Thomas Wakley

Thomas Wakley (July 11, 1795 – May 16, 1862), was an English surgeon. He became a demagogue and social reformer who campaigned against incompetence, privilege and nepotism. He was the founding editor of "The Lancet", and a radical Member of Parliament (MP).

Life

Thomas Wakley was born in Membury, Devon to a prosperous farmer and his wife. His father, Henry Wakley (1750–26 August 1842) inherited property, leased neighbouring land and became a large farmer by the standards of the day, and a government Commissioner on the Enclosure of Waste Land. He was described as a 'just but severe parent' and with his wife had eleven children, eight sons and three daughters. [Sprigge, S. Squire 1899. "The life and times of Thomas Wakley". Longmans Green, London. p3] Thomas was the youngest son, and attended grammar schools at Chard and Taunton. In his early teens he was apprenticed to a Taunton apothecary. Young Wakley was a sportsman, and a boxer: he fought bare-fisted in public houses. [Brook C. 1945. "Battling surgeon". Strickland, Glasgow. [A biography of Wakley and his times] ]

He then went to London, where he attended anatomy classes at St Thomas's Hospital, and enrolled in the United Hospitals of St. Thomas's Hospital and Guy's. [Sprigge, "op cit" p15] The dominant personality at these two hospitals was Sir Astley Cooper FRS (1768–1841). Wakley qualified as a Member of the Royal College of Surgeons (MRCS) in 1817. A surgeon at 22, he set up in practice in Regent Street, and married (1820) Miss Goodchild, whose father was a merchant and a governor of St Thomas' Hospital. They had three sons and a daughter, who died young. His eldest son, Henry Membury Wakley, became a barrister, and sat as deputy Coroner under his father. His youngest son, James Goodchild Wakley and his middle son, Thomas Henry Wakley, became joint editors of "The Lancet".

All through his career 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. Wakley was indirectly accused by the insurance company (which had refused his claim), of setting fire to his house himself. He won his case against the company. [Brook suggests that the assault may have been a follow-up to the Cato Street Conspiracy, whose supporters believed (wrongly) that the hangman was a surgeon. Brook C. "op cit" p24-32.]

Wakley's death, on May 16 1862, was occasioned by haemorrhage after a fall. He had been declining in health for about ten years, and the symptoms are entirely consistent with tuberculosis. [Brook C. "op cit" p175.] [The DNB records the place of death as Madeira, where he had gone to try and improve his health. "The concise DNB" (Dictionary of National Biography). Volume 1: To 1900. Oxford University Press. p1351] [Sprigge, "op cit" p494 et seq.] Wakley's three sons survived him, and the "Lancet" remained in Wakley hands for two more generations. At the funeral there was attendance from some of those whom he had pilloried: the long-term consequences of his radicalism were eventually appreciated, at least to some extent. Wakley is interred in the catacombs of Kensal Green Cemetery. There is a blue plaque on his house in Bedford Square, London.

The "Lancet" years

In 1823 he 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.

At first the editor of the "Lancet" was not named in the journal, but, after a few weeks rumours began to circulate. After the journal began printing the content of Sir Astley Cooper's lectures, the great man paid a surprise visit to his former pupil to discover Wakley correcting the proofs of the next issue. Wakley's discomforture at his lost anonymity so pleased Cooper that they were able to have a friendly discussion and reach an agreement which was mutually satisfactory. [Sprigge "op cit" p85 et seq.]

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

He 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". [quoted from Hansard by Brook C. "op cit" p145.]

London College of Medicine

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. [Desmond A. 1989. "The politics of evolution: morphology, medicine, and reform in radical London". Chicago. p104–107 ]

Miscellany

In its early years the "Lancet" also had other content of a non-medical kind. There was a chess column, the earliest regular chess column in any weekly periodical: "The Chess Table". [Hooper, David and Whyld, Kenneth 1996. "The Oxford companion to chess". 2nd ed, Oxford. 'Newspaper columns', p271, which notes a column in the daily "Liverpool Mercury" which started in 1813.] There were also occasional articles on politics, theatre reviews, biographies of non-medical persons, excerpts of material in other publications &c. None of this diminished its huge impact on surgery, hospitals and the Royal Colleges, which were opened up to public view as never before.

