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      ‘Bats, Rats and Barristers’: The Lancet, libel and the radical stylistics of early nineteenth-century English medicine*

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          Abstract

          INTRODUCTION The early decades of the nineteenth century were a turbulent time for English medicine. The return of demobilized military surgeons from the Napoleonic wars and the increasing numbers graduating from the Scottish universities and private anatomy schools served to swell the lowest ranks of the medical professional hierarchy. These general practitioners, as they were known, combined the practice of medicine and surgery while some also adopted the shop-based trade of the apothecary. Though predominantly catering to the nascent middle classes, their increasing numbers meant greater competition for trade, leading to widespread economic and social insecurity. It also fuelled internecine medical conflict as those at the bottom sought to challenge the hegemonic position occupied by the corporate elites of the Royal College of Physicians and the Royal College of Surgeons and reform the system in accordance with their own, avowedly democratic, interests. 1 Of course, this situation both mirrored and was shaped by events in the wider social, economic and political landscape. The post-war years were characterized by agricultural distress, labour unrest and radical political agitation, including such openly insurrectionary incidents as the Spa Fields Riots of 1816 and the Pentrich Rising of 1817. Indeed, as frustrated artisans, the general practitioners of the medical sphere had much in common with the radicalized followers of ‘King Ludd’ or Thomas Spence. A number of historians have been sensitive to these parallels between the medical and the political. In his peerless study of early nineteenth-century medical radicalism, for example, Adrian Desmond has drawn out the deep ideological affinities between the radical materialism of revolutionary-era French morphology and the political/social progressivism of its most enthusiastic British champions. 2 Likewise, both John Harley Warner and Ian Burney have developed sophisticated readings of the ways in which political critique served to shape the values and visions of medical reformism. 3 Within this historiography a particularly important place is frequently accorded to Thomas Wakley, general practitioner and founder/editor of the journal, The Lancet. It is widely recognized that, from its foundation in 1823, The Lancet functioned as the principal mouthpiece for the disadvantaged medical classes, endeavouring to raise their status through the promotion of medical science, the suppression of unlicensed practice and the reform of an elitist and exclusionary system of corporate governance. It is likewise recognized that, as its editor, Thomas Wakley occupied a uniquely powerful position from which to shape the radical medical political agenda. This article seeks to enhance our understanding of the cultures of early nineteenth-century medical radicalism by exploring the parallels between Thomas Wakley, The Lancet and more mainstream forms of radical political expression and performance. In particular it seeks to demonstrate how, by deliberately publishing libellous material and thus positively soliciting prosecutions, Wakley was able to locate his specifically medical campaign within the established traditions of democratic political reform. Given the acknowledged importance of Wakley as the man who most neatly exemplified the fit between medical and political critiques of ‘Old Corruption’ (from 1835 he was even a radical Member of Parliament for Finsbury), it is somewhat surprising that this area of research remains relatively underdeveloped. Despite the pioneering work of Desmond, Warner and Burney, much medical historical scholarship on this period remains isolated from established historical concerns. Thus, for the most part, scholars have approached The Lancet from a predominantly medical/clinical perspective. They have drawn attention to its novel periodicity (it was one of the first medical journals to be published weekly rather than quarterly), its relative cheapness (each number retailed at 6d compared with the 4s 6d charged for a quarterly number of the Medico-Chirurgical Review) and its extensive circulation (far higher than any of its rivals). 4 However, perhaps the most frequently noted characteristic is its style. With The Lancet, Wakley broke the mould of medical journalism, employing an acerbic and combative editorial voice which has earned him both the admiration and admonishment of posterity. Mary Bostetter, for example, describes his writing as ‘colourful, vigorous, and straightforward’, characterized by a ‘direct, say-it-like-it-is manner’. 5 Meanwhile, Jean and Irvine Loudon, clearly less enamoured by Wakley's invective, claim that ‘[h]is crude and often puerile attacks on medical men and medical corporations, at first amusing, soon become tedious'. 6 Critical or otherwise, medical historians have tended to explain The Lancet's apparent idiosyncrasies by attributing them to Wakley's unique personality. One has even gone so far as to suggest that he was ‘sui generis', a peculiar historical aberration. 7 And yet, while Wakley's personal biography is clearly important to understanding the roots of his ideology and editorial technique, such accounts tend to advance a somewhat decontextualized analysis which underplays the cultural politics of print and the historical importance of literary style. The continued prominence of The Lancet as a medical periodical may serve to encourage presentist readings. In recent years the journal has published a number of articles on its founding editor, but for the most part these have gratified little more than antiquarian curiosity or have sought to harness the past to contemporary medical debates. 8 Even in more academic studies The Lancet is often represented as a forerunner of something modern rather than a product of specific historical circumstance. The Loudons, for example, have claimed that it ‘was to the medical establishment of the 1820s and 1830s what Private Eye is to the political and social establishment today’ while Debbie Harrison opines that Wakley used controversy ‘as part of a thoroughly modern marketing strategy of the periodical press’ and that his work entails an early example of ‘what today we would call name and shame investigative journalism'. 9 For a more self-consciously historicist account one must look to an article by Brittany Pladek in which she endeavours to understand The Lancet's early journalistic style in terms of the conventions of non-medical publishing. 10 In particular, she is concerned to demonstrate how the relative success of the journal can be ascribed to Wakley's importation of ‘entertaining formal components from lay periodicals', most notably sections on society gossip, theatre reviews and chess puzzles, a contrivance which allowed The Lancet to ‘navigat[e] the space between general and specialist readers'. 11 Though notable for its emphasis on style, Pladek's account is not wholly satisfying; it is unspecific about exactly what kinds of cultural work these literary devices were intended to perform and does not adequately explain why The Lancet's circulation continued to rise even when they were discontinued after only two years. Moreover, while she alludes to the subject, she explicitly declines to focus on ‘the journal's engagement with medical politics’ or its resonances with the broader conventions of radical journalism. 12 As this article will demonstrate, however, the significance of The Lancet's stylistic radicalism can only be fully comprehended by situating it within its immediate political context. Rather than viewing it as the template for modern medical journalism, or as anticipating later styles of political and social commentary, it understands The Lancet as the product of an early nineteenth-century radical political heritage, as the Political Register or Black Dwarf of medicine. It seeks to extend and deepen the analytical project initiated by Desmond, Warner and Burney whereby the discourses of medical reform are considered in relation to those which sustained the cause of radical political sovereignty. Drawing upon the work of James Epstein, Kevin Gilmartin and others, it views The Lancet in terms of radical stylistics, demonstrating the extent to which it was framed by the literary conventions of the underground political press. 13 It opens with a brief account of Wakley's initiation into radical circles before considering the early editions of The Lancet, with a particular focus on the rhetorical functions of language, typography and editorial voice as well as the use of such radical literary tactics as exposure, ridicule and critique. This article does not merely aim to point up the similarities between The Lancet and its political contemporaries; it intends to show how such stylistic devices were marshalled in the pursuit of a specific political agenda. Of course splenetic prose was not the sole preserve of the radical ‘left’ and neither was it particularly novel. Similar tactics had been in use since the later 1700s by ‘King and Country’ Tories, a position from which Wakley's mentor and collaborator, William Cobbett, had only moved in 1806. 