Journal of Medicine celebrates 200 years of medical advances
Unhappy with today's health care? Think of what it was like to be sick 200 years ago.
No stethoscopes, antibiotics, X-rays or vaccines. Bloodletting was a common treatment. If you had a heart attack or a stroke, doctors put you in bed and hoped for the best. If you needed surgery, you got a few shots of whiskey and a bullet to bite.
Into this medical dark age, two Boston doctors brought a beacon of light. They started what is now the New England Journal of Medicine with the idea that science should guide care -- not whoever argued loudest or had the most persuasive theory.
The first 100 copies in January 1812 were delivered by horseback. Today, 2 million people read the journal online every month. It is the oldest continuously publishing medical journal in the world, and it has touched lives in more ways than you may know. Some examples:
* Stroke victims now get clot-busting medicine, not dark rooms to ride out their brain trauma, because a 1995 study in the journal proved its benefit.
* Heart attack patients have arteries unclogged without surgery, then go home on medicines that studies in the journal showed could prevent future attacks.
* Women with early stage breast cancer can have just the lump removed followed by radiation instead of losing the whole breast, thanks to a 1985 study that found the lesser surgery just as good.
* Rehydration is now recognized as the main treatment for many diarrheal diseases. A journal article warned against bloodletting in 1832 as cholera ravaged New York City.
* People no longer suffer surgery without anesthesia, a field that grew from Henry Jacob Bigelow's 1846 report on the first successful use of inhaled ether.
* Medicine is more ethical, and study participants have more protections, because of a 1966 report in the journal about researchers failing to get informed consent. Another top journal had rejected the article as too controversial.
The New England Journal started decades before the American Medical Association was founded in 1847 and is widely credited with promoting evidence-based care.
"It has been very good for society," said Pat Thibodeau, head librarian and associate dean for the Medical Center Library at Duke University. "When I go in, I'm hoping my doctor has read the New England Journal of Medicine or something similar and is following that information."
"It's the cream of the crop," said Dr. Barron Lerner, a Columbia University physician and medical historian.
"They get the best research submitted to them, and they do an extremely good job of peer reviewing" to make sure it is solid, he said.
Not all was grand in the journal's history, though, as Allan Brandt, a Harvard University medical historian writes in this week's issue.
When Harvard Medical School debated admitting female students in 1878, the journal expressed concern about men and women mingling during surgeries normally witnessed only by one sex. The school didn't admit women until 1945, when World War II caused a shortage of men.
