines, etc. ”

“ As for reporting, you can’t combat a disease until you know where it is established and whither it is spreading. So, I say, any health officer who succeeds in spurring up the medical profession, and in dragging the Great White Plague out of its lurking-places into the light of day ought to have a medal.”
“What about the other diseases? Is the same true of them?”
“Not to the same extent. No man can tell when or why the epidemic diseases—scarlet fever, measles, whooping-cough, and diphtheria—come and go. By the way, what about your diphtheria death rate here?” ”