14 However, during the early decades of the nineteenth century it was the radical and revolutionary press which made this style their own, and it was these conventions that Wakley sought to emulate. This was particularly true of his predilection for insult and defamation, and the main body of this article comprises a detailed analysis of a trial for libel in 1828 between Wakely and the Guy's Hospital surgeon, Bransby Cooper. Through a close analysis of Wakley's rhetorical, legal and performative strategies, as well as a critical reading of a number of contemporary satirical prints, it demonstrates how this trial functioned as the platform for a much broader critique of the established medical ‘system’ and provided a powerful means for Wakley to align himself with the cultures of popular radicalism. However, whatever parallels and connections Wakley sought to draw between the medical and the political, the reality was rather more complex. In the final section, therefore, this article examines the tensions and ambiguities within Wakley's political persona by reading them against the altered circumstances of the 1820s, particularly the rise of a more philosophic reformism. In so doing, it seeks not merely to place political radicalism at the heart of contemporary medical culture but, more ambitiously perhaps, to establish a more prominent place for medicine in accounts of the history of early nineteenth-century reform, as a potential bridge between the popular radicalism of the immediate post-war years and the reformist utilitarianism of the 1830s. WAKLEY, COBBETT AND RADICAL STYLE There was little in Thomas Wakley's early upbringing to suggest a natural inclination towards political radicalism, for he was born in 1795 into that bulwark of pre-modern political order, the prosperous farming family. 15 One of eleven children and the youngest of eight sons, he attended boarding school in Somerset, followed by a series of apprenticeships with local apothecaries and surgeons, enrolling as a student at the United Hospitals Medical School of Guy's and St Thomas's in 1815. 16 His nineteenth-century biographer, Samuel Squire Sprigge, portrays Wakley as a diligent, almost puritanical pupil, who threw himself into his studies, shunning the ‘orgy of porter, the Fleet Street amour, and the cutty of black tobacco, which played so large a part in the lighter side of student life'. What hobbies he did entertain were of a vigorously physical nature, for Wakley was a ‘very muscular, energetic and hearty young man', a noted sportsman and accomplished boxer. 17 Sprigge attributes this physicality to his country upbringing, claiming that he had inherited the values of a ‘self-respecting, sturdily independent labourer'. The same rustic simplicity also accounts for an independence of mind which would later mature into political radicalism. As he claims, ‘His youth had been spent among a simple folk, to whom truth was everything': As member of a large family he was [also] endowed with a deep sense of what was fair [and] it was freely recognized in [his father's] house that share and share alike in common goods was the only fair plan. So that there was early implanted in his breast a keen sense of rudimentary justice – that crude kind of socialism so often seen in children – only developed to an extraordinarily high degree. He desired that everyone should have his due. 18 Superficially, this emphasis upon an inchoate and unreflexive sense of distributive justice seems deeply apolitical. Rather than a product of intellectual development, Wakley's politics are figured as rustic, crude, even childlike. And yet these associations performed a decidedly political function, presenting Wakley's opposition to the contemporary medical establishment as the natural response to a self-evident injustice. In this sense, his biography has marked parallels with that of Cobbett, the plain-thinking, plain-speaking farmer whose own opposition to the political and commercial ‘system’ was as much an instinctual reaction as a point of philosophical principle. 19 Wakley's experience at the Borough Hospitals failed to live up to his high ideals and expectations. The great lecturers whom he had paid to hear would frequently delegate work to inferior subordinates, access to the dissecting room was secured only through bribery and the attendance of staff was irregular and inadequate: And, to cap all these injustices, he found that he was relegated to a class in his profession marked out from the beginning to constitute the rank and file, not in the least through want of personal merit, but because he had not paid exorbitant fees to apprentice himself to a great man. 20 Despite these impediments, Wakley appeared to be flourishing, for a mere two years after completing his studies he moved into a grand fifteen-room townhouse on Argyll Street in the West End and in February 1820 he married Elizabeth Goodchild, daughter of a wealthy governor of St Thomas's Hospital. 21 However, in a bizarre twist of fate, that very summer the promise of Wakley's new life came crashing down when masked assailants attacked him on his doorstep and burned his house to the ground. 22 Theories abounded as to the motive for the assault. The most likely explanation is that it was conducted by the remnants of Arthur Thistelwood's radical Spencean gang who erroneously suspected Wakley of having decapitated their erstwhile companions during their execution for their part in the Cato Street Conspiracy. 23 Even so, in the absence of any firm evidence the Hope Fire Assurance Company suspected fraud and refused to pay out. 24 Wakley, virtually destitute, was thus forced to relocate his practice and, after a couple of peripatetic years, he settled in the rather less salubrious surroundings of Norfolk Street, off the Strand. 25 It was here, in the heart of London's publishing underworld, where Wakley first met William Cobbett. According to Sprigge: Cobbett was exactly the man to make an impression upon Wakley…. He was thirty years Wakley's senior and had a life of chequered experiences behind him…. He was an eloquent propagandist and a practical man, in spite of the violent character of some of his political writing. In Cobbett's company Wakley met other journalists and men of the reforming type, and he saw how instinctively these men turned to pen and ink for the redress of any wrong. 26 The influence of Cobbett's example on the future course of Wakley's career is incalculable, for as Sprigge maintains, ‘there can be no doubt that [it] counted for much in Wakley's resolution … that he would set the medical profession aright by publishing wherein it was wrong'. 27 Certainly, when The Lancet first appeared on 5 October 1823 it was more reminiscent of the penny press than of its medical contemporaries: it was a mere thirty-six pages long, lacked a cover and cost only 6d. It also opened with a ‘bold and defiant preface’ in which Wakley outlined the journal's principal objects. 28 Stating that it had ‘long been a source of regret’ that the public, provincial practitioners and medical students had little access to the lectures given at the metropolitan hospital medical schools, Wakely announced his intention to publish a complete course of his former tutor Sir Astley Cooper's lectures on the theory and practice of surgery. He also proposed to publish reports of important medical and surgical cases that occurred ‘in England or on any part of the civilized Continent'. 29 From its inception, therefore, The Lancet figured itself as an organ for the dissemination and circulation of improving knowledge. Unlike other medical journals, however, this commitment to improvement was rooted in a radical discourse of openness and accessibility: [W]e shall exclude from our pages the semibarboarous [sic] phraseology of the Schools, and adopt as its substitute, plain English diction [my emphasis]. In this attempt, we are well aware that we shall be assailed by much interested opposition. But, notwithstanding this, we will fearlessly discharge our duty. 30 The use of such language clearly speaks to the influence of wider political tropes. As in the parliamentary realm, where radical journals such as Cobbett's Political Register positioned linguistic openness in opposition to an exclusionary and obfuscatory political system, Wakley saw The Lancet as providing both information and critique in equal measure. 31 Indeed, in an oft-quoted, though possibly apocryphal phrase, he claimed that a ‘lancet can be an arched window to let in the light, or it can be a sharp surgical instrument to cut out the dross, and I intend to use it in both senses’. 32 This dualism of purpose was especially evident in The Lancet's early publication of surgical lectures. Wakley had decided to carry Cooper's lectures because they were ‘probably the best of the kind delivered in Europe’ and he was of the view that they should be available to all for the improvement of the profession. 33 However, he had neither sought nor received permission to do so and initially Cooper threatened him with an injunction, though eventually the two men came to a compromise. 