Publisher Ownership, Physician Management: Canadian Medical Journals in the Victorian Era

Medical publications in book, pamphlet, periodical, and electronic media forms have provided the primary medium for research, communication, and education in medicine. Of these forms, the medical periodical became dominant over the past two centuries as a means to keep readers abreast of rapid developments in both their profession and its knowledge base. Although its frequency of publication, size, and format would vary throughout this period, its internal arrangement and content settled immediately into a structure still recognizable, with the most noticeable changes in its outward appearance in the twentieth century being the proliferation of authors for each research article, the technological advances in illustrations, and the heavy use of paid advertisements and coated paper.

With such prominence and import, medical periodicals therefore have attracted interest in their origins and development, appealing to writers in at least four disciplines. Nevertheless, their history comprises mainly chronological or bibliographical descriptions; little synthesis or even analysis of medical journalism has appeared. Indeed, well over a decade ago, M. Jeanne Peterson observed that study of medical periodicals for the Victorian period was “limited,” with very few scholars venturing to write histories of the “ocean of British periodicals” alone.¹ An important collection of wide-ranging historical essays, edited by leaders W.F. Bynum, Stephen Lock and Roy Porter, had only just appeared, but both Peterson and these editors approached the British periodicals from the perspective of their classification and contents. All these scholars, however, recognized our need to know more about the mechanisms of medical periodical publishing: that is, how periodicals were edited, financed, disseminated, and received, and how they shaped the profession of medicine.²

The contemporary medical journal and its publication processes subsequently attracted intense scrutiny by its own editors after widely publicized cases of research misconduct in the 1980s. In a recent provocative account, The Trouble with Medical Journals, Richard Smith distilled the concerns of medical journal editors: twenty-five years as editor of the British Medical Journal and a dozen years as Chief Executive of the BMJ Publishing Group support his perspectives on the problematic and contentious ethics of peer review, authorship, editorship, research, and the medical journal’s relationship with patients, media, and sponsors. Smith’s work extends in a personal way that of a scholarly collection of essays edited by Anne Hudson Jones and Faith McLellan entitled Ethical Issues in Biomedical Publication.³ It is this modern-day pressure to reform medical journals that has perhaps aided in directing attention away from historical analysis and obscured the possibility that current trends emerged in the nineteenth century, if not before.

To consider this latter possibility, to identify manifestations of similar concerns for earlier journals (the preferred term used here), and thereby to probe for broader understanding of the whole process for medical journalism, this essay examines English-language medical journals in Victorian Canada. Not only do these journals reflect the British outlook of their predominantly British-trained practitioners in this period, but Canada itself retained a colonial worldview for almost a century after its separate colonies joined in Confederation in 1867. Confirming this observation alone was the spectacular medical celebration in Montreal of the Queen’s Diamond Jubilee in 1897, to which was invited the British Medical Association meeting; indeed, so important was this event, as the first time the BMA had met outside Great Britain, that Canadian organizers issued several hundred invitations to their colleagues in the United States.⁴ Similarly, as members of the empire, prominent Canadian medical men often were knighted by the monarch for their work in various spheres of public life.⁵ Finally, unlike an apparent “ocean” of periodicals in Britain, about sixty medical journals existed in Canada; most had a national title, and even one that might seem local, the Montreal Medical Journal, represented a leading–and internationally recognized–Canadian journal that eventually folded into the newly founded Canadian Medical Association Journal in 1911. The material for analysis, though large, is therefore manageable.

This investigation foregrounds the mechanisms identified by Bynum, Lock and Porter that specifically cast the journal as commodity rather than as shaper...