This week, we trace the story of one of the most influential medical journals in the world: The Lancet. More than just a periodical, it has been a platform for scientific discovery, medical debate, and political controversy for nearly two centuries.
Founding Vision
The Lancet was founded in 1823 by Thomas Wakley, an English surgeon and radical reformer. At the time, Britain’s medical establishment was dominated by elite institutions such as the Royal College of Surgeons, which Wakley accused of corruption and elitism. By naming his journal The Lancet, a reference both to the surgical instrument and to the architectural term for a “window to let in light”, Wakley signalled his mission to cut through secrecy and open medicine to public scrutiny. A lancet is a small, pointed surgical knife with a double-edged blade, historically used to make precise incisions or open abscesses.
Portrait engraving of Thomas Wakley, about 1840, by W.H. Engleton, NLM
A Platform for Reform
From its earliest issues, The Lancet was more than a technical journal. It published lectures from hospitals, exposed malpractice, criticized entrenched authorities, and advocated for reform in medical education. This blending of scientific reporting with political commentary made it both influential and controversial. Wakley even faced libel suits, but his confrontational style also attracted a wide readership among reform-minded physicians and students.
Scientific Contributions
Over the years, The Lancet became a central stage for major advances in medical science. It published early reports on antiseptic surgery by Joseph Lister and countless clinical trials that shaped modern healthcare. Its influence has extended beyond medicine, too, as it frequently addresses issues of public health, sanitation, and the social determinants of disease.
Global Reach and Controversy
As medicine globalized, so did The Lancet. Today, it publishes research from around the world and has special commissions on global health issues such as climate change, maternal health, and infectious diseases. Yet controversy has never been far away. From its critiques of colonial medicine in the 19th century to its more recent retractions, such as the infamous 1998 paper by Andrew Wakefield, The Lancet has remained a journal at the heart of scientific and public debate.
Legacy
What began as Thomas Wakley’s tool of reform is now one of the most prestigious medical journals in the world. According to Clarivate’s Journal Citation Reports, The Lancet’s 2024 impact factor is 88.5. Impact factor measures the average citations of a journal’s recent articles and is widely viewed as a gauge of a journal’s influence and prestige. Lancet’s 88.5, the highest in general medicine, places it even above The New England Journal of Medicine, underscoring its enduring prominence in medical research. Its long history reminds us that medicine is not only about science but also about transparency, accountability, and the pursuit of truth in the service of human health.
Until next time, remember to embrace the lessons of history, but never get caught up in its cobwebs.
Warm regards, Hugh
“As a longtime enthusiast of The Lancet, I have been irritated many times by the often-meaningless quotes on the front cover of the journal. I consider these a waste of precious space.”
- K Wolfgang Rumpf, November 14th, 2015, Correspondence to the Lancet