34 Yet when it came to the second course of lectures, those of the St Bartholomew's surgeon, John Abernethy, Wakley's motives were somewhat different. After a plea to the anonymous student who was transcribing the lectures to desist fell on deaf ears, Abernethy obtained an injunction against The Lancet from the Court of Chancery. However, during proceedings it emerged that Wakley's decision to publish Abernethy's lectures did not derive from a desire to extend the benefits of expert knowledge, but rather to shame him for their poor quality: MR ABERNETHY is either extremely defective in natural capacity, or … he is extremely idle – the latter is more probable; and now that he is placed before the profession – now that he is placed at the bar of public criticism … his anxiety to preserve [his fame] by preventing a further exposure of his surgical defects, induced him to appeal to the Court of Chancery for protection. 35 Some eight years earlier Abernethy had been involved in a highly public dispute about vitality with his former pupil, William Lawrence, a debate which went to the heart of Romantic and post-Revolutionary ideas about politics, religion and the nature of matter. 36 Lawrence was one of Wakley's earliest collaborators on The Lancet and epitomized everything Abernethy was not. A radical and unapologetic Francophile, he embraced the cutting-edge materialism of French medical science with such enthusiasm as to invite charges of blasphemy and sedition. 37 By contrast, Wakley accused Abernethy of intellectual idleness, of merely restating the ideas of his former tutor, John Hunter, without reference to recent continental developments. In this way, incompetence and ignorance were made the epistemic corollary of nepotism, of a system of succession and patronage which mirrored the corruption of pocket boroughs and aristocratic governance. Indeed, Wakley compared his publication of surgical lectures to those of parliamentary debates, a practice of Cobbett's. 38 As in the parliamentary realm, then, the publication of medical and surgical proceedings functioned as a form of critical scrutiny, a vocal challenge to the monopolistic and oligarchic practices of political authority: Champions of ‘Hole and Corner’ surgery – Hospital imbeciles – Hospital drones – idiotic lecturers – Enemies to the freedom of the medical press! – your hour is at hand; you will no longer be quietly permitted to usurp those offices and stations which are the birth-right of the talented, you will no longer be allowed to blight the bud of genius – or deprive industry of its due reward … that mighty and indestructible engine, THE PRESS, will strip you of family protection, will disregard your official robes … and hurl you upon the pedestal of public opinion. 39 Such rhetorical invective was highly uncommon in the world of medical publishing prior to the foundation of The Lancet. Whereas established medical journals had tended to adopt a sober and even tone with minimal editorializing, The Lancet followed the lead of the political press in which there had been a shift from anonymous or pseudonymous discourse to what T. J. Wooler, editor of the Black Dwarf, termed ‘democratic celebrity'. 40 Thus, even if The Lancet was a composite publication, including input from Cobbett himself, the voice it adopted was unmistakably that of Wakley. In terms of typography, too, The Lancet drew from a different well to its contemporaries, confronting its readers with a riot of block capitals, italics and exclamation marks (see Figure 1). Not only were these expressive of outrage at the extent and audacity of medical corruption, but the staccato rhythm of Wakley's editorial prose evoked the immediacy and force of the spoken word. Again, Wakley had clearly been influenced by the Black Dwarf, whose own explosive typography constituted what Jon Klancher has called ‘an extraordinary symbolic violence'. 41 Melodrama was likewise central to Wakley's writing. Compared with Wooler, who, inspired by popular theatre, possessed an ‘almost extra-linguistic force … straining at the very limit of written language', Wakley's tone was perhaps less colourful. 42 And yet within the context of medical journalism his grandiloquence was unprecedented, his opponents denouncing his ‘mock bombast and sentimental lachrymation’. 43 Figure 1. ‘Dickey Fubs’, The Cooper's Adz!! versus the Lancet!! (1828). Reproduced with the permission of Wellcome Images. Like its political equivalents, The Lancet also employed a rich and imaginative lexicon of insult. 44 The metropolitan medical and surgical elites, for example, were referred to as ‘Bats', for ‘bred in dark dreary recesses’ they were often to be found ‘crawling upon the walls of old hospitals, infirmaries, colleges and other chartered institutions', while those who occupied posts at London teaching hospitals were denominated ‘Hole and Corner’ surgeons for the fact that they operated beyond public and professional scrutiny. 45 Physicians who obtained their MDs by virtue of diplomas from the universities of Aberdeen or St Andrews rather than a regular course of study were ridiculed as ‘Dubs', while the Society of Apothecaries was caricatured as the ‘Old Hags of Rhubarb Hall'. 46 As in the political realm, insult and epithet performed a variety of functions. At one level they reinforced the moral indignation of radical opposition, promoting and sustaining a culture of collective outrage. At another they served to configure the object of that outrage. By substituting epithets for names, Wakley at once identified the principal beneficiaries of medical corruption while simultaneously depersonalizing them, rendering them ‘at one’ with the system they perpetuated. Similarly, as with Cobbett's use of collective nouns such as ‘boroughmongers', terms like ‘Bats’ gave that otherwise nebulous and diffuse system a concrete linguistic form. Wakley's biographer, Sprigge, was alert to this when he claimed that his attacks on the corporations included ‘much that almost amounted to personal abuse of individuals', when they could have dealt with such complaints ‘in a more abstract manner’: But his reflections upon hospital administration were directed against systems whenever feasible, and although names were introduced, and although personal remarks formed the basis of much of his fault-finding, yet it was the administration rather than the administrators which he designed to attack. 47 This interplay between the individual and the abstract takes us to the very heart of The Lancet's stylistic radicalism. By attacking the system through the medium of individuals, Wakley opened himself up to accusations of libel. In his editorial pronouncements he repeatedly sought to differentiate between the personal and the political, maintaining that the ‘lash of censure’ applied only to public acts, not private characters. 48 In purely legal terms this distinction was bound to prove problematic. And yet, as we shall see, libel was not simply an unfortunate and inevitable consequence of radical discourse. Rather, it provided a critically important rhetorical resource by which Wakley could extend and deepen his critique of the medical establishment and by which he could embrace the broader traditions of radical political performance. BRANSBY COOPER AND THE POLITICS OF LIBEL In 1828 the Medico-Chirurgical Review published an article entitled ‘The age of libel’ which claimed that ‘the last four years have given origin to more libels in the medical press, and more law suits in consequence thereof, than … since the first introduction of medical periodical literature into this country’: That the LANCET … did avail itself, without scruple, of the public appetite for scandal … no one will be hardy enough to deny. Personal satire … became the order of the day; and the age of LIBEL commenced – an IRON AGE, that will form no gratifying epoch in the history of British medicine! 49 The author, most probably the editor, James Johnson, was aware that he was on somewhat shaky ground here. As in the political realm, where anti-authoritarian fury was met by an equally caustic Tory press, the sheer force of The Lancet's radical textuality encouraged stylistic emulation in his rivals and in 1826 Johnson had had to pay £100 in damages for making a libellous insinuation in his journal about the fire at Wakley's former house in Argyll Street. 50 None the less, he sought to distinguish between those who, like himself, had been ‘induced, by the irritation of the moment, to use libellous language’ and those, namely Wakley and his associates, who were engaged in a wholesale ‘system of literary warfare, in which the provocation and the libel are fired from the same cannon'. 51 Special pleading aside, the author of the article was right to identify The Lancet with libel. During the first ten years of the journal's existence (1823–33) Wakley was implicated in no fewer than ten legal proceedings, most of them libel cases. In fact, so strong was The Lancet's apparent penchant for defamation that Johnson's counsel at the aforementioned trial claimed that it was ‘impossible to select a Number of that work which did not contain a libel’. 