The Lancet and the medical journal as an instrument of reform

Thomas Wakley (1795–1862) Douglas Fry at Piranha Photography/© The Lancet, Elsevier Ltd Rising from the ashes of his own personal tragedy (including the loss of his house to arson), Wakley, until then a general practitioner, founded The Lancet in 1823 as an inexpensive, weekly reform journal at a time when medicine and British society wrestled alike with notions of entrenched privilege, secularism, and the rights of commoners. Under Fox in the 1940s, The Lancet spoke out in defence of the UK's emerging National Health Service and national health insurance. By the mid-20th century, the Journal of the American Medical Association and its Editor, Morris Fishbein (1889–1976), would play a key part in defeating national health insurance in the USA and ensuring the broader fear of “socialised medicine” among many members of the medical community and the public. In 2009, the journal, having published concerns about the global “changing climate” since the late 1980s, and stating that “climate change is the biggest global health threat of the 21st century”, published its first modern Commission: the Lancet–University College London Institute for Global Health Commission on managing the health effects of climate change.