Member of Parliament

Reform in the College of Surgeons was slow, and Wakley now set himself to rouse the House of Commons from within. He became a radical candidate for Parliament, and in 1835 was returned for Finsbury, retaining his seat till 1852. He spoke in the House of Commons against Poor Laws, police bills, newspaper tax, Lord's Day observance and for Chartism, Tolpuddle Martyrs, Free trade, Irish independence and, of course, medical reform. [Desmond A. "op cit" p428] All these topics were vigorously debated and fought over, for the 1830s was a turbulent decade; the origin of the difficulties lay in the massively expensive Napoleonic wars, and in the inherent injustice of the way British law and Parliament operated. The Chartist demands were 1. Universal suffrage for adult men 2. Annnual Parliaments 3. Payment for members of Parliament 4. Abolition of property qualifications for candidates 5. Vote by ballot (i.e. secret voting) 6. Abolition of rotten boroughs (rough equalization of electoral districts). Apart from annual Parliaments (it is not feasible or sensible to have annual elections) all this was eventually achieved, and more, but it took time. The effect was to give ordinary citizens a direct say in how the country was governed (see also Democracy). On this Wakley was one of many campaigners; his influence was greater than most because he was now "inside" Parliament.

As an Anglican and a regular church-goer, Wakley's opposition to aspects of the Lord's Day Observance legislation was based, not on secularism, but on his sympathy for the ordinary man. In his day, men worked a full six days each week, and could not shop on pay-nights. If all shops closed for the whole of Sunday this was clearly unfair to working men. Also, he advocated that places of education such as museums and zoos should be open to all on Sundays. [Sprigge, "op cit" p304. The working week became 5-day around 1960, and it was even later before shops were able to open on Sundays.]

Medical Coroner

Wakley also argued for medical coronerships, and when they were established he was elected Coroner for West Middlesex in 1839. Consistent with his views, he held inquests into any who died in police custody. 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.

Flogging

Wakley campaigned against flogging as a punishment for many years. Deaths from flogging in the British Army were not unknown, and not surprising when one reads the details. Wakley was Coroner when Private James White, after committing a disciplinary offence, was subjected to 150 lashes of the cat-o'-nine-tails in the Seventh Hussars in 1846, and died a month later after symptoms of 'serious cardiac and pulmonary mischief' were followed by pleurisy and pnuemonia. The army doctors, under direct pressure from the Colonel of the regiment, signed the cetificate saying 'cause of death was in no way connected with the corporal punishment'. Before burial the vicar communicated with Wakley, who issued a warrant for an inquest. Evidence was given by the Army surgeons, and by the hospital physician and orderlies, and by independent experts. In the event, it was the evidence of Erasmus Wilson, consulting surgeon the the St Pancras Infirmary, who made it clear that the flogging and the death were causally connected. [Sprigge, "op cit" p404 et seq. ] The jury concurred, and added a strongly-worded rider that expressed their 'horror and disgust that the law of the land provided that the revolting punishment of flogging should be permitted upon British soldiers'. Sprigge adds that it was not Erasmus Wilson's able scientific arguments which convinced the jury, it was his assertion that, had it not been for the flogging, James White would be alive. The Army Act of 1881 abolished flogging as a punishment.

Adulteration of foodstuffs

Wakley's last campaigns were against the adulteration of foodstuffs. This was far too common in his day, and his opposition was significant in bringing about much-needed reforming legislation. [Brook C. "op cit" p159–175.] In order to provide evidence, Wakley set up The "Lancet Analytical and Sanitary Commission", which provided 'records of the microscopical and chemical analyses of the solids and fluids consumed by all classes of the public'. The methods were devised by Wakley, Sir William Brooke O'Shaughnessy and Dr Arthur Hill Hassall, who was the Commissioner.

The first investigation showed that "it is a fact that coffee is largely adulterated". ["The Lancet", 4 January 1851] Of 34 coffees, 31 were adulterated; the three exceptions were of higher price. The main adulteration was chicory, otherwise bean-flour, potato-flour or roasted corn was used. Moreover, it was found that chicory itself was usually adulterated! The "Lancet" published the names of the genuine traders, and threatened the others with exposure if they failed to mend their ways. A second report (26 April 1851) actually carried out this threat. A third report showed that canister coffee was even more adulterated! Investigations of sugar, pepper, bread, tobacco, tea followed, and – most important of all – the purity of the water supply. The first Adulteration Act became law in 1860, a second in 1872. The Sale of Food and Drugs Acts of 1875 and 1879 followed on. All this was achieved by Wakley and his associates.

References

*cite book
last = Sprigge
first = Samuel Squire
title = Life and times of Thomas Wakley
url = http://books.google.com/books?id=8v0BAAAAYAAJ
accessdate =
publisher = The Lancet, Longman
date = 1897

*cite book
last = Wakley
first = Thomas
title = The Lancet, in two volumes
url = http://books.google.com/books?id=8v0BAAAAYAAJ
accessdate =
edition =
date = 1841