52 As is the case today, early nineteenth-century libel law was designed to protect the individual against false or malicious sentiments conveyed in material form which served to damage their character or public reputation. Its origins stretched back to medieval times, but it was during the early modern period, with the spread of printed words and images, that it assumed an important place within the English legal canon. In 1606 a criminal strand of the law, known as seditious libel, was codified. Until the later nineteenth century seditious libel lacked a concrete legal definition, but it generally pertained to any printed matter which had a tendency to promote a breach of the peace or which encouraged contempt for the Crown, its ministers or the tenets of the Christian faith (known as seditious blasphemy). 53 From its earliest days, when it was administered by the hated Star Chamber, the law of seditious libel was viewed by many of the Crown's opponents as a tool of political tyranny, anathema to English popular liberties. It had proved a most effective tool for crushing the Jacobite press earlier in the eighteenth century, while during the Pittite ‘Terror’ of the 1790s it was directed against radical groups such as the London Corresponding Society. Although the number of indictments trailed off during the early years of the nineteenth century they rose again after 1815. 54 Cobbett served two years for seditious libel in 1810 and was forced to flee to America when, in the aftermath of the Spa Fields Riots of 1816, parliament suspended habeas corpus and empowered local magistrates to imprison anyone suspected of publishing or selling seditious material. As a consequence of this campaign, William Hone was arraigned on three separate counts of blasphemy while T. J. Wooler was charged with two counts of seditious libel. Richard Carlile was likewise threatened with prosecutions for seditious libel and blasphemy, eventually serving a six-year prison term. 55 However, as Philip Harling has suggested, the law of libel proved to be an ambiguous tool of political repression; its application was sporadic and inconsistent and, in spite of juridical direction, juries generally proved reluctant to reach a simple guilty verdict (i.e. one without ‘special grounds') when the alleged libel could be construed as ‘fair comment’ on the political system. 56 Indeed, in radical circles prosecution for libel became a veritable badge of honour and a contributor to Cobbett's Political Register was only repeating a general maxim when he claimed ‘the greater the truth the greater the libel'. 57 As Smith, Epstein and Gilmartin have demonstrated, indictments for seditious libel could also backfire on the authorities as the trial itself ‘became a key forum for radical assembly and verbal expression'. 58 The defendant, often representing himself, subverted the space of the courtroom, presenting an image of the independent citizen subject to the unequal forces of political oppression. Meanwhile, the conventions of the trial provided an opportunity for the defendant to restate their opinions, turning legal defence into rhetorical and political offence not only for the benefit of their immediate audience but also for the readers of published accounts which would become radical documents themselves. 59 Libel therefore occupied a central place within early nineteenth-century radical culture. Unlike Wooler and Cobbett, of course, Wakley was not subject to criminal prosecutions for seditious libel. Rather, he was the object of civil suits, brought against him by private citizens. But despite this, libel, even in its civil incarnation, remained a deeply political issue, not least because Wakley made it so. Through his frequent and deliberate publication of libellous material he committed himself to defending one of the most important radical causes, the freedom of the press. As Cobbett had written: Liberty, actively speaking, means the right, or power, of doing with safety to yourself, that which is naturally disagreeable to, or contrary to the interests of another…. So of the Liberty of the Press which means the right, or power, of publishing, with safety and without any risk to one's self, that which is naturally disagreeable to, or contrary to the interest of another…. If you are to publish only that which offend nobody; if you are permitted to publish nothing that hurts any man's feelings; if you are not to say a word that any man can take amiss; would it not be a mockery, a base truckling, to say that you enjoyed the Liberty of the Press? 60 Wakley may have been a reformer in the widest sense of the word, but his targets were not the political establishment per se; whatever his personal opinions, he generally shied away from publishing any material which could be construed as a libel on the Crown or its ministers. 61 And yet by identifying himself so closely with one of the most important tropes of radical political discourse, Wakley was able to direct the popular appeal of that discourse toward his own specific ends. Broadening the axis of his attack, he figured medical reform as commensurate with the general cause of popular liberty and identified the medical and surgical elites as an incarnation of ‘Old Corruption’. While he may not have been charged with seditious libel, his encounters with its civil equivalent allowed him to transcend the level of the individual and to mount a much more extensive critique of the system as a whole. Nowhere was this more evident than with the 1828 trial between himself and Bransby Cooper. The fraternal nephew of Sir Astley Cooper, Bransby Cooper had started out in life as a naval midshipman before turning to surgery under the influence and tutelage of his uncle. After completing his studies he enlisted as a surgeon in the Royal Artillery, serving in both the Peninsula campaign and the Anglo-American war of 1812. By 1817 he was back in London where, without due consultation or formal procedure, he was effectively appointed his uncle's successor as lecturer to the Borough Hospitals medical school. 62 This provoked outrage among the governors of St Thomas's and effectively led to the collapse of the ‘United School’. With the split between the two hospitals, the treasurer of Guy's, Benjamin Harrison, established a separate school at which Bransby was appointed chair of anatomy. 63 In 1825 he was appointed surgeon to Guy's Hospital itself, again in his uncle's stead. 64 Bransby Cooper was therefore already something of a controversial figure when, at the end of March 1828, The Lancet published a ‘full, true and particular account’ of a lithotomy operation which he had performed before an audience of students and practitioners at Guy's. 65 Lithotomy, or the removal of calculi ('stones') deposited in the bladder, was one of the most invasive of early nineteenth-century surgical procedures, requiring considerable skill and manual dexterity. Ideally, the operation took no more than ten minutes, the patient being at great risk from shock and blood loss. From the very beginning of The Lancet's article, however, it was clear that this particular operation was far from ideal, the headline announcing that Cooper had taken ‘NEARLY ONE HOUR ! !’ to extract the stone. The report was prefaced by a sarcastic editorial observation that it would be instructive to the ‘country “draff” (a derogatory term for provincial practitioners) to ‘learn how things are managed by one of the privileged order – a Hospital surgeon – nephew and surgeon, and surgeon because he is “nephew”’. There followed an intensely melodramatic account of the operation itself, presented not in the conventional form of a hospital report, but as a theatrical ‘tragedy’ in two acts. 66 ‘Act 1’ opened with a description of the patient, Stephen Pollard, an apparently healthy labouring man from Sussex. After he was placed on the table and bound, Mr Callaway, Cooper's assistant, held the ‘straight staff (a grooved instrument used for guiding the passage of the knife) while Cooper attempted to make an incision in Pollard's perineum. The opening made, ‘forceps were now handed over and for some time attempted to be introduced, but without effect'. Cooper, declaring that the aperture was not sufficient, allegedly called for ‘my uncle's knife’ to widen it. The forceps were then reintroduced and ‘pushed onwards to a considerable distance, and with no small degree of force'. The first act closed with Cooper declaring that Pollard's perineum was ‘very deep’ and that he could not reach the bladder with his finger. 67 ‘Act 2’ opened in even more dramatic fashion, with Pollard subjected to such a horrific and invasive assault as to defy syntactic coherence: ‘The staff re-introduced and cutting gorget passed along it – various forceps employed: a blunt gorget – a scoop – sounds and staves introduced at the opening in the perineum.’ ‘I really can't conceive the difficulty,’ Cooper declared, before asking one of his attendants if they had a longer finger than his own so that they might reach the stone. ‘Good God,’ he exclaimed ‘the forceps won't touch it – O dear! O dear!’ Such were the hurried exclamations of the operator. Every now and then there was a cry of Hush! which was succeeded by the stillness of death, broken only by the horrible squash, squash of the forceps in the perineum. By this time Pollard was in almost unimaginable pain and repeatedly begged Cooper to stop and let his stone ‘keep in'. Cooper persisted, however, and after nearly an hour he finally managed to extract it. With Pollard still bound to the table, Cooper proceeded to address his audience, declaring, once more, that he could not ‘conceive of the difficulty’. Finally the ‘exhausted’ Pollard was put to bed and though he initially ‘rallied’, ‘death ended the poor fellow's sufferings, about 29 hours after the operation’. 68 The publication of the report and its subsequent notice in The Times caused an immediate sensation, with one anonymous correspondent chastising the paper, in terms redolent of the law of sedition, for its ‘dissemination of one of the most dangerous libels by which the repose, not only of an individual, but of society at large was ever attempted to be disturbed’. 69 This was followed by another letter from 178 ‘Students of the Borough Hospitals’ calling for an ‘unequivocal contradiction’ of the ‘defamatory calumnies’ contained in The Lancet's account and defending Cooper's ‘qualifications as a teacher … his superior skill as an operating surgeon, and … his worth and integrity as a man'. 70 Wakley was unmoved. It should come as no surprise, he suggested, that these students held their teacher in high regard, for of ‘Mr Bransby Cooper's amenity of manners, and kindness of disposition we entertain no doubt'. The real issue was not Cooper's private character, it was whether he performed the late operation with that degree of skill, which the public has a right to expect from a surgeon of Guy's Hospital … whether the unfortunate patient lost his life … because it was the turn of a surgeon to operate, who is indebted for his elevation to the influence of a corrupt system, and who … would never have been placed in a situation of such deep responsibility as that which he now occupies, had he not been the nephew of Sir Astley Cooper. This is … the only question, in which the public is interested. 71 In this manner, Wakley reconfigured the report as a function of systemic critique rather than personal defamation. Although the word libel had been bandied around, there was as yet no clear indication that Cooper would seek legal redress. 72 Even so, Wakley positively invited the prospect. ‘Whether this investigation be of a judicial character or not, we are indifferent,’ he claimed, with feigned insouciance. What was unquestionable was that there would be an investigation, not into Wakley's actions or the harm that had been done to Cooper's reputation, but rather into what ‘MR HARRISON, the treasurer of Guy's Hospital, knows … [are] the extraordinary circumstances attending his elevation to his present situation'. 73 Like Wooler, Hone and others before him, Wakley was preparing to turn the situation to his advantage, to transform the courtroom into an arena for the articulation of radical discourse. Defying his legally allotted role as defendant by electing to act as his own counsel, it was a drama in which he would take centre stage. The trial, which began on 12 December 1828, certainly opened in dramatic fashion. For a civil proceeding between two private individuals it sparked a remarkable degree of popular interest – so much so, in fact, that by eight o'clock that morning, an hour before proceedings were due to commence, ‘the different avenues leading into the court were so crowded that there was scarcely any possibility of forcing a passage'. According to The Times, ‘it was with utmost difficulty’ and only ‘with the most active assistance of constables and officers of the court’ that ‘counsel, jury and witnesses could obtain an entrance'. 74 Upon finally reaching their seats, ‘many of them presented a most ludicrous appearance; some of the wigs of the barristers were off, others half off; some gentlemen had parts of their coats torn entirely away, and large rents were made in others'. So great was the commotion that the start of the trial was delayed by a full ninety minutes, by which time the heaving courtroom contained ‘almost every hospital surgeon and eminent practitioner in London … besides an immense number of students'. 75 Like the great trials of radical folklore, then, this was to be a highly public occasion. In terms of its cast, too, the trial of Cooper v. Wakley at the Court of King's Bench could hardly have been better calculated to stir radical memory. On one side was Thomas Wakley, a radical journalist representing himself, albeit with the preparatory assistance of Henry Brougham, ‘foremost advocate of the rights and liberties of the people'. 76 On the other was Cooper's counsel, headed by none other than Sir James Scarlett. One of the wealthiest barristers of the age, Scarlett was a notorious opponent of the popular press and frequent target of radical satire. 77 As counsel for the Crown he had successfully prosecuted Henry Hunt for his part in the ill-fated Manchester meeting of 1819, and as an MP he had proposed a reform of the poor laws which, according to Cobbett, sought ‘to cure pauperism by starvation'. 78 During the trial, Wakley made numerous sardonic allusions to Scarlett's establishment Whiggism, fusing, imaginatively and linguistically, the discourses of medical and political radicalism. Drawing upon a possible etymology for the term Whig as deriving from the word ‘whey', he asked: If we have Whigs in the political state, why should we not have Bats in the surgical? I am sure that hospital surgeons are just as much, or more, like BATS, than Sir James Scarlett is like sour milk – (much laughter) – and yet that is the meaning of Whig. 79 He likewise quoted the observation of a ‘wag’ that ‘our worthy knight [Scarlett], owing to the extreme heat of the court, had taken an unusual quantity of SOUR MILK, a favourite drink, for a time, with BATS, RATS, and BARRISTERS'. 80 Nor was it only Scarlett whose presence evoked the broader confrontation between political authority and popular liberty. The presiding judge was none other than the Lord Chief Justice, Charles Abbott, Lord Tenterden, a man who owed his recent elevation to the peerage to Scarlett's political influence. A high Tory who, as a student at Oxford, had written a prize-winning essay on the ‘Use and abuse of satire', Tenterden had presided over some of the most notorious political trials of the age, including those of William Hone, T. J. Wooler, Richard Carlile, Francis Burdett and the Cato Street conspirators. 81 Throughout the proceedings Wakley and Scarlett adopted two distinct and opposed rhetorical strategies. In keeping with his political agenda, Wakley sought to focus attention on the broader implications of Cooper's alleged incompetence. He began his opening address by elaborating a vision of medicine as a form of public service. Guy's Hospital, he insisted, was an ‘institution of very great importance', not only as a charity but also because of its medical school, whose students would eventually practise throughout the length and breadth of the country. ‘Hence it is of utmost importance to the public welfare that the practice inculcated should be safe, and scientific, and … calculated to promote the interests of the public'. 82 The rest of his case endeavoured to establish that, because of the nepotistic system by which Cooper had come to occupy his post, this was not the case and that The Lancet had acted in the public interest by exposing his inabilities. Most of Wakley's witnesses had been present at the operation and were there to confirm the details of the procedure, with most affirming that they ‘never saw an operation performed so unscientifically and in such a bungling manner'. 83 Yet even with such specific questioning, Wakely endeavoured, as far as was possible, to keep the wider political issue in view, often to Lord Tenterden's consternation. For example, during the questioning of Alderman Partridge, a surgeon from Colchester, the following exchange took place: Mr Wakley. Do you believe, taking all the circumstances into consideration that Mr Cooper performed the operation in a scientific manner? No, I could not say I thought he did, certainly. Do you believe the operation was performed in a manner in which the public have a right to expect such an operation ought to be performed by a surgeon of Guy's Hospital? Lord Tenterden. He does not know the meaning of that, – what the public have a right to expect! Was it performed with proper skill? One hardly knows what the public have a right to expect. Mr Wakley. That is charged, my Lord. Lord Tenterden. Yes, I believe it is, – I see it is. You have a right to put the question. Mr Wakley. Do you think the operation was performed in a manner the public have a right to expect from a surgeon of Guy's Hospital? That operation? That operation? No, I do not. 84 Wakley's most audacious move, and the one which most answered his political purpose, was his summoning of Benjamin Harrison, treasurer of Guy's Hospital. Harrison had not witnessed the operation and had no medical knowledge to speak of, but it was through him that Wakley sought to illuminate the wider, systemic dimensions of the case. Questioned as to the details of Bransby's appointment, Harrison testified that he had been elected assistant surgeon on the very same day in 1825 that his uncle had been elected consulting surgeon and that no public notice was given of the vacancy. 85 Wakley then sought to paint a more general picture of institutional nepotism. Listing the names of all of Guy's surgical incumbents, he asked Harrison to confirm their relationship to Sir Astley Cooper. Harrison in turn confirmed that Mr Key, Mr Morgan and Mr Callaway were either the nephews or the apprentices of Sir Astley Cooper, or in Mr Key's case, both. 86 In marked contrast to Wakley's emphasis on the objective, the political and the systemic, Scarlett sought to return the case to the level of the subjective and the personal. Thus in his opening address on the second day of the trial he claimed that Cooper was a respectable and honest man whose reputation had been grossly impugned by Wakley, ‘a literary raven', as ‘ignorant of his own profession as he is of good taste, or the principles of social order exhibited in his writings'. 87 He positioned himself in direct opposition to the interests of the press, to which he claimed he was ‘no enemy … though I have never flattered it, and will never court it'. 88 Like Wakley, then, Scarlett located The Lancet within the wider political and stylistic cultures of radical journalism. However, where Wakley saw forceful critique, Scarlett saw a populist pandering to the baser sentiments of human nature: What do you think now of the feelings, what do you think of the taste … of the humanity of a man who could have witnessed this operation … and yet could have turned it into the form I shall now read to you, and printed it, accompanied with ludicrous remarks, and in dramatic appearance, for the purpose of amusing the public ear? 89 In contrast to Wakley's witnesses, most of those summoned by Scarlett were medical and surgical luminaries who had not been present at the operation in question but who were there to provide a subjective estimation of Cooper's character. Undoubtedly the most significant of these was his uncle and patron, Sir Astley Cooper. Originally subpoenaed by Wakley, Sir Astley gave an account of Bransby's education and career. However, when it came to the question of his nephew's abilities as a surgeon, he was oddly equivocal: I think him a good anatomist, and that he is a very, very, very good surgeon. But let me say this, that a man, when he first enters upon hospital practice, however clever he may suppose himself, he may necessarily have yet experience to acquire … but give him time, do not crush him at the outset of his career. 90 Needless to say, Wakley seized upon this extraordinary admission in his cross-examination, asking Sir Astley: But do you not think the public interest would be best promoted by placing in the hospitals experienced men, and not men who are to wade through blood to their necks, like great generals to gain experience? To which Sir Astley replied: I think it's foreign to the subject. 91 Cooper's response could hardly have provided a clearer expression of the cultural gulf between the two sides. Wakley's focus on the public and systemic dimensions of the case and Scarlett's insistence upon the personal and private implications of defamation were more than an expedient legal device: they embodied two contrasting visions of medical and social identity rooted in two mutually opposed cultural and political ideologies. Wakley's reformist vision of the medical profession as an abstract body of public servants dedicated to the social good was founded upon the inchoate middle-class values of meritocracy, duty and reward. 92 Scarlett and his witnesses, on the other hand, were wedded to the established and essentially aristocratic values of character, breeding and reputation. Hence while Wakley spoke of ‘men of talent, industry and ability', 93 Scarlett defined professional character in terms which distinguished it from the mere ‘plain-dealing’ of commerce: [I]n the practice of a liberal profession, there is a certain feeling of honour, which becomes a gentleman, and which a gentleman only can feel, which renders it not sordid, but gives to it a character which belongs to such a profession – a certain dignity, a certain pride which makes the man feel that profit is a secondary object to him – that fame, that reputation … are his true rewards, and that everything else is only secondary. 94 Ultimately the jury's verdict did little to settle the matter at hand. Wakley restated his opinions in an impassioned summing-up, though he had to interrupt his speech in order to regain his strength and composure. The jury then retired to discuss their decision, returning two hours later with a verdict for the plaintiff. However, rather than the £2000 initially proposed, they chose to award a mere £100. 95 Nevertheless, for Wakley, the trial had been a signal victory. Everything about his performance had been calculated. Even his temporary indisposition, though perhaps a genuine consequence of exhaustion and anxiety, evoked the memories of Hone, Cobbett, Wooler and Carlile, all of whom had come close to physical collapse in conducting their own defences. 96 By presenting himself as a radical following in the footsteps of the great champions of English popular liberty, Wakley established a congruity between his cause and that of popular democracy. As in the political realm, where systemic corruption was constructed as the bane of ‘the people', medical incompetence and nepotism were shown to be anathema, not simply to the interests of better qualified or more deserving practitioners but to the health and safety of the public as a whole. In this way, Wakley was able to scale up a relatively niche matter seemingly of concern only to a limited number of medical professionals and turn it into a much broader political issue. The popular response to this trial suggests that Wakley was successful in this endeavour to extend the political meanings of Cooper's alleged incompetence. Not only was the trial extremely well attended, but when he finally emerged from the court he was greeted by a large crowd and ‘cheered by the populace in Palace Yard'. 97 Moreover, popular interest in the trial extended into the media, not simply with the extensive coverage given by The Times but also by its representation in graphic satire. What is notable about these images is the way in which they replicate the same opposition between the personal and the political as had been evident at the trial itself. Figure 1, for example, is a coloured etching by the relatively unknown caricaturist ‘Dickey Fubs', its title turning upon a double pun involving Cooper's backside and the associated tools of the cooper's trade. One characteristic of the image is the way in which it engages with literary form. Its use of hyperbolic punctuation parallels Wakley's own typographic style, while Cooper's cry of ‘Oh! dear – Oh! dear …’ parodies his speech as reported by The Lancet. The other is its starkly personalized representation of the case. Both protagonists are portrayed as identifiable individuals. Cooper is dressed in a surgical apron, through the belt of which are tucked the forceps he attempted to introduce into Pollard's bladder. Meanwhile, Wakley is shown committing a literal act of bodily violence, appearing through a door to jab Cooper in the buttocks with a lancet. In reference to the damage done to his reputation, Cooper exclaims that ‘That cursed Lancet has cut so deep, I fear the wound will never be closed'. Wakley likewise alludes to his journal's incisiveness and Cooper's incompetence by claiming that, unlike Cooper's blunt instrument, his lancet is ‘sharp at the Point’ and will perform a ‘Scientific Operation with Expedition’. While the Cooper's Adz depicts the case as a clash between two individuals, Figure 2, a coloured etching by the satirist William Heath ('Paul Pry'), is a rather more complex work. 98 Once again, Cooper is clearly identifiable, pictured with surgical apron and rolled-up sleeves and given the irreverent nickname ‘Barney'. However, instead of a literal representation of Wakley, The Lancet is pictured in figurative form, a writing quill at the tip of its blade. Compared with Figure 1, the Cooper represented here is more sinister. He is shown using his ‘Uncle's’ knife to cut The Lancet's purse, out of which cascades £100 worth of damages, a remedy, the annotation suggests, ‘for curing wounded reputations'. Cooper recites a quote from Shakespeare's Henry the Sixth, ‘Give me thy gold – if thou hast any Gold, For I have bought it with an hundred blows’, another reference to the sum awarded as well as to his alleged lack of surgical skill. 99 Figure 2. William Heath ('Paul Pry'), Barney the Cooper or the Head of the Guy's performing his Last Operation (c. 1828). Reproduced with the permission of Wellcome Images. As with Figure 1, then, Cooper and The Lancet take centre stage, but to the left of the image is an indication that Heath sought to draw wider conclusions from the trial. Following on behind Cooper are a troop of blood-soaked surgeons ('the Guy's'), wading through a pile of dismembered bodies bearing spears topped with a skull, a head, a foot and a hand. In a clear reference to Wakley's melodramatic questioning of Sir Astley Cooper, the text identifies them as ‘Some of Astley's performers, coming on like Generals, up to their necks in blood'. Bransby Cooper's brutal incompetence is thereby figured as a more general consequence of his uncle's political influence, rather than an isolated case. However, if Barney the Cooper is a darker work than the Cooper's Adz then it is also a more ambivalent one. Cooper is clearly the object of satire here, but its depiction of his opponent is far from straightforwardly heroic. After all, despite their identification as ‘Astley‘s performers', it is not entirely clear whether this representation of surgery is meant to refer only to those at Guy's or to the profession as a whole. The image is noticeably unbalanced in this regard, lacking equivalent figures on the right to embody the nobler virtues of medicine and surgery. Moreover, the representation of The Lancet is also deeply ambiguous. Dangling from the end of its quill is a tiny droplet labelled ‘Gall', which, together with the brush dipped in pickle, signifies the bitter and rancorous spirit of Wakley's writings. While The Lancet may be the more sympathetic figure here, Heath also poses troubling questions about the literary stylistics of radical medical opposition. If Figures 1 and 2 both focus on the adversarial confrontation between Cooper and Wakley, then Figure 3 attempts something rather different. Although it contains a number of references to Cooper's botched lithotomy, including paintings of ‘Guy's Burial Ground’ with the grave of ‘Stephen [Pollard]', this is an attempt to represent a system of social and political relations rather than a particular episode. Entitled The Seat of Honor or Servility Rewarded, it is a coloured lithograph attributed to the celebrated satirist Robert Isaac Cruickshank. In accordance with its theme, Bransby Cooper is displaced from the centre of the image to make way for Benjamin Harrison, the treasurer of Guy's Hospital. Harrison was a notoriously autocratic administrator, a man who ran Guy's as his own personal demesne, guaranteeing preferment for his favourites and denying it to others who were equally, if not better, qualified. Harrison had inherited his position from his father (hence the legend ‘Old Harry's Son’ over his head) and he is shown sitting on a padlocked ‘Treasury Box’ (his ‘Seat of Honor'), declaring that ‘They who honor me shall be rewarded with promotion but they who neglect me, shall be treated with scorn and contempt'. Surrounding Harrison are some of the beneficiaries of his largesse. To the right of the box stand Sir Astley Cooper (labelled ‘A Barren Knight’ in punning reference to the fact that both of his children were adopted) and Bransby Cooper (represented as a Cyclops with a cup atop his head bearing the word ‘Consolation'). To their right are Edward Cock, Sir Astley's nephew, John Flint South and John Hilton. To the left of Harrison stand Aston Key, another nephew and lecturer in surgery (who holds the key to the treasury box marked ‘Servility') and John Morgan, one of Sir Astley's former pupils and a surgeon at Guy's, who claims that without Harrison's ‘wise discrimination and fostering care, we … luminaries … should have continued in the mist of obscurity'. Meanwhile, in the bottom left of the picture crouch three poor patients, crutches in hand. Pointing to the list of names held by Hilton, they identify ‘the man wot switch his face & call'd me a poor Devil', ‘the man who broke his promise’ and ‘the man wot d_d my eyes & tell'd me to go to Hell'. If Figure 1 constructs events in personal terms and if Figure 2 alludes to the wider implications of Cooper's incompetence, then this image eschews the specifics of the case entirely in favour of a representation of systemic corruption, a culture of nepotism and self-interest which, by its very nature, bred abuse, contempt and neglect. Figure 3. Robert Isaac Cruickshank, The Seat of Honor or Servility Rewarded (1830?). Reproduced with the permission of Wellcome Images. Reading across these three images is therefore akin to reading across Wakley's own radical discursive strategy. Though it struck at the level of the personal, the target of libel was not so much the individual as the system of which they were both a part and a product. The Cooper case provides a clear and rich demonstration of the ways in which Wakley employed libel as a radical device to cast a critical light upon the workings of ‘Old Corruption'. Following the trial he therefore abstained from any activity which could be conceived as an attack upon Cooper personally, even declining to attend a public dinner in his honour, lest it appear to be ‘directed against his private interests'. However, he had a clear message for any who took this as a sign of a weakening political resolve: If the enemies of a free medical press – if the corruptionists of our hospitals, – if the despicable BATS and ABERDEEN DUBS, who disgrace medical society, – cannot distinguish forbearance from fear, and forbearance arising from pity for the fallen, we will soon teach them a lesson, which they shall not forget to the last hour of their filthy existence. 100 FROM THE ‘PEOPLE’ TO THE ‘PUBLIC’: MEDICAL RADICALISM AND THE MARCH OF INTELLECT For the conservative London Medical Gazette, Wakley's performance during the Cooper trial had betrayed his true character. Rather than a medical man committed to the improvement of his profession, he had shown himself to be little more than a populist agitator. Alluding to the crowd which had cheered him as he left the court it claimed that he ‘throws off the mask, and openly declares himself the champion of the ignorant and illiterate…. Why really now, if the times of political turbulence were to return, and radical reform to come into vogue, Cobbett and Hunt would have a most valuable coadjutor.’ 101 Whether the Gazette was being wilfully ignorant of the fact that Hunt, Wakley and Cobbett were already allies is impossible to say. What is interesting about this quotation, however, is the way in which it presents radicalism and political conflict as a thing of the past. Certainly, the 1820s were rather different from the later 1810s. According to E. P. Thompson, ‘[w]hen contrasted to the Radical years which preceded and the Chartist years which succeeded it, the decade of the 1820s seems strangely quiet – a mildly prosperous plateau of social peace'. 102 Likewise, Arthur Burns and Joanna Innes suggest that while a ‘sense of incipient crisis had overhung the immediate post-war years … [in] the 1820s, this diminished, although it never disappeared'. 103 This is not to say that the 1820s witnessed the end of radicalism. If anything, the Queen Caroline Affair of 1820 had helped to forge an ever-broader radical/reformist coalition, while the succeeding years threw up a range of issues such as the Combination Laws and Catholic Emancipation which further galvanized radical opinion. 104 Also, while Wooler ceased production of the Black Dwarf in 1824, the radical press continued with such journals as Cobbett's Political Register and Carlile's The Lion. None the less, the 1820s did give rise to a more cautious and intellectual form of radicalism epitomized by the phrase ‘march of intellect’ and embodied by the figure of Francis Place. Of humble artisanal origins, Place was influenced by the work of Thomas Paine to join the London Corresponding Society in 1794. By the 1820s, however, he was moving away from the political utopianism of his youth and toward a more theoretical radicalism. Embracing the utilitarian philosophy of Jeremy Bentham and James Mill and the political economics of Thomas Malthus and David Ricardo he saw education and the social application of knowledge as the true route to political progress. 105 In many ways, the growth of this movement can be seen as a reaction to the turbulence of the 1810s as the Peterloo Massacre and the Cato Street Conspiracy convinced many who were otherwise sympathetic to the radical cause that unrestrained revolutionary zeal might ultimately tear apart the very social fabric of the nation. Thus in 1824, the very year that the Black Dwarf folded, Henry Southern and John Bowring founded the Westminster Review as the principal organ of utilitarian social philosophy. Meanwhile, Wakley's lawyer Henry Brougham and the Quaker physician George Birkbeck set about putting the principle of moral and intellectual improvement into practice by establishing the London Mechanics’ Institute in 1823 and then the Society for the Diffusion of Useful Knowledge in 1826. In the same year Brougham, together with John Stuart Mill, was also influential in the founding of London University as a rational, secular and utilitarian challenge to the intellectual and political hegemony of Oxford and Cambridge. 107 There was no necessary or inherent incongruity between this new philosophic radicalism and more popular forms. After all, Bentham was a republican who supported universal suffrage. 108 That said, there was certainly the potential for conflict, as was the case with the London Mechanics’ Institute and the Society for the Diffusion of Useful Knowledge, both of which were conceived, at least in part, to ‘produce subordination and respect on the part of inferiors … and so be a safeguard against blind revolt and rebellion'. 109 In general, however, it would be true to say that the so-called ‘march of intellect’ served to complicate popular radicalism as much as to forestall it, adding a new set of ideological and rhetorical ingredients to the melange of social progressivism. This much can be seen in the conversion of Richard Carlile and his followers into advocates of science, political economy and, ultimately, of Malthusian-inspired birth control. 110 It is within this ideological matrix that one must situate Thomas Wakley, for while his political performances suggest an unalloyed champion of popular sovereignty, his relationship with the people was somewhat more complex than this. In the preface to the first number of The Lancet, Wakley sought to address the laity as well as medical practitioners, suggesting that his new journal would equip the reader with enough medical knowledge to ‘avert from himself and his family half the constitutional disorders that afflict society’ as well as to ‘detect and expose the impositions of ignorant practitioners'. 111 Now in reality it seems unlikely that The Lancet was ever read, or intended to be read, by large swathes of the laity. 112 Nevertheless, the tenor of Wakley's address suggests something quite profound about his political agenda. Wakley did not claim that The Lancet would enable a lay audience to heal themselves without medical intervention. Rather, he proposed to educate the public to take prophylactic health measures and to recognize the value of medical expertise rather than credulously entertaining the claims of quacks and imposters. Indeed, during the course of the 1820s and 1830s The Lancet would become actively involved in a campaign to destroy the businesses of those who, like James Morison, claimed to be the real medical democrats, contesting medical monopoly by making ‘everyman his own physician'. 113 In this sense, Wakley's vision of medicine was an essentially Benthamite one in which rational expertise was harnessed to the alleviation of social and bodily distress. If, as I have suggested, in evoking the radicalism of Cobbett, Wooler and others, Wakley's assault on ‘Old Corruption’ shifted its ideological referent from the people to the profession, then in the course of this transformation the people themselves became ‘the public', less an active subject of political power than a passive object of professional guardianship. Unlike his political mentors, Wakley's performance at his trial did not hinge upon the issue of popular sovereignty but rather upon the capacity of medical practitioners to protect and guarantee the public's corporeal interests. For Wakley, the medical system was corrupt because by promoting nepotism, personal self-interest and professional ignorance it worked against the ‘public good'. What was needed instead was meritocracy, disinterestedness and, above all, scientific expertise. Let us remind ourselves of Wakley's examination of Alderman Partridge in which he asked whether Cooper's operation had been ‘scientific’ and whether it had been performed in ‘a manner in which the public have a right to expect'. Tenterden questioned this assertion of the public's ‘rights', but even for Wakley these rights were not those of autonomous agency, of political independence. They were, instead, the corollary of professional responsibility, the necessary consequence of social dependence. CONCLUSION This article has sought to demonstrate the debt which Thomas Wakley and The Lancet owed to the cultural, literary and stylistic traditions of early nineteenth-century radical political discourse. It contends that in order to reach a more nuanced and sophisticated understanding of The Lancet we must widen our interpretive field of vision and pay closer attention not simply to the broader cultures of reform but also to the cultural politics of print, to read across medical and political texts and to appreciate the ideological and stylistic interplay between them. By focusing on the issue of libel it has endeavoured to understand the ways in which the agents of radical medical reform borrowed from the discursive strategies of their political associates, not simply as an expedient device but as a way of aligning themselves with a broader cultural, social and political agenda. As I have argued elsewhere, the early decades of the nineteenth century were ones in which medicine was carved out of the broader cultural field as a discrete disciplinary domain. 114 The Lancet was integral to that process of disciplinary formation and, as such, might be expected to have retained the residual vestiges of established cultural and literary forms. 115 But beyond this, what it demonstrates is that the formation of modern medicine was an intensely political process, one which struck at the heart of key contemporary issues such as social justice and good governance. In that process of disciplinary formation, I suggest, the cutting edge of radical medical reform was partly smoothed off by the influence of a more restrained political utilitarianism. Having said that, Wakley was a complicated man living in extremely complex times, and while most radically inclined medical reformers would take the Benthamite road as the 1820s turned to the 1830s, Wakley would retain a remarkable attachment to the cause of radical popular sovereignty. He would, for example, play an active role in both the National Political Union and the ultra-radical National Union of the Working Classes and, after becoming an MP in 1835, he would be active in his support for the ‘Tolpuddle Martyrs’ and the Chartists. 116 Indeed, while he retained the friendship of both Henry Hunt and William Cobbett until their deaths in 1835, his relationships with moderate, philosophical reformers such as Henry Brougham and Francis Place were significantly more fraught. 117 Wakley's politics were a complex fusion of different strands of radical thought. As Ian Burney has shown in his masterful account of his campaign to be elected coroner of Middlesex in 1830, Wakley could display a banner bearing the slogan ‘Wakley and the Sovereignty of the People’ as well as ones reading ‘Wakley and Medical Reform’ and ‘Reason and Science against Ignorance and Prejudice'. 118 For Wakley, no doubt, these positions were complementary rather than antagonistic. But even so, his sympathy for popular radicalism could occasionally complicate his stance on issues that one would otherwise have expected a reforming medical practitioner to have championed. For example, in the same year as the Cooper trial, Wakley gave evidence before a Parliamentary Select Committee on Anatomy designed to inquire into the means by which bodies were procured for dissection. Combined with the discovery of Burke and Hare's crimes the following year, the committee's report encouraged efforts to come up with a solution to the problem and to answer public fears about the illicit practice of grave-robbing. 119 The result was a classic piece of utilitarian legislation which made the public both a subject of medical expertise and an object of medical care. Drafted by Dr Thomas Southwood Smith, with the assistance of Bentham himself, it proposed that the unclaimed bodies of those who died in public institutions such as prisons and workhouses should be given up to the anatomist for the purposes of study. 120 However, despite claims that it would benefit the public through improvements in medical knowledge, the Anatomy Act, which was granted royal assent a mere two months after the compromised Reform Act, enraged many plebeian radicals who saw it as an extension of political tyranny. 121 John Doherty's Poor Man's Advocate observed that ‘the “anatomy bill” has passed the legislature and is now the law of the land. Not content with the people's toil while living, the rich insist upon having their bodies cut up and mangled when dead, for their instruction or amusement.’ 122 Despite his advocacy of medical improvement and of the necessity of anatomical knowledge, Wakley was inclined to agree: [H]ow can the poor people believe that those persons who support the corn laws, which prevent the labouring classes from possessing cheap bread – how can they believe in the sincerity and disinterestedness of those very individuals, when they affect to support the science of anatomy, because it may confer great benefits on the poor? The people, we repeat, are not blind, stupid or mad … why is science forced upon that community while food is as strongly withheld? … Simply, because the laws relating to the members of the medical profession, as well as the laws affecting the poorer members of the community, have been enacted and enforced during the last forty years, by a series of boroughmongering governments, and their offsets in corruption – a monopolising batch of boroughmongering medical corporations. 123 Rarely had he sounded more like Cobbett. University of Roehampton

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          Author and article information

          Journal
          Soc Hist
          Soc Hist
          rshi
          Social History
          Taylor & Francis
          0307-1022
          1470-1200
          23 June 2014
          May 2014
          : 39
          : 2
          : 182-209
          Author notes
          [*]

          This work was generously supported by the Wellcome Trust [grant number 082229].

          Article
          10.1080/03071022.2014.905277
          4373151
          060b056e-3b24-4168-a33a-02e5cfdc2224
          © 2014 The Author(s). Published by Taylor & Francis.

          This is an open access article distributed under the Supplemental Terms and Conditions for iOpenAccess articles published in Taylor & Francis journals , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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